WorldWideScience

Sample records for geographic cost-of-living differences

  1. Does It or Doesn't It? Geographic Differences and the Costs of Living

    Science.gov (United States)

    Zimmerman, Julie N.; Ham, Sunny; Frank, Sarah Michelle

    2008-01-01

    The relative cost of living in rural areas has long been of interest to rural sociologists. Today, the popular perception is that rural prices are lower. This study examines geographic differences in the costs of living in Kentucky. The results indicate that, contrary to the popular perception, when prices of the same products and services were…

  2. The impact of local public services and geographical cost of living differences on poverty estimates

    OpenAIRE

    Aaberge, Rolf; Langørgen, Audun; Mogstad, Magne; Østensen, Marit

    2008-01-01

    Abstract: Despite a broad consensus on the need to account for the value of public services and geographical cost of living differences on the measurement of poverty, there is little reliable evidence on how these factors actually affect poverty estimates. Unlike the standard approach in studies of the distribution of public services, this paper employs a method for valuing sector-specific local public services that accounts for differences between municipalities in the costs and capacity ...

  3. Geographical aspects of geo-arbitrage: work in Canada and live in countries with low cost of living

    Science.gov (United States)

    Penney, J.; Dramowicz, K.

    2016-04-01

    The term geo-arbitrage means taking advantage of the difference in living costs between different geographic locations. This paper focuses on geographical aspects of international geo-arbitrage based on differences in the cost of living from one country to another. More precisely, the paper shows the perspective for a Canadian (student, volunteer, entrepreneur, IT person, or retiree) with some sort of mobile income or savings can take advantage of price differences by traveling to other countries. The paper is based on world development indicators, which cover a wide range of criteria when moving to another country. The data were collected for approximately 200 countries and represent the following categories of criteria: cost of living (economic factors), standard of living (such as safety, health care, environmental issues), and personal preferences (such as distance to home, Internet access or popularity of English language). The user input is required to rank or weight the importance of each of the criteria when moving to another country. One model was developed to emphasize the cost of living by controlling the weights ‘behind-the-scenes’. The results produce a list of the top suitable countries to practice geo-arbitrage. Another model allows the user to input weights for each criteria instead of ranks. The results from both models are mapped based on resulting suitability values. The top selected suitable countries are mapped, and the more specific information on each selected country is presented to the user, including the detailed cost of living, and current travel warning.

  4. Geographic Variations in Cost of Living: Associations with Family and Child Well-Being

    Science.gov (United States)

    Chien, Nina C.; Mistry, Rashmita S.

    2013-01-01

    The effects of geographic variations in cost of living and family income on children's academic achievement and social competence in first grade (mean age = 86.9 months) were examined, mediated through material hardship, parental investments, family stress, and school resources. Using data from the Early Childhood Longitudinal Study-Kindergarten…

  5. Cost of fertility treatment and live birth outcome in women of different ages and BMI.

    Science.gov (United States)

    Pandey, Shilpi; McLernon, David J; Scotland, Graham; Mollison, Jill; Wordsworth, Sarah; Bhattacharya, Siladitya

    2014-10-10

    What is the impact of different age and BMI groups on total investigation and treatment costs in women attending a secondary/tertiary care fertility clinic? Women in their early to mid-30s and women with normal BMI had higher cumulative investigation and treatment costs, but also higher probability of live birth. Female age and BMI have been used as criteria for rationing publically funded fertility treatments. Population-based data on the costs of investigating and treating infertility are lacking. A retrospective cohort study of 2463 women was conducted in a single secondary/tertiary care fertility clinic in Aberdeen, Scotland from 1998 to 2008. Participants included all women living in a defined geographical area referred from primary care to a specialized fertility clinic over an 11-year period. Women were followed up for 5 years or until live birth if this occurred sooner. Mean discounted cumulative National Health Service costs (expressed in 2010/2011 GBP) of fertility investigations, treatments (including all types of assisted reproduction), and pregnancy (including delivery episode) and neonatal admissions were calculated and summarized by age (≤ 30, 31-35, 36-40, >40 years) and BMI groupings (years, with 694 (55.1%) of these being natural conceptions. The live birth rate was highest among women in the youngest age group (64.3%), and lowest in those aged >40 years (13.4%). Overall live birth rates were generally lower in women with BMI >30 kg/m(2). The total costs of investigations were generally highest among women younger than 30 years (£491 in those with normal BMI), whilst treatment costs tended to be higher in 31-35 year olds (£1,840 in those with normal BMI). Multivariate modelling predicted a cost increase associated with treatment which was highest among women in the lowest BMI group (across all ages), and also highest among women aged 31-35 years. The increase in the predicted probability of live birth with exposure to treatment was consistent

  6. Seasonal and geographic differences in treatment-seeking and household cost of febrile illness among children in Malawi

    Directory of Open Access Journals (Sweden)

    Roca-Feltrer Arantxa

    2011-02-01

    Full Text Available Abstract Background Households in malaria endemic countries experience considerable costs in accessing formal health facilities because of childhood malaria. The Ministry of Health in Malawi has defined certain villages as hard-to-reach on the basis of either their distance from health facilities or inaccessibility. Some of these villages have been assigned a community health worker, responsible for referring febrile children to a health facility. Health facility utilization and household costs of attending a health facility were compared between individuals living near the district hospital and those in hard-to-reach villages. Methods Two cross-sectional household surveys were conducted in the Chikhwawa district of Malawi; one during each of the wet and dry seasons. Half the participating villages were located near the hospital, the others were in areas defined as hard-to-reach. Data were collected on attendance to formal health facilities and economic costs incurred due to recent childhood febrile illness. Results Those living in hard-to-reach villages were less likely to attend a formal health facility compared to those living near the hospital (Dry season: OR 0.35, 95%CI0.18-0.67; Wet season: OR 0.46, 95%CI0.27-0.80. Analyses including community health workers (CHW as a source of formal health-care decreased the strength of this relationship, and suggested that consulting a CHW may reduce attendance at health facilities, even if indicated. Although those in hard-to-reach villages were still less likely to attend in both the dry (OR 0.53, 95%CI 0.25-1.11 and wet (OR 0.60, 95%CI 0.37-0.98 seasons. Household costs for those who attended a health facility were greater for those in HTR villages (Dry: USD5.24; Wet: USD5.60 than for those living near the district hospital (Dry: USD3.45; Wet: USD4.46. Conclusion Those living in hard-to-reach areas were less likely to attend a health facility for a childhood febrile event and experienced greater

  7. Estimating the extra cost of living with disability in Vietnam.

    Science.gov (United States)

    Minh, Hoang Van; Giang, Kim Bao; Liem, Nguyen Thanh; Palmer, Michael; Thao, Nguyen Phuong; Duong, Le Bach

    2015-01-01

    Disability is shown to be both a cause and a consequence of poverty. However, relatively little research has investigated the economic cost of living with a disability. This study reports the results of a study on the extra cost of living with disability in Vietnam in 2011. The study was carried out in eight cities/provinces in Vietnam, including Hanoi and Ho Chi Minh cities (two major metropolitan in Vietnam) and six provinces from each of the six socio-economic regions in Vietnam. Costs are estimated using the standard of living approach whereby the difference in incomes between people with disability and those without disability for a given standard of living serves as a proxy for the cost of living with disability. The extra cost of living with disability in Vietnam accounted for about 8.8-9.5% of annual household income, or valued about US$200-218. Communication difficulty was shown to result in highest additional cost of living with disability and self-care difficulty was shown to lead to the lowest levels of extra of living cost. The extra cost of living with disability increased as people had more severe impairment. Interventions to promote the economic security of livelihood for people with disabilities are needed.

  8. 20 CFR 404.270 - Cost-of-living increases.

    Science.gov (United States)

    2010-04-01

    ... INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.270 Cost-of-living... rises in the cost of living. These automatic increases also apply to other benefit amounts, as described...

  9. 5 CFR 838.241 - Cost-of-living adjustments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.241... Affecting Employee Annuities Procedures for Computing the Amount Payable § 838.241 Cost-of-living... provide for cost-of-living adjustments on the former spouse's payment from employee annuity, the cost-of...

  10. Geographical cost-supply analysis forest biomass for distributed generation in Denmark

    DEFF Research Database (Denmark)

    Möller, Bernd

    2004-01-01

    The article presents a study which uses geographical information system (GIS) to perform cost-supply analysis of wood chips resources for energy production.......The article presents a study which uses geographical information system (GIS) to perform cost-supply analysis of wood chips resources for energy production....

  11. Cost-effectiveness of Antihypertensive Medication: Exploring Race and Sex Differences Using Data From the REasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Tajeu, Gabriel S; Mennemeyer, Stephen; Menachemi, Nir; Weech-Maldonado, Robert; Kilgore, Meredith

    2017-06-01

    Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature. CVD events and health states considered in the model included stroke, coronary heart disease, heart failure, chronic kidney disease, and end-stage renal disease. White and black adults with hypertension in the United States, 45 years of age and above. Yearly risk of CVD was determined using REGARDS data and published literature. Antihypertensive medication costs were determined using Medicare claims. Event and health state costs were estimated from published literature. All costs were adjusted to 2012 US dollars. Effectiveness was assessed using QALYs. Antihypertensive medication treatment was cost-saving and increased QALYs compared with no-treatment for white men ($7387; 1.14 QALYs), white women ($7796; 0.89 QALYs), black men ($8400; 1.66 QALYs), and black women ($10,249; 1.79 QALYs). Antihypertensive medication treatment is cost-saving and increases QALYs for all groups considered in the model, particularly among black adults.

  12. 20 CFR 404.278 - Additional cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Additional cost-of-living increase. 404.278... DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.278 Additional cost-of-living increase. (a) General. In addition to the cost-of-living increase explained in...

  13. 5 CFR 847.705 - Cost-of-living adjustments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 847.705... FUND INSTRUMENTALITIES Computation of Benefits Under the Retroactive Provisions § 847.705 Cost-of-living adjustments. Cost-of-living adjustments are applied to the rate payable to the retiree or survivor...

  14. 31 CFR 29.345 - Cost-of-living adjustments.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Cost-of-living adjustments. 29.345 Section 29.345 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT... Federal Benefit Payments § 29.345 Cost-of-living adjustments. Cost-of-living increases are applied...

  15. 5 CFR 838.735 - Cost-of-living adjustments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.735... Awarding Former Spouse Survivor Annuities Payment Procedures § 838.735 Cost-of-living adjustments. (a) OPM applies cost-of-living adjustments to all former spouse survivor annuities in pay status at the time of...

  16. 5 CFR 838.1017 - Cost-of-living adjustments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.1017... Retirement Benefits § 838.1017 Cost-of-living adjustments. In cases where the court order apportions a... proper payment. That amount will be increased by future cost-of-living increases unless the court directs...

  17. 37 CFR 253.10 - Cost of living adjustment.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Cost of living adjustment... NONCOMMERCIAL EDUCATIONAL BROADCASTING § 253.10 Cost of living adjustment. (a) (a) On December 1, 2003, the Librarian of Congress shall publish in the Federal Register a notice of the change in the cost of living as...

  18. 37 CFR 381.10 - Cost of living adjustment.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Cost of living adjustment... EDUCATIONAL BROADCASTING § 381.10 Cost of living adjustment. (a) On or before December 1, 2007, the Copyright Royalty Judges shall publish in the Federal Register a notice of the change in the cost of living as...

  19. 20 CFR 228.60 - Cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost-of-living increase. 228.60 Section 228... COMPUTATION OF SURVIVOR ANNUITIES The Tier II Annuity Component § 228.60 Cost-of-living increase. The tier II... tier II component at the time the survivor annuity begins, all cost-of-living increases that were...

  20. What’s Normal? Immune Profiling of Human Milk from Healthy Women Living in Different Geographical and Socioeconomic Settings

    Science.gov (United States)

    Ruiz, Lorena; Espinosa-Martos, Irene; García-Carral, Cristina; Manzano, Susana; McGuire, Michelle K.; Meehan, Courtney L.; McGuire, Mark A.; Williams, Janet E.; Foster, James; Sellen, Daniel W.; Kamau-Mbuthia, Elizabeth W.; Kamundia, Egidioh W.; Mbugua, Samwel; Moore, Sophie E.; Kvist, Linda J.; Otoo, Gloria E.; Lackey, Kimberly A.; Flores, Katherine; Pareja, Rossina G.; Bode, Lars; Rodríguez, Juan M.

    2017-01-01

    Human milk provides a very wide range of nutrients and bioactive components, including immune factors, human milk oligosaccharides, and a commensal microbiota. These factors are essential for interconnected processes including immunity programming and the development of a normal infant gastrointestinal microbiome. Newborn immune protection mostly relies on maternal immune factors provided through milk. However, studies dealing with an in-depth profiling of the different immune compounds present in human milk and with the assessment of their natural variation in healthy women from different populations are scarce. In this context, the objective of this work was the detection and quantification of a wide array of immune compounds, including innate immunity factors (IL1β, IL6, IL12, INFγ, TNFα), acquired immunity factors (IL2, IL4, IL10, IL13, IL17), chemokines (IL8, Groα, MCP1, MIP1β), growth factors [IL5, IL7, epidermal growth factor (EGF), granulocyte colony-stimulating factor, granulocyte–macrophage colony-stimulating factor, TGFβ2], and immunoglobulins (IgA, IgG, IgM), in milk produced by healthy women of different ethnicities living in different geographic, dietary, socioeconomic, and environmental settings. Among the analyzed factors, IgA, IgG, IgM, EGF, TGFβ2, IL7, IL8, Groα, and MIP1β were detected in all or most of the samples collected in each population and, therefore, this specific set of compounds might be considered as the “core” soluble immune factors in milk produced by healthy women worldwide. This approach may help define which immune factors are (or are not) common in milk produced by women living in various conditions, and to identify host, lifestyle, and environmental factors that affect the immunological composition of this complex biological fluid. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02670278. PMID:28713365

  1. What’s Normal? Immune Profiling of Human Milk from Healthy Women Living in Different Geographical and Socioeconomic Settings

    Directory of Open Access Journals (Sweden)

    Lorena Ruiz

    2017-06-01

    Full Text Available Human milk provides a very wide range of nutrients and bioactive components, including immune factors, human milk oligosaccharides, and a commensal microbiota. These factors are essential for interconnected processes including immunity programming and the development of a normal infant gastrointestinal microbiome. Newborn immune protection mostly relies on maternal immune factors provided through milk. However, studies dealing with an in-depth profiling of the different immune compounds present in human milk and with the assessment of their natural variation in healthy women from different populations are scarce. In this context, the objective of this work was the detection and quantification of a wide array of immune compounds, including innate immunity factors (IL1β, IL6, IL12, INFγ, TNFα, acquired immunity factors (IL2, IL4, IL10, IL13, IL17, chemokines (IL8, Groα, MCP1, MIP1β, growth factors [IL5, IL7, epidermal growth factor (EGF, granulocyte colony-stimulating factor, granulocyte–macrophage colony-stimulating factor, TGFβ2], and immunoglobulins (IgA, IgG, IgM, in milk produced by healthy women of different ethnicities living in different geographic, dietary, socioeconomic, and environmental settings. Among the analyzed factors, IgA, IgG, IgM, EGF, TGFβ2, IL7, IL8, Groα, and MIP1β were detected in all or most of the samples collected in each population and, therefore, this specific set of compounds might be considered as the “core” soluble immune factors in milk produced by healthy women worldwide. This approach may help define which immune factors are (or are not common in milk produced by women living in various conditions, and to identify host, lifestyle, and environmental factors that affect the immunological composition of this complex biological fluid.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02670278.

  2. Geographical differences in food allergy.

    Science.gov (United States)

    Bartra, Joan; García-Moral, Alba; Enrique, Ernesto

    2016-06-01

    Food allergy represents a health problem worldwide and leads to life-threatening reactions and even impairs quality of life. Epidemiological data during the past decades is very heterogeneous because of the use of different diagnostic procedures, and most studies have only been performed in specific geographical areas. The aim of this article is to review the available data on the geographical distribution of food allergies at the food source and molecular level and to link food allergy patterns to the aeroallergen influence in each area. Systematic reviews, meta-analysis, studies performed within the EuroPrevall Project and EAACI position papers regarding food allergy were analysed. The prevalence of food allergy sensitization differs between geographical areas, probably as a consequence of differences among populations, their habits and the influence of the cross-reactivity of aeroallergens and other sources of allergens. Geographical differences in food allergy are clearly evident at the allergenic molecular level, which seems to be directly influenced by the aeroallergens of each region and associated with specific clinical patterns.

  3. Impacts of Scale on Geographic Analysis of Health Data: An Example of Obesity Prevalence

    Directory of Open Access Journals (Sweden)

    Jay Lee

    2014-10-01

    Full Text Available The prevalence of obesity has increased dramatically in recent decades. It is an important public health issue as it causes many other chronic health conditions, such as hypertension, cardiovascular diseases, and type II diabetics. Obesity affects life expectancy and even the quality of lives. Eventually, it increases social costs in many ways due to increasing costs of health care and workplace absenteeism. Using the spatial patterns of obesity prevalence as an example; we show how different geographic units can reveal different degrees of detail in results of analysis. We used both census tracts and census block groups as units of geographic analysis. In addition; to reveal how different geographic scales may impact on the analytic results; we applied geographically weighted regression to model the relationships between obesity rates (dependent variable and three independent variables; including education attainment; unemployment rates; and median family income. Though not including an exhaustive list of explanatory variables; this regression model provides an example for revealing the impacts of geographic scales on analysis of health data. With obesity data based on reported heights and weights on driver’s licenses in Summit County, Ohio, we demonstrated that geographically weighted regression reveals varying spatial trends between dependent and independent variables that conventional regression models such as ordinary least squares regression cannot. Most importantly, analyses carried out with different geographic scales do show very different results. With these findings, we suggest that, while possible, smaller geographic units be used to allow better understanding of the studies phenomena.

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

    Science.gov (United States)

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

    2011-01-01

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

  5. An Exploratory Note on Interstate Living-Cost Differentials

    OpenAIRE

    Cebula, Richard

    1985-01-01

    This exploratory study seeks to identify factors that systematically influence interstate living-cost differentials. Living costs refer to the average cost of living for a four-person family in each of the 50 states. For the year 1977, the living cost level is found to be an increasing function of population density, average income, and the degree of urbanization, while being a decreasing function of the presence of right-to-work laws.

  6. The cost-of-living index with trade barriers

    OpenAIRE

    Thomas von Brasch

    2013-01-01

    The standard cost-of-living index hinges on the assumption that there is free trade. Applying it to situations where trade barriers are present yields biased results with respect to a true cost-of-living index. Import price indices are particularly vulnerable to this bias since many of the goods included in these indices are characterised by either explicit or implicit trade barriers. In this article I generalise the cost-of-living index to also allow for barriers to trade in the form of quan...

  7. An Introduction to Cost-of-Living Adjustments in Public Retirement Plans: Details Matter

    Science.gov (United States)

    Jennings, Penelope R.; Jennings, William P.; Phillips, G. Michael

    2016-01-01

    While financial planning students are expected to be able to understand client retirement plans, subtle differences in cost-of-living adjustments can have major impact on the success of client retirement plans. This teaching note compares the cost-of-living adjustments in the largest government sponsored retirement systems and a hypothetical…

  8. Comparison of Turkey’s Geographical Regions in terms of Stand-Alone PV System Design and Cost Parameters

    Directory of Open Access Journals (Sweden)

    Nevzat Onat

    2017-01-01

    Full Text Available Stand-alone photovoltaic (SAPV systems are widely used in rural areas where there is no national grid or as a precaution against power outages. In this study, technical and economic analysis of a SAPV system was carried out using meteorological data for 75 province centers in seven geographical regions of Turkey. Obtained results for each province center were separated by geographical area. The averages of the centers for each region are taken as output. A calculation algorithm based on MsExcel has been established for these operations. The analyses made with the developed algorithm are repeated for five different scenarios that they cover periods of time when a constant strong load is active for all seasons (winter, spring, summer, and autumn and all year round. The developed algorithm calculates the life-cycle cost, the unit energy cost, the electrical capacity utilization rate, the amount of generated/excess energy per month, the initial investment/replacement, and operating and maintenance (O&M costs of each element. As a result, geographical regions of Turkey are compared in terms of these outputs graphically. Further investigations may include the sale of excess energy generated, small-scale PV system cost factors parallel to the grid, and the effects of government incentives.

  9. Geographic information system in marine biology: Way for sustainable utilization of living resources

    Digital Repository Service at National Institute of Oceanography (India)

    Chavan, V.S.; Sreepada, R.A.

    Sustainable utilization of aquatic living resources needs accurate assessment. This stress the need for use of Geographic Information System (GIS). In the recent past interest has been generated for use of GIS in various areas of biological...

  10. On the cost/delay tradeoff of wireless delay tolerant geographic routing

    OpenAIRE

    Tasiopoulos, Argyrios; Tsiaras, Christos; Toumpis, Stavros

    2012-01-01

    In Delay Tolerant Networks (DTNs), there is a fundamental tradeoff between the aggregate transport cost of a packet and the delay in its delivery. We study this tradeoff in the context of geographical routing in wireless DTNs.We ?rst specify the optimal cost/delay tradeoff, i.e., the tradeoff under optimal network operation, using a dynamic network construction termed the Cost/Delay Evolving Graph (C/DEG) and the Optimal Cost/Delay Curve (OC/DC), a function that gives the minimum possible agg...

  11. 5 CFR 837.505 - Cost-of-living adjustments on Member annuities.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments on Member... Cost-of-living adjustments on Member annuities. (a) Applying cost-of-living adjustments to recomputed... appointive position subject to CSRS, will include the cost-of-living adjustments under section 8340 of title...

  12. Geographical analyses of wood chips potentials, cost and supply for sustainable energy production in Denmark

    DEFF Research Database (Denmark)

    Möller, Bernd

    2004-01-01

    The paper presents a study which uses a practical application of rasterbased geographical information system to perform cost-supply analysis of wood chips resources for energy production.......The paper presents a study which uses a practical application of rasterbased geographical information system to perform cost-supply analysis of wood chips resources for energy production....

  13. A cost-effective Geographic Information Systems for Transportation ...

    African Journals Online (AJOL)

    A cost-effective Geographic Information Systems for Transportation (GIS-T) application for traffic congestion analyses in the Developing World. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like ...

  14. 20 CFR 10.420 - How are cost-of-living adjustments applied?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How are cost-of-living adjustments applied... cost-of-living adjustments applied? (a) In cases of disability, a beneficiary is eligible for cost-of... the date the cost-of-living adjustment took effect. The employee's use of continuation of pay as...

  15. Social Security cost-of-living adjustments and the Consumer Price Index.

    Science.gov (United States)

    Burdick, Clark; Fisher, Lynn

    2007-01-01

    OASDI benefits are indexed for inflation to protect beneficiaries from the loss of purchasing power implied by inflation. In the absence of such indexing, the purchasing power of Social Security benefits would be eroded as rising prices raise the cost of living. By statute, cost-of-living adjustments (COLAs) for Social Security benefits are calculated using the Bureau of Labor Statistics (BLS) Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). Some argue that this index does not accurately reflect the inflation experienced by the elderly population and should be changed to an elderly-specific price index such as the Experimental Consumer Price Index for Americans 62 Years of Age and Older, often referred to as the Consumer Price Index for the Elderly (CPI-E). Others argue that the measure of inflation underlying the COLA is technically biased, causing it to overestimate changes in the cost of living. This argument implies that current COLAs tend to increase, rather than merely maintain, the purchasing power of benefits over time. Potential bias in the CPI as a cost-of-living index arises from a number of sources, including incomplete accounting for the ability of consumers to substitute goods or change purchasing outlets in response to relative price changes. The BLS has constructed a new index called the Chained Consumer Price Index for All Urban Consumers (C-CPI-U) that better accounts for those consumer adjustments. Price indexes are not true cost-of-living indexes, but approximations of cost-of-living indexes (COLI). The Bureau of Labor Statistics (2006a) explains the difference between the two: As it pertains to the CPI, the COLI for the current month is based on the answer to the following question: "What is the cost, at this month ' market prices, of achieving the standard of living actually attained in the base period?" This cost is a hypothetical expenditure-the lowest expenditure level necessary at this month's prices to achieve the

  16. 20 CFR 404.273 - When are automatic cost-of-living increases effective?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When are automatic cost-of-living increases..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.273 When are automatic cost-of-living increases effective? We make automatic cost-of-living...

  17. Cost-effectiveness of cadaveric and living-donor liver transplantation.

    Science.gov (United States)

    Sagmeister, Markus; Mullhaupt, Beat; Kadry, Zakiyah; Kullak-Ublick, Gerd A; Clavien, Pierre A; Renner, Eberhard L

    2002-02-27

    Cadaveric liver transplantation (5-year survival >80%) represents the standard of care for end-stage liver disease (ESLD). Because the demand for cadaveric organs exceeds their availability, living-donor liver transplantation has gained increasing acceptance. Our aim was to assess the marginal cost-effectiveness of cadaveric and living-donor orthotopic liver transplantation (OLT) in adults with ESLD. Using a Markov model, outcomes and costs of ESLD treated (1) conservatively, (2) with cadaveric OLT alone, and (3) with cadaveric OLT or living-donor OLT were computed. The model was validated with published data. The case-based scenario consisted of data on all 15 ESLD patients currently on our waiting list (3 women, 12 men; median age, 48 years [range, 33-59 years]) and on the outcome of all OLT performed for ESLD at our institution since 1995 (n=51; actuarial 5-year survival 93%). Living-donor OLT was allowed in 15% during the first year of listing; fulminant hepatic failure and hepatocellular carcinoma were excluded. Cadaveric OLT gained on average 6.2 quality-adjusted life-years (QALYs) per patient compared with conservative treatment, living-donor OLT, an additional 1.3 QALYs compared with cadaveric OLT alone. Marginal cost-effectiveness of a program with cadaveric OLT alone and a program with cadaveric and living-donor OLT combined were similar (E 22,451 and E 23,530 per QALY gained). Results were sensitive to recipient age and postoperative survival rate. Offering living-donor OLT in addition to cadaveric OLT improves survival at costs comparable to accepted therapies in medicine. Cadaveric OLT and living-donor OLT are cost-effective.

  18. 20 CFR 225.44 - When a cost-of-living increase is payable.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false When a cost-of-living increase is payable... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.44 When a cost-of-living increase is payable. A cost-of-living increase is payable beginning with December of the year for...

  19. 20 CFR 404.271 - When automatic cost-of-living increases apply.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When automatic cost-of-living increases apply... AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.271 When automatic cost-of-living increases apply. Besides increases in the primary insurance amounts...

  20. Similar Gender Dimorphism in the Costs of Reproduction across the Geographic Range of Fraxinus ornus

    Science.gov (United States)

    Verdú, Miguel; Spanos, Kostas; čaňová, Ingrid; Slobodník, Branko; Paule, Ladislav

    2007-01-01

    Background and Aims The reproductive costs for individuals with the female function have been hypothesized to be greater than for those with the male function because the allocation unit per female flower is very high due to the necessity to nurture the embryos until seed dispersal occurs, while the male reproductive allocation per flower is lower because it finishes once pollen is shed. Consequently, males may invest more resources in growth than females. This prediction was tested across a wide geographical range in a tree with a dimorphic breeding system (Fraxinus ornus) consisting of males and hermaphrodites functioning as females. The contrasting ecological conditions found across the geographical range allowed the evaluation of the hypothesis that the reproductive costs of sexual dimorphism varies with environmental stressors. Methods By using random-effects meta-analysis, the differences in the reproductive and vegetative investment of male and hermaphrodite trees of F. ornus were analysed in 10 populations from the northern (Slovakia), south-eastern (Greece) and south-western (Spain) limits of its European distribution. The variation in gender-dimorphism with environmental stress was analysed by running a meta-regression between these effect sizes and the two environmental stress indicators: one related to temperature (the frost-free period) and another related to water availability (moisture deficit). Key Results Most of the effect sizes showed that males produced more flowers and grew more quickly than hermaphrodites. Gender differences in reproduction and growth were not minimized or maximized under adverse climatic conditions such as short frost-free periods or severe aridity. Conclusions The lower costs of reproduction for F. ornus males allow them to grow more quickly than hermaphrodites, although such differences in sex-specific reproductive costs are not magnified under stressful conditions. PMID:17098751

  1. Geographic Differences in the Earnings of Economics Majors

    Science.gov (United States)

    Winters, John V.; Xu, Weineng

    2014-01-01

    Economics has been shown to be a relatively high-earning college major, but geographic differences in earnings have been largely overlooked. The authors of this article use the American Community Survey to examine geographic differences in both absolute earnings and relative earnings for economics majors. They find that there are substantial…

  2. 20 CFR 225.43 - PIA's subject to cost-of-living increases.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false PIA's subject to cost-of-living increases... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.43 PIA's subject to cost-of-living increases. The Retirement Tier I, Overall Minimum, Survivor Tier I, Employee RIB and RLS...

  3. Do unmet needs differ geographically for children with special health care needs?

    Science.gov (United States)

    Fulda, Kimberly G; Johnson, Katandria L; Hahn, Kristen; Lykens, Kristine

    2013-04-01

    The purpose of this study was to identify geographic differences in health indicators for children with special health care needs (CSHCN). It was hypothesized that geographic differences in unmet health care needs exist among CSHCN by region in the United States. Data were obtained from the National Survey of Children with Special Health Care Needs, 2005-2006. Nine variables representing unmet needs were analyzed by geographic region. The region with the highest percent of unmet needs was identified for each service. Logistic regression was utilized to determine differences by region after controlling for age, gender, ethnicity, race, federal poverty level, relationship of responder to child, insurance status, severity of condition, and size of household. A total of 40,723 CSHCN were represented. Crude analysis demonstrated that the greatest unmet need for routine preventive care, specialist care, prescription medications, physical/occupational/speech therapy, mental health care, and genetic counseling occurred in the West. The greatest unmet need for preventive dental care, respite care, and vision care occurred in the South. Significant differences between regions remained for six of the nine services after controlling for potential confounders. Geographic differences in unmet health care needs exist for CSHCN. Further delving into these differences provides valuable information for program and policy planning and development. Meeting the needs of CSHCN is important to reduce cost burden and improve quality of life for the affected child and care providers.

  4. 26 CFR 1.912-1 - Exclusion of certain cost-of-living allowances.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Exclusion of certain cost-of-living allowances... Exclusion of certain cost-of-living allowances. (a) Amounts received by Government civilian personnel stationed outside the continental United States as cost-of-living allowances in accordance with regulations...

  5. 32 CFR 269.4 - Cost of living adjustments of civil monetary penalties.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Cost of living adjustments of civil monetary... DEFENSE (CONTINUED) MISCELLANEOUS CIVIL MONETARY PENALTY INFLATION ADJUSTMENT § 269.4 Cost of living... increasing the maximum civil monetary penalty for each civil monetary penalty by the cost-of-living...

  6. 46 CFR 506.4 - Cost of living adjustments of civil monetary penalties.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Cost of living adjustments of civil monetary penalties... MONETARY PENALTY INFLATION ADJUSTMENT § 506.4 Cost of living adjustments of civil monetary penalties. (a... penalty for each civil monetary penalty by the cost-of-living adjustment. Any increase determined under...

  7. 14 CFR 13.305 - Cost of living adjustments of civil monetary penalties.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Cost of living adjustments of civil... Inflation Adjustment § 13.305 Cost of living adjustments of civil monetary penalties. (a) Except for the... and maximum civil monetary penalty for each civil monetary penalty by the cost-of-living adjustment...

  8. Geographic differences in heart failure trials.

    Science.gov (United States)

    Ferreira, João Pedro; Girerd, Nicolas; Rossignol, Patrick; Zannad, Faiez

    2015-09-01

    Randomized controlled trials (RCTs) are essential to develop advances in heart failure (HF). The need for increasing numbers of patients (without substantial cost increase) and generalization of results led to the disappearance of international boundaries in large RCTs. The significant geographic differences in patients' characteristics, outcomes, and, most importantly, treatment effect observed in HF trials have recently been highlighted. Whether the observed regional discrepancies in HF trials are due to trial-specific issues, patient heterogeneity, structural differences in countries, or a complex interaction between factors are the questions we propose to debate in this review. To do so, we will analyse and review data from HF trials conducted in different world regions, from heart failure with preserved ejection fraction (HF-PEF), heart failure with reduced ejection fraction (HF-REF), and acute heart failure (AHF). Finally, we will suggest objective and actionable measures in order to mitigate regional discrepancies in future trials, particularly in HF-PEF where prognostic modifying treatments are urgently needed and in which trials are more prone to selection bias, due to a larger patient heterogeneity. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  9. Adjusting Wages to Living Costs: A Historical Note

    Science.gov (United States)

    Lowenstern, Henry

    1974-01-01

    The significant historical developments of the cost of living wage adjustments are summarized. Since the concept of cost of living took effect in 1919, developments that are noted are: World War II, the GM contract 1948, the GM Contract 1950, and the impact of the agreements. (DS)

  10. The Costs and Benefits of Collaborating across Geographic Distance and Organizational Boundaries

    DEFF Research Database (Denmark)

    Mors, Louise; Waguespack, David

    to shed further light on the costs of cross-boundary collaborations. In particular, we examine how such collaborations evolve and whether the costs persist over time. We study collaborations in the Internet Engineering Task Force (IETF). In this open innovation community participants collaborate in work....... In fact, the further away authors are from each other the more likely they are to continue collaborating. Yet we find that crossing geographic distance does become more costly over time - perhaps suggesting that low quality projects get sorted from the process. However, crossing organizational boundaries...

  11. Cost-effectiveness analysis of different embryo transfer strategies in England.

    Science.gov (United States)

    Dixon, S; Faghih Nasiri, F; Ledger, W L; Lenton, E A; Duenas, A; Sutcliffe, P; Chilcott, J B

    2008-05-01

    The objective of this study was to assess the cost-effectiveness of different embryo transfer strategies for a single cycle when two embryos are available, and taking the NHS cost perspective. Cost-effectiveness model. Five in vitro fertilisation (IVF) centres in England between 2003/04 and 2004/05. Women with two embryos available for transfer in three age groups (Costs and adverse outcomes are estimated up to 5 years after the birth. Incremental cost per live birth was calculated for different embryo transfer strategies and for three separate age groups: less than 30, 30-35 and 36-39 years. Premature birth, neonatal intensive care unit admissions and days, cerebral palsy and incremental cost-effectiveness ratios. Single fresh embryo transfer (SET) plus frozen single embryo transfer (fzSET) is the more costly in terms of IVF costs, but the lower rates of multiple births mean that in terms of total costs, it is less costly than double embryo transfer (DET). Adverse events increase when moving from SET to SET+fzSET to DET. The probability of SET+fzSET being cost-effective decreases with age. When SET is included in the analysis, SET+fzSET no longer becomes a cost-effective option at any threshold value for all age groups studied. The analyses show that the choice of embryo transfer strategy is a function of four factors: the age of the mother, the relevance of the SET option, the value placed on a live birth and the relative importance placed on adverse outcomes. For each patient group, the choice of strategy is a trade-off between the value placed on a live birth and cost.

  12. A cost per live birth comparison of HMG and rFSH randomized trials.

    Science.gov (United States)

    Connolly, Mark; De Vrieze, Kathleen; Ombelet, Willem; Schneider, Dirk; Currie, Craig

    2008-12-01

    To help inform healthcare treatment practices and funding decisions, an economic evaluation was conducted to compare the two leading gonadotrophins used for IVF in Belgium. Based on the results of a recently published meta-analysis, a simulated decision tree model was constructed with four states: (i) fresh cycle, (ii) cryopreserved cycle, (iii) live birth and (iv) treatment withdrawal. Gonadotrophin costs were based on highly purified human menopausal gonadotrophin (HP-HMG; Menopur) and recombinant FSH (rFSH) alpha (Gonal-F). After one fresh and one cryopreserved cycle the average treatment cost with HP-HMG was lower than with rFSH (HP-HMG euro3635; rFSH euro4103). The average cost saving per person started on HP-HMG when compared with rFSH was euro468. Additionally, the average costs per live birth of HP-HMG and rFSH were found to be significantly different: HP-HMG euro9996; rFSH euro13,009 (P cost-saving even after key parameters in the model were varied in the probabilistic sensitivity analysis. Treatment with HP-HMG was found to be the dominant treatment strategy in IVF because of improved live birth rates and lower costs. Within a fixed healthcare budget, the cost-savings achieved using HP-HMG would allow for the delivery of additional IVF cycles.

  13. The geographic accessibility of pharmacies in Nova Scotia.

    Science.gov (United States)

    Law, Michael R; Heard, Deborah; Fisher, Judith; Douillard, Jay; Muzika, Greg; Sketris, Ingrid S

    2013-01-01

    Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia. We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas. We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas. The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients' access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46.

  14. The Cost of Living in Ancient Greece

    Directory of Open Access Journals (Sweden)

    Roberto Morales Harley

    2014-11-01

    Full Text Available The paper focuses on the most relevant economic aspects of Ancient Greece, more specifically, 5th century BC Athens. It explores the Greek notion of economy, the monetary system, the financial administration and the labor market, in order to contextualize the cost of living. The examples on this matter take into account the products’ costs and the people’s wages.

  15. 75 FR 34336 - Reimbursement Transportation Cost Payment Program for Geographically Disadvantaged Farmers and...

    Science.gov (United States)

    2010-06-17

    ... DEPARTMENT OF AGRICULTURE Farm Service Agency 7 CFR Part 755 RIN 0560-AI08 Reimbursement... Reimbursement Transportation Cost Payment (RTCP) Program for geographically disadvantaged farmers and ranchers.... To be eligible for reimbursement, the transportation costs must have been incurred in the FY for...

  16. 5 CFR 838.622 - Cost-of-living and salary adjustments.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living and salary adjustments....622 Cost-of-living and salary adjustments. (a)(1) A court order that awards adjustments to a former... such as “salary adjustments” or “pay adjustments” occurring after the date of the decree provides...

  17. 20 CFR 404.275 - How is an automatic cost-of-living increase calculated?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How is an automatic cost-of-living increase..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.275 How is an automatic cost-of-living increase calculated? (a) Increase based on the CPI. We...

  18. 20 CFR 226.13 - Cost-of-living increase in employee vested dual benefit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost-of-living increase in employee vested... Annuity § 226.13 Cost-of-living increase in employee vested dual benefit. If the employee's annuity begins June 1, 1975 or later, a cost-of-living increase is added to the total vested dual benefit amount. This...

  19. 20 CFR 225.42 - Notice of the percentage amount of a cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... THE RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.42 Notice of the percentage amount of a cost-of-living increase. The percentage amount of the cost-of-living... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Notice of the percentage amount of a cost-of...

  20. 5 CFR 838.923 - Cost-of-living adjustment before the death of a retiree.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustment before the... annuity is deemed to order OPM to add to the survivor annuity rate cost-of-living adjustments that occur... adjustments to the survivor annuity rate. (See § 838.735 for information concerning cost-of-living adjustments...

  1. Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region.

    Science.gov (United States)

    Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B; Dusetzina, Stacie B

    This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12-14 visits. . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium. Copyright © 2018 by the American Occupational Therapy Association, Inc.

  2. 20 CFR 225.41 - How a cost-of-living increase is determined and applied.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How a cost-of-living increase is determined... RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.41 How a cost-of-living increase is determined and applied. Depending on the condition of the social security...

  3. Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Romano, Patrick S

    2013-10-01

    Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

  4. International comparison of cost of falls in older adults living in the community: a systematic review.

    Science.gov (United States)

    Davis, J C; Robertson, M C; Ashe, M C; Liu-Ambrose, T; Khan, K M; Marra, C A

    2010-08-01

    Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries. The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community. This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged > or =60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond's checklist. Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK. The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries.

  5. The internet trap five costs of living online

    CERN Document Server

    Mukherjee, Ashesh

    2018-01-01

    In The Internet Trap, Ashesh Mukherjee uses the latest research in consumer psychology to highlight five hidden costs of living online: too many temptations, too much information, too much customization, too many comparisons, and too little privacy.

  6. 78 FR 68133 - Cost-of-Living Increases and Other Determinations for 2014; Correction

    Science.gov (United States)

    2013-11-13

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2013-0057] Cost-of-Living Increases and Other Determinations for 2014; Correction AGENCY: Social Security Administration. ACTION: Notice; Correction. SUMMARY..., concerning the cost-of-living increase in Social Security benefits effective December 2013. The document...

  7. 20 CFR 228.40 - Cost of living increase applicable to the tier I annuity component.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost of living increase applicable to the... § 228.40 Cost of living increase applicable to the tier I annuity component. The tier I annuity... the Federal Register annually. The cost-of-living increase is payable beginning with the benefit for...

  8. Cost Differences Between Open and Minimally Invasive Surgery.

    Science.gov (United States)

    Fitch, Kathryn; Engel, Tyler; Bochner, Andrew

    2015-09-01

    To analyze the cost difference between minimally invasive surgery (MIS) and open surgery from a commercial payer perspective for colectomy, ventral hernia repair, thoracic resection (resection of the lung), and hysterectomy. A retrospective claims data analysis was conducted using the 2011 and 2012 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. Study eligibility criteria included age 18-64 years, pharmacy coverage, ≥ 1 month of eligibility in 2012, and a claim coded with 1 of the 4 surgical procedures of interest; the index year was 2012. Average allowed facility and professional costs were calculated during inpatient stay (or day of surgery for outpatient hysterectomy) and the 30 days after discharge for MIS vs open surgery. Cost difference was compared after adjusting for presence of cancer, geographic region, and risk profile (age, gender, and comorbidities). In total, 46,386 cases in the 2012 MarketScan database represented one of the surgeries of interest. The difference in average allowed surgical procedure cost (facility and professional) between open surgery vs adjusted MIS was $10,204 for colectomy; $3,721, ventral hernia repair; $12,989, thoracic resection; and $1,174, noncancer hysterectomy (P average allowed cost in the 30 days after surgery between open surgery vs adjusted MIS was $1,494 for colectomy, $1,320 for ventral hernia repair, negative $711 for thoracic resection, and negative $425 for noncancer hysterectomy (P costs than open surgery for all 4 analyzed surgeries.

  9. Determinants of reproductive costs in the long-lived Black-legged Kittiwake: A multiyear experiment

    Science.gov (United States)

    Golet, Gregory H.; Schmutz, Joel A.; Irons, David B.; Estes, James A.

    2004-01-01

    We studied reproductive costs of Black-legged Kittiwakes (Rissa tridactyla) in Prince William Sound, Alaska (USA) by removing entire clutches from randomly selected nests over four successive years, and then contrasting survival and fecundity of adults from manipulated and unmanipulated nests in each subsequent year. To elucidate mechanisms that lead to the expression of reproductive costs, we simultaneously characterized several behavioral and physiological parameters among adults in the two treatment groups. We also examined naturally nonbreeding adults that previously bred to determine their survival and future nonbreeding probabilities.Food availability varied during the study, being generally poor at the onset, and improving in later years. Adult nest attendance and body condition (assessed late in the chick- rearing period) varied accordingly among years, and between adults raising chicks and adults that had their eggs removed. Adults from unmanipulated nests incurred significant survival costs in all years, although fecundity costs were strongly expressed in only one of four years. Neither survival nor fecundity costs were strongly influenced by body condition or food availability, and no difference in reproductive costs was detected between the sexes. Although unmanipulated breeders survived at lower rates than manipulated breeders due to costs of reproduction, their survival rates were elevated compared to those of natural nonbreeders, presumably due to differences in individual ability. These findings indicate that models of adult survival must consider not only an organism's reproductive state, but also the factors that lead to that state.Although body condition appeared to be weakly related to survival, it was insufficient to explain the full magnitude of survival costs observed. We suggest that other parameters that were found to differ between treatment groups (e.g., rates of energy turnover, baseline levels of stress, and patterns of allocating body

  10. Cost-effective age structure and geographical distribution of boreal forest reserves.

    Science.gov (United States)

    Lundström, Johanna; Ohman, Karin; Perhans, Karin; Rönnqvist, Mikael; Gustafsson, Lena; Bugman, Harald

    2011-02-01

    1. Forest reserves are established to preserve biodiversity, and to maintain natural functions and processes. Today there is heightened focus on old-growth stages, with less attention given to early successional stages. The biodiversity potential of younger forests has been overlooked, and the cost-effectiveness of incorporating different age classes in reserve networks has not yet been studied.2. We performed a reserve selection analysis in boreal Sweden using the Swedish National Forest Inventory plots. Seventeen structural variables were used as biodiversity indicators, and the cost of protecting each plot as a reserve was assessed using the Heureka system. A goal programming approach was applied, which allowed inclusion of several objectives and avoided a situation in which common indicators affected the result more than rare ones. The model was limited either by budget or area.3. All biodiversity indicators were found in all age classes, with more than half having the highest values in ages ≥ 100 years. Several large-tree indicators and all deadwood indicators had higher values in forests 0-14 years than in forests 15-69 years.4. It was most cost-effective to protect a large proportion of young forests since they generally have a lower net present value compared to older forests, but still contain structures of importance for biodiversity. However, it was more area-effective to protect a large proportion of old forests since they have a higher biodiversity potential per area.5. The geographical distribution of reserves selected with the budget-constrained model was strongly biassed towards the north-western section of boreal Sweden, with a large proportion of young forest, whereas the area-constrained model focussed on the south-eastern section, with dominance by the oldest age class.6.Synthesis and applications. We show that young forests with large amounts of structures important to biodiversity such as dead wood and remnant trees are cheap and cost

  11. The evolution of cooperation on geographical networks

    Science.gov (United States)

    Li, Yixiao; Wang, Yi; Sheng, Jichuan

    2017-11-01

    We study evolutionary public goods game on geographical networks, i.e., complex networks which are located on a geographical plane. The geographical feature effects in two ways: In one way, the geographically-induced network structure influences the overall evolutionary dynamics, and, in the other way, the geographical length of an edge influences the cost when the two players at the two ends interact. For the latter effect, we design a new cost function of cooperators, which simply assumes that the longer the distance between two players, the higher cost the cooperator(s) of them have to pay. In this study, network substrates are generated by a previous spatial network model with a cost-benefit parameter controlling the network topology. Our simulations show that the greatest promotion of cooperation is achieved in the intermediate regime of the parameter, in which empirical estimates of various railway networks fall. Further, we investigate how the distribution of edges' geographical costs influences the evolutionary dynamics and consider three patterns of the distribution: an approximately-equal distribution, a diverse distribution, and a polarized distribution. For normal geographical networks which are generated using intermediate values of the cost-benefit parameter, a diverse distribution hinders the evolution of cooperation, whereas a polarized distribution lowers the threshold value of the amplification factor for cooperation in public goods game. These results are helpful for understanding the evolution of cooperation on real-world geographical networks.

  12. Behavioral and physiological correlates of the geographic distributions of amphibious sea kraits (Laticauda spp.)

    Science.gov (United States)

    Brischoux, François; Tingley, Reid; Shine, Richard; Lillywhite, Harvey B.

    2013-02-01

    The physiological costs of living in seawater likely influenced the secondary evolutionary transitions to marine life in tetrapods. However, these costs are alleviated for species that commute between the land and the sea, because terrestrial habitats can provide frequent access to fresh water. Here, we investigate how differences in the ecology and physiology of three sea krait species (Laticauda spp.) interact to determine their environmental tolerances and geographic distributions. These three species vary in their relative use of terrestrial versus marine environments, and they display concomitant adaptations to life on land versus at sea. A species with relatively high dehydration rates in seawater (Laticauda colubrina) occupied oceanic areas with low mean salinities, whereas a species with comparatively high rates of transcutaneous evaporative water loss on land (Laticauda semifasciata) occupied regions with low mean temperatures. A third taxon (Laticauda laticaudata) was intermediate in both of these traits, and yet occupied the broadest geographic range. Our results suggest that the abilities of sea kraits to acquire fresh water on land and tolerate dehydration at sea determine their environmental tolerances and geographic distributions. This finding supports the notion that speciation patterns within sea kraits have been driven by interspecific variation in the degree of reliance upon terrestrial versus marine habitats. Future studies could usefully examine the effects of osmotic challenges on diversification rates in other secondarily marine tetrapod species.

  13. Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program.

    Science.gov (United States)

    Basu, Sanjay; Wimer, Christopher; Seligman, Hilary

    2016-11-01

    To examine the association of county-level cost of living with nutrition among low-income Americans. We used the National Household Food Acquisition and Purchase Survey (2012-2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Living in a higher-cost county-particularly one with high rent costs-was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living.

  14. A Geographic Method for High Resolution Spatial Heat Planning

    DEFF Research Database (Denmark)

    Nielsen, Steffen

    2014-01-01

    more detailed modelling that takes the geographic placement of buildings and the differences among DH systems into account. In the present article, a method for assessing the costs of DH expansions has been developed. The method was applied in a geographic information system (GIS) model that consists...... are considering distribution costs based on the geographic properties of each area and assessing transmission costs based on an iterative process that examines expansion potentials gradually. The GIS model is only applicable to a Danish context, but the method itself can be applied to other countries....... of three parts and assesses the costs of heat production, distribution, and transmission. The model was also applied to an actual case in order to show how it can be used. The model shows many improvements in the method for the assessment of distribution costs and transmission costs. Most notable...

  15. Cost recovery in geographic information systems and conflicts with copyright law

    Science.gov (United States)

    Roberts, Jon L.

    1993-10-01

    The ability to recover cost by the sale of geographic information is dependent upon the ownership of the copyright in and to that information. The ownership of the copyright turns upon whether one entity is an employee of the other or whether the copyrightable work falls within certain statutorily defined categories in the copyright law. Absent the specific requirements being fulfilled the ownership of the data may not be exactly as the parties expect.

  16. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes

    Directory of Open Access Journals (Sweden)

    Mihas Constantinos

    2006-05-01

    Full Text Available Abstract Background Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among normal girls in various geographic latitudes. An attempt is also made to implicate a possible role of melatonin in the above association. Material-methods 20 peer-reviewed published papers reporting adolescent idiopathic scoliosis prevalence and 33 peer-reviewed papers reporting age at menarche in normal girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included regression of the adolescent idiopathic scoliosis prevalence and age at menarche by latitude. Results The regression of prevalence of adolescent idiopathic scoliosis and age at menarche by latitude is statistically significant (p Conclusion Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis.

  17. 20 CFR 404.272 - Indexes we use to measure the rise in the cost-of-living.

    Science.gov (United States)

    2010-04-01

    ... cost-of-living. 404.272 Section 404.272 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.272 Indexes we use to measure the rise in the cost-of-living. (a) The bases. To measure...

  18. Time and financial costs of programs for live trapping feral cats.

    Science.gov (United States)

    Nutter, Felicia B; Stoskopf, Michael K; Levine, Jay F

    2004-11-01

    To determine the time and financial costs of programs for live trapping feral cats and determine whether allowing cats to become acclimated to the traps improved trapping effectiveness. Prospective cohort study. 107 feral cats in 9 colonies. 15 traps were set at each colony for 5 consecutive nights, and 5 traps were then set per night until trapping was complete. In 4 colonies, traps were immediately baited and set; in the remaining 5 colonies, traps were left open and cats were fed in the traps for 3 days prior to the initiation of trapping. Costs for bait and labor were calculated, and trapping effort and efficiency were assessed. Mean +/- SD overall trapping effort (ie, number of trap-nights until at least 90% of the cats in the colony had been captured or until no more than 1 cat remained untrapped) was 8.9 +/- 3.9 trap-nights per cat captured. Mean overall trapping efficiency (ie, percentage of cats captured per colony) was 98.0 +/- 4.0%. There were no significant differences in trapping effort or efficiency between colonies that were provided an acclimation period and colonies that were not. Overall trapping costs were significantly higher for colonies provided an acclimation period. Results suggest that these live-trapping protocols were effective. Feeding cats their regular diets in the traps for 3 days prior to the initiation of trapping did not have a significant effect on trapping effort or efficiency in the present study but was associated with significant increases in trapping costs.

  19. Unique Nature of the Quality of Life in the Context of Extreme Climatic, Geographical and Specific Socio-Cultural Living Conditions

    Science.gov (United States)

    Kulik, Anastasia; Neyaskina, Yuliya; Frizen, Marina; Shiryaeva, Olga; Surikova, Yana

    2016-01-01

    This article presents the results of a detailed empirical research, aimed at studying the quality of life in the context of extreme climatic, geographical and specific sociocultural living conditions. Our research is based on the methodological approach including social, economical, ecological and psychological characteristics and reflecting…

  20. Variations in living donor graft rates by dialysis clinic: effect on outcome and cost of chronic renal failure therapy.

    Science.gov (United States)

    Baltzan, M A; Ahmed, S; Baltzan, R B; Marshall, R P; Thoma, E L; Nicol, M F

    1997-06-01

    Examination of nephrology practice variations in living donor renal grafts to determine their influence on organ supply, quality, and cost of chronic renal failure therapy. Saskatchewan chronic dialysis, cadaveric, and living donor renal grafts in 1983-1994 inclusive. Saskatchewan has three dialysis (I, II, III) and one transplant clinic. In the period the renal graft incidences/million population by these dialysis clinics by organ source were; Cadaveric: 23.1, 23.2, 21.1 (p = ns). Living: 5.4, 21.7, 8.3 (I or III vs II p actuarial patient survival is 92% and B 44%. Series A ten-year actuarial graft survival (including regrafts) is 77% and B 39%. Rehabilitation rate in patients with functioning grafts is 88.5%. Province-wide extension of the Clinic II living-donor graft rate in 1983-1994 would have produced 160 more renal grafts or 59% of those receiving chronic dialysis in 1994. The annual maintenance for a graft with the initial grafting cost taken over five years was $10,825 and the dialysis cost $40,100. (1) nephrology practice variations caused a 2.5-4.0-fold difference in living donor renal graft rates, indicating patient education by the attending nephrologist influences the living donor transplantation rate, (2) with such education the combined living donor and the cadaveric organ supply virtually meets graft demand, (3) living donor renal grafts yield a better quantity and quality of life and better cost control than dialysis with their annual cost being one-quarter that for dialysis.

  1. Geographic differences in allele frequencies of susceptibility SNPs for cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Kullo Iftikhar J

    2011-04-01

    Full Text Available Abstract Background We hypothesized that the frequencies of risk alleles of SNPs mediating susceptibility to cardiovascular diseases differ among populations of varying geographic origin and that population-specific selection has operated on some of these variants. Methods From the database of genome-wide association studies (GWAS, we selected 36 cardiovascular phenotypes including coronary heart disease, hypertension, and stroke, as well as related quantitative traits (eg, body mass index and plasma lipid levels. We identified 292 SNPs in 270 genes associated with a disease or trait at P -8. As part of the Human Genome-Diversity Project (HGDP, 158 (54.1% of these SNPs have been genotyped in 938 individuals belonging to 52 populations from seven geographic areas. A measure of population differentiation, FST, was calculated to quantify differences in risk allele frequencies (RAFs among populations and geographic areas. Results Large differences in RAFs were noted in populations of Africa, East Asia, America and Oceania, when compared with other geographic regions. The mean global FST (0.1042 for 158 SNPs among the populations was not significantly higher than the mean global FST of 158 autosomal SNPs randomly sampled from the HGDP database. Significantly higher global FST (P FST of 2036 putatively neutral SNPs. For four of these SNPs, additional evidence of selection was noted based on the integrated Haplotype Score. Conclusion Large differences in RAFs for a set of common SNPs that influence risk of cardiovascular disease were noted between the major world populations. Pairwise comparisons revealed RAF differences for at least eight SNPs that might be due to population-specific selection or demographic factors. These findings are relevant to a better understanding of geographic variation in the prevalence of cardiovascular disease.

  2. Cost analysis of living donor kidney transplantation in China: a single-center experience.

    Science.gov (United States)

    Zhao, Wenyu; Zhang, Lei; Han, Shu; Zhu, Youhua; Wang, Liming; Zhou, Meisheng; Zeng, Li

    2012-01-01

    Kidney transplantation is the most cost-effective option for the treatment of end-stage renal disease, but the financial aspects of kidney transplantation have not yet been fully investigated. The purpose of this study was to determine the hospital cost of living donor kidney transplantation in China and to identify factors associated with the high cost. Demographic and clinical data of 103 consecutive patients who underwent living donor kidney transplantation from January 2007 to January 2011 at our center were reviewed, and detailed hospital cost of initial admission for kidney transplantation was analyzed. A stepwise multiple regression analysis was computed to determine predictors affecting the total hospital cost. The median total hospital cost was US $10,531, of which 69.2% was for medications, 13.2% for surgical procedures, 11.4% for para clinics, 3.7% for accommodations, 0.5% for nursing care, and 2.0% for other miscellaneous medical services. A multivariate stepwise logistic regression model for overall cost of transplantation revealed that the length of hospital stay, induction therapy, steroid-resistant rejection, maintenance therapy, infection status and body weight were independent predictors affecting the total hospitalization cost. Although the cost of living donor kidney transplantation in China is much lower than that in developed countries, it is a heavy burden for both the government and the patients. As medications formed the greater proportion of the total hospitalization cost, efforts to reduce the cost of drugs should be addressed.

  3. A geographically resolved method to estimate levelized power plant costs with environmental externalities

    International Nuclear Information System (INIS)

    Rhodes, Joshua D.; King, Carey; Gulen, Gürcan; Olmstead, Sheila M.; Dyer, James S.; Hebner, Robert E.; Beach, Fred C.; Edgar, Thomas F.; Webber, Michael E.

    2017-01-01

    In this analysis we developed and applied a geographically-resolved method to calculate the Levelized Cost of Electricity (LCOE) of new power plants on a county-by-county basis while including estimates of some environmental externalities. We calculated the LCOE for each county of the contiguous United States for 12 power plant technologies. The minimum LCOE option for each county varies based on local conditions, capital and fuel costs, environmental externalities, and resource availability. We considered ten scenarios that vary input assumptions. We present the results in a map format to facilitate comparisons by fuel, technology, and location. For our reference analysis, which includes a cost of $62/tCO_2 for CO_2 emissions natural gas combined cycle, wind, and nuclear are most often the lowest-LCOE option. While the average cost increases when internalizing the environmental externalities (carbon and air pollutants) is small for some technologies, the local cost differences are as high as $0.62/kWh for coal (under our reference analysis). These results display format, and online tools could serve as an educational tool for stakeholders when considering which technologies might or might not be a good fit for a given locality subject to system integration considerations. - Highlights: • We propose a method to add externalities to LCOE. • We present the least cost technology for every county in the US. • The cheapest technology depends on many characteristics of that locale. • We present online tools for users to change our assumptions. • Our tools are useful in discussing the impact of policy on the cost of electricity.

  4. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    Science.gov (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  5. Costs of achieving live birth from assisted reproductive technology: a comparison of sequential single and double embryo transfer approaches.

    Science.gov (United States)

    Crawford, Sara; Boulet, Sheree L; Mneimneh, Allison S; Perkins, Kiran M; Jamieson, Denise J; Zhang, Yujia; Kissin, Dmitry M

    2016-02-01

    To assess treatment and pregnancy/infant-associated medical costs and birth outcomes for assisted reproductive technology (ART) cycles in a subset of patients using elective double embryo (ET) and to project the difference in costs and outcomes had the cycles instead been sequential single ETs (fresh followed by frozen if the fresh ET did not result in live birth). Retrospective cohort study using 2012 and 2013 data from the National ART Surveillance System. Infertility treatment centers. Fresh, autologous double ETs performed in 2012 among ART patients younger than 35 years of age with no prior ART use who cryopreserved at least one embryo. Sequential single and double ETs. Actual live birth rates and estimated ART treatment and pregnancy/infant-associated medical costs for double ET cycles started in 2012 and projected ART treatment and pregnancy/infant-associated medical costs if the double ET cycles had been performed as sequential single ETs. The estimated total ART treatment and pregnancy/infant-associated medical costs were $580.9 million for 10,001 double ETs started in 2012. If performed as sequential single ETs, estimated costs would have decreased by $195.0 million to $386.0 million, and live birth rates would have increased from 57.7%-68.0%. Sequential single ETs, when clinically appropriate, can reduce total ART treatment and pregnancy/infant-associated medical costs by reducing multiple births without lowering live birth rates. Published by Elsevier Inc.

  6. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes

    Science.gov (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin

    2008-01-01

    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

  7. 20 CFR 404.277 - When does the frozen minimum primary insurance amount increase because of cost-of-living...

    Science.gov (United States)

    2010-04-01

    ... insurance amount increase because of cost-of-living adjustments? 404.277 Section 404.277 Employees' Benefits... Primary Insurance Amounts Cost-Of-Living Increases § 404.277 When does the frozen minimum primary insurance amount increase because of cost-of-living adjustments? (a) What is the frozen minimum primary...

  8. 75 FR 74623 - Cost of Living Adjustment for Performance of Musical Compositions by Colleges and Universities

    Science.gov (United States)

    2010-12-01

    ... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 381 [Docket No. 2010-9 CRB] Cost of Living... Board, Library of Congress. ACTION: Final rule. SUMMARY: The Copyright Royalty Judges announce a cost of... before December 1 of each year the Judges shall publish a notice of the change in the cost of living as...

  9. 76 FR 74703 - Cost of Living Adjustment for Performance of Musical Compositions by Colleges and Universities

    Science.gov (United States)

    2011-12-01

    ... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 381 [Docket No. 2011-9 CRB NCEB COLA] Cost... announce a cost of living adjustment (``COLA'') of 3.5% in the royalty rates that colleges, universities... Judges shall publish a notice of the change in the cost of living as determined by the Consumer Price...

  10. 78 FR 71501 - Cost of Living Adjustment for Performance of Musical Compositions by Colleges and Universities

    Science.gov (United States)

    2013-11-29

    ... LIBRARY OF CONGRESS Copyright Royalty Board 37 CFR Part 381 [Docket No. 2013-9 CRB NCEB COLA] Cost... announce a cost of living adjustment (COLA) of 2% in the royalty rates that colleges, universities, and... change in the cost of living for the rate codified at Sec. 381.5(c)(3) relating to compositions in the...

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

    Science.gov (United States)

    Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

    2017-11-07

    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. 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 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. 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 resource allocation strategies. It can be a useful tool for

  12. 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

  13. Does the CPI mirror costs-of-living? Engel's law suggests not in Norway

    OpenAIRE

    Larsen, Erling Røed

    2004-01-01

    There is considerable interest in identifying the magnitude of the difference between increases in CPI and costs-of-living, and this article uses the technique proposed by Hamilton (2001) to measure this discrepancy for Norway for the 90s. The method is extended along several dimensions by introducing a framework in which measurement errors are modelled. A non-parametric approach is then employed to segment households into demographic types while allowing for flexibility in costso...

  14. The cost-effectiveness of using payment to increase living donor kidneys for transplantation.

    Science.gov (United States)

    Barnieh, Lianne; Gill, John S; Klarenbach, Scott; Manns, Braden J

    2013-12-01

    For eligible candidates, transplantation is considered the optimal treatment compared with dialysis for patients with ESRD. The growing number of patients with ESRD requires new strategies to increase the pool of potential donors. Using decision analysis modeling, this study compared a strategy of paying living kidney donors to waitlisted recipients on dialysis with the current organ donation system. In the base case estimate, this study assumed that the number of donors would increase by 5% with a payment of $10,000. Quality of life estimates, resource use, and costs (2010 Canadian dollars) were based on the best available published data. Compared with the current organ donation system, a strategy of increasing the number of kidneys for transplantation by 5% by paying living donors $10,000 has an incremental cost-savings of $340 and a gain of 0.11 quality-adjusted life years. Increasing the number of kidneys for transplantation by 10% and 20% would translate into incremental cost-savings of $1640 and $4030 and incremental quality-adjusted life years gain of 0.21 and 0.39, respectively. Although the impact is uncertain, this model suggests that a strategy of paying living donors to increase the number of kidneys available for transplantation could be cost-effective, even with a transplant rate increase of only 5%. Future work needs to examine the feasibility, legal policy, ethics, and public perception of a strategy to pay living donors.

  15. Adjusting Teacher Salaries for the Cost of Living: The Effect on Salary Comparisons and Policy Conclusions

    Science.gov (United States)

    Stoddard, C.

    2005-01-01

    Teaching salaries are commonly adjusted for the cost of living, but this incorrectly accounts for welfare differences across states. Adjusting for area amenities and opportunities, however, produces more accurate salary comparisons. Amenities and opportunities can be measured by the wage premium other workers in a state face. The two methods…

  16. Determinants of caesarean section in Lebanon: geographical differences.

    Science.gov (United States)

    Carayol, Marion; Zein, Ali; Ghosn, Nada; Du Mazaubrun, Christiane; Breart, Gérard

    2008-03-01

    This study, based on the Lebanese National Perinatal Survey which included 5231 women, examined the relations between the caesarean section (CS) rate and the characteristics of mothers, children, antenatal care and maternity units in two geographical zones of Lebanon (Beirut-Mount Lebanon and the rest of the country) and then looked at geographical variations. This analysis concerned 3846 women with singleton pregnancies and livebirths at low risk of CS, after exclusion of women with a previous CS, non-cephalic fetal presentations, or delivery before 37 weeks' gestation. The principal end point was caesarean delivery. The relations between the factors studied and CS were estimated by odds ratios (OR), both crude and adjusted, using logistic regression. The rate of CS was higher in the Beirut-Mount Lebanon zone than elsewhere (13.4% vs. 7.6%). After adjustment, several factors remained associated with caesarean delivery in each zone. Common factors were primiparity, gestational age > or = 41 weeks and antenatal hospitalisation. Factors identified only in the Beirut-Mount Lebanon zone were obstetric history and insurance coverage, whereas for the other zones we only found major risk factors for obstetric disease: maternal age > or = 35 years, number of antenatal consultations > or = 4 and birthweight Lebanon (OR = 1.80 [95% CI 1.09, 2.95]). In conclusion, the CS rates in Lebanon were high, with geographical differences that were associated with access to care and with obstetric practices.

  17. Survival benefits select for group living in a social spider despite reproductive costs

    DEFF Research Database (Denmark)

    Bilde, T.; Coates, K.S.; Birkhofer, K.

    2007-01-01

    The evolution of cooperation requires benefits of group living to exceed costs. Hence, some components of fitness are expected to increase with increasing group size, whereas others may decrease because of competition among group members. The social spiders provide an excellent system to investig......The evolution of cooperation requires benefits of group living to exceed costs. Hence, some components of fitness are expected to increase with increasing group size, whereas others may decrease because of competition among group members. The social spiders provide an excellent system...... to investigate the costs and benefits of group living: they occur in groups of various sizes and individuals are relatively short-lived, therefore life history traits and Lifetime Reproductive Success (LRS) can be estimated as a function of group size. Sociality in spiders has originated repeatedly...... and survival in the social spider Stegodyphus dumicola in two populations in Namibia. In both populations, the major benefit of group living was improved survival of colonies and late-instar juveniles with increasing colony size. By contrast, female fecundity, female body size and early juvenile survival...

  18. Development and implementation of a low cost micro computer system for LANDSAT analysis and geographic data base applications

    Science.gov (United States)

    Faust, N.; Jordon, L.

    1981-01-01

    Since the implementation of the GRID and IMGRID computer programs for multivariate spatial analysis in the early 1970's, geographic data analysis subsequently moved from large computers to minicomputers and now to microcomputers with radical reduction in the costs associated with planning analyses. Programs designed to process LANDSAT data to be used as one element in a geographic data base were used once NIMGRID (new IMGRID), a raster oriented geographic information system, was implemented on the microcomputer. Programs for training field selection, supervised and unsupervised classification, and image enhancement were added. Enhancements to the color graphics capabilities of the microsystem allow display of three channels of LANDSAT data in color infrared format. The basic microcomputer hardware needed to perform NIMGRID and most LANDSAT analyses is listed as well as the software available for LANDSAT processing.

  19. Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome: Prospective Analysis of the SUN Cohort

    Directory of Open Access Journals (Sweden)

    Amaya Lopez-Pascual

    2017-01-01

    Full Text Available Living in a geographically higher altitude affects oxygen availability. The possible connection between environmental factors and the development of metabolic syndrome (MetS feature is not fully understood, being the available epidemiological evidence still very limited. The aim of the present study was to evaluate the longitudinal association between altitude and incidence of MetS and each of its components in a prospective Spanish cohort, The Seguimiento Universidad de Navarra (SUN project. Our study included 6860 highly educated subjects (university graduates free from any MetS criteria at baseline. The altitude of residence was imputed with the postal code of each individual subject residence according to the data of the Spanish National Cartographic Institute and participants were categorized into tertiles. MetS was defined according to the harmonized definition. Cox proportional hazards models were used to assess the association between the altitude of residence and the risk of MetS during follow-up. After a median follow-up period of 10 years, 462 incident cases of MetS were identified. When adjusting for potential confounders, subjects in the highest category of altitude (>456 m exhibited a significantly lower risk of developing MetS compared to those in the lowest tertile (<122 m of altitude of residence [Model 2: Hazard ratio = 0.75 (95% Confidence interval: 0.58–0.97; p for trend = 0.029]. Living at geographically higher altitude was associated with a lower risk of developing MetS in the SUN project. Our findings suggest that geographical elevation may be an important factor linked to metabolic diseases.

  20. Cost of living dictates what whales, dolphins and porpoises eat: the importance of prey quality on predator foraging strategies.

    Directory of Open Access Journals (Sweden)

    Jérôme Spitz

    Full Text Available Understanding the mechanisms that drive prey selection is a major challenge in foraging ecology. Most studies of foraging strategies have focused on behavioural costs, and have generally failed to recognize that differences in the quality of prey may be as important to predators as the costs of acquisition. Here, we tested whether there is a relationship between the quality of diets (kJ · g(-1 consumed by cetaceans in the North Atlantic and their metabolic costs of living as estimated by indicators of muscle performance (mitochondrial density, n = 60, and lipid content, n = 37. We found that the cost of living of 11 cetacean species is tightly coupled with the quality of prey they consume. This relationship between diet quality and cost of living appears to be independent of phylogeny and body size, and runs counter to predictions that stem from the well-known scaling relationships between mass and metabolic rates. Our finding suggests that the quality of prey rather than the sheer quantity of food is a major determinant of foraging strategies employed by predators to meet their specific energy requirements. This predator-specific dependence on food quality appears to reflect the evolution of ecological strategies at a species level, and has implications for risk assessment associated with the consequences of changing the quality and quantities of prey available to top predators in marine ecosystems.

  1. Three-dimensional visualization of geographical terrain data using temporal parallax difference induction

    Science.gov (United States)

    Mayhew, Christopher A.; Mayhew, Craig M.

    2009-02-01

    Vision III Imaging, Inc. (the Company) has developed Parallax Image Display (PIDTM) software tools to critically align and display aerial images with parallax differences. Terrain features are rendered obvious to the viewer when critically aligned images are presented alternately at 4.3 Hz. The recent inclusion of digital elevation models in geographic data browsers now allows true three-dimensional parallax to be acquired from virtual globe programs like Google Earth. The authors have successfully developed PID methods and code that allow three-dimensional geographical terrain data to be visualized using temporal parallax differences.

  2. Epidemiology of hip fracture: Worldwide geographic variation

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2011-01-01

    Full Text Available Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.

  3. 20 CFR 416.405 - Cost-of-living adjustments in benefits.

    Science.gov (United States)

    2010-04-01

    ... which the title II benefits are being increased based on the Consumer Price Index, or, if greater, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Cost-of-living adjustments in benefits. 416.405 Section 416.405 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME...

  4. Geographical variation in dementia: systematic review with meta-analysis

    Science.gov (United States)

    Russ, Tom C; Batty, G David; Hearnshaw, Gena F; Fenton, Candida; Starr, John M

    2012-01-01

    Background Geographical variation in dementia prevalence and incidence may indicate important socio-environmental contributions to dementia aetiology. However, previous comparisons have been hampered by combining studies with different methodologies. This review systematically collates and synthesizes studies examining geographical variation in the prevalence and incidence of dementia based on comparisons of studies using identical methodologies. Methods Papers were identified by a comprehensive electronic search of relevant databases, scrutinising the reference sections of identified publications, contacting experts in the field and re-examining papers already known to us. Identified articles were independently reviewed against inclusion/exclusion criteria and considered according to geographical scale. Rural/urban comparisons were meta-analysed. Results Twelve thousand five hundred and eighty records were reviewed and 51 articles were included. Dementia prevalence and incidence varies at a number of scales from the national down to small areas, including some evidence of an effect of rural living [prevalence odds ratio (OR) = 1.11, 90% confidence interval (CI) 0.79–1.57; incidence OR = 1.20, 90% CI 0.84–1.71]. However, this association of rurality was stronger for Alzheimer disease, particularly when early life rural living was captured (prevalence OR = 2.22, 90% CI 1.19–4.16; incidence OR = 1.64, 90% CI 1.08–2.50). Conclusions There is evidence of geographical variation in rates of dementia in affluent countries at a variety of geographical scales. Rural living is associated with an increased risk of Alzheimer disease, and there is a suggestion that early life rural living further increases this risk. However, the fact that few studies have been conducted in resource-poor countries limits conclusions. PMID:22798662

  5. Living renal donors: optimizing the imaging strategy--decision- and cost-effectiveness analysis

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina); M.C.J.M. Kock (Marc); W. Weimar (Willem); K. Visser (Karen); M.G.M. Hunink (Myriam); J.N.M. IJzermans (Jan)

    2003-01-01

    textabstractPURPOSE: To determine the most cost-effective strategy for preoperative imaging performed in potential living renal donors. MATERIALS AND METHODS: In a decision-analytic model, the societal cost-effectiveness of digital subtraction angiography (DSA), gadolinium-enhanced

  6. Cost-effectiveness of short COH protocols with GnRH antagonists using different types of gonadotropins for in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Guenka Petrova

    2016-05-01

    Full Text Available The aim of this study was to explore the cost-effectiveness of short protocols including different types of gonadotropins for controlled ovarian hyperstimulation (COH for in vitro fertilization (IVF. A retrospective, observational study of the real-life practice in a specialized IVF gynaecology clinic in 2009–2013 was carried out. All women on short COH protocols were recruited into three groups: COH including recombinant follicle stimulating hormone (rFSH and urinary-FSH (urFSH (n = 173; including urFSH alone (n = 289; and including rFSH alone (n = 212. The cost-effectiveness of the COH protocols was explored in two different case scenarios for possible outcomes. The first case scenario took into consideration a successful live birth, and the second one, the women to achieve pregnancy with live birth. Decision modelling was done using the TreeAge 2014 Software. According to the results in the first case scenario, the rFSH plus urFSH COH approach showed the highest weighted probability (p = 0.38 of live birth, but the urFSH alternative was cost-effective. The results in the second case scenario demonstrated that the urFSH protocol was again the cost-effective alternative. These results suggest that the strategy with urFSH should be preferred in both cases, but rFSH could also be considered as a cost-effective alternative for successful live birth and achieving pregnancy and delivery, since the incremental cost-effectiveness ratio in comparison with the urFSH protocol is below the gross domestic product per capita. The combined approach of rFSH and urFSH was shown not to be cost-effective in both explored scenarios.

  7. Geographical differences in the prevalence of hypospadias in Finland

    International Nuclear Information System (INIS)

    Aho, Martti Olavi; Koivisto, Anna-Maija; Juhani Tammela, Teuvo Leo; Auvinen, Anssi-Pekka

    2003-01-01

    Hypospadias is one of the most common congenital anomalies but the etiology is not fully understood. There seem to be genetic, endocrinological, and environmental factors involved. Great geographical variation in the prevalence of hypospadias has been reported both between and within countries. We studied the determinants of geographical variation in the prevalence of hypospadias in Finland. All patients treated for hypospadias in 1970-1996 before the age of 9 years among boys born in 1970-1986 were identified in the national hospital discharge registry. Prevalence of hypospadias was calculated for each of the 355 municipalities in Finland. Demographic data were obtained from Statistics Finland. Association of the explanatory factors with prevalence of hypospadias was assessed using Poisson regression methods. The prevalence of operated hypospadias varied between provinces and between university hospital districts, from a ratio of 0.65 to a ratio of 1.01. An association between the prevalence of hypospadias and the remoteness from the closest city was observed. There was no association with level of education, social class, or occupation. The observed differences in the prevalence of operated hypospadias in Finland may have several explanations. Different levels of ascertainment and both genetic and environmental factors can not be ruled out

  8. Clone-specific differences in Pragmites australis: Effects of ploidy level and geographic origin

    DEFF Research Database (Denmark)

    Hansen, D.; Lambertini, Carla; Jampeetong, Arunothai

    2007-01-01

    by the geographic origin, the euploidy level (4x, 6x, 8x and 12x), and to assess differences between native and introduced clones in North America. Growth, morphology, photosynthetic characteristics, photosynthetic pigments and enzymes were measured on 11 geographically distinct clones propagated in a common...... result in an increase in plant size, probably because the number of cell divisions during development is reduced. Four North American clones were included in the study. The clone from the Atlantic Coast and the supposed invasive European clone resembled each other. The Gulf Coast clone differed from...

  9. Different positions of uncertain lives

    DEFF Research Database (Denmark)

    Stenum, Helle

    On the basis of my ethnographic research in Denmark and Spain, I will investigate and compare four different positions of illegality in two different national contexts. Legal and institutional practices on the one hand produce the conditions for migrant illegality as such, but are also decisive...... for both the lived experience as irregular migrant and the opportunities for agency and strategizing among migrants....

  10. Molecular Characterization of Fasciola Samples Using Sequences of Second Internal Transcribed Spacer-rDNA in Different Geographical Localities of Sistan and Balouchestan Province, Iran

    Directory of Open Access Journals (Sweden)

    Mahsa Shahbakhsh

    2016-02-01

    Full Text Available Background: The Fasciola trematodes are the most common liver flukes, living in a range of animals with global distribution and resulting in profound economic loss and public health challenges. Previous studies have indicated that the sequences of the second internal transcribed spacer (ITS-2 of ribosomal DNA (rDNA provide reliable genetic markers for molecular systemic studies of Fasciola. Objectives: The objective of the present study was to characterize Fasciola samples from different geographical regions of Sistan and Balouchestan province using sequences of second internal transcribed spacer (ITS-2 of ribosomal DNA (rDNA. Materials and Methods: Twenty adult trematodes were collected from the livers of slaughtered infected cattle. Total genomic DNA was extracted and ITS-2 rDNA targets were amplified by polymerase chain reaction (PCR. All samples were sequenced and investigated using the ClustalW2 sequence alignment tool and MEGA software. The sequences of some Iranian and non-Iranian isolates were used for comparison, in order to evaluate the variation in sequence homology between geographically different trematode populations. Results: The results of comparing the ITS-2 sequences with the BLAST GenBank database showed one type of sequence for F. hepatica and three different types of sequences for F. gigantica in the specimens. Conclusions: The present study demonstrated that Fasciola samples from cattle in two geographical locations in Sistan and Balouchestan province represented no genetic diversity in F. hepatica and high genetic variation in F. gigantica.

  11. 76 FR 66111 - Cost-of-Living Increase and Other Determinations for 2012

    Science.gov (United States)

    2011-10-25

    ... visit our Internet site, Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2011-0075] Cost-of-Living Increase and Other Determinations for 2012 AGENCY: Social Security Administration. ACTION: Notice. SUMMARY: Under title II of the...

  12. Age-specific cost and public funding of a live birth following assisted reproductive treatment in Japan.

    Science.gov (United States)

    Maeda, Eri; Ishihara, Osamu; Saito, Hidekazu; Kuwahara, Akira; Toyokawa, Satoshi; Kobayashi, Yasuki

    2014-05-01

    The aim of this study was to calculate and assess the cost of assisted reproductive technology (ART) treatment cycles and live-birth events in Japan in 2010. We performed a retrospective analysis of 238,185 ART cycles, registered with the national registry of assisted reproductive treatment during 2010. Costs were calculated, using a decision analysis model. The average cost per live birth was ¥1,974,000. This varied from ¥1,155,000 in women aged birth was ¥442,000. This was ¥6,118,000 in women aged ≥ 45, 15.4 times higher than that of the 35-39-year-old age group. The costs and public funding of a live birth after ART treatment rises with age due to the lower success rates in older women. It may provide economic background to improve the current subsidy system for ART and to provide practical knowledge about fertility for the general population. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  13. Economic analysis of the living expenses costs in Coahuila’s northern border

    Directory of Open Access Journals (Sweden)

    Blanca Vázquez Delgado

    2000-07-01

    Full Text Available The purpose of this work is to reflect on the change of strategy that was taken with regards to the occurrence of a rupture of the relation between the salary and the basic household supply and purchasing power of the workers. We are particularly interested in evidencing the case of the cities along the Northern border of Coahuila. In view of the loss of the relationship between the salary and the cost of life of the population and its basic needs, under the new development salary strategy, the attainment of the macroeconomic equilibrium aims have been by means of a salary restraint. Nonetheless, this strategy has brought about no other outcome but the greatest loss of well-being among the population. The changes that have taken place in the salary policy have undermined the capabilities of most of the population in having access to the elements deemed necessary for a scheme of basic satisfaction. Such scenario is agravated by the differences existing in the economic cost of living in certain cities, mainly along border cities.

  14. 75 FR 65696 - Cost-of-Living Increase and Other Determinations for 2011

    Science.gov (United States)

    2010-10-26

    ... eligibility or claiming benefits, call 1-800-772-1213, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION Office of the Commissioner [Docket No. SSA-2010-0054] Cost-of-Living Increase and Other Determinations for 2011 AGENCY: Social Security Administration. ACTION: Notice...

  15. Workstation Related Anthropometric and Body Composition Parameters of Indian Women of Different Geographical Regions

    Directory of Open Access Journals (Sweden)

    Inderjeet Singh

    2015-01-01

    Full Text Available Background: Anthropometry plays an important role in industrial design, clothing design, ergonomics and architecture where statistical data about the distribution of body dimensions in the population are used to optimize products. Changes in lifestyles, nutrition, and ethnic composition of populations lead to changes in the distribution of body dimensions (e.g. the obesity epidemic, and require regular updating of anthropometric data collections. Aim and Objectives: This study analyzed the variation in anthropometric dimensions and body composition parameters of working women employees of different geographical zones. Material and Methods: The study was undertaken on nine hundred forty (940 women employees of Defence Research and Development Organization (DRDO working in seventeen different laboratories and belonged to different states of India. The age range of studied women was between 20-60 years. Fourteen body dimensions namely stature, popliteal height, knee height, buttock to popliteal length, hip breadth, waist breadth, shoulder breadth, forearm length, arm length, eye height (sitting, sitting shoulder height, hand length, hand breadth and elbow width were measured in cm using Martin anthropometers and Martin's sliding caliper. Body composition parameters like weight, percentage body fat, fat mass and fat free mass were recorded. Results: All anthropometric parameters were found significantly different (p<0.001. Body composition variables of women were also found significantly different in all three zones but fat free mass was not significantly different. Conclusion:It can be concluded that diet, environmental conditions and living style of different regions can influence the anthropometry and body composition of the individuals, however the influence of ethnic, genetic and hereditary factor are not controlled in this study.

  16. Different Factors of Llap as a Geographic Region

    OpenAIRE

    , F. Isufi; , S. Halimi; , F. Humolli

    2011-01-01

    In this work attempts were made to express in the best possible manner the factors which differentiate the Llap as geographic region. The Llap Region is located in the north-east of Kosovo. Within the ethnic geography, the Llap area is having peripheric position, but within the Balkan Penninsula it is having a central position, while along Llap goes the Highway which connects Kosovo and Serbia. The Llap region has important natural conditions; such as very good geographic position, running an...

  17. 77 FR 65754 - Cost-of-Living Increase and Other Determinations for 2013

    Science.gov (United States)

    2012-10-30

    ... eligibility or claiming benefits, call 1-800-772-1213, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0054] Cost-of-Living Increase and Other Determinations for 2013 AGENCY: Social Security Administration. ACTION: Notice. SUMMARY: Under title II of the...

  18. Cross-cultural similarities and differences in North Americans' geographic location judgments.

    Science.gov (United States)

    Friedman, Alinda; Kerkman, Dennis D; Brown, Norman R; Stea, David; Cappello, Hector M

    2005-12-01

    We examined some potential causes of bias in geographic location estimates by comparing location estimates of North American cities made by Canadian, U.S., and Mexican university students. All three groups placed most Mexican cities near the equator, which implies that all three groups were influenced by shared beliefs about the locations of geographical regions relative to global reference points. However, the groups divided North America into different regions and differed in the relative accuracy of the estimates within them, which implies that there was an influence of culture-specific knowledge. The data support a category-based system of plausible reasoning, in which biases in judgments are multiply determined, and underscore the utility of the estimation paradigm as a tool in cross-cultural cognitive research.

  19. Hospital costs associated with depression in a cohort of older men living in Western Australia

    NARCIS (Netherlands)

    Prina, A.M.; Huisman, M.; Yeap, B.B.; Hankey, G.J.; Flicker, L.; Brayne, C.; Almeida, O.P.

    2014-01-01

    Background: There is lack of information of the hospital costs related to depression. Here, we compare the costs associated with general hospital admissions over 2 years between older men with and without a documented past history of depression. Methods: A community-based cohort of older men living

  20. The Data Reliability of Volunteered Geographic Information with Using Traffic Accident Data

    Science.gov (United States)

    Sevinç, H. K.; Karaş, I. R.

    2017-11-01

    The development of mobile technologies is important in the lives of humans. Mobile devices constitute a great part of the daily lives of people. It has come to such a point that when people first wake up, they check their smart phones for the first thing. Users may share their positions with the GNSS sensors in mobile devices or they can add information about their positions in mobile applications. Users contribute to Geographical Information System with this sharing. These users consist of native (citizens) living in that geographical position not of the CBS specialists. Creating, collecting, sharing and disseminating the geographical data provided by voluntary individuals constitute the Volunteered Geographic Information System. The data in the Volunteered Geographic Information System are received from amateur users. "How reliable will the data received from amateur users instead of specialists of the field be in scientific terms?" In this study, the reliability between the data received from the voluntary users through Volunteered Geographic Information System and real data is investigated. The real data consist of the traffic accident coordinates. The data that will be received from users will be received through the speed values in the relevant coordinates and the marking of the users for possible accident points on the map.

  1. Tuition and Living Accommodation Costs at Canadian Universities, 1978-79 and 1979-80.

    Science.gov (United States)

    Dulac, Claude

    Tuition and living accommodation costs for students at most Canadian universities are summarized in this publication from Statistics Canada. Extensive data tables include information on accommodation costs for university-operated residences and housing and tuition fees. The range of tuition fees at the undergraduate level reflects a fee structure…

  2. Low cost label-free live cell imaging for biological samples

    Science.gov (United States)

    Seniya, C.; Towers, C. E.; Towers, D. P.

    2017-02-01

    This paper reports the progress to develop a practical phase measuring microscope offering new capabilities in terms of phase measurement accuracy and quantification of cell:cell interactions over the longer term. A novel, low cost phase interference microscope for imaging live cells (label-free) is described. The method combines the Zernike phase contrast approach with a dual mirror design to enable phase modulation between the scattered and un-scattered optical fields. Two designs are proposed and demonstrated, one of which retains the common path nature of Zernike's original microscopy concept. In both setups the phase shift is simple to control via a piezoelectric driven mirror in the back focal plane of the imaging system. The approach is significantly cheaper to implement than those based on spatial light modulators (SLM) at approximately 20% of the cost. A quantitative assessment of the performance of a set of phase shifting algorithms is also presented, specifically with regard to broad bandwidth illumination in phase contrast microscopy. The simulation results show that the phase measurement accuracy is strongly dependent on the algorithm selected and the optical path difference in the sample.

  3. Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?

    Science.gov (United States)

    Rodiek, Susan; Boggess, May M; Lee, Chanam; Booth, Geoffrey J; Morris, Alisan

    2013-01-01

    This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals. Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations. This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals. Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents. Improved outdoor space can provide substantial cost benefits for assisted living providers. Increasing resident well-being and satisfaction, and thereby generating additional word-of-mouth referrals, can result in higher occupancy levels. Outdoor environments, assisted living, cost benefits, resident satisfaction, occupancy levels, seniors, rental income, word-of-mouth referralPreferred Citation: Rodiek, S., Boggess, M. M., Lee

  4. Systems-based modeling of generation variability under alternate geographic configurations of photovoltaic (PV) installations in Virginia

    International Nuclear Information System (INIS)

    Collins, Ross D.; Crowther, Kenneth G.

    2011-01-01

    With increased focus on renewable energy in our modern era, it is increasingly important to understand the impact of policies on the performance and reliability of regional energy systems. This research develops a model to understand how geographic dispersion of PV installations impacts the reliability of electricity generated from the total PV network, measured by the variance of the distribution of generated electricity. Using NREL data, beta probability distributions of sunlight (kWh/m 2 /day) in various regions of Virginia are estimated using a fitting method that minimizes the Kolmogorov-Smirnov test statistic. A Monte Carlo simulation model is developed to measure PV electricity generation from multiple centralized and dispersed configurations over 100,000 days of probabilistic sunlight. There is a calculable tradeoff between average generation and generation variability, and increased geographic dispersion of PV installations can decrease this variability. Controlling variable generation through policies that promote efficient PV siting can help provide reliable power, minimizing the need for load-balancing peaking power infrastructure and costly electricity purchases from the grid. Using a tradeoff framework of generation and costs, this paper shows that geographically dispersed generation can mitigate the risk of unreliable solar generation that can significantly impact the end-user costs and make PV infrastructure unattractive. - Highlights: → We model how uncertain sunlight affects generation of different PV systems. → We show that geographically dispersed systems decrease generation variability. → Geographically dispersed PV systems are potentially more costly in the short run. → Controlling variability provides reliable power, which can decrease long-run costs. → Promoting mixes of uncertain energy sources requires assessment of these tradeoffs.

  5. Genetic characterization of Bombyx mori (Lepidoptera: Bombycidae) breeding and hybrid lines with different geographic origins.

    Science.gov (United States)

    Furdui, Emilia M; Mărghitaş, Liviu A; Dezmirean, Daniel S; Paşca, Ioan; Pop, Iulia F; Erler, Silvio; Schlüns, Ellen A

    2014-01-01

    The domesticated silkworm Bombyx mori L. comprises a large number of geographical breeds and hybrid lines. Knowing the genetic structure of those may provide information to improve the conservation of commercial lines by estimating inbreeding over generations and the consequences of excessive use of those lineages. Here, we analyzed the genetic diversity of seven breeds and eight hybrid lines from Eastern Europe and Asia using highly polymorphic microsatellites markers to determine its genetical impact on their use in global breeding programs. No consistent pattern of deviation from Hardy-Weinberg equilibrium was found for most breed and hybrids; and the absence of a linkage disequilibrium also suggests that the strains are in equilibrium. A principal coordinate analysis revealed a clear separation of two silkworm breeds from the rest: one (IBV) originated from India and the other one (RG90) from Romania/Japan. The tendency of the other breeds from different geographic origins to cluster together in a general mix might be due to similar selection pressures (climate and anthropogenic factors) in different geographic locations. Phylogenetic analyses grouped the different silkworm breeds but not the hybrids according to their geographic origin and confirmed the pattern found in the principal coordinate analysis. © The Author 2014. Published by Oxford University Press on behalf of the Entomological Society of America.

  6. Leveraging community health worker system to map a mountainous rural district in low resource setting: a low-cost approach to expand use of geographic information systems for public health.

    Science.gov (United States)

    Munyaneza, Fabien; Hirschhorn, Lisa R; Amoroso, Cheryl L; Nyirazinyoye, Laetitia; Birru, Ermyas; Mugunga, Jean Claude; Murekatete, Rachel M; Ntaganira, Joseph

    2014-12-06

    Geographic Information Systems (GIS) have become an important tool in monitoring and improving health services, particularly at local levels. However, GIS data are often unavailable in rural settings and village-level mapping is resource-intensive. This study describes the use of community health workers' (CHW) supervisors to map villages in a mountainous rural district of Northern Rwanda and subsequent use of these data to map village-level variability in safe water availability. We developed a low literacy and skills-focused training in the local language (Kinyarwanda) to train 86 CHW Supervisors and 25 nurses in charge of community health at the health center (HC) and health post (HP) levels to collect the geographic coordinates of the villages using Global Positioning Systems (GPS). Data were validated through meetings with key stakeholders at the sub-district and district levels and joined using ArcMap 10 Geo-processing tools. Costs were calculated using program budgets and activities' records, and compared with the estimated costs of mapping using a separate, trained GIS team. To demonstrate the usefulness of this work, we mapped drinking water sources (DWS) from data collected by CHW supervisors from the chief of the village. DWSs were categorized as safe versus unsafe using World Health Organization definitions. Following training, each CHW Supervisor spent five days collecting data on the villages in their coverage area. Over 12 months, the CHW supervisors mapped the district's 573 villages using 12 shared GPS devices. Sector maps were produced and distributed to local officials. The cost of mapping using CHW supervisors was $29,692, about two times less than the estimated cost of mapping using a trained and dedicated GIS team ($60,112). The availability of local mapping was able to rapidly identify village-level disparities in DWS, with lower access in populations living near to lakes and wetlands (p villages even in mountainous rural areas. These data

  7. Geographic and racial-ethnic differences in satisfaction with and perceived benefits of mental health services.

    Science.gov (United States)

    Kim, Giyeon; Parton, Jason M; Ford, Katy-Lauren; Bryant, Ami N; Shim, Ruth S; Parmelee, Patricia

    2014-12-01

    This study examined whether racial-ethnic differences in satisfaction with and perceived benefits from mental health services vary by geographic region among U.S. adults. Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), selected samples consisted of 2,160 adults age 18 and older from diverse racial-ethnic groups (Asian, black, Hispanic/Latino, and white) who had used mental health services in the past 12 months. Generalized linear model analysis was conducted for the United States as a whole and separately by geographic region (Northeast, South, Midwest, and West) after adjustment for covariates. In the national sample, no significant main effects of race-ethnicity and geographic region were found in either satisfaction with or perceived benefits from mental health services. In the stratified analyses for geographic regions, however, significant racial-ethnic differences were observed in the West; blacks in the West were significantly more likely to report higher satisfaction and perceived benefits, whereas Hispanics/Latinos in the West were significantly less likely to do so. The findings suggest that there are regional variations of racial-ethnic differences in satisfaction with and perceived benefits from mental health services among U.S. adults and that addressing needs of Hispanics/Latinos in the West may help reduce racial-ethnic disparities in mental health care. Clinical and policy implications are discussed.

  8. [Investigation of geographic relationship between farmer's market with live birds and human infections with avian influenza A(H7N9)virus based on internet data analysis].

    Science.gov (United States)

    Yu, Weiwen; Du, Pengcheng; Chen, Chen; Lu, Shan; Kan, Biao; Du, Xiaoping; Xu, Jianguo

    2014-03-01

    Farmer's markets with live birds (FMLB) are key sites where human infections by influenza A virus subtype H7N9 happened. Approximately 80% cases have exposed to FMLB. This study is to investigate the geographic relationship between FMLB and human cases based on analysis of internet data of their geographic locations. Using big data from internet, we searched all FMLB in the cities where the human cases have been reported, then analyzed geographic relations, and evaluated the possibility of visits of the patients to the FMLB around them. The densities of FMLB, population and live poultries were also analyzed. Forty-two cities and 10 615 markets were included in the study. It is indicated that the number of human cases has positive correlations with the population density, the number and density of markets. Except three markets in Foshan, human cases have been reported within 5 km of 10 of 13 markets, which shows that the live bird trading is highly relevant with the distribution of cases. We identified 13 hot spots in the cities including Hangzhou, Shenzhen, et al, where clustered cases have emerged. The numbers of human cases are significantly high in cities where FMLB are detected positive for H7N9 virus. These virus positive markets usually affect the people's residence within 5km area. The number and location of FMLB in cities should be re-evaluated and re-planed for healthy city where the risk of residents infecting avian influenza virus is greatly reduced or eliminated.

  9. Projecting the potential impact of the Cap-Score™ on clinical pregnancy, live births, and medical costs in couples with unexplained infertility.

    Science.gov (United States)

    Babigumira, Joseph B; Sharara, Fady I; Garrison, Louis P

    2018-01-01

    The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles. We developed and parameterized a decision-analytic model of management of unexplained infertility for women based on data from the published literature. We calculated the clinical pregnancy rates, live birth rates, and medical costs comparing CS-TI and SOC. We used Monte Carlo simulation to quantify uncertainty in projected estimates and performed univariate sensitivity analysis. Compared to SOC, CS-TI was projected to increase the pregnancy rate by 1-26%, marginally reduce live birth rates by 1-3% in couples with women below 40 years, increase live birth rates by 3-7% in couples with women over 40 years, reduce mean medical costs by $4000-$19,200, reduce IUI costs by $600-$1370, and reduce IVF costs by $3400-$17,800, depending on the woman's age. The Cap-Score™ is a potentially valuable clinical tool for management of unexplained infertility because it is projected to improve clinical pregnancy rates, save money, and, depending on the price of the test, increase access to treatment for infertility.

  10. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  11. EPSTEIN–BARR VIRUS IN THE POPULATION OF TWO GEOGRAPHICALLY DIFFERENT REGIONS OF RUSSIA

    Directory of Open Access Journals (Sweden)

    N. B. Senyuta

    2017-01-01

    Full Text Available It is well known that the Epstein–Barr virus (EBV being widely spread in the human population is also the etiologic agent for a number of malignancies. A notable feature of tumors associated with EBV is their different incidence in various geographical regions, that, as suggested, related with mutational events in multiple loci of the EBV genome and its oncogene, the latent membrane protein 1 (LMP1, associated with the transforming potential of the virus. Given the multi-ethnic composition of Russian population and the diversity of geographical areas and conditions of their residence, it was relevant to examine the representatives of different geographical regions for the nature of their relationship with EBV. To solve this task the antibody response to locally circulating EBV strains, determined by indirect immunofluorescence, was studied in residents of the Central, North Caucasus and Far Eastern Federal Districts, represented by healthy individuals and patients with various head and neck tumors. The levels of antibody titers obtained were compared with the incidence rates of nasopharyngeal tumors (NPT in population of above Districts. In order to determine possible structural modifications in LMP1 gene of EBV strains persisting in selected geographic regions, samples of the gene have been amplified from a biological material collected by “nested” PCR and sequenced. The results obtained have shown that levels of antibody response to EBV among representatives of the regions included in the study vary significantly. It was found that in residents of the Dagestan and the Chechen Republics, the inhabitants of the North Caucasus Federal District, the correlation between enhanced humoral response to EBV and increased incidence of NPT was detected. Since among NPT the EBV-associated form of nasopharyngeal carcinoma (NPCEBV is dominated, the findings allow us to suggest that the population of these Republics have genetic

  12. Comparing alternative approaches to measuring the geographical accessibility of urban health services: Distance types and aggregation-error issues

    OpenAIRE

    Riva Mylène; Abdelmajid Mohamed; Apparicio Philippe; Shearmur Richard

    2008-01-01

    Abstract Background Over the past two decades, geographical accessibility of urban resources for population living in residential areas has received an increased focus in urban health studies. Operationalising and computing geographical accessibility measures depend on a set of four parameters, namely definition of residential areas, a method of aggregation, a measure of accessibility, and a type of distance. Yet, the choice of these parameters may potentially generate different results leadi...

  13. What shapes fitness costs of reproduction in long-lived iteroparous species? A case study on the Alpine ibex.

    Science.gov (United States)

    Garnier, Alexandre; Gaillard, Jean-Michel; Gauthier, Dominique; Besnard, Aurélien

    2016-01-01

    The fitness costs of reproduction can be masked by individual differences, and may only become apparent during adverse environmental conditions. Individual differences, however, are usually assessed by reproductive success, so how fitness costs are influenced by the interplay between the environmental context and overall individual differences requires further investigation. Here, we evaluated fitness costs of reproduction based on 15 yr of monitoring of individual Alpine ibex (Capra ibex) during a period when the population was affected by a severe disease outbreak (pneumonia). We quantified fitness costs using a novel multi-event capture-mark-recapture (CMR) modeling approach that accounted for uncertainty in reproductive status to estimate the survival and reproductive success of female ibex while also accounting for overall individual heterogeneity using mixture models. Our results show that the ability of females to reproduce was highly heterogeneous. In particular, one group including 76% of females had a much higher probability of giving birth annually (between 0.66 and 0.77, depending on the previous reproductive status) than females of the second group (24% of females, between 0 and 0.05 probability of giving birth annually). Low reproductive costs in terms of future reproduction occurred and were independent of the pneumonia outbreak. There was no survival cost of reproduction either before or after the epizootic, but the cost was high during the epizootic. Our findings indicate that adverse environmental conditions, such as disease outbreaks, may lead to survival costs of reproduction in long-lived species and select against females that have a high reproductive effort. Thereby, the occurrence of adverse conditions increases the diversity of reproductive tactics within a population.

  14. Social living mitigates the costs of a chronic illness in a cooperative carnivore

    Science.gov (United States)

    Almberg, Emily S.; Cross, Paul C.; Dobson, Andrew P.; Smith, Douglas W.; Metz, Matthew C; Stahler, Daniel R.; Hudson, Peter J.

    2015-01-01

    Infection risk is assumed to increase with social group size, and thus be a cost of group living. We assess infection risk and costs with respect to group size using data from an epidemic of sarcoptic mange (Sarcoptes scabiei) among grey wolves (Canis lupus). We demonstrate that group size does not predict infection risk and that individual costs of infection, in terms of reduced survival, can be entirely offset by having sufficient numbers of pack-mates. Infected individuals experience increased mortality hazards with increasing proportions of infected pack-mates, but healthy individuals remain unaffected. The social support of group hunting and territory defence are two possible mechanisms mediating infection costs. This is likely a common phenomenon among other social species and chronic infections, but difficult to detect in systems where infection status cannot be measured continuously over time.

  15. Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial.

    Science.gov (United States)

    Suijker, Jacqueline J; MacNeil-Vroomen, Janet L; van Rijn, Marjon; Buurman, Bianca M; de Rooij, Sophia E; Moll van Charante, Eric P; Bosmans, Judith E

    2017-01-01

    To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year follow-up. Participants were aged ≥ 70 years and at increased risk of functional decline. Participants in the intervention group (n = 1209) received a comprehensive geriatric assessment and individually tailored multifactorial interventions coordinated by a community-care registered nurse with multiple follow-up visits. The control group (n = 1074) received usual care. Costs were assessed from a healthcare perspective. Outcome measures included disability (modified Katz-Activities of Daily Living (ADL) index score), and quality-adjusted life-years (QALYs). Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated using bootstrapped bivariate regression models while adjusting for confounders. There were no statistically significant differences in Katz-ADL index score and QALYs between the two groups. Total mean costs were significantly higher in the intervention group (EUR 6518 (SE 472) compared with usual care (EUR 5214 (SE 338); adjusted mean difference €1457 (95% CI: 572; 2537). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.14 at a willingness to pay (WTP) of EUR 50,000 per one point improvement on the Katz-ADL index score and 0.04 at a WTP of EUR 50,000 per QALY gained. The current intervention was not cost-effective compared to usual care to prevent or postpone new disabilities over a one-year period. Based on these findings, implementation of the evaluated multifactorial nurse-led care model is not to be recommended.

  16. Respiratory infection rates differ between geographically distant paediatric cystic fibrosis cohorts

    Directory of Open Access Journals (Sweden)

    Kathryn A. Ramsey

    2016-09-01

    Full Text Available Respiratory infections are a major cause of pulmonary decline in children with cystic fibrosis (CF. We compared the prevalence of infection in early life at geographically distant CF treatment centres participating in the same surveillance programme in Australia. Lower airway microbiology, inflammation and structural lung disease at annual review were evaluated for 260 children 0–8 years old with CF at 1032 visits to CF treatment centres in Melbourne or Perth. Melbourne patients were more likely to be culture-positive for common respiratory pathogens at all age groups (odds ratio (OR 1.85, 95% CI 1.33–2.58. Subjects 5 years old. Patients at both centres had a similar rate of hospitalisations and prescribed antibiotics. No procedural differences were identified that could explain the disparity between pathogen prevalence. Geographical differences in early acquisition of infection may contribute to variability in outcomes between CF centres.

  17. Geographical and temporal changes of anthropometric traits in historical Yemen.

    Science.gov (United States)

    Danubio, Maria Enrica; Milia, Nicola; Coppa, Alfredo; Rufo, Fabrizio; Sanna, Emanuele

    2016-02-01

    This study investigates secular changes of anthropometric variables among four geographic groups in historical Yemen, to evaluate possible regional differences in the evolution of living standards. Nineteen somatic and cephalic measures collected by Coon in 1939, and 8 anthropometric indices in 1244 Yemenite adult males were analyzed. The individuals were divided into 10-year age groups. Within-group variations were tested by One-way ANCOVA (age as covariate). ANCOVA (controlling for age), and Forward stepwise discriminant analysis were used to evaluate and represent regional differences. ANCOVA and discriminant analysis confirmed and enhanced previous findings. At the time, the Yemenite population presented high intergroup heterogeneity. The highest mean values of height at all ages were found in the "mountain" region, which is characterized by very fertile soils and where, nowadays, most of the cereals and pulses are grown and where most livestock is raised. Within-group variations were limited and generally inconsistent in all geographic regions and concern vertical dimensions, but mean values of height never differed. The prolonged internal isolation of these groups resulted in significant regional morphometric differentiation. The main evidence comes from height which suggests that socioeconomic factors have played a role. Nevertheless, the possible better living conditions experienced by the "mountain" group, with the highest mean values of stature in all periods, did not allow the secular trend to take place in that region, too. Copyright © 2015. Published by Elsevier GmbH.

  18. Cost effectiveness of open versus laparoscopic living-donor nephrectomy

    DEFF Research Database (Denmark)

    Hamidi, Vida; Andersen, Marit Helen; Oyen, Ole

    2009-01-01

    , and a consequent potential to increase the pool of kidney donors. However, the cost effectiveness of LLDN remains unknown. The aim of this study was to explore the health and cost consequences of replacing open-donor nephrectomy by LLDN. METHODS: Kidney donors were randomized to laparoscopic (n=63) or open surgery...... (n=59). We obtained data on operating time, personnel costs, length of stay, cost of analgesic, disposable instruments and complications, and indirect costs. Quality of life was captured before the operation and at 1, 6, and 12 months postdonation by means of short form-36. The scores were translated...... into utilities by means of Brazier's 6D algorithm. RESULTS: The cost per patient was U.S. $55,292 with laparoscopic and U.S. $29,886 with open surgery. The greatest cost difference was in costs attributed to complications (U.S. $33,162 vs. U.S. $4,573). The 1-year quality-adjusted life years (QALYs) were 0...

  19. Geographic variation in the relationship between body mass index and the built environment.

    Science.gov (United States)

    Adachi-Mejia, Anna M; Lee, Chanam; Lee, Chunkuen; Carlos, Heather A; Saelens, Brian E; Berke, Ethan M; Doescher, Mark P

    2017-07-01

    Studies examining associations between weight status and neighborhood built environment (BE) have shown inconsistent results and have generally focused on urban settings. However, many Americans do not live in metropolitan areas and BE impacts may be different outside of metropolitan areas. We sought to examine whether the relationship between body mass index (BMI) and neighborhood BE exists and varies by geographic region across small towns in the United States. We conducted telephone surveys with 2156 adults and geographic information systems data in nine towns located within three geographic regions (Northeast, Texas, Washington) in 2011 and 2012. Multiple regression models examined the relationship between individual BMI and BE measures. Most physical activity variables were significantly associated with lower BMI in all geographic regions. We saw variation across geographic region in the relationship between characteristics of the BE variables and BMI. Some perceived and objectively-measured characteristics of the BE were significantly associated with adult BMI, but significant relationships varied by geographic region. For example, in the Northeast, perceived attractiveness of the neighborhood as a reason for why they chose to live there was associated with lower BMI; in Texas, the perceived presence of a fast food restaurant was negatively associated with BMI; in Washington, perceived presence of trees along the streets was associated with lower BMI. Our findings suggest that regional variation plays a role in the relationship between adult BMI and BE characteristics in small towns. Regardless of geographic location, interventions should encourage utilitarian walking and other forms of physical activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Cost benchmarking of railway projects in Europe – can it help to reduce costs?

    DEFF Research Database (Denmark)

    Trabo, Inara; Landex, Alex; Nielsen, Otto Anker

    a certain overview of the range of costs in various budget disciplines. The Copenhagen-Ringsted project is shown to be right in the middle of the range in terms of total costs per kilometre, and its values in the discipline comparisons do not significantly differ from the values of the less expensive...... projects. Deeper analysis of project unit costs is still continuing, but the preliminary results show that the cost values for projects located in the same geographical zone are similar. For example, this can be explained by their use of the same construction companies. However, unit prices in southern...

  1. Do differences in the administrative structure of populations confound comparisons of geographic health inequalities?

    LENUS (Irish Health Repository)

    Jackson, Andrew L

    2010-08-18

    Abstract Background Geographical health inequalities are naturally described by the variation in health outcomes between areas (e.g. mortality rates). However, comparisons made between countries are hampered by our lack of understanding of the effect of the size of administrative units, and in particular the modifiable areal unit problem. Our objective was to assess how differences in geographic and administrative units used for disseminating data affect the description of health inequalities. Methods Retrospective study of standard populations and deaths aggregated by administrative regions within 20 European countries, 1990-1991. Estimated populations and deaths in males aged 0-64 were in 5 year age bands. Poisson multilevel modelling was conducted of deaths as standardised mortality ratios. The variation between regions within countries was tested for relationships with the mean region population size and the unequal distribution of populations within each country measured using Gini coefficients. Results There is evidence that countries whose regions vary more in population size show greater variation and hence greater apparent inequalities in mortality counts. The Gini coefficient, measuring inequalities in population size, ranged from 0.1 to 0.5 between countries; an increase of 0.1 was accompanied by a 12-14% increase in the standard deviation of the mortality rates between regions within a country. Conclusions Apparently differing health inequalities between two countries may be due to differences in geographical structure per se, rather than having any underlying epidemiological cause. Inequalities may be inherently greater in countries whose regions are more unequally populated.

  2. Living Arrangements of Young Adults in Europe

    Directory of Open Access Journals (Sweden)

    Katrin Schwanitz

    2015-12-01

    Full Text Available Comparative research suggests that there are great cross-national and cross-temporal differences in living arrangements of young adults aged 18-34 in Europe. In this paper, we examine young adults’ living arrangements (1 across several European countries and different national contexts, and (2 by taking into account cross-time variability. In doing so, we pay careful attention to a comprehensive conceptualisation of living arrangements (including extended and non-family living arrangements. The aim of this paper is to deepen our understanding of family structure and household arrangements in Europe by examining and mapping the cross-national and cross-temporal variety of young adults’ living arrangements. For our analysis we use data from the Integrated Public Use Microdata Series International (IPUMSi for the census rounds 1980, 1990, and 2000 for eight European countries (Austria, France, Greece, Hungary, Ireland, Portugal, Romania, and Switzerland. We employ log-linear models to ascertain the influence of individual and contextual factors on living arrangements. The analyses lend further support to a North/West – South/East divide in living arrangements and general gender differentials in extended family living. Other interesting results are the heterogeneity in the living arrangements of single mothers across geographic areas, and the upward trend of extended household living for young men and women between 1980 and 2000.

  3. Effect of Different Workscope Strategies on Wind Turbine Gearbox Life Cycle Repair Costs

    Directory of Open Access Journals (Sweden)

    D. Crowley

    2013-01-01

    Full Text Available The wind turbine industry is beginning to establish orthodoxies governing the repair of gearboxes, including policies governing the replacement of bearings during gearbox heavy maintenance events. Some maintainers recommend replacing all of the bearings, every time, regardless of condition or age. At the same time, others prefer to only replace the failed bearing. The former rationale achieves availability by spending more money than absolutely necessary; the latter sacrifices reliability in exchange for a lower shop visit cost. Even though neither approach results in the lowest Life Cycle Cost, no standard practice has yet been implemented to methodically determine what would be the best approach. Furthermore, as gearboxes approach the end of their planned service lives, a different strategy may be called-for. This paper presents an example of using a reliability-based statistical analysis to determine which strategy will yield the lowest Life Cycle Cost for wind turbine gearboxes.

  4. Developmental toxicity in flounder embryos exposed to crude oils derived from different geographical regions.

    Science.gov (United States)

    Jung, Jee-Hyun; Lee, Eun-Hee; Choi, Kwang-Min; Yim, Un Hyuk; Ha, Sung Yong; An, Joon Geon; Kim, Moonkoo

    2017-06-01

    Crude oils from distinct geographical regions have distinct chemical compositions, and, as a result, their toxicity may be different. However, developmental toxicity of crude oils derived from different geographical regions has not been extensively characterized. In this study, flounder embryos were separately exposed to effluents contaminated by three crude oils including: Basrah Light (BLO), Pyrenees (PCO), and Sakhalin Vityaz (SVO), in addition to a processed fuel oil (MFO-380), to measure developmental toxicity and for gene expressions. Each oil possessed a distinct chemical composition. Edema defect was highest in embryos exposed to PCO and MFO-380 that both have a greater fraction of three-ring PAHs (33% and 22%, respectively) compared to BLO and SVO. Observed caudal fin defects were higher in embryos exposed to SVO and MFO-380, which are both dominated by naphthalenes (81% and 52%, respectively). CYP1A gene expressions were also highest in embryos exposed to SVO and MFO-380. Higher incidence of cardiotoxicity and lower nkx 2.5 expression were detected in embryos exposed to PCO. Unique gene expression profiles were observed in embryos exposed to crude oils with distinct compositions. This study demonstrates that crude oils of different geographical origins with different compositional characteristics induce developmental toxicity to different degrees. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Cost of reproduction in a long-lived bird: incubation effort reduces immune function and future reproduction.

    Science.gov (United States)

    Hanssen, Sveinn Are; Hasselquist, Dennis; Folstad, Ivar; Erikstad, Kjell Einar

    2005-05-22

    Life-history theory predicts that increased current reproductive effort should lead to a fitness cost. This cost of reproduction may be observed as reduced survival or future reproduction, and may be caused by temporal suppression of immune function in stressed or hard-working individuals. In birds, consideration of the costs of incubating eggs has largely been neglected in favour of the costs of brood rearing. We manipulated incubation demand in two breeding seasons (2000 and 2001) in female common eiders (Somateria mollissima) by creating clutches of three and six eggs (natural range 3-6 eggs). The common eider is a long-lived sea-duck where females do not eat during the incubation period. Mass loss increased and immune function (lymphocyte levels and specific antibody response to the non-pathogenic antigens diphtheria and tetanus toxoid) was reduced in females incubating large clutches. The increased incubation effort among females assigned to large incubation demand did not lead to adverse effects on current reproduction or return rate in the next breeding season. However, large incubation demand resulted in long-term fitness costs through reduced fecundity the year after manipulation. Our data show that in eiders, a long-lived species, the cost of high incubation demand is paid in the currency of reduced future fecundity, possibly mediated by reduced immune function.

  6. Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: how close is close enough?

    Science.gov (United States)

    Eberhart, Michael G; Share, Amanda M; Shpaner, Mark; Brady, Kathleen A

    2015-02-01

    Travel distance to medical care has been assessed using a variety of geographic methods. Network analyses are less common, but may generate more accurate estimates of travel costs. We compared straight-line distances and driving distance, as well as average drive time and travel time on a public transit network for 1789 persons diagnosed with HIV between 2010 and 2012 to identify differences overall, and by distinct geographic areas of Philadelphia. Paired t-tests were used to assess differences across methods, and analysis of variance was used to assess between-group differences. Driving distances were significantly longer than straight-line distances (ptravel costs, and may improve models to predict medical care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Implications of Wide-Area Geographic Diversity for Short- Term Variability of Solar Power

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Andrew; Wiser, Ryan

    2010-08-23

    Worldwide interest in the deployment of photovoltaic generation (PV) is rapidly increasing. Operating experience with large PV plants, however, demonstrates that large, rapid changes in the output of PV plants are possible. Early studies of PV grid impacts suggested that short-term variability could be a potential limiting factor in deploying PV. Many of these early studies, however, lacked high-quality data from multiple sites to assess the costs and impacts of increasing PV penetration. As is well known for wind, accounting for the potential for geographic diversity can significantly reduce the magnitude of extreme changes in aggregated PV output, the resources required to accommodate that variability, and the potential costs of managing variability. We use measured 1-min solar insolation for 23 time-synchronized sites in the Southern Great Plains network of the Atmospheric Radiation Measurement program and wind speed data from 10 sites in the same network to characterize the variability of PV with different degrees of geographic diversity and to compare the variability of PV to the variability of similarly sited wind. The relative aggregate variability of PV plants sited in a dense 10 x 10 array with 20 km spacing is six times less than the variability of a single site for variability on time scales less than 15-min. We find in our analysis of wind and PV plants similarly sited in a 5 x 5 grid with 50 km spacing that the variability of PV is only slightly more than the variability of wind on time scales of 5-15 min. Over shorter and longer time scales the level of variability is nearly identical. Finally, we use a simple approximation method to estimate the cost of carrying additional reserves to manage sub-hourly variability. We conclude that the costs of managing the short-term variability of PV are dramatically reduced by geographic diversity and are not substantially different from the costs for managing the short-term variability of similarly sited wind in

  8. Geographic Ontologies, Gazetteers and Multilingualism

    Directory of Open Access Journals (Sweden)

    Robert Laurini

    2015-01-01

    Full Text Available Different languages imply different visions of space, so that terminologies are different in geographic ontologies. In addition to their geometric shapes, geographic features have names, sometimes different in diverse languages. In addition, the role of gazetteers, as dictionaries of place names (toponyms, is to maintain relations between place names and location. The scope of geographic information retrieval is to search for geographic information not against a database, but against the whole Internet: but the Internet stores information in different languages, and it is of paramount importance not to remain stuck to a unique language. In this paper, our first step is to clarify the links between geographic objects as computer representations of geographic features, ontologies and gazetteers designed in various languages. Then, we propose some inference rules for matching not only types, but also relations in geographic ontologies with the assistance of gazetteers.

  9. Diversity of Blastocystis subtypes in dogs in different geographical settings

    DEFF Research Database (Denmark)

    Wang, Wenqi; Cuttell, Leigh; Bielefeldt-Ohmann, Helle

    2013-01-01

    Background: Blastocystis is a ubiquitous, globally distributed intestinal protist infecting humans and a wide range of animals. Several studies have shown that Blastocystis is a potentially zoonotic parasite. A 1996 study reported a 70% Blastocystis prevalence in Brisbane pound dogs while another...... study found that pet dogs/cats of 11 symptomatic Blastocystis infected patients harboured at least one Blastocystis subtype (ST) in common with the patient. These results raised the possibility that dogs might be natural hosts of Blastocystis. In this study, we aimed to investigate this hypothesis...... by estimating the prevalence of Blastocystis carriage and characterising the diversity of STs in dogs from three different environmental settings and comparing these STs with the range that humans harbour. Methods: Two hundred and forty faecal samples from dogs from three different geographical regions...

  10. [Living conditions: stumbling block or path to successful ageing? Results of the Augsburg regional conference "Living environment, age and health"].

    Science.gov (United States)

    Strobl, R; Maier, W; Mielck, A; Fuchs, J; Richter-Kornweitz, A; Gostomzyk, J; Grill, E

    2014-09-01

    In addition to good medical care, living environment is of central importance in encouraging social participation among older people. Therefore, municipalities should prioritise the age-appropriate design of living environments. Results of the KORA Age study were presented at the regional conference "Living environment, age and health" in the Augsburg town hall on October 1, 2013. The results on participation and living environment were discussed with local policy makers and senior citizens' representatives from Augsburg and two surrounding regions. The study examined the impact of living environment on participation using two different approaches: qualitative findings from focus group discussions and quantitative findings based on telephone interviews and the use of a geographic information system. The results were complemented by contributions from a regional and national perspective. It was stressed in the closing discussion that a senior-friendly living environment can only be created by using a broad range of different measures. On the one hand physical barriers need to be removed, while at the same time the sense of community, neighborhood cohesion and solidarity should be encouraged further.

  11. Estimation of geographic variation in human papillomavirus vaccine uptake in men and women: an online survey using facebook recruitment.

    Science.gov (United States)

    Nelson, Erik J; Hughes, John; Oakes, J Michael; Pankow, James S; Kulasingam, Shalini L

    2014-09-01

    Federally funded surveys of human papillomavirus (HPV) vaccine uptake are important for pinpointing geographically based health disparities. Although national and state level data are available, local (ie, county and postal code level) data are not due to small sample sizes, confidentiality concerns, and cost. Local level HPV vaccine uptake data may be feasible to obtain by targeting specific geographic areas through social media advertising and recruitment strategies, in combination with online surveys. Our goal was to use Facebook-based recruitment and online surveys to estimate local variation in HPV vaccine uptake among young men and women in Minnesota. From November 2012 to January 2013, men and women were recruited via a targeted Facebook advertisement campaign to complete an online survey about HPV vaccination practices. The Facebook advertisements were targeted to recruit men and women by location (25 mile radius of Minneapolis, Minnesota, United States), age (18-30 years), and language (English). Of the 2079 men and women who responded to the Facebook advertisements and visited the study website, 1003 (48.2%) enrolled in the study and completed the survey. The average advertising cost per completed survey was US $1.36. Among those who reported their postal code, 90.6% (881/972) of the participants lived within the previously defined geographic study area. Receipt of 1 dose or more of HPV vaccine was reported by 65.6% women (351/535), and 13.0% (45/347) of men. These results differ from previously reported Minnesota state level estimates (53.8% for young women and 20.8% for young men) and from national estimates (34.5% for women and 2.3% for men). This study shows that recruiting a representative sample of young men and women based on county and postal code location to complete a survey on HPV vaccination uptake via the Internet is a cost-effective and feasible strategy. This study also highlights the need for local estimates to assess the variation in HPV

  12. Estimation of Geographic Variation in Human Papillomavirus Vaccine Uptake in Men and Women: An Online Survey Using Facebook Recruitment

    Science.gov (United States)

    Hughes, John; Oakes, J Michael; Pankow, James S; Kulasingam, Shalini L

    2014-01-01

    Background Federally funded surveys of human papillomavirus (HPV) vaccine uptake are important for pinpointing geographically based health disparities. Although national and state level data are available, local (ie, county and postal code level) data are not due to small sample sizes, confidentiality concerns, and cost. Local level HPV vaccine uptake data may be feasible to obtain by targeting specific geographic areas through social media advertising and recruitment strategies, in combination with online surveys. Objective Our goal was to use Facebook-based recruitment and online surveys to estimate local variation in HPV vaccine uptake among young men and women in Minnesota. Methods From November 2012 to January 2013, men and women were recruited via a targeted Facebook advertisement campaign to complete an online survey about HPV vaccination practices. The Facebook advertisements were targeted to recruit men and women by location (25 mile radius of Minneapolis, Minnesota, United States), age (18-30 years), and language (English). Results Of the 2079 men and women who responded to the Facebook advertisements and visited the study website, 1003 (48.2%) enrolled in the study and completed the survey. The average advertising cost per completed survey was US $1.36. Among those who reported their postal code, 90.6% (881/972) of the participants lived within the previously defined geographic study area. Receipt of 1 dose or more of HPV vaccine was reported by 65.6% women (351/535), and 13.0% (45/347) of men. These results differ from previously reported Minnesota state level estimates (53.8% for young women and 20.8% for young men) and from national estimates (34.5% for women and 2.3% for men). Conclusions This study shows that recruiting a representative sample of young men and women based on county and postal code location to complete a survey on HPV vaccination uptake via the Internet is a cost-effective and feasible strategy. This study also highlights the need

  13. An analysis of the costs of treating schizophrenia in Spain: a hierarchical Bayesian approach.

    Science.gov (United States)

    Vázquez-Polo, Francisco-Jose; Negrín, Miguel; Cabasés, Juan M; Sánchez, Eduardo; Haro, Joseph M; Salvador-Carulla, Luis

    2005-09-01

    Health care decisions should incorporate cost of illness and treatment data, particularly for disorders such as schizophrenia with a high morbidity rate and a disproportionately low allocation of resources. Previous cost of illness analyses may have disregarded geographical aspects relevant for resource consumption and unit cost calculation. To compare the utilisation of resources and the care costs of schizophrenic patients in four mental-health districts in Spain (in Madrid, Catalonia, Navarra and Andalusia), and to analyse factors that determine the costs and the differences between areas. A treated prevalence bottom-up three year follow-up design was used for obtaining data concerning socio-demography, clinical evolution and the utilisation of services. 1997 reference prices were updated for years 1998-2000 in euros. We propose two different scenarios, varying in the prices applied. In the first (Scenario 0) the reference prices are those obtained for a single geographic area, and so the cost variations are only due to differences in the use of resources. In the second situation (Scenario 1), we analyse the variations in resource utilisation at different levels, using the prices applicable to each healthcare area. Bayesian hierarchical models are used to discuss the factors that determine such costs and the differences between geographic areas. In scenario 0, the estimated mean cost was 4918.948 euros for the first year. In scenario 1 the highest cost was in Gava (Catalonia) and the lowest in Loja (Andalusia). Mean costs were respectively 4547.24 and 2473.98 euros. With respect to the evolution of costs over time, we observed an increase during the second year and a reduction during the third year. Geographical differences appeared in follow-up costs. The variables related to lower treatment costs were: residence in the family household, higher patient age and being in work. On the contrary, the number of relapses is directly related to higher treatment costs

  14. The Value of Caregiver Time: Costs of Support and Care for Individuals Living with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Carolyn Dudley

    2016-01-01

    Full Text Available WHY IS THIS AN IMPORTANT ISSUE? An estimated 1 in 86 children are diagnosed with Autism Spectrum Disorder (ASD1 making it the most commonly diagnosed childhood neurological condition in Canada.2 The true costs of lifelong support for people living with ASD3 are often underestimated and fail to acknowledge the value of caregiver time over the lifespan. Significant gaps in publically provided support systems leave the cost burden to be picked up by families. Relying on continued family supports where community services are fragmented or unavailable is not a sustainable approach. WHAT DOES THE RESEARCH TELL US? A continuum of supports are needed Most people living with ASD need supports that range from occasional assistance with higher level tasks, like organizing appointments or banking, to those who need continuous help with daily living.4 Areas where supportive care may be needed can be categorized broadly to include: self care, home living, service co-ordination, personal organization, health and safety management, adult day opportunities/employment, transportation, advocacy and social skills. These supports are most successful when they address the individual’s uniqueness in terms of communication, social, sensory, behavioural needs and physical and/or mental health conditions. Currently there are a lack of available supports, limiting opportunities for socialization, employment and residential living resulting in reduced independence for adults with ASD.

  15. A narrative review of cost-effectiveness analysis of people living with HIV treated with HAART: from interventions to outcomes

    Directory of Open Access Journals (Sweden)

    Tse WF

    2015-08-01

    Full Text Available Wah Fung Tse,1 Weimin Yang,2 Wenlong Huang1,3 1School of International Pharmaceutical Business, China Pharmaceutical University, 2Editorial Department of Journal of Nanjing University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, 3Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, People's Republic of China Background: Since its introduction in 1996, highly active antiretroviral therapy (HAART, which involves the combination of antiretroviral drugs, has resulted in significant improvements in the morbidity, mortality, and life expectancy of HIV-infected patients. Numerous studies of the cost-effectiveness of HAART from different perspectives in HIV have been reported.Aim: To investigate the economic outcomes and relevance of HAART for people living with HIV.Materials and methods: A narrative literature review was conducted on 22 peer-reviewed full economic evaluations of people living with HIV treated with different HAART regimens and published in English between January 2005 and December 2014. Information regarding study details, such as interventions, outcomes, and modeling methods, was extracted. The high heterogeneity of the included studies rendered a meta-analysis inappropriate; therefore, we conducted a comparative analysis of studies grouped according to the similarity of the different intervention types and outcomes.Results: Most of the economic evaluations of HAART focused on comparisons between the specific HAART regimens and others from the following perspectives: injecting drug users versus noninjecting drug users, HIV-infected adults without AIDS versus those with AIDS, regimens based on developed world guidelines versus those based on developing world guidelines, self-administered HAART versus directly observed HAART, and “ideal” versus “typical” regimens.Conclusion: In general, HAART is more cost-effective than other therapeutic

  16. The Forecast Scenarios of Development of the National Economy in the Context of the Need to Improve the «Cost of Living»

    Directory of Open Access Journals (Sweden)

    Kulakov Gennady T.

    2017-04-01

    Full Text Available The article is aimed at elaborating and materialization of the forecast scenarios of development of the national economy in the context of substantiating the feasibility of improving the «cost of living» being the equivalent of the liability of public authorities for the value of human life. The article researches the phenomenon of the «cost of living» in the context of sustainable innovative development of a socially oriented development of economy as an axis for developing its forecast scenarios. Focus has been set on complementarity of the terms of «cost of living» and «sustainable development» in the context of satisfying vital interests of the population of Ukraine. It has been suggested that wages accounting as an equivalent to the «cost of living» should not be included with costs but with the value added, however, the growth rate of wages must not outpace the growth rate of labor productivity. For the first time on the basis of the interdisciplinary and intersectoral approach, as well as the index method, have been elaborated baseline scenarios of development of the national economy on the basis of the upgraded human development index: pessimistic, realistic, and optimistic forecasts.

  17. Antioxidant properties of Mediterranean food plant extracts: geographical differences.

    Science.gov (United States)

    Schaffer, S; Schmitt-Schillig, S; Müller, W E; Eckert, G P

    2005-03-01

    Locally grown, wild food plants seasonally contribute a considerable portion of the daily diet in certain Mediterranean areas and it has been suggested that the beneficial effects of the Mediterranean diet on human health partly originate from the antioxidant effect of flavonoid-rich food plants. The nutrient content of most wild plants is higher than that of cultivated ones and may vary depending on the prevailing environmental conditions. Accordingly, three local Mediterranean plant foods (i.e. Cichorium intybus, Sonchus oleraceus, Papaver rhoeas) were collected in Greece (Crete), southern Italy, and southern Spain in order to assess possible differences in their in vitro antioxidant potential. The biological assays revealed diverse intra-plant specific antioxidant effects for the tested extracts ranging from no activity to almost complete protection. Furthermore, substantial differences in the polyphenol content were found for the nutritionally used part of the same plant originating from different locations. However, no clear correlations between the polyphenol content and the extracts' antioxidant activities were found. Taken together, the data suggest that certain local Mediterranean plant foods possess promising antioxidant activity and that the observed biological effects are possibly influenced by the geographically-dependent environmental conditions prevailing during plant growth.

  18. ABO and Rhesus blood groups and risk of endometriosis in a French Caucasian population of 633 patients living in the same geographic area.

    Science.gov (United States)

    Borghese, Bruno; Chartier, Mélanie; Souza, Carlos; Santulli, Pietro; Lafay-Pillet, Marie-Christine; de Ziegler, Dominique; Chapron, Charles

    2014-01-01

    The identification of epidemiological factors increasing the risk of endometriosis could shorten the time to diagnosis. Specific blood groups may be more common in patients with endometriosis. We designed a cross-sectional study of 633 Caucasian women living in the same geographic area. Study group included 311 patients with histologically proven endometriosis. Control group included 322 patients without endometriosis as checked during surgery. Frequencies of ABO and Rhesus groups in the study and control groups were compared using univariate and multivariate analyses. We observed a higher proportion of Rh-negative women in the study group, as compared to healthy controls. Multivariate analysis showed that Rh-negative women are twice as likely to develop endometriosis (aOR = 1.90; 95% CI: 1.20-2.90). There was no significant difference in ABO group distribution between patients and controls. There was no difference when taking into account either the clinical forms (superficial endometriosis, endometrioma, and deep infiltration endometriosis) or the rAFS stages. Rh-negative women are twice as likely to develop endometriosis. Chromosome 1p, which contains the genes coding for the Rhesus, could also harbor endometriosis susceptibility genes.

  19. Landscape features influence gene flow as measured by cost-distance and genetic analyses: a case study for giant pandas in the Daxiangling and Xiaoxiangling Mountains

    Directory of Open Access Journals (Sweden)

    Wei Fuwen

    2010-07-01

    Full Text Available Abstract Background Gene flow maintains genetic diversity within a species and is influenced by individual behavior and the geographical features of the species' habitat. Here, we have characterized the geographical distribution of genetic patterns in giant pandas (Ailuropoda melanoleuca living in four isolated patches of the Xiaoxiangling and Daxiangling Mountains. Three geographic distance definitions were used with the "isolation by distance theory": Euclidean distance (EUD, least-cost path distance (LCD defined by food resources, and LCD defined by habitat suitability. Results A total of 136 genotypes were obtained from 192 fecal samples and one blood sample, corresponding to 53 unique genotypes. Geographical maps plotted at high resolution using smaller neighborhood radius definitions produced large cost distances, because smaller radii include a finer level of detail in considering each pixel. Mantel tests showed that most correlation indices, particularly bamboo resources defined for different sizes of raster cell, were slightly larger than the correlations calculated for the Euclidean distance, with the exception of Patch C. We found that natural barriers might have decreased gene flow between the Xiaoxiangling and Daxiangling regions. Conclusions Landscape features were found to partially influence gene flow in the giant panda population. This result is closely linked to the biological character and behavior of giant pandas because, as bamboo feeders, individuals spend most of their lives eating bamboo or moving within the bamboo forest. Landscape-based genetic analysis suggests that gene flow will be enhanced if the connectivity between currently fragmented bamboo forests is increased.

  20. Physical Activity in the Lives of Hong Kong Chinese Children

    Science.gov (United States)

    Ha, Amy S.; Macdonald, Doune; Pang, Bonnie O. H.

    2010-01-01

    To understand the physical activity culture in the lives of Hong Kong Chinese children and their parents, 48 young people between the ages 9 and 16 and their parents, with different socio-economic backgrounds and geographical locations, were interviewed for this study. By applying Confucianism and postcolonialism, this study aimed to investigate…

  1. Geographic differences in the associations between impaired glucose regulation and cardiovascular risk factors among young adults

    DEFF Research Database (Denmark)

    Oya, J.; Vistisen, D.; Christensen, Dirk Lund

    2015-01-01

    AIMS: To assess geographic differences in the association between BMI, blood pressure and lipid levels with impaired glucose regulation among young adults from various geographical regions. METHODS: This was a cross-sectional study including data from 6987 participants aged ≤ 30 years from India,...

  2. Public health impact and cost-effectiveness of intranasal live attenuated influenza vaccination of children in Germany.

    Science.gov (United States)

    Damm, Oliver; Eichner, Martin; Rose, Markus Andreas; Knuf, Markus; Wutzler, Peter; Liese, Johannes Günter; Krüger, Hagen; Greiner, Wolfgang

    2015-06-01

    In 2011, intranasally administered live attenuated influenza vaccine (LAIV) was approved in the EU for prophylaxis of seasonal influenza in 2-17-year-old children. Our objective was to estimate the potential epidemiological impact and cost-effectiveness of an LAIV-based extension of the influenza vaccination programme to healthy children in Germany. An age-structured dynamic model of influenza transmission was developed and combined with a decision-tree to evaluate different vaccination strategies in the German health care system. Model inputs were based on published literature or were derived by expert consulting using the Delphi technique. Unit costs were drawn from German sources. Under base-case assumptions, annual routine vaccination of children aged 2-17 years with LAIV assuming an uptake of 50% would prevent, across all ages, 16 million cases of symptomatic influenza, over 600,000 cases of acute otitis media, nearly 130,000 cases of community-acquired pneumonia, nearly 1.7 million prescriptions of antibiotics and over 165,000 hospitalisations over 10 years. The discounted incremental cost-effectiveness ratio was 1,228 per quality-adjusted life year gained from a broad third-party payer perspective (including reimbursed direct costs and specific transfer payments), when compared with the current strategy of vaccinating primarily risk groups with the conventional trivalent inactivated vaccine. Inclusion of patient co-payments and indirect costs in terms of productivity losses resulted in discounted 10-year cost savings of 3.4 billion. In conclusion, adopting universal influenza immunisation of healthy children and adolescents would lead to a substantial reduction in influenza-associated disease at a reasonable cost to the German statutory health insurance system. On the basis of the epidemiological and health economic simulation results, a recommendation of introducing annual routine influenza vaccination of children 2-17 years of age might be taken into

  3. Global cost-effectiveness of GDM screening and management

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  4. Identifying areas of need relative to liver disease: geographic clustering within a health service district.

    Science.gov (United States)

    El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

    2017-08-01

    Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and

  5. Role of satellite remote sensing in the geographic information economics in France

    Science.gov (United States)

    Denégre, Jean

    In national and international economics, geographic information plays a role which is generally acknowledged to be important but which is however, difficult to assess quantitatively, its applications being rather miscellaneous and indirect. Computer graphics and telecommunications increae that importance still more and justify many investments and research into new cartographic forms. As part of its responsibility for participating in the promotion of those developments, by taking into account needs expressed by public or private users, the National Council for Geographic Information (C.N.I.G.) has undertaken a general evaluation of the economic and social utility of geographic information in France. The study involves an estimation of the cost of production and research activities, which are probably about 0.1% of the Cross National Product—similar to many other countries. It also devised a method of estimating "cost/advantage" ratios applicable to these "intangible" benefits. Within that framework, remote sensing emphasizes particular aspects related both to the increase of economic performances in cartographic production and to the advent of new products and new ways of utilization. A review of some significant sectors shows effective earnings of about 10-20%, or even 50% or 100% of the costs, and these are doubtless much greater for the efficacy in the exploitation of products. Finally, many applications, entirely new result from extensions in various fields which would have been impossible without remote sensing: here the "cost advantage" ratio cannot even be compared with previous processes. Studies were undertaken in parallel for defining different types of products derived from satellite imagery, as well as those domains where development effort is required in order to make new advances.

  6. Geographic Variations in Cardiovascular Disease Mortality Among Asian American Subgroups, 2003-2011.

    Science.gov (United States)

    Pu, Jia; Hastings, Katherine G; Boothroyd, Derek; Jose, Powell O; Chung, Sukyung; Shah, Janki B; Cullen, Mark R; Palaniappan, Latha P; Rehkopf, David H

    2017-07-12

    There are well-documented geographical differences in cardiovascular disease (CVD) mortality for non-Hispanic whites. However, it remains unknown whether similar geographical variation in CVD mortality exists for Asian American subgroups. This study aims to examine geographical differences in CVD mortality among Asian American subgroups living in the United States and whether they are consistent with geographical differences observed among non-Hispanic whites. Using US death records from 2003 to 2011 (n=3 897 040 CVD deaths), age-adjusted CVD mortality rates per 100 000 population and age-adjusted mortality rate ratios were calculated for the 6 largest Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) and compared with non-Hispanic whites. There were consistently lower mortality rates for all Asian American subgroups compared with non-Hispanic whites across divisions for CVD mortality and ischemic heart disease mortality. However, cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup. There were a number of regional divisions where certain Asian American subgroups (Filipino and Japanese men, Korean and Vietnamese men and women) possessed no mortality advantage compared with non-Hispanic whites. The most striking geographical variation was with Filipino men (age-adjusted mortality rate ratio=1.18; 95% CI, 1.14-1.24) and Japanese men (age-adjusted mortality rate ratio=1.05; 95% CI: 1.00-1.11) in the Pacific division who had significantly higher cerebrovascular mortality than non-Hispanic whites. There was substantial geographical variation in Asian American subgroup mortality for cerebrovascular disease when compared with non-Hispanic whites. It deserves increased attention to prioritize prevention and treatment in the Pacific division where approximately 80% of Filipinos CVD deaths and 90% of Japanese CVD deaths occur in the United States. © 2017 The Authors

  7. Regional cost differences of hospital supply in Germany

    Directory of Open Access Journals (Sweden)

    Lauterbach, Karl W.

    2005-04-01

    Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.

  8. Cost uncertainty for different levels of technology maturity

    International Nuclear Information System (INIS)

    DeMuth, S.F.; Franklin, A.L.

    1996-01-01

    It is difficult at best to apply a single methodology for estimating cost uncertainties related to technologies of differing maturity. While highly mature technologies may have significant performance and manufacturing cost data available, less well developed technologies may be defined in only conceptual terms. Regardless of the degree of technical maturity, often a cost estimate relating to application of the technology may be required to justify continued funding for development. Yet, a cost estimate without its associated uncertainty lacks the information required to assess the economic risk. For this reason, it is important for the developer to provide some type of uncertainty along with a cost estimate. This study demonstrates how different methodologies for estimating uncertainties can be applied to cost estimates for technologies of different maturities. For a less well developed technology an uncertainty analysis of the cost estimate can be based on a sensitivity analysis; whereas, an uncertainty analysis of the cost estimate for a well developed technology can be based on an error propagation technique from classical statistics. It was decided to demonstrate these uncertainty estimation techniques with (1) an investigation of the additional cost of remediation due to beyond baseline, nearly complete, waste heel retrieval from underground storage tanks (USTs) at Hanford; and (2) the cost related to the use of crystalline silico-titanate (CST) rather than the baseline CS100 ion exchange resin for cesium separation from UST waste at Hanford

  9. Cost implications of PSA screening differ by age.

    Science.gov (United States)

    Rao, Karthik; Liang, Stella; Cardamone, Michael; Joshu, Corinne E; Marmen, Kyle; Bhavsar, Nrupen; Nelson, William G; Ballentine Carter, H; Albert, Michael C; Platz, Elizabeth A; Pollack, Craig E

    2018-05-09

    Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios. We determined the prevalence of PSA screening among men aged 50 and higher using 2013-2014 data from a large, multispecialty group, obtained reimbursed costs associated with screening, diagnosis, and treatment from a commercial health plan, and identified transition probabilities for biopsy, diagnosis, treatment, and complications from the literature to generate a cost model. We estimated annual total costs for groups of men ages 50-54, 55-69, and 70+ years, and varied annual prostate cancer screening prevalence in each group from 5 to 50% and tested hypothetical examples of different test characteristics (e.g., true/false positive rate). Under the baseline screening patterns, costs of the PSA screening represented 10.1% of the total costs; costs of biopsies and associated complications were 23.3% of total costs; and, although only 0.3% of all screen eligible patients were treated, they accounted for 66.7% of total costs. For each 5-percentage point decrease in PSA screening among men aged 70 and older for a single calendar year, total costs associated with prostate cancer screening decreased by 13.8%. For each 5-percentage point decrease in PSA screening among men 50-54 and 55-69 years old, costs were 2.3% and 7.3% lower respectively. With constrained financial resources and with national pressure to decrease use of clinically unnecessary PSA-based prostate cancer screening, there is an opportunity for cost savings, especially by focusing on the downstream costs disproportionately associated with

  10. 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.

  11. Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities.

    Science.gov (United States)

    Church, Jody L; Haas, Marion R; Goodall, Stephen

    2015-12-01

    To evaluate the cost effectiveness of interventions designed to prevent falls and fall-related injuries among older people living in residential aged care facilities (RACFs) from an Australian health care perspective. A decision analytic Markov model was developed that stratified individuals according to their risk of falling and accounted for the risk of injury following a fall. The effectiveness of the interventions was derived from two Cochrane reviews of randomized controlled trials for falls/fall-related injury prevention in RACFs. Interventions were considered effective if they reduced the risk of falling or reduced the risk of injury following a fall. The interventions that were modelled included vitamin D supplementation, annual medication review, multifactorial intervention (a combination of risk assessment, medication review, vision assessment and exercise) and hip protectors. The cost effectiveness was calculated as the incremental cost relative to the incremental benefit, in which the benefit was estimated using quality-adjusted life-years (QALYs). Uncertainty was explored using univariate and probabilistic sensitivity analysis. Vitamin D supplementation and medication review both dominated 'no intervention', as these interventions were both more effective and cost saving (because of healthcare costs avoided). Hip protectors are dominated (less effective and more costly) by vitamin D and medication review. The incremental cost-effectiveness ratio (ICER) for medication review relative to vitamin D supplementation is AU$2442 per QALY gained, and the ICER for multifactorial intervention relative to medication review is AU$1,112,500 per QALY gained. The model is most sensitive to the fear of falling and the cost of the interventions. The model suggests that vitamin D supplementation and medication review are cost-effective interventions that reduce falls, provide health benefits and reduce health care costs in older adults living in RACFs.

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

    Directory of Open Access Journals (Sweden)

    Willem Adrianus de Bruijn

    2006-08-01

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

  13. Geographic and temporal differences in band reporting rates for American black ducks

    Science.gov (United States)

    Conroy, M.J.; Blandin, W.W.

    1984-01-01

    Recoveries of reward- and standard-banded American black ducks (Anas rubripes) were used to estimate band reporting rates and to investigate geographic and temporal variability in reporting rate for 1978-80. Reporting rates were higher close ( 20 km) to the parent banding site in 3 of 42 samples and were higher close to the nearest black duck banding site in 3 of 35 samples., Reporting rates were higher P 0.05) in Canada than in the Atlantic Flyway for the pre-huntIng season 1980-banded sample, but were otherwise similar among regions. Temporal differences over the duration of the study occured, but there were no consistent trends over time. The small number of rejections suggests that there is little evidence of differences in band reporting rate by proximity to banding sites, geographic location, or over time. Thus, the best estimate of band reporting rate for black ducks is a constant 0.43. This estimate should be used with caution, because we believe that it overestimates reporting rate due to the unknown proportion of reward bands found that were not reported.

  14. Geographic and temporal validity of prediction models: Different approaches were useful to examine model performance

    NARCIS (Netherlands)

    P.C. Austin (Peter); D. van Klaveren (David); Y. Vergouwe (Yvonne); D. Nieboer (Daan); D.S. Lee (Douglas); E.W. Steyerberg (Ewout)

    2016-01-01

    textabstractObjective: Validation of clinical prediction models traditionally refers to the assessment of model performance in new patients. We studied different approaches to geographic and temporal validation in the setting of multicenter data from two time periods. Study Design and Setting: We

  15. Growth status of children 6-12 years from two different geographic regions of Mexico.

    Science.gov (United States)

    Peña Reyes, M E; Cárdenas Barahona, E E; Cahuich, M B; Barragán, A; Malina, R M

    2002-01-01

    The purposes of the study are to assess the growth status of urban Mexican children living in different geographic areas of the country, to estimate the prevalence of overweight and obesity, and to explore secular trends in body size. Cross-sectional surveys of 293 children 6-11 years from Sonora in the north-west of the country (155 boys, 138 girls), and 356 children 7-12 years from Veracruz on the Gulf Coast (194 boys, 162 girls) were undertaken in 1992 and 1993, respectively. Height and weight were measured; the body mass index (BMI, kg m(-2)) was calculated. Growth status was compared to USA reference data and to samples of Mexican children in 1926 and 1975. The prevalence of overweight (BMI > or = 85th and or = 95th percentile) was estimated. Girls and boys from Sonora and Veracruz do not differ in height, weight and the BMI. Mean heights are at (girls) or below (boys) the medians of USA growth charts, while mean weights are at (boys) or just below (girls) the 75th percentiles at most ages. As a result, mean BMIs are above (boys) and below (girls) the 75th percentiles over the age range studied. The prevalence of overweight and obesity is 40% in boys and 35% in girls, whereas the prevalence of obesity per se is 23% in boys and 17% in girls. Compared to urban Mexican children in the Federal District surveyed in 1926, children in the present sample are taller and heavier, but the secular trend in body weight is more pronounced since the mid-1960s. Heights of the current samples are similar to those of well-off children in Mexico City in the early 1970s, but weights are heavier. The gap in height between well-off and lower socioeconomic status children in different regions of Mexico has been reduced, but there is an increase in the prevalence of overweight and obesity.

  16. Stable isotope composition of cocoa beans of different geographical origin.

    Science.gov (United States)

    Perini, Matteo; Bontempo, Luana; Ziller, Luca; Barbero, Alice; Caligiani, Augusta; Camin, Federica

    2016-09-01

    The isotopic profile (δ(13) C, δ(15) N, δ(18) O, δ(2) H, δ(34) S) was used to characterise a wide selection of cocoa beans from different renowned production areas (Africa, Asia, Central and South America). The factors most influencing the isotopic signatures of cocoa beans were climate and altitude for δ(13) C and the isotopic composition of precipitation water for δ(18) O and δ(2) H, whereas δ(15) N and δ(34) S were primarily affected by geology and fertilisation practises. Multi-isotopic analysis was shown to be sufficiently effective in determining the geographical origin of cocoa beans, and combining it with Canonical Discriminant Analysis led to more than 80% of samples being correctly reclassified. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization

    Directory of Open Access Journals (Sweden)

    Agnus M. Kim

    2016-07-01

    Full Text Available Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

  18. Ecophysiological Traits of Leaves of Three Marsilea Species Distributed in Different Geographical Regions

    Directory of Open Access Journals (Sweden)

    Tai-Chung Wu

    2011-11-01

    Full Text Available Marsilea, an amphibian fern genus (containing ca. 80 species characterized by their unusual leaves and reproductive structures, is distributed over the five continents. To investigate the adaptation traits of three Marsilea species (M. crenata, M. quadrifolia, and M. schelpiana, distributed in different geographic regions, to terrestrial conditions, we compared morphological features, optical properties and photosynthetic performance of leaflets of the three species grown in terrestrial environment. The results showed that leaflets of the three species had significant differences in some of the ecophysiogical traits. Among the three species, M. quadrifolia (distributed in temperate region where receiving low precipitation had the highest trichome density on its leaflet surface and the highest water use efficiency, M. schelpiana (mainly in southern Africa where accepting high level of solar irradiance had the tallest petiole and the highest leaf dissection index, total stomatal pore area index, PSII electron transport rate and photosaturated photosynthetic rate, M. crenata (mainly in southeastern Asia region where receiving high precipitation and with high humidity had the lowest leaf dissection index and water use efficiency. Accordingly, leaf characteristics of the three Marsilea species reflect the climate pattern of their habitats. The results also suggest that water availability and light intensity are two of the important factors contributing to the geographic distribution of the three species.

  19. Geographic Variations and Time Trends in Cancer Treatments in Taiwan.

    Science.gov (United States)

    Hsu, Jason C; Chang, Sheng-Mao; Lu, Christine Y

    2017-08-02

    Targeted therapies have become important treatment options for cancer care in many countries. This study aimed to examine recent trends in utilization of antineoplastic drugs, particularly the use of targeted therapies for treatment of cancer, by geographic region in Taiwan (northern, midwestern, southern, and eastern regions and the outer islands). This was a retrospective observational study of antineoplastic agents using 2009-2012 quarterly claims data from Taiwan's National Health Insurance Research Database. Yearly market shares by prescription volume and costs for targeted therapies among total antineoplastic agents by region were estimated. We used multivariate regression model and ANOVA to examine variations in utilization of targeted therapies between geographic regions and used ARIMA models to estimate longitudinal trends. Population-adjusted use and costs of antineoplastic drugs (including targeted therapies) were highest in the southern region of Taiwan and lowest in the outer islands. We found a 4-fold difference in use of antineoplastic drugs and a 49-fold difference in use of targeted therapies between regions if the outer islands were included. There were minimal differences in use of antineoplastic drugs between other regions with about a 2-fold difference in use of targeted therapies. Without considering the outer islands, the market share by prescription volume and costs of targeted therapies increased almost 2-fold (1.84-1.90) and 1.5-fold (1.26-1.61) respectively between 2009 and 2012. Furthermore, region was not significantly associated with use of antineoplastic agents or use of targeted therapies after adjusting for confounders. Region was associated with costs of antineoplastic agents but it was not associated with costs of targeted therapies after confounding adjustments. Use of antineoplastic drugs overall and use of targeted therapies for treatment of cancer varied somewhat between regions in Taiwan; use was notably low in the outer

  20. 75 FR 74123 - Office of the Commissioner; Cost-of-Living Increase and Other Determinations for 2011; Correction

    Science.gov (United States)

    2010-11-30

    ... claiming benefits, call 1-800-772- 1213, or visit our Internet site, Social Security Online, at http://www... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2010-0054] Office of the Commissioner; Cost-of-Living Increase and Other Determinations for 2011; Correction AGENCY: Social Security Administration...

  1. Geographic variation in resistance to nectar robbing and consequences for pollination.

    Science.gov (United States)

    Adler, Lynn S; Leege, Lissa M; Irwin, Rebecca E

    2016-10-01

    Floral evolution is frequently ascribed to selection by pollinators, but may also be shaped by antagonists. However, remarkably few studies have examined geographic mosaics in resistance to floral antagonists or the consequences for other floral interactions. Gelsemium sempervirens experiences frequent nectar robbing in northern Georgia, but rarely in southern Georgia. We conducted common-garden experiments in both locations using genotypes from each region and measured robbing, pollinator attraction, floral attractive and defensive traits, and plant reproduction. Nectar robbing was more than four times higher in the north vs. south, and pollinator visits did not differ between gardens. Across both gardens, northern genotypes were half as likely to be nectar-robbed but received half as many pollinator visits as southern genotypes, suggesting evolution of resistance to robbing at a cost of reduced pollinator attraction. Plant-level traits, such as height and number of flowers, were more closely associated with resistance to robbing than floral size, shape, or chemistry. Northern genotypes had lower female and estimated male reproduction compared to southern genotypes at both locations, which could be due to costs of resistance to nectar robbing, or costs of adaptations to other biotic or abiotic differences between regions. Our study indicates that geographic variation can play a strong role structuring interactions with floral antagonists and mutualists and provides evidence consistent with the hypothesis that local resistance to nectar robbing imposes costs in terms of decreased pollinator attraction and reproduction. © 2016 Botanical Society of America.

  2. Cultural Differences in Opportunity Cost Consideration.

    Science.gov (United States)

    Zhang, Ning; Ji, Li-Jun; Li, Ye

    2017-01-01

    Two studies were conducted to investigate cultural differences in opportunity cost consideration between Chinese and Euro-Canadians. Opportunity cost is defined as the cost of a benefit that must be forgone in order to pursue a better alternative (Becker et al., 1974). In both studies, participants read about hypothetical purchase scenarios, and then decided whether they would buy a certain product. Opportunity cost consideration was measured in two ways: (1) participants' thoughts pertaining to other (nonfocal) products while making decisions; (2) participants' decisions not to buy a focal product (Study 1) or a more expensive product (Study 2). Across both indexes, we found that after controlling for individual difference variables and amount of pocket money, Chinese participants in China considered financial opportunity cost more than Euro-Canadians in Study 1. Similar results were observed in Study 2 when comparing Chinese in Canada with Euro-Canadians However, the cultural effect on opportunity cost consideration was confounded by family income in Study 2. Implications for resource management, limitations of the current research and directions for future research are discussed.

  3. The costs of acute readmissions to a different hospital –

    DEFF Research Database (Denmark)

    Dahl, Christian M.; Kongstad, Line Planck

    2017-01-01

    Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occu....... If teaching hospitals are not compensated for the additional costs of treating different-hospital readmission patients, they might be unfairly funded under a DRG-based payment scheme.......Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occur...... to a different hospital. The change in hospital indicates that a progression of the illness has occurred since the initial hospitalisation. As a result, different-hospital readmissions might be more costly compared to same-hospital admissions. The aim of this paper is twofold. Firstly, to analyse differences...

  4. Costs of climate impacts

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, W O

    1980-03-01

    The surest prospect for future world climate patterns is that they will differ from present ones. What is uncertain is how much, and exactly in what way in different geographical regions. The anthropogenic CO/sub 2/ increase will probably exceed the unknown forcing functions of natural climate change within 30 to 60 years. It is not unlikely that by AD 2040 the world's climate, driven by the CO/sub 2/ increase, will enter a domain warmer than any within the past few million years. The costs of averting this climate change or of absorbing its impact are likely to be huge, even though today imponderable. Not least among these are intangible and unquantifiable costs associated with changes in human values and the quality of everyday life for future generations.

  5. A critical assessment of geographic clusters of breast and lung cancer incidences among residents living near the Tittabawassee and Saginaw Rivers, Michigan, USA.

    Science.gov (United States)

    Guajardo, Olga A; Oyana, Tonny J

    2009-01-01

    To assess previously determined geographic clusters of breast and lung cancer incidences among residents living near the Tittabawassee and Saginaw Rivers, Michigan, using a new set of environmental factors. Breast and lung cancer data were acquired from the Michigan Department of Community Health, along with point source pollution data from the U.S. Environmental Protection Agency. The datasets were used to determine whether there is a spatial association between disease risk and environmental contamination. GIS and spatial techniques were combined with statistical analysis to investigate local risk of breast and lung cancer. The study suggests that neighborhoods in close proximity to the river were associated with a high risk of breast cancer, while increased risk of lung cancer was detected among neighborhoods in close proximity to point source pollution and major highways. Statistically significant (P of cancer incidences were observed among residents living near the rivers. These findings are useful to researchers and governmental agencies for risk assessment, regulation, and control of environmental contamination in the floodplains.

  6. A Critical Assessment of Geographic Clusters of Breast and Lung Cancer Incidences among Residents Living near the Tittabawassee and Saginaw Rivers, Michigan, USA

    Directory of Open Access Journals (Sweden)

    Olga A. Guajardo

    2009-01-01

    Full Text Available Objectives. To assess previously determined geographic clusters of breast and lung cancer incidences among residents living near the Tittabawassee and Saginaw Rivers, Michigan, using a new set of environmental factors. Materials and Methods. Breast and lung cancer data were acquired from the Michigan Department of Community Health, along with point source pollution data from the U.S. Environmental Protection Agency. The datasets were used to determine whether there is a spatial association between disease risk and environmental contamination. GIS and spatial techniques were combined with statistical analysis to investigate local risk of breast and lung cancer. Results and Conclusion. The study suggests that neighborhoods in close proximity to the river were associated with a high risk of breast cancer, while increased risk of lung cancer was detected among neighborhoods in close proximity to point source pollution and major highways. Statistically significant (P≤.001 clusters of cancer incidences were observed among residents living near the rivers. These findings are useful to researchers and governmental agencies for risk assessment, regulation, and control of environmental contamination in the floodplains.

  7. A Critical Assessment of Geographic Clusters of Breast and Lung Cancer Incidences among Residents Living near the Tittabawassee and Saginaw Rivers, Michigan, USA

    International Nuclear Information System (INIS)

    Guajardo, O.A.; Oyana, T.J.

    2010-01-01

    Objectives. To assess previously determined geographic clusters of breast and lung cancer incidences among residents living near the Tittabawassee and Saginaw Rivers, Michigan, using a new set of environmental factors. Materials and Methods. Breast and lung cancer data were acquired from the Michigan Department of Community Health, along with point source pollution data from the U.S. Environmental Protection Agency. The datasets were used to determine whether there is a spatial association between disease risk and environmental contamination. GIS and spatial techniques were combined with statistical analysis to investigate local risk of breast and lung cancer. Results and Conclusion. The study suggests that neighborhoods in close proximity to the river were associated with a high risk of breast cancer, while increased risk of lung cancer was detected among neighborhoods in close proximity to point source pollution and major highways. Statistically significant (P=.001) clusters of cancer incidences were observed among residents living near the rivers. These findings are useful to researchers and governmental agencies for risk assessment, regulation, and control of environmental contamination in the flood plains.

  8. Differences in virulence and sporulation of Phytophthora kernoviae isolates originating from two distinct geographical regions

    Science.gov (United States)

    Phytophthora kernoviae has only been isolated from the United Kingdom (U.K.) and New Zealand. To understand what differences may exist between isolates from these two distinct geographical regions, virulence studies on three host plants and sporulation on host leaves were conducted on select isolat...

  9. Overview of low level waste disposal facility costs

    International Nuclear Information System (INIS)

    Saverot, P.M.

    1995-01-01

    Economics and uncertainty go hand-in-hand and it is too soon to have conclusive data on the life cycle costs of a disposal facility. While LLW volumes from are decreasing year after year, the effect of the projected LLW volumes from decommissioning may have a significant impact on the final unit costs. This overview recognizes that countries see LLW disposal costs differently depending on the scale of their programs and on the geographical, political and economic frameworks within which they operate. The reasons for the cost differences arise from a number of factors: differences in designs and in technologies (near surface engineered vault, enhanced shallow land burial, silo type caverns,...), disposal capacities, programmatic and regulatory requirements, organizational, managerial and institutional frameworks, contractual arrangements, etc. Comparison of actual project costs, if done incorrectly, can lead to invalid conclusions and little purpose would be served by so doing since cost variations reflect the reality faced by each country

  10. Neighbourhood disadvantage, geographic remoteness and body mass index among immigrants to Australia: A national cohort study 2006-2014.

    Science.gov (United States)

    Menigoz, Karen; Nathan, Andrea; Heesch, Kristiann C; Turrell, Gavin

    2018-01-01

    Obesity is socioeconomically, geographically and ethnically patterned. Understanding these elements of disadvantage is vital in understanding population obesity trends and the development of effective and equitable interventions. This study examined the relationship between neighbourhood socioeconomic disadvantage and geographic remoteness with prospective trends in mean body mass index (BMI) among immigrants to Australia. Longitudinal data (2006-2014) from a national panel survey of Australian adults was divided into an immigrant-only sample (n = 4,293, 52.6% women and 19,404 person-year observations). The data were analysed using multi-level random effects linear regression modelling that controlled for individual socioeconomic and demographic factors. Male immigrants living in the most disadvantaged neighbourhoods had significantly higher mean BMI compared with those living in the least disadvantaged. Over time, mean BMI increased for all groups except for men living in the least disadvantaged neighbourhoods, for whom mean BMI remained almost static (0.1 kg/m2 increase from 2006 to 2014), effectively widening neighbourhood inequalities. Among women, mean BMI was also significantly higher in the most compared with the least, disadvantaged neighbourhoods (β = 2.08 kg/m2; 95%CI: 1.48, 2.68). Neighbourhood inequalities were maintained over time as mean BMI increased for all groups at a similar rate. Male and female immigrants residing in outer regional areas had significantly higher mean BMI compared with those living in major cities; however, differences were attenuated and no longer significant following adjustment for ethnicity, individual socioeconomic position and neighbourhood disadvantage. Over time, mean BMI increased in all male and female groups with no differences based on geographic remoteness. Obesity prevention policy targeted at immigrant cohorts needs to include area-level interventions that address inequalities in BMI arising from neighbourhood

  11. Cost-effectiveness of a mild compared with a standard strategy for IVF: a randomized comparison using cumulative term live birth as the primary endpoint.

    Science.gov (United States)

    Polinder, S; Heijnen, E M E W; Macklon, N S; Habbema, J D F; Fauser, B J C M; Eijkemans, M J C

    2008-02-01

    BACKGROUND Conventional ovarian stimulation and the transfer of two embryos in IVF exhibits an inherent high probability of multiple pregnancies, resulting in high costs. We evaluated the cost-effectiveness of a mild compared with a conventional strategy for IVF. METHODS Four hundred and four patients were randomly assigned to undergo either mild ovarian stimulation/GnRH antagonist co-treatment combined with single embryo transfer, or standard stimulation/GnRH agonist long protocol and the transfer of two embryos. The main outcome measures are total costs of treatment within a 12 months period after randomization, and the relationship between total costs and proportion of cumulative pregnancies resulting in term live birth within 1 year of randomization. RESULTS Despite a significantly increased average number of IVF cycles (2.3 versus 1.7; P costs over a 12-month period (8333 versus euro10 745; P = 0.006) were observed using the mild strategy. This was mainly due to higher costs of the obstetric and post-natal period for the standard strategy, related to multiple pregnancies. The costs per pregnancy leading to term live birth were euro19 156 in the mild strategy and euro24 038 in the standard. The incremental cost-effectiveness ratio of the standard strategy compared with the mild strategy was euro185 000 per extra pregnancy leading to term live birth. CONCLUSIONS Despite an increased mean number of IVF cycles within 1 year, from an economic perspective, the mild treatment strategy is more advantageous per term live birth. It is unlikely, over a wide range of society's willingness-to-pay, that the standard treatment strategy is cost-effective, compared with the mild strategy.

  12. Family living sets the stage for cooperative breeding and ecological resilience in birds.

    Directory of Open Access Journals (Sweden)

    Michael Griesser

    2017-06-01

    Full Text Available Cooperative breeding is an extreme form of cooperation that evolved in a range of lineages, including arthropods, fish, birds, and mammals. Although cooperative breeding in birds is widespread and well-studied, the conditions that favored its evolution are still unclear. Based on phylogenetic comparative analyses on 3,005 bird species, we demonstrate here that family living acted as an essential stepping stone in the evolution of cooperative breeding in the vast majority of species. First, families formed by prolonging parent-offspring associations beyond nutritional independency, and second, retained offspring began helping at the nest. These findings suggest that assessment of the conditions that favor the evolution of cooperative breeding can be confounded if this process is not considered to include 2 steps. Specifically, phylogenetic linear mixed models show that the formation of families was associated with more productive and seasonal environments, where prolonged parent-offspring associations are likely to be less costly. However, our data show that the subsequent evolution of cooperative breeding was instead linked to environments with variable productivity, where helpers at the nest can buffer reproductive failure in harsh years. The proposed 2-step framework helps resolve current disagreements about the role of environmental forces in the evolution of cooperative breeding and better explains the geographic distribution of this trait. Many geographic hotspots of cooperative breeding have experienced a historical decline in productivity, suggesting that a higher proportion of family-living species could have been able to avoid extinction under harshening conditions through the evolution of cooperative breeding. These findings underscore the importance of considering the potentially different factors that drive different steps in the evolution of complex adaptations.

  13. Family living sets the stage for cooperative breeding and ecological resilience in birds.

    Science.gov (United States)

    Griesser, Michael; Drobniak, Szymon M; Nakagawa, Shinichi; Botero, Carlos A

    2017-06-01

    Cooperative breeding is an extreme form of cooperation that evolved in a range of lineages, including arthropods, fish, birds, and mammals. Although cooperative breeding in birds is widespread and well-studied, the conditions that favored its evolution are still unclear. Based on phylogenetic comparative analyses on 3,005 bird species, we demonstrate here that family living acted as an essential stepping stone in the evolution of cooperative breeding in the vast majority of species. First, families formed by prolonging parent-offspring associations beyond nutritional independency, and second, retained offspring began helping at the nest. These findings suggest that assessment of the conditions that favor the evolution of cooperative breeding can be confounded if this process is not considered to include 2 steps. Specifically, phylogenetic linear mixed models show that the formation of families was associated with more productive and seasonal environments, where prolonged parent-offspring associations are likely to be less costly. However, our data show that the subsequent evolution of cooperative breeding was instead linked to environments with variable productivity, where helpers at the nest can buffer reproductive failure in harsh years. The proposed 2-step framework helps resolve current disagreements about the role of environmental forces in the evolution of cooperative breeding and better explains the geographic distribution of this trait. Many geographic hotspots of cooperative breeding have experienced a historical decline in productivity, suggesting that a higher proportion of family-living species could have been able to avoid extinction under harshening conditions through the evolution of cooperative breeding. These findings underscore the importance of considering the potentially different factors that drive different steps in the evolution of complex adaptations.

  14. Development of a Carbon Management Geographic Information System (GIS) for the United States

    Energy Technology Data Exchange (ETDEWEB)

    Howard Herzog; Holly Javedan

    2009-12-31

    In this project a Carbon Management Geographical Information System (GIS) for the US was developed. The GIS stored, integrated, and manipulated information relating to the components of carbon management systems. Additionally, the GIS was used to interpret and analyze the effect of developing these systems. This report documents the key deliverables from the project: (1) Carbon Management Geographical Information System (GIS) Documentation; (2) Stationary CO{sub 2} Source Database; (3) Regulatory Data for CCS in United States; (4) CO{sub 2} Capture Cost Estimation; (5) CO{sub 2} Storage Capacity Tools; (6) CO{sub 2} Injection Cost Modeling; (7) CO{sub 2} Pipeline Transport Cost Estimation; (8) CO{sub 2} Source-Sink Matching Algorithm; and (9) CO{sub 2} Pipeline Transport and Cost Model.

  15. Geographical differences in blood donation and philanthropy in the Netherlands : what role for social capital?

    NARCIS (Netherlands)

    Bekkers, René; Veldhuizen, Ingrid

    2008-01-01

    The key question addressed in this paper is whether geographical differences in blood donation and philanthropy reflect differences in social capital. We do find considerable spatial variation in blood donation and philanthropy between municipalities in the Netherlands. But we do not find that blood

  16. Conceptual Model of Dynamic Geographic Environment

    Directory of Open Access Journals (Sweden)

    Martínez-Rosales Miguel Alejandro

    2014-04-01

    Full Text Available In geographic environments, there are many and different types of geographic entities such as automobiles, trees, persons, buildings, storms, hurricanes, etc. These entities can be classified into two groups: geographic objects and geographic phenomena. By its nature, a geographic environment is dynamic, thus, it’s static modeling is not sufficient. Considering the dynamics of geographic environment, a new type of geographic entity called event is introduced. The primary target is a modeling of geographic environment as an event sequence, because in this case the semantic relations are much richer than in the case of static modeling. In this work, the conceptualization of this model is proposed. It is based on the idea to process each entity apart instead of processing the environment as a whole. After that, the so called history of each entity and its spatial relations to other entities are defined to describe the whole environment. The main goal is to model systems at a conceptual level that make use of spatial and temporal information, so that later it can serve as the semantic engine for such systems.

  17. Geographic Prevalence and Mix of Regional Cuisines in Chinese Cities

    Directory of Open Access Journals (Sweden)

    Jingwei Zhu

    2018-05-01

    Full Text Available Previous research on the geographies of food put a considerable focus on analyzing how different types of food or ingredients are consumed across different places. Little is known, however, about how food culture is manifested through various cooking traditions as well as people’s perceptions over different culinary styles. Using a data set captured from one of the largest online review sites in China (www.dianping.com, this study demonstrates how geo-referenced social review data can be leveraged to better understand the geographic prevalence and mix of regional cuisines in Chinese cities. Based on information of millions of restaurants obtained in selected cities (i.e., provincial capitals and municipalities under direct supervision of the Chinese central government, we first measure by each city the diversity of restaurants that serve regional Chinese cuisines using the Shannon entropy, and analyze how cities with different characteristics are geographically distributed. A hierarchical clustering algorithm is then used to further explore the similarities of consumers’ dining options among these cities. By associating each regional Chinese cuisine to its origin, we then develop a weighted distance measure to quantify the geographic prevalence of each cuisine type. Finally, a popularity index (POPU is introduced to quantify consumers’ preferences for different regional cuisines. We find that: (1 diversity of restaurants among the cities shows an “east–west” contrast that is in general agreement with the socioeconomic divide in China; (2 most of the cities have their own unique characteristics, which are mainly driven by a large market share of the corresponding local cuisine; (3 there exists great heterogeneity of the geographic prevalence of different Chinese cuisines. In particular, Chuan and Xiang, which are famous for their spicy taste, are widely distributed across the mainland China and (4 among the top-tier restaurants ranked

  18. Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people : Results of a cluster randomized trial

    NARCIS (Netherlands)

    Suijker, Jacqueline J.; MacNeil-Vroomen, Janet L.; van Rijn, Marjon; Buurman, Bianca M.; de Rooij, Sophia E.; van Charente, Eric P. Moll; Bosmans, Judith E.

    2017-01-01

    Objective To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. Methods We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year

  19. Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial

    NARCIS (Netherlands)

    Suijker, Jacqueline J.; MacNeil-Vroomen, Janet L.; van Rijn, Marjon; Buurman, Bianca M.; de Rooij, Sophia E.; Moll van Charante, Eric P.; Bosmans, Judith E.

    2017-01-01

    Objective To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. Methods We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year

  20. Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people : Results of a cluster randomized trial

    NARCIS (Netherlands)

    Suijker, Jacqueline J; MacNeil-Vroomen, Janet L; van Rijn, Marjon; Buurman, Bianca M; de Rooij, Sophia E; Moll van Charante, Eric P; Bosmans, Judith E

    2017-01-01

    OBJECTIVE: To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. METHODS: We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year

  1. Societal costs and effects of implementing population-based mammography screening in Greenland

    DEFF Research Database (Denmark)

    Christensen, Maria Klitgaard; Niclasen, Birgit; Moesgaard Iburg, Kim

    2017-01-01

    With a low breast cancer incidence and low population density, Greenland is geographically and organisationally challenged in implementing a cost effective breast cancer screening programme where a large proportion of the Greenlandic women will have to travel far to attend. The aim of this paper ...... transportation and accommodation costs and loss of productivity, and none would be accepted as cost-effective per YLS/QALY gained within a conventional threshold level. The least expensive strategy was regional screening with hotel accommodation.......With a low breast cancer incidence and low population density, Greenland is geographically and organisationally challenged in implementing a cost effective breast cancer screening programme where a large proportion of the Greenlandic women will have to travel far to attend. The aim of this paper...... is to evaluate the cost effectiveness and cost utility of different strategies for implementing population-based breast cancer screening in Greenland. Two strategies were evaluated: Centralised screening in the capital Nuuk and decentralised screening in the five municipal regions of Greenland. A cost...

  2. COMPARATIVE AND QUANTITATIVE DETERMINATION OF QUERCETIN AND RUTIN IN TRIBULUS TERRESTRIS L. FRUITS FROM DIFFERENT SEASONAL AND GEOGRAPHICAL POPULATIONS OF SOUTH INDIA

    OpenAIRE

    Suresh Reddy Yanala* and D. Sathyanarayana

    2018-01-01

    The objective of the present research work was comparative and quantitative determination of quercetin and rutin in Tribulus terrestirs fruits from different geographical regions and seasons by using HPLC. The Tribulus terrestris fruit samples collected from three different geographical regions of south India in June and December months. In the current HPLC analysis flavonoids in Tribulus terrestris Linn fruits were quantified at 360 nm with help of peak area by comparing to a calibration cur...

  3. Cost-effectiveness of community vegetable gardens for people living with HIV in Zimbabwe.

    Science.gov (United States)

    Puett, Chloe; Salpéteur, Cécile; Lacroix, Elisabeth; Zimunya, Simbarashe Dennis; Israël, Anne-Dominique; Aït-Aïssa, Myriam

    2014-01-01

    There is little evidence to date of the potential impact of vegetable gardens on people living with HIV (PLHIV), who often suffer from social and economic losses due to the disease. From 2008 through 2011, Action Contre la Faim France (ACF) implemented a project in Chipinge District, eastern Zimbabwe, providing low-input vegetable gardens (LIGs) to households of PLHIV. Program partners included Médecins du Monde, which provided medical support, and Zimbabwe's Agricultural Extension Service, which supported vegetable cultivation. A survey conducted at the end of the program found LIG participants to have higher Food Consumption Scores (FCS) and Household Dietary Diversity Scores (HDDS) relative to comparator households of PLHIV receiving other support programs. This study assessed the incremental cost-effectiveness of LIGs to improve FCS and HDDS of PLHIV compared to other support programs. This analysis used an activity-based cost model, and combined ACF accounting data with estimates of partner and beneficiary costs derived using an ingredients approach to build an estimate of total program resource use. A societal perspective was adopted to encompass costs to beneficiary households, including their opportunity costs and an estimate of their income earned from vegetable sales. Qualitative methods were used to assess program benefits to beneficiary households. Effectiveness data was taken from a previously-conducted survey. Providing LIGs to PLHIV cost an additional 8,299 EUR per household with adequate FCS and 12,456 EUR per household with HDDS in the upper tertile, relative to comparator households of PLHIV receiving other support programs. Beneficiaries cited multiple tangible and intangible benefits from LIGs, and over 80% of gardens observed were still functioning more than one year after the program had finished. Cost outcomes were 20-30 times Zimbabwe's per capita GDP, and unlikely to be affordable within government services. This analysis concludes that

  4. Formal and informal care for disabled elderly living in the community: an appraisal of French care composition and costs.

    Science.gov (United States)

    Paraponaris, Alain; Davin, Bérengère; Verger, Pierre

    2012-06-01

    Choices between formal and informal care for disabled elderly people living at home are a key component of the long-term care provision issues faced by an ageing population. This paper aims to identify factors associated with the type of care (informal, formal, mixed or no care at all) received by the French disabled elderly and to assess the care's relative costs. This paper uses data from a French survey on disability; the 3,500 respondents of interest lived at home, were aged 60 and over, had severe disability and needed help with activities of daily living. We use a multinomial probit model to determine factors associated with type of care. We also assess the cost of care with the help of the proxy good method. One-third of disabled elderly people receive no care. Among those who are helped, 55% receive informal, 25% formal, and 20% mixed care. Low socioeconomic status increases difficulties in accessing formal care. The estimated economic value of informal care is 6.6 billion euro [95% CI = 5.9-7.2] and represents about two-thirds of the total cost of care. Public policies should pay more attention to inequalities in access to community care. They also should better support informal care, through respite care or workplace accommodations (working hours rescheduling or reduction for instance) not detrimental for the career of working caregivers.

  5. 20 CFR 404.274 - What are the measuring periods we use to calculate cost-of-living increases?

    Science.gov (United States)

    2010-04-01

    ... ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts... determine whether there will be an automatic cost-of-living increase and if so, its amount. (b) Measuring... increase is effective; or (ii) The third calendar quarter of any year in which the last automatic increase...

  6. Pregnancy and internet: sociodemographic and geographic differences in e-health practice. Results from an Italian multicenter study.

    Science.gov (United States)

    Scaioli, G; Bert, F; Galis, V; Brusaferro, S; De Vito, E; La Torre, G; Manzoli, L; Messina, G; Torregrossa, M V; Ricciardi, W; Gualano, M R; Siliquini, R

    2015-09-01

    Since the new millennium, the number of e-health users has significantly increased. Among these, a particular category of people who are interested by this phenomenon is the one of pregnant women. The aim of the present study is to assess the sociodemographic and geographic differences existing in a sample of Italian pregnant women who search for information on the web. Multicenter cross-sectional survey. The present study has been conducted from November 2011 to September 2012, in seven Italian cities, located in the North, in the Centre and in the South of Italy. Data were collected through an anonymous questionnaire, administered in waiting rooms of outpatient departments by trained medical doctors. Data were analysed through multivariate logistic regression models. Overall, 1347 responders were interviewed. Eighty-six percent of them declared to surf the internet to retrieve pregnancy-related information. The most searched topics were fetal development (51.3%), healthy lifestyle during pregnancy (48.7%), physiology of pregnancy (39.8%), generic and specific tips/advices during pregnancy (37.2%) and lactation (36.8%). Statistically significant differences (P < 0.05) according to geographic origin, age and educational level were found with regard to the most frequently searched information on the Web, the reasons that pushed pregnant women to practice e-health, and the possibility to change lifestyles after e-health. Our findings suggest that the phenomenon of pregnancy e-health is widespread and show social and geographic differences, in particular about city of residence, age and educational level. It might encourage healthcare professionals to be more available and exhaustive during routine visits and to be more careful about web content on this topic, also addressing the different needs into different geographic contexts. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. An efficient and reliable multi-hop geographical broadcast protocol in vehicular ad-hoc networks

    NARCIS (Netherlands)

    Rajendran, R.; Jongh, J. de

    2013-01-01

    In Intelligent Transportation Systems (ITS), disseminating warning messages in a timely and efficient way through wireless short-range communications can save many lives and reduce traffic congestion. A geographical broadcast protocol provides data delivery to specified geographical areas, using

  8. Environmental statistical modelling of mosquito vectors at different geographical scales

    NARCIS (Netherlands)

    Cianci, D.

    2015-01-01

    Vector-borne diseases are infections transmitted by the bite of infected arthropod vectors, such as mosquitoes, ticks, fleas, midges and flies. Vector-borne diseases pose an increasingly wider threat to global public health, both in terms of people affected and their geographical spread. Mosquitoes

  9. Costs of an immune challenge and terminal investment in a long-lived bird.

    Science.gov (United States)

    Hanssen, Sveinn Are

    2006-10-01

    An induced immune challenge can have two counteracting effects on an individual's reproductive investment. (1) The resource demand could increase to "fuel" the immunologic reaction, which in turn can lead to an adaptive decrease in investment in resource-costly activities, such as reproduction. One the other hand, (2) the individual could assume that the immune activity it experiences is indicative of a serious infection. The latter can lead to an adaptive increase in reproductive investment in response to the reduced prospects of survival and future reproduction, so called "terminal investment." To measure such life-history-related consequences of increased immune activity, one group of incubating female Common Eiders (Somateria mollissima) was injected with a nonpathogenic antigen (sheep red blood cells, SRBC) while controls were injected with sterile saline. The eider is a long-lived sea-duck. Females, who incubate the eggs and care for young without assistance from the male, engage in facultative anorexia during incubation leading to a large reduction in body mass. Eiders can abandon their young to other females at the cost of reduced young survival. The immune challenge resulted in a larger mass loss, a prolonged incubation period, and reduced return rate, demonstrating both short- and long-term costs of immune challenge. Additionally, in response to what might have been interpreted as reduced survival chances in immune-challenged females, these females more often tended their own brood after hatching, despite having suffered higher costs during incubation.

  10. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    Science.gov (United States)

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  11. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    Directory of Open Access Journals (Sweden)

    Lucas Miyake Okumura

    2016-05-01

    Full Text Available There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70, however, it was more efficient (US$ 27,549.15 vs 29,011.46. Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

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

    International Nuclear Information System (INIS)

    Berkhout, F.

    1994-01-01

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

  13. Composing Models of Geographic Physical Processes

    Science.gov (United States)

    Hofer, Barbara; Frank, Andrew U.

    Processes are central for geographic information science; yet geographic information systems (GIS) lack capabilities to represent process related information. A prerequisite to including processes in GIS software is a general method to describe geographic processes independently of application disciplines. This paper presents such a method, namely a process description language. The vocabulary of the process description language is derived formally from mathematical models. Physical processes in geography can be described in two equivalent languages: partial differential equations or partial difference equations, where the latter can be shown graphically and used as a method for application specialists to enter their process models. The vocabulary of the process description language comprises components for describing the general behavior of prototypical geographic physical processes. These process components can be composed by basic models of geographic physical processes, which is shown by means of an example.

  14. Regional Extinctions and Quaternary Shifts in the Geographic Range of Lestodelphys halli, the Southernmost Living Marsupial: Clues for Its Conservation.

    Directory of Open Access Journals (Sweden)

    Anahí E Formoso

    Full Text Available The Patagonian opossum (Lestodelphys halli, the southernmost living marsupial, inhabits dry and open environments, mainly in the Patagonian steppe (between ~32 °S and ~49 °S. Its rich fossil record shows its occurrence further north in Central Argentina during the Quaternary. The paleoenvironmental meaning of the past distribution of L. halli has been mostly addressed in a subjective framework without an explicit connection with the climatic "space" currently occupied by this animal. Here, we assessed the potential distribution of this species and the changes occurred in its geographic range during late Pleistocene-Holocene times and linked the results obtained with conservation issues. To this end, we generated three potential distribution models with fossil records and three with current ones, using MaxEnt software. These models showed a decrease in the suitable habitat conditions for the species, highlighting a range shift from Central-Eastern to South-Western Argentina. Our results support that the presence of L. halli in the Pampean region during the Pleistocene-Holocene can be related to precipitation and temperature variables and that its current presence in Patagonia is more related to temperature and dominant soils. The models obtained suggest that the species has been experiencing a reduction in its geographic range since the middle Holocene, a process that is in accordance with a general increase in moisture and temperature in Central Argentina. Considering the findings of our work and the future scenario of global warming projected for Patagonia, we might expect a harsh impact on the distribution range of this opossum in the near future.

  15. Regional Extinctions and Quaternary Shifts in the Geographic Range of Lestodelphys halli, the Southernmost Living Marsupial: Clues for Its Conservation

    Science.gov (United States)

    Formoso, Anahí E.; Martin, Gabriel M.; Teta, Pablo; Carbajo, Aníbal E.; Sauthier, Daniel E. Udrizar; Pardiñas, Ulyses F. J.

    2015-01-01

    The Patagonian opossum (Lestodelphys halli), the southernmost living marsupial, inhabits dry and open environments, mainly in the Patagonian steppe (between ~32°S and ~49°S). Its rich fossil record shows its occurrence further north in Central Argentina during the Quaternary. The paleoenvironmental meaning of the past distribution of L. halli has been mostly addressed in a subjective framework without an explicit connection with the climatic “space” currently occupied by this animal. Here, we assessed the potential distribution of this species and the changes occurred in its geographic range during late Pleistocene-Holocene times and linked the results obtained with conservation issues. To this end, we generated three potential distribution models with fossil records and three with current ones, using MaxEnt software. These models showed a decrease in the suitable habitat conditions for the species, highlighting a range shift from Central-Eastern to South-Western Argentina. Our results support that the presence of L. halli in the Pampean region during the Pleistocene-Holocene can be related to precipitation and temperature variables and that its current presence in Patagonia is more related to temperature and dominant soils. The models obtained suggest that the species has been experiencing a reduction in its geographic range since the middle Holocene, a process that is in accordance with a general increase in moisture and temperature in Central Argentina. Considering the findings of our work and the future scenario of global warming projected for Patagonia, we might expect a harsh impact on the distribution range of this opossum in the near future. PMID:26203650

  16. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

  17. Unit Cost of Medical Services at Different Hospitals in India

    Science.gov (United States)

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  18. Geographic correlation between tapeworm carriers and heavily infected cysticercotic pigs.

    Directory of Open Access Journals (Sweden)

    Seth E O'Neal

    Full Text Available Neurocysticercosis is a leading cause of preventable epilepsy in the developing world. Sustainable community-based interventions are urgently needed to control transmission of the causative parasite, Taenia solium. We examined the geospatial relationship between live pigs with visible cysticercotic cysts on their tongues and humans with adult intestinal tapeworm infection (taeniasis in a rural village in northern Peru. The objective was to determine whether tongue-positive pigs could indicate high-risk geographic foci for taeniasis to guide targeted screening efforts. This approach could offer significant benefit compared to mass intervention.We recorded geographic coordinates of all village houses, collected stool samples from all consenting villagers, and collected blood and examined tongues of all village pigs. Stool samples were processed by enzyme-linked immunosorbent assay (ELISA for presence of Taenia sp. coproantigens indicative of active taeniasis; serum was processed by enzyme-linked immunoelectrotransfer blot for antibodies against T. solium cysticercosis (EITB LLGP and T. solium taeniasis (EITB rES33.Of 548 pigs, 256 (46.7% were positive for antibodies against cysticercosis on EITB LLGP. Of 402 fecal samples, 6 (1.5% were positive for the presence of Taenia sp. coproantigens. The proportion of coproantigen-positive individuals differed significantly between residents living within 100-meters of a tongue-positive pig (4/79, 5.1% and residents living >100 meters from a tongue-positive pig (2/323, 0.6% (p = 0.02. The prevalence of taeniasis was >8 times higher among residents living within 100 meters of a tongue-positive pig compared to residents living outside this range (adjusted PR 8.1, 95% CI 1.4-47.0.Tongue-positive pigs in endemic communities can indicate geospatial foci in which the risk for taeniasis is increased. Targeted screening or presumptive treatment for taeniasis within these high-risk foci may be an effective and

  19. Geographic Correlation between Tapeworm Carriers and Heavily Infected Cysticercotic Pigs

    Science.gov (United States)

    O'Neal, Seth E.; Moyano, Luz M.; Ayvar, Viterbo; Gonzalvez, Guillermo; Diaz, Andre; Rodriguez, Silvia; Wilkins, Patricia P.; Tsang, Victor C. W.; Gilman, Robert H.; Garcia, Hector H.; Gonzalez, Armando E.

    2012-01-01

    Background Neurocysticercosis is a leading cause of preventable epilepsy in the developing world. Sustainable community-based interventions are urgently needed to control transmission of the causative parasite, Taenia solium. We examined the geospatial relationship between live pigs with visible cysticercotic cysts on their tongues and humans with adult intestinal tapeworm infection (taeniasis) in a rural village in northern Peru. The objective was to determine whether tongue-positive pigs could indicate high-risk geographic foci for taeniasis to guide targeted screening efforts. This approach could offer significant benefit compared to mass intervention. Methods We recorded geographic coordinates of all village houses, collected stool samples from all consenting villagers, and collected blood and examined tongues of all village pigs. Stool samples were processed by enzyme-linked immunosorbent assay (ELISA) for presence of Taenia sp. coproantigens indicative of active taeniasis; serum was processed by enzyme-linked immunoelectrotransfer blot for antibodies against T. solium cysticercosis (EITB LLGP) and T. solium taeniasis (EITB rES33). Findings Of 548 pigs, 256 (46.7%) were positive for antibodies against cysticercosis on EITB LLGP. Of 402 fecal samples, 6 (1.5%) were positive for the presence of Taenia sp. coproantigens. The proportion of coproantigen-positive individuals differed significantly between residents living within 100-meters of a tongue-positive pig (4/79, 5.1%) and residents living >100 meters from a tongue-positive pig (2/323, 0.6%) (p = 0.02). The prevalence of taeniasis was >8 times higher among residents living within 100 meters of a tongue-positive pig compared to residents living outside this range (adjusted PR 8.1, 95% CI 1.4–47.0). Conclusions Tongue-positive pigs in endemic communities can indicate geospatial foci in which the risk for taeniasis is increased. Targeted screening or presumptive treatment for taeniasis within these high

  20. [Health risks in different living circumstances of mothers. Analyses based on a population study].

    Science.gov (United States)

    Sperlich, Stefanie

    2014-12-01

    The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.

  1. Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study.

    Science.gov (United States)

    Rodrigue, J R; Schold, J D; Morrissey, P; Whiting, J; Vella, J; Kayler, L K; Katz, D; Jones, J; Kaplan, B; Fleishman, A; Pavlakis, M; Mandelbrot, D A

    2016-03-01

    Some living kidney donors (LKDs) incur costs associated with donation, although these costs are not well characterized in the United States. We collected cost data in the 12 mo following donation from 182 LKDs participating in the multicenter prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 167, 92%) had one direct cost or more following donation, including ground transportation (86%), health care (41%), meals (53%), medications (36%), lodging (23%), and air transportation (12%). LKDs missed 33 072 total work hours, 40% of which were unpaid and led to $302 175 in lost wages (mean $1660). Caregivers lost $68 655 in wages (mean $377). Although some donors received financial assistance, 89% had a net financial loss in the 12-mo period, with one-third (33%) reporting a loss exceeding $2500. Financial burden was higher for those with greater travel distance to the transplant center (Spearman's ρ = 0.26, p neutrality for LKDs must be an immediate priority for the transplant community, governmental agencies, insurance companies, nonprofit organizations, and society at large. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. On the Development of Methodology for Planning and Cost-Modeling of a Wide Area Network

    OpenAIRE

    Ahmedi, Basri; Mitrevski, Pece

    2014-01-01

    The most important stages in designing a computer network in a wider geographical area include: definition of requirements, topological description, identification and calculation of relevant parameters (i.e. traffic matrix), determining the shortest path between nodes, quantification of the effect of various levels of technical and technological development of urban areas involved, the cost of technology, and the cost of services. These parameters differ for WAN networks in different regions...

  3. Family Planning Behavior and Small Family Concept Acceptance in Two Different Geographical Characteristics Municipality of South Klaten, Klaten, Central Java

    Directory of Open Access Journals (Sweden)

    P Priyono

    2014-12-01

    Full Text Available The research aim to know the family planning behaviour, the acceptance small family norm and the influential factors in two villages that have different geographical aspect. The behaviour involve the knowledge, the attitude and the practice where as the influential factors involve education, accupation, values of children, income, children still born and family size desired. The research areas are chosen purposive in two villages that have different geographical aspect, social aspect and cultural aspect. The aspect are: 1 location and topography, 2 socialy  structure, and 3 the achievement of effective acceptor. Based on the three aspects, Ngalas village (developing and Sumberejo (developed are chosen as research areas. The recorded as ative acceptor (recordedin RI/PUS/1991 form. The respondents are chosen by cencus at two neighborhoord association at every village. There are six variables in this research are assumed influence the periode of the contraceptives use, such as education, occupation status, values of children, family income, children still born, and family size desired. There are three variables are assumed influence the small family norm, such as education, occupation status, and values of children. The data was analyzed by frequency table, crosee table, and statistical analysis (Q square and Regresion. The data was always compared between the two villages. The analysis use computer by Microsoft Program.  The research result showed that Sumberejo was better than Ngalas in the knowledge, the attitude, and the practice of family planning. Most of the people who live in Sumberejo understood the contraception device well (52,4%, where as in Ngalas (26,8%. Both of them agreed on using contraception device (more than 70%. The respondent who live in Sumberejo used IUD (40% and MOW/MOP (23,23%. They had used of the contraception device for 4.8 years on an average. Mean  while the respondents in Ngalas use IUD (23,68% and MOW/MOP (2

  4. Effect of simultaneously started clomiphene citrate and gonadotropins in antagonist regimes, on cumulative live births, fresh-cycle live births and cost of stimulation in IVF cycles.

    Science.gov (United States)

    Satwik, Ruma; Kochhar, Mohinder

    2018-04-11

    The aim of the study was to compare simultaneously started clomiphene citrate (CC) and gonadotropins (Gn) with gonadotropins alone in conventional antagonist regimes with respect to fresh-cycle live births, cumulative live births and cost of ovarian stimulation per started cycle. This was a single-center prospective cohort study conducted over 1 year. Women undergoing autologous in vitro fertilization (IVF) treatment in antagonist protocols and who consented to participate in the study were divided into two cohorts. The CC cohort (n = 86) received 50 mg CC for 5 days and individualized Gn daily until the hCG trigger, both starting from day 2 and antagonist daily from day 8 of menstrual cycle. The Gn-only cohort (n = 349) received individualized Gn from day 2 and the antagonist from day 7 of menstrual cycle. IVF outcomes and cost of stimulation were compared between two cohorts across expected ovarian response categories. The CC cohort used a mean lower dose of Gn (1741.38 ± 604.46 vs 1980.54 ± 686.42; MD = -239.16; 95%CI = -348.03 to -189.24; P = 0.003) over fewer days (8.54 ± 1.86 vs 9.25 ± 1.97; MD =-0.71;95% CI = -1.17 to -0.25; P = 0.0026) to achieve similar retrieved oocytes, (9.19 ± 5.92 vs 9.36 ± 6.96; MD = -0.17; 95%CI -1.77 to + 1.43; P = 0.83), positive bhCG rates (40% vs 29.6%, MD = 10.4%; OR = 1.65, 95%CI = 0.95-2.86; P = 0.078) and live births in fresh cycles (32.31% vs 21.30%; MD = 11.01%; OR = 1.76; 95%CI = 0.97-3.19; P = 0.06) and cumulative live births per initiated cycle (30.23% vs 20.34%; MD = 9.89%; OR = 1.697; 95%CI = 0.99-2.88; P = 0.0501). The dose lowering achieved a 28-40% reduction in the cost of stimulation, which was most noticeable in the hyper-responder category for both hMG cycles, (Rs.11 602.3 ± 3365.9 vs 19615 ± 2677.1; MD = -8012.7; %age reduction: 40.8%; P = 0.0007) and recombinant FSH cycles (Rs. 22

  5. Geographical access to care at birth in Ghana: a barrier to safe motherhood

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2012-11-01

    Full Text Available Abstract Background Appropriate facility-based care at birth is a key determinant of safe motherhood but geographical access remains poor in many high burden regions. Despite its importance, geographical access is rarely audited systematically, preventing integration in national-level maternal health system assessment and planning. In this study, we develop a uniquely detailed set of spatially-linked data and a calibrated geospatial model to undertake a national-scale audit of geographical access to maternity care at birth in Ghana, a high-burden country typical of many in sub-Saharan Africa. Methods We assembled detailed spatial data on the population, health facilities, and landscape features influencing journeys. These were used in a geospatial model to estimate journey-time for all women of childbearing age (WoCBA to their nearest health facility offering differing levels of care at birth, taking into account different transport types and availability. We calibrated the model using data on actual journeys made by women seeking care. Results We found that a third of women (34% in Ghana live beyond the clinically significant two-hour threshold from facilities likely to offer emergency obstetric and neonatal care (EmONC classed at the ‘partial’ standard or better. Nearly half (45% live that distance or further from ‘comprehensive’ EmONC facilities, offering life-saving blood transfusion and surgery. In the most remote regions these figures rose to 63% and 81%, respectively. Poor levels of access were found in many regions that meet international targets based on facilities-per-capita ratios. Conclusions Detailed data assembly combined with geospatial modelling can provide nation-wide audits of geographical access to care at birth to support systemic maternal health planning, human resource deployment, and strategic targeting. Current international benchmarks of maternal health care provision are inadequate for these purposes because

  6. Geographical and genetic factors do not account for significant differences in the clinical spectrum of giant cell arteritis in southern europe.

    Science.gov (United States)

    Gonzalez-Gay, Miguel A; Boiardi, Luigi; Garcia-Porrua, Carlos; Macchioni, Pierluigi; Amor-Dorado, Juan C; Salvarani, Carlo

    2004-03-01

    To investigate whether genetic and geographical differences may influence the clinical spectrum of giant cell arteritis (GCA), we compared the demographic and clinical features of patients with biopsy-proven GCA from Reggio Emilia (Northern Italy) and Lugo (Northwest Spain) during a 15-year period. We performed a retrospective review of the case records of all patients diagnosed with biopsy-proven GCA at Hospital Xeral-Calde (Lugo, Spain) and Hospital Santa Maria Nuova (Reggio Emilia, Italy) between 1 January 1986 and 31 December 2001. Both hospitals are the only referral centers for populations living in central Galicia and central Emilia Romagna, respectively. During the period of study, 194 Lugo residents and 126 Reggio Emilia residents were diagnosed with biopsy proven GCA. Reggio Emilia patients were more likely to be female (74% vs 54%; p = 0.0001). Although Lugo patients complained of headache (86%) more commonly than did those from Reggio Emilia (77%), the difference was only marginally significant (p = 0.05). The proportion of patients with visual manifestations or visual loss was remarkably similar (22% for visual manifestations and 17% for visual loss in Lugo and 29% and 21% for Reggio Emilia residents). The mean erythrocyte sedimentation rate prior to the onset of therapy was also similar. Apart from differences in sex, the clinical spectrum of GCA in these 2 Southern European regions was similar.

  7. Self-caring of women with osteoarthritis living at different levels of independence.

    Science.gov (United States)

    Baird, Carol L; Schmeiser, Donna; Yehle, Karen T

    2003-08-01

    Successful management of chronic conditions such as osteoarthritis (OA) may improve health and quality of life and foster independence. Health professionals need to understand what women do to manage their OA by self-caring in order to support the improvement of health in older adults. A descriptive study of difficulties of living with and self-caring of OA was conducted. Sixty women over 65 years old who lived in homes in the community, in assisted living (AL) apartments, and in long-term care (LTC) facilities participated in interviews. Data were the reports of symptoms and self-caring behaviors. Descriptive, Kendall tau-b and tau-c, and chi-square analyses revealed that there were similarities and differences among the women. All of the women used a variety of self-caring techniques. Differences included that community-residing women reported more often that they had pain, moved too slowly, and had sleep disturbances. Community-residing women reported more negative emotions, while reporting significantly more often that they used a wide range of positive coping methods. By anticipating severe physical and functional problems of living with OA and difficulties in self-caring, health care providers may help women maintain an independent lifestyle.

  8. U Plant Geographic Zone Cleanup Prototype

    International Nuclear Information System (INIS)

    Romine, L.D.; Leary, K.D.; Lackey, M.B.; Robertson, J.R.

    2006-01-01

    The U Plant geographic zone (UPZ) occupies 0.83 square kilometers on the Hanford Site Central Plateau (200 Area). It encompasses the U Plant canyon (221-U Facility), ancillary facilities that supported the canyon, soil waste sites, and underground pipelines. The UPZ cleanup initiative coordinates the cleanup of the major facilities, ancillary facilities, waste sites, and contaminated pipelines (collectively identified as 'cleanup items') within the geographic zone. The UPZ was selected as a geographic cleanup zone prototype for resolving regulatory, technical, and stakeholder issues and demonstrating cleanup methods for several reasons: most of the area is inactive, sufficient characterization information is available to support decisions, cleanup of the high-risk waste sites will help protect the groundwater, and the zone contains a representative cross-section of the types of cleanup actions that will be required in other geographic zones. The UPZ cleanup demonstrates the first of 22 integrated zone cleanup actions on the Hanford Site Central Plateau to address threats to groundwater, the environment, and human health. The UPZ contains more than 100 individual cleanup items. Cleanup actions in the zone will be undertaken using multiple regulatory processes and decision documents. Cleanup actions will include building demolition, waste site and pipeline excavation, and the construction of multiple, large engineered barriers. In some cases, different cleanup actions may be taken at item locations that are immediately adjacent to each other. The cleanup planning and field activities for each cleanup item must be undertaken in a coordinated and cohesive manner to ensure effective execution of the UPZ cleanup initiative. The UPZ zone cleanup implementation plan (ZCIP) [1] was developed to address the need for a fundamental integration tool for UPZ cleanup. As UPZ cleanup planning and implementation moves forward, the ZCIP is intended to be a living document that will

  9. Global collective dose commitments from release of long-lived radionuclides. Differential cost-benefit considerations

    International Nuclear Information System (INIS)

    Gjoerup, H.L.

    1977-01-01

    The concept of global collective dose commitment as a measure of total detriment from the release of radioactivity to the environment is outlined. Estimates are given of global collective dose commitments resulting from the release of 14 C and uranium daughter products from the nuclear fuel cycle. Comparisons are made with similar estimates of global collective dose commitments resulting from the use of fossil fuels and certain fertilizers due to their content of uranium and its daughter products. In the case of long-lived radionuclides that remain in circulation in the biosphere, it is shown that the use of global collective dose commitments in differential cost-benefit analysis can lead to questionable results. In differential cost-benefit analysis it is suggested that population exposures should not simply be integrated irrespective of their time of occurrence, but that a certain discount rate should be applied for future doses. This suggestion is examined. (author)

  10. Antigenic evidence of bluetongue virus from small ruminant population of two different geographical regions of Odisha, India

    Directory of Open Access Journals (Sweden)

    Shaswati Subhadarsini Pany

    2016-03-01

    Full Text Available Aim: The aim of the present study was to carry out antigenic detection of bluetongue virus (BTV among the small ruminant population of two different geographical regions of Odisha (coastal and central using recombinant VP7 (r-VP-7 based sandwich enzyme-linked immunosorbent assay (s-ELISA. Materials and Methods: Blood samples (n=274 were collected from two different geographical pockets of Odisha, which covered mostly the coastal and central regions. Of the total samples under study 185 were from goat and 89 were from sheep. The blood samples were tested for the presence of BTV antigen by r-VP7 based s-ELISA. Results: r-VP-7 s-ELISA detected BTV antigen in 52.43% and 44.94% of the goat and sheep population under study, respectively. This study highlights the antigenic persistence of BTV in the state for the 1st time. Conclusion: This high antigenic presence in both sheep and goat population suggests an alarming BTV infection in field conditions which warrants more systematic study directed toward isolation and characterization studies as well as the implementation of control strategy for BT in Odisha.

  11. The costs of the different pathways of electricity production and saving

    International Nuclear Information System (INIS)

    Dessus, B.

    2012-01-01

    The author discusses the content and methodology of a report published by the French Court of Audit on the assessment of the costs of the nuclear sector. He briefly recalls the principle adopted by the Court, i.e. the method of the economic current cost which calculates a global MWh cost on the whole operation duration of the selected production tool. The author discusses the application of this method to different electricity production and consumption sectors: ground-based wind energy, the Flamanville EPR, use of low-energy bulbs, air-air heat pumps, a refrigerator. He compares and discusses the results obtained for different electricity production sectors (EPR, ground-based wind energy, and gas combined cycle technology) and their sensitivity to adopted hypotheses. He comments the evolution of the investment cost of nuclear reactors in France, the economic current costs of offshore wind energy and small photovoltaic production. He finally discusses the economic current costs of the different ways of energy saving and their sensitivity to the adopted hypotheses

  12. International differences in wage and nonwage labor costs

    OpenAIRE

    Riveros, Luis A.

    1989-01-01

    The ratio of nonwage labor costs (for social security, pensions, vacation days, severence compensation, and the like) to direct wage costs is proportionately higher in Europe and Latin America than in Asia and Africa - largely because workers there are protected more by regulations. The distortionary growth of labor costs because of increasing nonwage costs is not common in the LDCs however. The author of this paper found that international differences in labor costs are attributable largely ...

  13. Are There Geographical Variations in the Psychological Cost of Unemployment in South Africa?

    Science.gov (United States)

    Powdthavee, Nattavudh

    2007-01-01

    Are certain groups of unemployed individuals hurt less by unemployment than others? This paper is an attempt to test the hypothesis that non-pecuniary costs of unemployment may vary between societies with different unemployment rates. Using cross-sectional data from the SALDRU93 survey, I show that households' perceptions of life satisfaction are…

  14. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

    Science.gov (United States)

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-07-06

    Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

  15. Sex-specific differences of craniofacial traits in Croatia: the impact of environment in a small geographic area.

    Science.gov (United States)

    Buretic-Tomljanovic, Alena; Giacometti, Jasminka; Ostojic, Sasa; Kapovic, Miljenko

    2007-01-01

    Craniometric variation in humans reflects different genetic and environmental influences. Long-term climatic adaptation is less likely to show an impact on size and shape variation in a small local area than at the global level. The aim of this work was to assess the contribution of the particular environmental factors to body height and craniofacial variability in a small geographic area of Croatia. A total of 632 subjects, aged 18-21, participated in the survey. Body height, head length, head breadth, head height, head circumference, cephalic index, morphological face height, face breadth, and facial index were analysed regarding geographic, climatic and dietary conditions in different regions of the country, and correlated with the specific climatic variables (cumulative multiyear sunshine duration, cumulative multiyear average precipitation, multiyear average air temperatures) and calcium concentrations in drinking water. Significant differences between groups classified according to geographic, climatic or dietary affiliation, and the impact of the environmental predictors on the variation in the investigated traits were assessed using multiple forward stepwise regression analyses. Higher body height measures in both sexes were significantly correlated with Mediterranean diet type. Mediterranean diet type also contributed to higher head length and head circumference measures in females. Cephalic index values correlated to geographic regions in both sexes, showing an increase from southern to eastern Croatia. In the same direction, head length significantly decreased in males and head breadth increased in females. Mediterranean climate was associated with higher and narrower faces in females. The analysis of the particular climatic variables did not reveal a significant influence on body height in either sex. Concurrently, climatic features influenced all craniofacial traits in females and only head length and facial index in males. Mediterranean climate

  16. Transport link scanner: simulating geographic transport network expansion through individual investments

    Science.gov (United States)

    Jacobs-Crisioni, C.; Koopmans, C. C.

    2016-07-01

    This paper introduces a GIS-based model that simulates the geographic expansion of transport networks by several decision-makers with varying objectives. The model progressively adds extensions to a growing network by choosing the most attractive investments from a limited choice set. Attractiveness is defined as a function of variables in which revenue and broader societal benefits may play a role and can be based on empirically underpinned parameters that may differ according to private or public interests. The choice set is selected from an exhaustive set of links and presumably contains those investment options that best meet private operator's objectives by balancing the revenues of additional fare against construction costs. The investment options consist of geographically plausible routes with potential detours. These routes are generated using a fine-meshed regularly latticed network and shortest path finding methods. Additionally, two indicators of the geographic accuracy of the simulated networks are introduced. A historical case study is presented to demonstrate the model's first results. These results show that the modelled networks reproduce relevant results of the historically built network with reasonable accuracy.

  17. Competitive pricing in markets with different overhead costs : Concealment or leakage of cost information?

    NARCIS (Netherlands)

    Cardinaels, E.; Roodhooft, F.; Warlop, L.; Van Herck, G.

    2008-01-01

    This paper experimentally investigates how leaders and followers in a duopoly set prices for two product markets that have different overhead costs. In a fully crossed two‐by‐two design, we manipulate the participants' private cost report quality as either low or high, representing the extent to

  18. Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness.

    Science.gov (United States)

    Turrell, Gavin; Oldenburg, Brian F; Harris, Elizabeth; Jolley, Damien

    2004-04-01

    To examine the association between socio-economic status (SES) and GP utilisation across Statistical Local Areas (SLAs) that differed in their geographic remoteness, and to assess whether Indigenous status and GP availability modified the association. Retrospective analysis of Medicare data for all unreferred GP consultations (1996/97) for 952 SLAs comprising the six Australian States. Geographic remoteness was ascertained using the Area Remoteness Index of Australia (ARIA), and SES was measured by grouping SLAs into tertiles based on their Index of Relative Socioeconomic Disadvantage score. Age/sex standardised rates of GP utilisation for each SLA. In SLAs classified as 'highly accessible', rates of GP use were 10.8% higher (95% CI 5.7-16.0) in the most socio-economically disadvantaged tertile after adjustment for Indigenous status and GP availability. A very different pattern of GP utilsation was found in 'remote/very remote' SLAs. After adjustment, rates of GP use in the most socio-economically disadvantaged tertile were 25.3% lower (95% CI 5.9-40.7) than in the most advantaged tertile. People in socio-economically disadvantaged metropolitan SLAs have higher rates of GP utilisation, as would be expected due to their poorer health. This is not true for people living in disadvantaged remote/very remote SLAs: in these areas, those most in need of GP services are least likely to receive them. Australia may lay claim to having a primary health care system that provides universal coverage, but we are still some way from having a system that is economically and geographically accessible to all.

  19. Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods.

    Science.gov (United States)

    Nunes, Sheila Elke Araujo; Minamisava, Ruth; Vieira, Maria Aparecida da Silva; Itria, Alexander; Pessoa, Vicente Porfirio; Andrade, Ana Lúcia Sampaio Sgambatti de; Toscano, Cristiana Maria

    2017-01-01

    To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective. Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test. Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (pmetodologias de custeio, na perspectiva do Sistema Único de Saúde. Estudo de custo, com coleta de dados primários de uma amostra de 59 crianças com 28 dias a 35 meses de idade hospitalizadas por pneumonia bacteriana. Foram considerados custos diretos médicos e não médicos. Três metodologias de custeio foram utilizadas: microcusteio por revisão de prontuários, microcusteio considerando diretriz terapêutica e macrocusteio por ressarcimento do Sistema Único de Saúde. Os custos estimados pelas diferentes metodologias foram comparados utilizando o teste de Friedman. Os custos hospitalares de crianças com pneumonia grave foram R$ 780,70 ($Int. 858.7) por revisão de prontuários, R$ 641,90 ($Int. 706.90) por diretriz terapêutica e R$ 594,80 ($Int. 654.28) por

  20. Identifying Geographic Areas at Risk of Soil-transmitted Helminthes Infection Using Remote Sensing and Geographical Information Systems: Boaco, Nicaragua as a Case Study

    Science.gov (United States)

    Moreno, Max J.; Al-Hamdan, Mohammad Z.; Parajon, David G.; Rickman, Douglas L.; Luvall, Jeffrey; Estes, Sue; Podest, Erika

    2011-01-01

    Several types of intestinal nematodes, that can infect humans and specially school-age children living in poverty, develop part of their life cycle in soil. Presence and survival of these parasites in the soil depend on given environmental characteristics like temperature and moisture that can be inferred with remote sensing (RS) technology. Prevalence of diseases caused by these parasitic worms can be controlled and even eradicated with anthelmintic drug treatments and sanitation improvement. Reliable and updated identification of geographic areas at risk is required to implement effective public health programs; to calculate amount of drug required and to distribute funding for sanitation projects. RS technology and geographical information systems (GIS) will be used to analyze for associations between in situ prevalence and remotely sensed data in order to establish RS proxies of environmental parameters that indicate the presence of these parasits. In situ data on helminthisasis will be overlaid over an ecological map derived from RS data using ARC Map 9.3 (ESRI). Temperature, vegetation, and distance to bodies of water will be inferred using data from Moderate-Resolution Imaging Spectroradiometer (MODIS) and Landsat TM and ETM+. Elevation will be estimated with data from The Shuttle Radar Topography Mission (SRTM). Prevalence and intensity of infections are determined by parasitological survey (Kato Katz) of children enrolled in rural schools in Boaco, Nicaragua, in the communities of El Roblar, Cumaica Norte, Malacatoya 1, and Malacatoya 2). This study will demonstrate the importance of an integrated GIS/RS approach to define clusters and areas at risk. Such information will help to the implementation of time and cost efficient control programs and sanitation efforts.

  1. WAYS TO IMPROVE THE TRANSPORT OF LIVE FISH

    Directory of Open Access Journals (Sweden)

    V. Chernik

    2014-03-01

    Full Text Available Purpose. To calculate the cost of transportation of live fish by various means of transport and to identify ways to improve the efficiency of their transport. Methodology. The studies were conducted using an economic analysis. Findings. Based on the study we estimated the prime cost of live fish delivery, which ranged from 3.7 to 6.5 UAH for 1 km for the delivery of 1 ton depending on the type of vehicle. The main backup to increase the efficiency of the transport is to increase the density of fish. Total economic effect from introduction of a modernized park of transportation of live fish vehicles in Ukraine can be assessed based on the amount of commodity fish and stocking fish. So, last years, enterprises which report their activity in the bodies of state statistics, rear up to 20 000 t of common carp and silver carp annually. Greater part of fish will be sold to the eventual consumer in alive condition and the mean distance where the fish is transported is about 100 km. The economic effect from the decrease of prime price of transportation will make to 2 000 000 UAH per year. In addition, more than 1000 t of rainbow trout is delivered from Western regions of Ukraine at distances greater than 100 km. cost saving during transport of trout will make up to 500 000 UAH per year. Originality. An analysis of the use of different types of vehicles for the transport of live fish has been performed. Practical Value. To ensure the safe transport of live fish it is necessary to use modernized live fish vehicles.

  2. A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women

    Science.gov (United States)

    2011-01-01

    Background Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. Methods A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009. Results The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas. Conclusion It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic. PMID:21981986

  3. Low-cost, locally available shelters in Pakistan

    Directory of Open Access Journals (Sweden)

    Ammarah Mubarak

    2017-06-01

    Full Text Available Flooding in 2010 affected 18 million people in Pakistan. With declining donor funds and flooding again in 2011 and 2012, the humanitarian community required low-cost solutions that could be scaled up to meet both the immediate and the transitional needs of large populations in differing geographical areas.

  4. The Social Costs of Electricity Generation—Categorising Different Types of Costs and Evaluating Their Respective Relevance

    Directory of Open Access Journals (Sweden)

    Sascha Samadi

    2017-03-01

    Full Text Available Various electricity generation technologies using different primary energy sources are available. Many published studies compare the costs of these technologies. However, most of those studies only consider plant-level costs and do not fully take into account additional costs that societies may face in using these technologies. This article reviews the literature on the costs of electricity generation technologies, aiming to determine which types of costs are relevant from a societal point of view when comparing generation technologies. The paper categorises the relevant types of costs, differentiating between plant-level, system and external costs as the main categories. It discusses the relevance of each type of cost for each generation technology. The findings suggest that several low-carbon electricity generation technologies exhibit lower social costs per kWh than the currently dominant technologies using fossil fuels. More generally, the findings emphasise the importance of taking not only plant-level costs, but also system and external costs, into account when comparing electricity generation technologies from a societal point of view. The article intends to inform both policymakers and energy system modellers, the latter who may strive to include all relevant types of costs in their models.

  5. Cost distribution of bluetongue surveillance and vaccination programmes in Austria and Switzerland (2007–2016)

    Science.gov (United States)

    Pinior, Beate; Loitsch, Angelika; Stockreiter, Simon; Hutter, Sabine; Richter, Veronika; Lebl, Karin; Schwermer, Heinzpeter; Käsbohrer, Annemarie

    2018-01-01

    Bluetongue virus (BTV) is an emerging transboundary disease in Europe, which can cause significant production losses among ruminants. The analysis presented here assessed the costs of BTV surveillance and vaccination programmes in Austria and Switzerland between 2007 and 2016. Costs were compared with respect to time, type of programme, geographical area and who was responsible for payment. The total costs of the BTV vaccination and surveillance programmes in Austria amounted to €23.6 million, whereas total costs in Switzerland were €18.3 million. Our analysis demonstrates that the costs differed between years and geographical areas, both within and between the two countries. Average surveillance costs per animal amounted to approximately €3.20 in Austria compared with €1.30 in Switzerland, whereas the average vaccination costs per animal were €6.20 in Austria and €7.40 in Switzerland. The comparability of the surveillance costs is somewhat limited, however, due to differences in each nation’s surveillance (and sampling) strategy. Given the importance of the export market for cattle production, investments in such programmes are more justified for Austria than for Switzerland. The aim of the retrospective assessment presented here is to assist veterinary authorities in planning and implementing cost-effective and efficient control strategies for emerging livestock diseases. PMID:29363572

  6. Cost of production of live attenuated dengue vaccines: a case study of the Instituto Butantan, Sao Paulo, Brazil.

    Science.gov (United States)

    Mahoney, R T; Francis, D P; Frazatti-Gallina, N M; Precioso, A R; Raw, I; Watler, P; Whitehead, P; Whitehead, S S

    2012-07-06

    A vaccine to prevent dengue disease is urgently needed. Fortunately, a few tetravalent candidate vaccines are in the later stages of development and show promise. But, if the cost of these candidates is too high, their beneficial potential will not be realized. The price of a vaccine is one of the most important factors affecting its ultimate application in developing countries. In recent years, new vaccines such as those for human papilloma virus and pneumococcal disease (conjugate vaccine) have been introduced with prices in developed countries exceeding $50 per dose. These prices are above the level affordable by developing countries. In contrast, other vaccines such as those against Japanese encephalitis (SA14-14-2 strain vaccine) and meningitis type A have prices in developing countries below one dollar per dose, and it is expected that their introduction and use will proceed more rapidly. Because dengue disease is caused by four related viruses, vaccines must be able to protect against all four. Although there are several live attenuated dengue vaccine candidates under clinical evaluation, there remains uncertainty about the cost of production of these tetravalent vaccines, and this uncertainty is an impediment to rapid progress in planning for the introduction and distribution of dengue vaccines once they are licensed. We have undertaken a detailed economic analysis, using standard industrial methodologies and applying generally accepted accounting practices, of the cost of production of a live attenuated vaccine, originally developed at the US National Institutes of Health (National Institute of Allergy and Infectious Diseases), to be produced at the Instituto Butantan in Sao Paulo, Brazil. We determined direct costs of materials, direct costs of personnel and labor, indirect costs, and depreciation. These were analyzed assuming a steady-state production of 60 million doses per year. Although this study does not seek to compute the price of the final

  7. Costs and cost-effectiveness of different DOT strategies for the treatment of tuberculosis in Pakistan. Directly Observed Treatment.

    Science.gov (United States)

    Khan, M A; Walley, J D; Witter, S N; Imran, A; Safdar, N

    2002-06-01

    An economic study was conducted alongside a clinical trial at three sites in Pakistan to establish the costs and effectiveness of different strategies for implementing directly observed treatment (DOT) for tuberculosis. Patients were randomly allocated to one of three arms: DOTS with direct observation by health workers (at health centres or by community health workers); DOTS with direct observation by family members; and DOTS without direct observation. The clinical trial found no statistically significant difference in cure rate for the different arms. The economic study collected data on the full range of health service costs and patient costs of the different treatment arms. Data were also disaggregated by gender, rural and urban patients, by treatment site and by economic categories, to investigate the costs of the different strategies, their cost-effectiveness and the impact that they might have on patient compliance with treatment. The study found that direct observation by health centre-based health workers was the least cost-effective of the strategies tested (US dollars 310 per case cured). This is an interesting result, as this is the model recommended by the World Health Organization and International Union against Tuberculosis and Lung Disease. Attending health centres daily during the first 2 months generated high patient costs (direct and in terms of time lost), yet cure rates for this group fell below those of the non-observed group (58%, compared with 62%). One factor suggested by this study is that the high costs of attending may be deterring patients, and in particular, economically active patients who have most to lose from the time taken by direct observation. Without stronger evidence of benefits, it is hard to justify the costs to health services and patients that this type of direct observation imposes. The self-administered group came out as most cost-effective (164 dollars per case cured). The community health worker sub-group achieved the

  8. 42 CFR 435.135 - Individuals who become ineligible for cash assistance as a result of OASDI cost-of-living...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals who become ineligible for cash assistance as a result of OASDI cost-of-living increases received after April 1977. 435.135 Section 435.135..., Blind, and Disabled § 435.135 Individuals who become ineligible for cash assistance as a result of OASDI...

  9. Least cost supply strategies for wood chips

    DEFF Research Database (Denmark)

    Möller, Bernd

    The abstract presents a study based on a geographical information system, which produce  cost-supply curves by location for forest woods chips in Denmark.......The abstract presents a study based on a geographical information system, which produce  cost-supply curves by location for forest woods chips in Denmark....

  10. The intermediate effect of geographic proximity on intergenerational support: A comparison of France and Bulgaria

    Directory of Open Access Journals (Sweden)

    Leen Heylen

    2012-10-01

    Full Text Available BACKGROUND The geographic proximity of parents and adult children is a key element of intergenerational solidarity. Many studies have identified geographical distance as an important determinant of intergenerational support: living nearby increases the amount of mutual support provided. It can, however, also be regarded as a dimension of intergenerational solidarity: the current degree of proximity is the result of past migration decisions made by both generations, in which present and future care demands potentially played a key role. OBJECTIVE We take this endogenous nature of geographical distance into account by examining theindirect effect of the determinants of the actual level of support through geographical distance. Both upward support (personal care provided to mother and downward support (help with childcare received from mother are considered. METHODS Path analyses are performed on data from the Generations and Gender Survey for France and Bulgaria using a general latent-variable modelling framework in multiple-group models. RESULTS In addition to strongly affecting the level of support provided and received, geographical distance itself is affected by several individual and family-related variables, which in turn have an indirect effect on the level of intergenerational support. The results suggest that proximity can be used as an adaptive strategy: e.g., working adult children in France receive more help with childcare because of their greater proximity to their mothers. Having a greater care need may have triggered this choice of residence. Similarly, single parents with no partner to rely on tend to live closer to their mothers, and therefore receive more help. CONCLUSIONS Geographic proximity can be considered a latent form of solidarity that functions as a mediator between background factors and manifest, functional solidarity.

  11. Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China.

    Science.gov (United States)

    Zeng, Yi; Chen, Huashuai; Wang, Zhenglian; Land, Kenneth C

    2015-04-01

    To better understand future home-based care needs and costs for disabled elders in China. To further develop and apply the ProFamy extended cohort-component method and the most recent census and survey data. (a) Chinese disabled elders and the annual growth rate of the percentage of national gross domestic product (GDP) devoted to home-based care costs for disabled elders will increase much more rapidly than the growth of total elderly population; (b) home-based care needs and costs for disabled oldest-old aged 80+ will increase much faster than that for disabled young-old aged 65-79 after 2030; (c) disabled unmarried elders living alone and their home-based care costs increase substantially faster than those disabled unmarried elders living with children; (d) percent of rural disabled oldest-old will be substantially higher than that of rural population after 2030; (e) sensitivity analyses show that possible changes in mortality and elderly disability status are the major direct factors affecting home-based care needs and costs; (f) caregivers resources under the universal two-child policy will be substantially better than that under the rigorous fertility policy unchanged. We discuss policy recommendations concerning pathways to healthy aging with relatively reduced care costs, including reductions of the prevalence of disability, gender equality, the universal two-child policy and resources of caregivers, encouragements of rural-to-urban family migration and elder's residential proximity to their adult children, and remarriages of not-married elders. © The Author(s) 2014.

  12. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    Directory of Open Access Journals (Sweden)

    Tariq Luqman

    2010-07-01

    Full Text Available Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. Method To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009. We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. Results The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. Conclusions The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total

  13. Carbon and nitrogen accumulation in forest floor and surface soil under different geographic origins of Maritime pine (Pinus pinaster Aiton.) plantations

    Energy Technology Data Exchange (ETDEWEB)

    Ozdemir, E.; Oral, H. V.; Akburak, S.; Makineci, E.; Yilmaz, E.

    2013-09-01

    Aim of study: To determine if plantations consisting of different geographic origins of the Maritime pine (Pinus pinaster Aiton.) could have altered C and N stocks in the forest floor and surface soils. Area of study: Forest floor and mineral soil C and N stocks were measured in four adjacent plantations of different geographic origins of Maritime pine (Gironde, Toulon, Corsica and Spain) and adjacent primary native Sessile oak (Quercus petraea L.) at Burunsuz region in Belgrad Forest where is located in the Istanbul province in the Marmara geographical region between 41° 09’-41° 12’ N latitude and 28° 54’-29° 00’ E longitude in Turkey. Material and methods: Plots were compared as common garden experiments without replications. 15 surface soil (0-10 cm) and 15 forest floor samples were taken from each Maritime pine origins and adjacent native Sessile oak forest. C and N contents were determined on LECO Truspec 2000 CN analyzer. The statistical significance of the results was evaluated by one-way Analysis of Variance (ANOVA). Research highlights: Forest floor carbon mass, nitrogen concentration and nitrogen mass of forest floor showed a significant difference among origins. Soil carbon mass and nitrogen mass did not significantly differ among investigated plots. (Author)

  14. REVIEW OF METHODOLOGIES FOR COSTS CALCULATING OF RUMINANTS IN SLOVAKIA

    Directory of Open Access Journals (Sweden)

    Zuzana KRUPOVÁ

    2012-09-01

    Full Text Available The objective of this work was to synthesise and analyse the methodologies and the biological aspects of the costs calculation in ruminants in Slovakia. According to literature, the account classification of cost items is most often considered for construction of costing formula. The costs are mostly divided into fixed (costs independent from volume of herd’s production and variable ones (costs connected with improvement of breeding conditions. Cost for feeds and beddings, labour costs, other direct costs and depreciations were found as the most important cost items in ruminants. It can be assumed that including the depreciations into costs of the basic herd takes into consideration the real costs simultaneously invested into raising of young animals in the given period. Costs are calculated for the unit of the main and by-products and their classification is influenced mainly by the type of livestock and production system. In dairy cows is usually milk defined as the main product, and by- products are live born calf and manure. The base calculation unit is kilogram of milk (basic herd of cows and kilogram of gain and kilogram of live weight (young breeding cattle. In suckler cows is a live-born calf the main product and manure is the by-product. The costs are mostly calculated per suckler cow, live-born calf and per kilogram of live weight of weaned calf. Similar division of products into main and by-products is also in cost calculation for sheep categories. The difference is that clotted cheese is also considered as the main product of basic herd in dairy sheep and greasy wool as the by-products in all categories. Definition of the base calculation units in sheep categories followed the mentioned classification. The value of a by-product in cattle and sheep is usually set according to its quantity and intra- plant price of the by-product. In the calculation of the costs for sheep and cattle the “structural ewe” and “structural cow

  15. Cost distribution of bluetongue surveillance and vaccination programmes in Austria and Switzerland (2007-2016).

    Science.gov (United States)

    Pinior, Beate; Firth, Clair L; Loitsch, Angelika; Stockreiter, Simon; Hutter, Sabine; Richter, Veronika; Lebl, Karin; Schwermer, Heinzpeter; Käsbohrer, Annemarie

    2018-03-03

    Bluetongue virus (BTV) is an emerging transboundary disease in Europe, which can cause significant production losses among ruminants. The analysis presented here assessed the costs of BTV surveillance and vaccination programmes in Austria and Switzerland between 2007 and 2016. Costs were compared with respect to time, type of programme, geographical area and who was responsible for payment. The total costs of the BTV vaccination and surveillance programmes in Austria amounted to €23.6 million, whereas total costs in Switzerland were €18.3 million. Our analysis demonstrates that the costs differed between years and geographical areas, both within and between the two countries. Average surveillance costs per animal amounted to approximately €3.20 in Austria compared with €1.30 in Switzerland, whereas the average vaccination costs per animal were €6.20 in Austria and €7.40 in Switzerland. The comparability of the surveillance costs is somewhat limited, however, due to differences in each nation's surveillance (and sampling) strategy. Given the importance of the export market for cattle production, investments in such programmes are more justified for Austria than for Switzerland. The aim of the retrospective assessment presented here is to assist veterinary authorities in planning and implementing cost-effective and efficient control strategies for emerging livestock diseases. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Uncontacted Waorani in the Yasuní Biosphere Reserve: Geographical Validation of the Zona Intangible Tagaeri Taromenane (ZITT)

    Science.gov (United States)

    Pappalardo, Salvatore Eugenio; De Marchi, Massimo; Ferrarese, Francesco

    2013-01-01

    The Tagaeri Taromenane People are two indigenous groups belonging to the Waorani first nation living in voluntary isolation within the Napo region of the western Amazon rainforest. To protect their territory the Ecuadorean State has declared and geographically defined, by Decrees, the Zona Intangible Tagaeri Taromenane (ZITT). This zone is located within the UNESCO Yasuní Biosphere Reserve (1989), one of the most biodiverse areas in the world. Due to several hydrocarbon reserve exploitation projects running in the area and the advancing of a large-scale deforestation front, the survival of these groups is presently at risk. The general aim was to validate the ZITT boundary using the geographical references included in the Decree 2187 (2007) by analyzing the geomorphological characteristics of the area. Remote sensing data such as Digital Elevation Models (DEM), Landsat imagery, topographic cartography of IGM-Ecuador, and fieldwork geographical data have been integrated and processed by Geographical Information System (GIS). The ZITT presents two levels of geographic inconsistencies. The first dimension is about the serious cartographical weaknesses in the perimeter delimitation related to the impossibility of linking two rivers belonging to different basins while the second deals with the perimeter line not respecting the hydrographic network. The GIS analysis results clearly show that ZITT boundary is cartographically nonsense due to the impossibility of mapping out the perimeter. Furthermore, GIS analysis of anthropological data shows presence of Tagaeri Taromenane clans outside the ZITT perimeter, within oil production areas and in nearby farmer settlements, reflecting the limits of protection policies for non-contacted indigenous territory. The delimitation of the ZITT followed a traditional pattern of geometric boundary not taking into account the nomadic characteristic of Tagaeri Taromenane: it is necessary to adopt geographical approaches to recognize the

  17. [Multicriteria evaluation of environmental risk exposure using a geographic information system in Argentina].

    Science.gov (United States)

    Pietri, Diana De; Dietrich, Patricia; Mayo, Patricia; Carcagno, Alejandro

    2011-10-01

    Develop a spatial model that includes environmental factors posing a health hazard, for application in the Matanza-Riachuelo River Basin (MRB) in Argentina. Multicriteria evaluation procedures were used with geographic information systems to obtain territorial zoning based on the degree of suitability for residence. Variables that characterize the habitability of housing and potential sources of basin pollution were geographically referenced. Health information was taken from the Risk Factor Survey (RFS) to measure the relative risk of living in unsuitable areas (exposed population) compared with suitable areas (unexposed population). Sixty percent of the MRB area is in suitable condition, a situation that affects 40% of residents. The rest of the population lives in unsuitable territory, and 6% live in the basin's most unsuitable conditions. Environmental conditions that are detrimental to health in the unsuitable areas became evident during the interviews through three of the pathologies considered: diarrheal diseases, respiratory diseases, and cancer. A regional analysis that provides valid information to support decisionmaking was obtained. Considering the basin as a unit of analysis allowed the use of a single protocol to undertake comprehensive measurement of the magnitude of risk and, thus, set priorities.

  18. Rapid and sustained cost management

    International Nuclear Information System (INIS)

    Hanson, D.

    2009-01-01

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

  19. IL FENOMENO VOLUNTEERED GEOGRAPHIC INFORMATION

    Directory of Open Access Journals (Sweden)

    Flavio Lupia

    2014-12-01

    Full Text Available The contribution addresses the phenomenon of Voluntereed Geographic Informationexplaining these new and burgeoning sources of information offers multidisciplinary scientists an unprecedented opportunity to conduct research on a variety of topics at multiple spatial and temporal scales. In particular the contribution refers to two COST Actions which have been recently activated on the subject which areparticularly relevant for the growing of the European scientific community.

  20. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

    Directory of Open Access Journals (Sweden)

    Korenromp Eline L

    2012-03-01

    Full Text Available Abstract Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST, extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent. Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination. Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy

  1. Modeling the live-pig trade network in Georgia: Implications for disease prevention and control.

    Directory of Open Access Journals (Sweden)

    Esther Andrea Kukielka

    Full Text Available Live pig trade patterns, drivers and characteristics, particularly in backyard predominant systems, remain largely unexplored despite their important contribution to the spread of infectious diseases in the swine industry. A better understanding of the pig trade dynamics can inform the implementation of risk-based and more cost-effective prevention and control programs for swine diseases. In this study, a semi-structured questionnaire elaborated by FAO and implemented to 487 farmers was used to collect data regarding basic characteristics about pig demographics and live-pig trade among villages in the country of Georgia, where very scarce information is available. Social network analysis and exponential random graph models were used to better understand the structure, contact patterns and main drivers for pig trade in the country. Results indicate relatively infrequent (a total of 599 shipments in one year and geographically localized (median Euclidean distance between shipments = 6.08 km; IQR = 0-13.88 km pig movements in the studied regions. The main factors contributing to live-pig trade movements among villages were being from the same region (i.e., local trade, usage of a middleman or a live animal market to trade live pigs by at least one farmer in the village, and having a large number of pig farmers in the village. The identified villages' characteristics and structural network properties could be used to inform the design of more cost-effective surveillance systems in a country which pig industry was recently devastated by African swine fever epidemics and where backyard production systems are predominant.

  2. Environment and geographic distance differ in relative importance for determining fungal community of rhizosphere and bulk soil.

    Science.gov (United States)

    Zhang, Kaoping; Adams, Jonathan M; Shi, Yu; Yang, Teng; Sun, Ruibo; He, Dan; Ni, Yingying; Chu, Haiyan

    2017-09-01

    Rhizospheric fungi play major roles in both natural and agricultural ecosystems. However, little is known about the determinants of their diversity and biogeographic patterns. Here, we compared fungal communities in rhizosphere and bulk soils of wheat fields in the North China Plain. The rhizosphere had a lower fungal diversity (observed OTUs and Chao1) than bulk soil, and a distinct fungal community structure in rhizosphere compared with bulk soil. The relative importance of environmental factors and geographic distance for fungal distribution differed between rhizosphere and bulk soil. Environmental factors were the primary cause of variations in total fungal community and major fungal phyla in bulk soil. By contrast, fungal communities in soils loosely attached to roots were predictable from both environmental factors and influences of geographic distance. Communities in soils tightly attached to roots were mainly determined by geographic distance. Our results suggest that both contemporary environment processes (present-day abiotic and biotic environment characters) and historical processes (spatial isolation, dispersal limitation occurred in the past) dominate variations of fungal communities in wheat fields, but their relative importance of all these processes depends on the proximity of fungal community to the plant roots. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  3. The Value of Caregiver Time: Costs of Support and Care for Individuals Living with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Carolyn Dudley

    2014-01-01

    expensive condition and governments may underestimate the full cost of community-based supports needed for the vast range of unique needs of those living with autism. A scan of provincial programs finds a patchwork of unequal and incomplete supports for individuals living with autism spectrum disorders. Gaps are particularly evident once individuals leave the public school system, where they are at least provided with some form of day support. Sufficient adult day supports, evening and night supports, quality group homes, the availability of properly trained caregivers and respite services, recreational activities, post-secondary opportunities and employment supports all suffer varying levels of inadequacy across the country. As autism becomes increasingly prevalent, continuing to rely largely on family supports where community services are fragmented or unavailable is not a sustainable approach. Canadian policy-makers will need to consider the costs of a growing and aging population of individuals living with autism who need a range of supports so that adequate quality of care and a decent quality of life are enjoyed by many who remain some of this country’s most vulnerable citizens.

  4. How Do Social Capital and HIV/AIDS Outcomes Geographically Cluster and Which Sociocontextual Mechanisms Predict Differences Across Clusters?

    Science.gov (United States)

    Ransome, Yusuf; Dean, Lorraine T; Crawford, Natalie D; Metzger, David S; Blank, Michael B; Nunn, Amy S

    2017-09-01

    Place of residence has been associated with HIV transmission risks. Social capital, defined as features of social organization that improve efficiency of society by facilitating coordinated actions, often varies by neighborhood, and hypothesized to have protective effects on HIV care continuum outcomes. We examined whether the association between social capital and 2 HIV care continuum outcomes clustered geographically and whether sociocontextual mechanisms predict differences across clusters. Bivariate Local Moran's I evaluated geographical clustering in the association between social capital (participation in civic and social organizations, 2006, 2008, 2010) and [5-year (2007-2011) prevalence of late HIV diagnosis and linkage to HIV care] across Philadelphia, PA, census tracts (N = 378). Maps documented the clusters and multinomial regression assessed which sociocontextual mechanisms (eg, racial composition) predict differences across clusters. We identified 4 significant clusters (high social capital-high HIV/AIDS, low social capital-low HIV/AIDS, low social capital-high HIV/AIDS, and high social capital-low HIV/AIDS). Moran's I between social capital and late HIV diagnosis was (I = 0.19, z = 9.54, P social capital was lowest and HIV burden the highest, compared with clusters with high social capital and lowest HIV burden. The association between social participation and HIV care continuum outcomes cluster geographically in Philadelphia, PA. HIV prevention interventions should account for this phenomenon. Reducing geographic disparities will require interventions tailored to each continuum step and that address socioeconomic factors such as neighborhood median income.

  5. ROMANIA: GEOGRAPHICAL AND GEOPOLITICAL POSITION

    Directory of Open Access Journals (Sweden)

    Ciprian Beniamin Benea

    2016-12-01

    Full Text Available The paper intends to bring to the reader’s attention the importance of understanding the role education plays in creating a good geopolitical position for a state which has a good geographical position, and which is well endowed in natural resources. The case of Romania is the main focus of the paper. There is presented a peculiar strange situation of a country (Romania which is very well located from geographical point of view but which is incapable to exploit its natural endowments and special location. One reason for this situation is the fact that most people living in present Romania belong to a category named in this paper ‘individuals’. Individuals are not aware of their country’s geography and history, let alone its possible future development possibilities. They do not know the role their country could play, and living in an atomized society, they choose emigration as the easiest way to escape harsh social and economic environment. Contrary to this attitude is that of a citizen, a man conscious about his country’s potential, and which is dedicated to work hardly together with his fellows in order to promote national interests in a peaceful manner. Even there was found remnants of an ancient city close to present day Romanian territory – proves of well endowed environment – moral and psychological factors have contributed after 1990 in an crucial manner to push Romania from its civilization path back to the archaic spirit, from active urban spirit to rural mentality. In such a situation it is not uncommon for a nation to lose its means for projecting power, which could promote the value and the importance of a geographical position – transportation; rural mentality has nothing to do with modern transportation as they are technical tools with geopolitical essence for controlling space. It is a well known fact that transportation and geopolitics are closely interrelated. Furthermore, social dissolution in post communist

  6. Costs of Tractor Ownership under Different Management Systems in ...

    African Journals Online (AJOL)

    Costs of Tractor Ownership under Different Management Systems in Nigeria. ... It requires high initial capital investment. ... making management plans and decisions especially in comparing different tractor types and models thereby assisting ...

  7. Development of mathematical models to elaborate strategies, select alternatives and development of plans for adaptation of communities to climate change in different geographical areas including costs to implement it

    Science.gov (United States)

    Anton, J. M.; Grau, J. B.; Tarquis, A. M.; Andina, D.; Cisneros, J. M.

    2012-04-01

    There is evidence that the climate changes and that now, the change is influenced and accelerated by the CO2 augmentation in atmosphere due to combustion by humans. Such "Climate change" is on the policy agenda at the global level, with the aim of understanding and reducing its causes and to mitigate its consequences. In most countries and international organisms UNO (e.g. Rio de Janeiro 1992), OECD, EC, etc … the efforts and debates have been directed to know the possible causes, to predict the future evolution of some variable conditioners, and trying to make studies to fight against the effects or to delay the negative evolution of such. The Protocol of Kyoto 1997 set international efforts about CO2 emissions, but it was partial and not followed e.g. by USA and China …, and in Durban 2011 the ineffectiveness of humanity on such global real challenges was set as evident. Among all that, the elaboration of a global model was not boarded that can help to choose the best alternative between the feasible ones, to elaborate the strategies and to evaluate the costs, and the authors propose to enter in that frame for study. As in all natural, technological and social changes, the best-prepared countries will have the best bear and the more rapid recover. In all the geographic areas the alternative will not be the same one, but the model must help us to make the appropriated decision. It is essential to know those areas that are more sensitive to the negative effects of climate change, the parameters to take into account for its evaluation, and comprehensive plans to deal with it. The objective of this paper is to elaborate a mathematical model support of decisions, which will allow to develop and to evaluate alternatives of adaptation to the climatic change of different communities in Europe and Latin-America, mainly in especially vulnerable areas to the climatic change, considering in them all the intervening factors. The models will consider criteria of physical

  8. Variation in the Cost of Managing Actinic Keratosis

    Science.gov (United States)

    Gregory, Tanner; Liu, Guodong; Leslie, Douglas L.; Miller, Jeffrey J.

    2017-01-01

    Importance Actinic keratosis (AK), a skin growth induced by ultraviolet light exposure, requires chronic management because a small proportion can progress into squamous cell skin cancer. Spending for AK management was more than $1 billion in 2004. Investigating geographic variation in AK spending presents an opportunity to decrease waste or recoup excess spending. Objective To evaluate geographic variation in health care cost for management of AKs and the association with patient-related and health-related factors. Design, Setting, and Participants This retrospective cohort study was performed using data from the MarketScan medical claims database of 488 324 continuously enrolled members with 2 or more claims for AK. Data from January 1, 2008, to December 31, 2012, was used. Main Outcomes and Measures Annual costs of care were calculated for outpatient visits, AK destruction, and medications for AKs, and the total of these components. Costs were adjusted for inflation to 2014 US dollars. To display cost variation, we calculated the ratio of mean cost in the highest quintile (Q5) relative to the mean in the lowest quintile (Q1), or the Q5:Q1 ratio; Q5:Q1 ratios were adjusted based on age, sex, history of nonmelanoma skin cancer, US geographic region, and population density (metropolitan statistical area). Results Overall, data from 488 324 continuously enrolled members (mean [SD] age, 53.1 [7.5] years; 243 662 women) with 2 or more claims for AK were included. Overall, patients had 1 085 985 claims related to AK, and dermatologists accounted for 71.0% of claims. The 2-year total cost was $111.5 million, with $52.4 million in 2011 and $59.1 million in 2012. The unadjusted Q5:Q1 ratios for total annual cost per patient ranged from 9.49 to 15.10. Adjusted ratios ranged from 1.72 to 1.80. Conclusions and Relevance There is variation in AK management cost within and between regions. This is not fully explained by differences in patient characteristics such as

  9. Stress associated with group living in a long-lived bird.

    Science.gov (United States)

    Selva, Nuria; Cortés-Avizanda, Ainara; Lemus, Jesús A; Blanco, Guillermo; Mueller, Thomas; Heinrich, Bernd; Donázar, José A

    2011-08-23

    Many long-lived avian species adopt life strategies that involve a gregarious way of life at juvenile and sub-adult stages and territoriality during adulthood. However, the potential associated costs of these life styles, such as stress, are poorly understood. We examined the effects of group living, sex and parasite load on the baseline concentration of faecal stress hormone (corticosterone) metabolites in a wild population of common ravens (Corvus corax). Corticosterone concentrations were significantly higher in non-breeding gregarious ravens than in territorial adults. Among territorial birds, males showed higher stress levels than their mates. Parasite burdens did not affect hormone levels. Our results suggest a key role of the social context in the stress profiles of the two population fractions, and that group living may be more energetically demanding than maintaining a territory. These findings have implications for understanding hormonal mechanisms under different life styles and may inspire further research on the link between hormone levels and selective pressures modulating gregarious and territorial strategies in long-lived birds. This journal is © 2011 The Royal Society

  10. Differences in ability to perform activities of daily living among women with fibromyalgia: A cross-sectional study.

    Science.gov (United States)

    von Bülow, Cecilie; Amris, Kirstine; la Cour, Karen; Danneskiold-Samsøe, Bente; Ejlersen, Eva Wæhrens

    2015-11-01

    To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences in ability to perform activities of daily living. Cross-sectional study. A total of 257 women with fibromyalgia. Participants were evaluated with the AMPS (measuring activities of daily living motor and activities of daily living process ability), FIQ and SF-36. AMPS independence cut-offs were used to divide the participants into 4 subgroups. Clinically relevant differences between subgroups were investigated based on the AMPS, FIQ PF and SF-36 PF. Participants in the 4 AMPS-derived subgroups demon-strated clinically relevant differences in observed activities of daily living motor and process ability. Neither the FIQ PF nor the SF-36 PF could differentiate between subgroups with clinically relevant differences in AMPS activities of daily living process ability. Activities of daily living process skills reflect underlying organizational and adaptive capacities of the individual and are relevant targets for interventions aiming at improving activities of daily living ability. Since self-report instruments do not capture differences in activities of daily living process ability, clinicians should include observations-based assessment of activities of daily living ability in order to individualize interventions offered.

  11. Toward a low-cost gait analysis system for clinical and free-living assessment.

    Science.gov (United States)

    Ladha, Cassim; Del Din, Silvia; Nazarpour, Kianoush; Hickey, Aodhan; Morris, Rosie; Catt, Michael; Rochester, Lynn; Godfrey, Alan

    2016-08-01

    Gait is an important clinical assessment tool since changes in gait may reflect changes in general health. Measurement of gait is a complex process which has been restricted to bespoke clinical facilities until recently. The use of inexpensive wearable technologies is an attractive alternative and offers the potential to assess gait in any environment. In this paper we present the development of a low cost analysis gait system built using entirely open source components. The system is used to capture spatio-temporal gait characteristics derived from an existing conceptual model, sensitive to ageing and neurodegenerative pathology (e.g. Parkinson's disease). We demonstrate the system is suitable for use in a clinical unit and will lead to pragmatic use in a free-living (home) environment. The system consists of a wearable (tri-axial accelerometer and gyroscope) with a Raspberry Pi module for data storage and analysis. This forms ongoing work to develop gait as a low cost diagnostic in modern healthcare.

  12. The costs, effects and cost-effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: systematic review of the grey literature.

    Science.gov (United States)

    Batt, Katherine; Fox-Rushby, J A; Castillo-Riquelme, Marianela

    2004-09-01

    Evidence-based reviews of published literature can be subject to several biases. Grey literature, however, can be of poor quality and expensive to access. Effective search strategies also vary by topic and are rarely known in advance. This paper complements a systematic review of the published literature on the costs and effects of expanding immunization services in developing countries. The quality of data on the effectiveness and cost-effectiveness of strategies to increase immunization coverage is shown to be similar across literatures, but the quality of information on costing is much lower in the grey literature. After excluding poorer quality studies from this review we found the quantity of available evidence almost doubled, particularly for more complex health-system interventions and cost or cost-effectiveness analyses. Interventions in the grey literature are more up to date and cover a different geographical spread. Consequently the conclusions of the published and grey literatures differ, although the number of papers is still too low to account for differences across types of interventions. We recommend that in future researchers consider using non-English keywords in their searches.

  13. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    OpenAIRE

    Lucas Miyake Okumura; Bruno Salgado Riveros; Monica Maria Gomes-da-Silva; Izelandia Veroneze

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardshi...

  14. Hands-On Experiences in Deploying Cost-Effective Ambient-Assisted Living Systems.

    Science.gov (United States)

    Dasios, Athanasios; Gavalas, Damianos; Pantziou, Grammati; Konstantopoulos, Charalampos

    2015-06-18

    Older adults' preferences to remain independent in their own homes along with the high costs of nursing home care have motivated the development of Ambient Assisted Living (AAL) technologies which aim at improving the safety, health conditions and wellness of the elderly. This paper reports hands-on experiences in designing, implementing and operating UbiCare, an AAL based prototype system for elderly home care monitoring. The monitoring is based on the recording of environmental parameters like temperature and light intensity as well as micro-level incidents which allows one to infer daily activities like moving, sitting, sleeping, usage of electrical appliances and plumbing components. The prototype is built upon inexpensive, off-the-shelf hardware (e.g., various sensors, Arduino microcontrollers, ZigBee-compatible wireless communication modules) and license-free software, thereby ensuring low system deployment costs. The network comprises nodes placed in a house's main rooms or mounted on furniture, one wearable node, one actuator node and a centralized processing element (coordinator). Upon detecting significant deviations from the ordinary activity patterns of individuals and/or sudden falls, the system issues automated alarms which may be forwarded to authorized caregivers via a variety of communication channels. Furthermore, measured environmental parameters and activity incidents may be monitored through standard web interfaces.

  15. Hands-On Experiences in Deploying Cost-Effective Ambient-Assisted Living Systems

    Directory of Open Access Journals (Sweden)

    Athanasios Dasios

    2015-06-01

    Full Text Available Older adults’ preferences to remain independent in their own homes along with the high costs of nursing home care have motivated the development of Ambient Assisted Living (AAL technologies which aim at improving the safety, health conditions and wellness of the elderly. This paper reports hands-on experiences in designing, implementing and operating UbiCare, an AAL based prototype system for elderly home care monitoring. The monitoring is based on the recording of environmental parameters like temperature and light intensity as well as micro-level incidents which allows one to infer daily activities like moving, sitting, sleeping, usage of electrical appliances and plumbing components. The prototype is built upon inexpensive, off-the-shelf hardware (e.g., various sensors, Arduino microcontrollers, ZigBee-compatible wireless communication modules and license-free software, thereby ensuring low system deployment costs. The network comprises nodes placed in a house’s main rooms or mounted on furniture, one wearable node, one actuator node and a centralized processing element (coordinator. Upon detecting significant deviations from the ordinary activity patterns of individuals and/or sudden falls, the system issues automated alarms which may be forwarded to authorized caregivers via a variety of communication channels. Furthermore, measured environmental parameters and activity incidents may be monitored through standard web interfaces.

  16. Carbon and nitrogen accumulation in forest floor and surface soil under different geographic origins of Maritime pine (Pinus pinaster Aiton. plantations

    Directory of Open Access Journals (Sweden)

    E. Ozdemir

    2013-07-01

    Full Text Available Aim of study : To determine if plantations consisting of different geographic origins of the Maritime pine (Pinus pinaster Aiton. could have altered C and N stocks in the forest floor and surface soils.Area of study : Forest floor and mineral soil C and N stocks were measured in four adjacent plantations of different geographic origins of Maritime pine (Gironde, Toulon, Corsica and Spain and adjacent primary native Sessile oak (Quercus petraea L. at Burunsuz region in Belgrad Forest where is located in the Istanbul province in the Marmara geographical region between 41°09' -41°12' N latitude and 28°54' - 29°00' E longitude in Turkey.Material and Methods : Plots were compared as common garden experiments without replications. 15 surface soil (0-10 cm and 15 forest floor samples were taken from each Maritime pine origins and adjacent native Sessile oak forest. C and N contents were determined on LECO Truspec 2000 CN analyzer. The statistical significance of the results was evaluated by one-way Analysis of Variance (ANOVA.Research highlights : Forest floor carbon mass, nitrogen concentration and nitrogen mass of forest floor showed a significant difference among origins. Soil carbon mass and nitrogen mass did not significantly differ among investigated plots.Keywords: carbon sequestration; C/N ratio; decomposition; exotic; tree provenance.

  17. Cultural Differences on Chinese and English Idioms of Diet and the Translation

    Science.gov (United States)

    Yang, Chunli

    2010-01-01

    Idioms is a special culture which is shaped in the daily lives of the local people, particularly the idioms of diet has a close relation with various elements, such as the eating custom, history, fairy tales, geographic situations. Also, different ways of translation on different diet idioms in English and Chinese will be analyzed in this article.…

  18. Gender, race, age, and regional differences in the association of pulse pressure with atrial fibrillation: the Reasons for Geographic and Racial Differences in Stroke study.

    Science.gov (United States)

    Ghazi, Lama; Safford, Monika M; Khodneva, Yulia; O'Neal, Wesley T; Soliman, Elsayed Z; Glasser, Stephen P

    2016-08-01

    Pulse pressure (PP) has been associated with atrial fibrillation (AF) independent of other measures of arterial pressure and other AF risk factors. However, the impact of gender, race, age, and geographic region on the association between PP and AF is unclear. A cross-sectional study of data from 25,109 participants (65 ± 9 years, 54% women, 40% black) from the Reasons for Geographic and Racial Differences in Stroke study recruited between 2003 and 2007 were analyzed. AF was defined as a self-reported history of a previous physician diagnosis or presence of AF on ECG. Multivariable logistic regression models were used to calculate the odds ratio for AF. Interactions for age (race, and region were examined in the multivariable adjusted model. The prevalence of AF increased with widening PP (7.9%, 7.9%, 8.4%, and 11.6%, for PP differences by gender, race, and region were observed. However, there was evidence of significant effect modification by age (interaction P = .0002). For those differ for older versus younger individuals. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  19. Improvements in low-cost label-free QPI microscope for live cell imaging

    Science.gov (United States)

    Seniya, C.; Towers, C. E.; Towers, D. P.

    2017-07-01

    This paper reports an improvement in the development of a low-cost QPI microscope offering new capabilities in term of phase measurement accuracy for label-free live samples in the longer term (i.e., hours to days). The spatially separated scattered and non-scattered image light fields are reshaped in the Fourier plane and modulated to form an interference image at a CCD camera. The apertures that enable these two beams to be generated have been optimised by means of laser-cut apertures placed on the mirrors of a Michelson interferometer and has improved the phase measuring and reconstruction capability of the QPI microscope. The microscope was tested with transparent onion cells as an object of interest.

  20. Cost Analysis of Water Transport for Climate Change Impact Assessment

    Science.gov (United States)

    Szaleniec, V.; Buytaert, W.

    2012-04-01

    It is expected that climate change will have a strong impact on water resources worldwide. Many studies exist that couple the output of global climate models with hydrological models to assess the impact of climate change on physical water availability. However, the water resources topology of many regions and especially that of cities can be very complex. Changes in physical water availability do therefore not translate easily into impacts on water resources for cities. This is especially the case for cities with a complex water supply topology, for instance because of geographical barriers, strong gradients in precipitation patterns, or competing water uses. In this study we explore the use of cost maps to enable the inclusion of water supply topologies in climate change impact studies. We use the city of Lima as a case study. Lima is the second largest desert city in the world. Although Peru as a whole has no water shortage, extreme gradients exist. Most of the economic activities including the city of Lima are located in the coastal desert. This region is geographically disconnected from the wet Amazon basin because of the Andes mountain range. Hence, water supply is precarious, provided by a complex combination of high mountain ecosystems including wetlands and glaciers, as well as groundwater aquifers depending on recharge from the mountains. We investigate the feasibility and costs of different water abstraction scenarios and the impact of climate change using cost functions for different resources. The option of building inter basins tunnels across the Andes is compared to the costs of desalinating seawater from the Pacific Ocean under different climate change scenarios and population growth scenarios. This approach yields recommendations for the most cost-effective options for the future.

  1. Living antennas on communication satellites

    DEFF Research Database (Denmark)

    Lumholt, Michael

    2003-01-01

    Crises change the global pattern of communication. The communications problems occur because the satellites are optimized to cover specific geographic areas, and these areas cannot be altered once the satellites are in Earth orbit. An effective solution to the problem is to equip communication sa...... satellites with "living" antennas that can adjust their radiation coverage areas according to the new demands. The development of living antennas is, therefore, among the focus areas identified and supported by the European Space Agency, ESA....

  2. Geographic profiling and animal foraging.

    Science.gov (United States)

    Le Comber, Steven C; Nicholls, Barry; Rossmo, D Kim; Racey, Paul A

    2006-05-21

    Geographic profiling was originally developed as a statistical tool for use in criminal cases, particularly those involving serial killers and rapists. It is designed to help police forces prioritize lists of suspects by using the location of crime scenes to identify the areas in which the criminal is most likely to live. Two important concepts are the buffer zone (criminals are less likely to commit crimes in the immediate vicinity of their home) and distance decay (criminals commit fewer crimes as the distance from their home increases). In this study, we show how the techniques of geographic profiling may be applied to animal data, using as an example foraging patterns in two sympatric colonies of pipistrelle bats, Pipistrellus pipistrellus and P. pygmaeus, in the northeast of Scotland. We show that if model variables are fitted to known roost locations, these variables may be used as numerical descriptors of foraging patterns. We go on to show that these variables can be used to differentiate patterns of foraging in these two species.

  3. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    OpenAIRE

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    Abstract There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial s...

  4. Modeling of geographical pricing: A game analysis of siberian fuel costs

    Science.gov (United States)

    Sivushina, Anastasiya; Kombu, Anchy; Ryumkin, Valeriy

    2017-11-01

    In the present study, we propose a novel game-theoretic pricing model describing the interaction between producers and retailers of goods in conditions of poor transport infrastructure and sparse geographical distribution of the points of sale. The proposed model generalizes the Stackelberg leadership model for an arbitrary number of leaders and followers. We show that the model always has a Nash and Stackelberg equilibria. We also provide formulas for the equilibrium prices and volume of sales. As an example we model diesel pricing in south Siberia. Our model found no signs of a cartel. The results of this paper can be used by policymakers to inform market regulations aimed at promoting free competition and avoiding monopolies in production and retail of goods.

  5. Differences in ability to perform activities of daily living among women with fibromyalgia

    DEFF Research Database (Denmark)

    von Bülow, Cecilie; Amris, Kirstine; La Cour, Karen

    2015-01-01

    Objective: To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences...... in ability to perform activities of daily living. Design: Cross-sectional study. Subjects: A total of 257 women with fibromyalgia. Methods: Participants were evaluated with the AMPS (measuring activities of daily living motor and activities of daily living process ability), FIQ and SF-36. AMPS independence...

  6. RURAL-URBAN DIFFERENCES IN NURSING HOME ACCESS, QUALITY AND COST

    OpenAIRE

    Yu, Wei; Bradford, Garnett L.

    1995-01-01

    Rural-urban differences in the supply of nursing home services as hypothesized to be jointly affected by competitive and regulatory forces, government policies, and the cost structure. Study findings indicate that rural services are slightly less accessible and lower in quality. A translog cost share function reveals no difference in the operating cost structure of rural and urban homes. Cost shares for nursing care are directly related to the degree of skilled nursing provided by homes. Sign...

  7. Saving lives and saving money: hospital-based violence intervention is cost-effective.

    Science.gov (United States)

    Juillard, Catherine; Smith, Randi; Anaya, Nancy; Garcia, Arturo; Kahn, James G; Dicker, Rochelle A

    2015-02-01

    Victims of violence are at significant risk for injury recidivism, including fatality. We previously demonstrated that our hospital-based violence intervention program (VIP) resulted in a fourfold reduction in injury recidivism, avoiding trauma care costs of $41,000 per injury. Given limited trauma center resources, assessing cost-effectiveness of interventions is fundamental to inform use of these programs in other institutions. This study examines the cost-effectiveness of hospital-based VIP. We used a decision tree and Markov disease state modeling to analyze cost utility for a hypothetical cohort of violently injured subjects, comparing VIP versus no VIP at a trauma center. Quality-adjusted life-years (QALYs) were calculated using differences in mortality and published health state utilities. Costs of trauma care and VIP were obtained from institutional data, and risk of recidivism with and without VIP were obtained from our trial. Outcomes were QALYs gained and net costs over a 5-year horizon. Sensitivity analyses examined the impact of uncertainty in input values on results. VIP results in an estimated 25.58 QALYs and net costs (program plus trauma care) of $5,892 per patient. Without VIP, these values are 25.34 and $5,923, respectively, suggesting that VIP yields substantial health benefits (24 QALYs) and savings ($4,100) if implemented for 100 individuals. In the sensitivity analysis, net QALYs gained with VIP nearly triple when the injury recidivism rate without VIP is highest. Cost-effectiveness remained robust over a range of values; $6,000 net cost savings occur when 5-year recidivism rate without VIP is at 7%. VIP costs less than having no VIP with significant gains in QALYs especially at anticipated program scale. Across a range of plausible values at which VIP would be less cost-effective (lower injury recidivism, cost of injury, and program effectiveness), VIP still results in acceptable cost per health outcome gained. VIP is effective and cost

  8. Ventilation cost impact of reduced radon-daughter working levels

    International Nuclear Information System (INIS)

    Bates, R.C.

    1981-01-01

    Published information on costs of radon-daughter control in uranium mines was analyzed to develop estimates of the cost per ton for any level of radiation exposure control. All data were converted to 1967 cost of living index to provide a common analysis base. Results of the analysis show that the cost per ton increases exponentially as the radiation level is lowered. A linear relationship with the cost of living index is assumed, and equations and graphs are provided to estimate control cost per ton for any exposure control level and cost of living index

  9. Geographic Disparities in Access to Agencies Providing Income-Related Social Services.

    Science.gov (United States)

    Bauer, Scott R; Monuteaux, Michael C; Fleegler, Eric W

    2015-10-01

    Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.

  10. The Evolutionary Relationships between Endosymbiotic Green Algae of Paramecium bursaria Syngens Originating from Different Geographical Locations.

    Science.gov (United States)

    Zagata, Patrycja; Greczek-Stachura, Magdalena; Tarcz, Sebastian; Rautian, Maria

    2016-01-01

    Paramecium bursaria (Ehrenberg 1831), a freshwater ciliate, typically harbors hundreds of green algal symbionts inside the cell. The aim of present study was the molecular identification of newly analyzed P. bursaria symbionts. The second aspect of the present survey was testing a hypothesis whether endosymbionts prefer the specified syngen of the host, and the specified geographical distribution. Ten strains of endosymbionts isolated from strains of P. bursaria originating from different geographical locations were studied. We analyzed for the first time, both the fragment of plastid genome containing 3'rpl36-5' infA genes and a fragment of a nuclear gene encoding large subunit ribosomal RNA (LSU rDNA). The analysis of the LSU rDNA sequences showed the existence of 3 haplotypes and the haplotype diversity of 0.733, and 8 haplotypes for the 3'rpl36-5' infA gene fragment and haplotype diversity of 0.956. The endosymbionts isolated from P. bursaria strains were identified as Chlorella vulgaris, Ch. variabilis and Micractinium conductrix. There was no correlation between the syngen of P. bursaria and the species of endosymbiont.

  11. Do consumers' preferences for improved provision of malaria treatment services differ by their socio-economic status and geographic location? A study in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Tasie Nnenna G

    2010-01-01

    Full Text Available Abstract Background Improvement of utilization of malaria treatment services will depend on provision of treatment services that different population groups of consumers prefer and would want to use. Treatment of malaria in Nigeria is still problematic and this contributes to worsening burden of the disease in the country. Therefore this study explores the socio-economic and geographic differences in consumers' preferences for improved treatment of malaria in Southeast Nigeria and how the results can be used to improve the deployment of malaria treatment services. Methods This study was undertaken in Anambra state, Southeast Nigeria in three rural and three urban areas. A total of 2,250 randomly selected householders were interviewed using a pre tested interviewer administered questionnaire. Preferences were elicited using both a rating scale and ranking of different treatment provision sources by the respondents. A socio-economic status (SES index was used to examine for SES differences, whilst urban-rural comparison was used to examine for geographic differences, in preferences. Results The most preferred source of provision of malaria treatment services was public hospitals (30.5%, training of mothers (19% and treatment in Primary healthcare centres (18.1%. Traditional healers (4.8% and patent medicine dealers (4.2% were the least preferred strategies for improving malaria treatment. Some of the preferences differed by SES and by a lesser extent, the geographic location of the respondents. Conclusion Preferences for provision of improved malaria treatment services were influenced by SES and by geographic location. There should be re-invigoration of public facilities for appropriate diagnosis and treatment of malaria, in addition to improving the financial and geographic accessibility of such facilities. Training of mothers should be encouraged but home management will not work if the quality of services of patent medicine dealers and pharmacy

  12. Geographic variation in the surgical management of lumbar spondylolisthesis: characterizing practice patterns and outcomes.

    Science.gov (United States)

    Azad, Tej D; Vail, Daniel; O'Connell, Chloe; Han, Summer S; Veeravagu, Anand; Ratliff, John K

    2018-05-07

    The role of arthrodesis in the surgical management of lumbar spondylolisthesis remains controversial. We hypothesized that practice patterns and outcomes for this patient population may vary widely. To characterize geographic variation in surgical practices and outcomes for patients with lumbar spondylolisthesis. Retrospective analysis on a national longitudinal database between 2007 and 2014. We calculated arthrodesis rates, inpatient and long term costs, and key quality indicators (e.g. reoperation rates). Using linear and logistic regression models, we then calculated expected quality indicator values, adjusting for patient-level demographic factors, and compared these values to the observed values, to assess quality variation apart from differences in patient populations. We identified a cohort of 67,077 patients (60.7% female, mean age of 59.8 years (SD, 12.0) with lumbar spondylolisthesis who received either laminectomy or laminectomy with arthrodesis. The majority of patients received arthrodesis (91.8%). Actual rates of arthrodesis varied from 97.5% in South Dakota to 81.5% in Oregon. Geography remained a significant predictor of arthrodesis even after adjusting for demographic factors (pgeographic variation was also observed in initial costs ($32,485 in Alabama to $78,433 in Colorado), two-year post-operative costs ($15,612 in Arkansas to $34,096 in New Jersey), length of hospital stay (2.6 days in Arkansas to 4.5 in Washington, D.C.), 30-day complication rates (9.5% in South Dakota to 22.4% in Maryland), 30-day readmission rates (2.5% in South Dakota to 13.6% in Connecticut), and reoperation rates (1.8% in Maine to 12.7% in Alabama). There is marked geographic variation in the rates of arthrodesis in treatment of spondylolisthesis within the United States. This variation remains pronounced after accounting for patient-level demographic differences. Costs of surgery and quality outcomes also vary widely. Further study is necessary to understand the drivers

  13. Effects of living environment on the postoperative Scoliosis Research Society-24 results in females with adolescent idiopathic scoliosis

    OpenAIRE

    Misterska, Ewa; G?owacki, Maciej; Panek, S?awomir; Igny?-O?Byrne, Anna; G?owacki, Jakub; Igny?, Iwona; Krauss, Hanna; Pi?tek, Jacek

    2012-01-01

    Summary Background There are many factors influencing postoperative health-related quality of life of adolescent idiopathic scoliosis patients, including the degree of the deformity, culture, differences in geography, rural versus urban living environments, and social factors. The objective of this study was to analyze the significance of geographic factors and their differences influencing the postoperative quality of life in females with adolescent idiopathic scoliosis residing in urban and...

  14. Utilization of the emergency room: impact of geographic distance

    Directory of Open Access Journals (Sweden)

    Jae Eun Lee

    2007-05-01

    Full Text Available The aim of this study was to estimate the distance Mississippi patients must travel to access hospital-based emergency rooms (ERs and to determine whether an association exists between geographic distance and ER utilization. To that end, great circle distances between Census Block Group Centroid Points and 89 hospitals with emergency departments were calculated for the State of Mississippi. Data on the socio-demographic characteristics of each block group came from the 2000 US Census data. Logistic regression analyses were conducted to test if there was any association between ER utilization and travel distance. Compared to the national benchmark of 35.7%, more than one in two (56.7%, or 1,612,762 Mississippians visited ERs in 2003 with an estimated 6.1 miles per person annual travel for this purpose. The majority of the target population (54.9% was found to live within 5 miles of hospitals with ERs. Logistic analyses revealed that block groups associated with less miles traveled to hospitals with ERs had a higher proportion of African Americans, impoverished people, female householders, people with more than 12 years education, people older than 65 years, people with high median house values, and people without employment. Twenty-nine of the 89 hospitals (33% providing ER care in Mississippi were found to be in areas with above-average ER utilization rates. These hospitals served a smaller geographical area (28% of the total but had a greater proportion of visitors (57% and served a higher percentage (37% of the state population. People in areas served by the less utilized ERs traveled more miles to be cared for (7.1 miles vs 5.4 miles; p<0.0001. Logistic regression analysis revealed that shorter distances were associated with increased use of the ERs, even after controlling for socio-demographic factors. The conclusion is that Mississippi ERs are typically located in block groups with higher percentages of disadvantaged residents and that

  15. Complex Comparison of Bavarian and Bohemian Forest National Parks from Geographical Perspective: Is there More Similarity or Difference?

    Directory of Open Access Journals (Sweden)

    Janík Tomáš

    2017-01-01

    Full Text Available This article focuses on comparison of the landscape of two National Parks (Bavarian and Bohemian Forest, which together create the largest area of wilderness in Central Europe. The article shows how different they are in social-economic and physical-geographical perspective. Social and economic conditions were introduced from perspective of path dependency and recent situation and its perception. Furthermore, we integrated social-economic and environmental perspective in the ecosystem services concept. Despite the lesser number tourists arriving to the Bavarian part of the area, perception is better than among mayors of municipalities on the Czech side. Different history, management and top-down and bottom-up approaches usage can explain these differences. The typologies of environmental conditions help us to distinguish differences between both National Parks. In the Bavarian Forest we can find more equal share of forests (coniferous, broad-leaved, mixed and surprisingly, thanks to large unmanaged part bigger relative share of regenerating forest landscapes than in the Bohemian Forest. Physical-geographical typology distinguishes five classes. Relative distribution of the classes is similar, but we can determine area of high plateau mainly on Czech side and on the other hand class of steeper terrain is located mainly in Bavarian Forest. Ecosystem services was presented by integrating landscape capacity analysis showing small differences between both National Parks in this case and no relation between land cover and attractiveness for tourism.

  16. Distance costs and the degree of inter-partner involvement in international relational-based technology alliances

    NARCIS (Netherlands)

    van Kranenburg, H.L.; Hagedoorn, J.; Lorenz-Orlean, S.

    2014-01-01

    This research studies the effect of specific institutional and distance cost issues, in particular the protection of intellectual property rights and geographic distance, on the preference of companies for different governance modalities in terms of the degree of their involvement in international

  17. Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy.

    Science.gov (United States)

    Lyttle Schumacher, B; Grover, N; Mesen, T; Steiner, A; Mersereau, J

    2017-10-01

    What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC). The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist. This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients. Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed). Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC. Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be

  18. Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients.

    Science.gov (United States)

    Denhaerynck, K; Schmid-Mohler, G; Kiss, A; Steiger, J; Wüthrich, R P; Bock, A; De Geest, S

    2014-01-01

    Literature review suggests that adherence to immunosuppressive drugs may be lower in recipients of living than of deceased donor kidney grafts, possibly because of profile differences. To compare the level of immunosuppressive adherence levels between patients with deceased and living (-related; -unrelated) donor grafts in Switzerland. Using data from two similar cross-sectional studies at two transplant centers in Switzerland, the level of adherence between the two groups was compared. Medication adherence was assessed by self-report or electronic monitoring. Possible explanatory factors included age, beliefs regarding immunosuppressive drugs, depressive symptomatology, pre-emptive transplantation, and the number of transplants received, were also considered. Data were analyzed using logistic regression analysis. Unadjusted non-adherence odds were 2 to 3 times higher in living-related than deceased donor transplantation (ORs: 2.09-3.05; padherence in recipients of living-related donor kidneys, possibly owing to differences in patient profile (ie, health beliefs regarding their immunosuppressive needs), knowledge of which may enhance adherence if addressed.

  19. Geographic variation in premiums in health insurance marketplaces.

    Science.gov (United States)

    Barker, Abigail R; McBride, Timothy D; Kemper, Leah M; Mueller, Keith

    2014-08-01

    This policy brief analyzes the 2014 premiums associated with qualified health plans (QHPs) made available through new health insurance marketplaces (HIMs), an implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. We report differences in premiums by insurance rating areas while controlling for other important factors such as the actuarial value of the plan (metal level), cost-of-living differences, and state-level decisions over type of rating area. While market equilibrium, based on experience and understanding of the characteristics of the new market, should not be expected this soon, preliminary results give policymakers key issues to monitor.

  20. Army ants dynamically adjust living bridges in response to a cost-benefit trade-off.

    Science.gov (United States)

    Reid, Chris R; Lutz, Matthew J; Powell, Scott; Kao, Albert B; Couzin, Iain D; Garnier, Simon

    2015-12-08

    The ability of individual animals to create functional structures by joining together is rare and confined to the social insects. Army ants (Eciton) form collective assemblages out of their own bodies to perform a variety of functions that benefit the entire colony. Here we examine ‟bridges" of linked individuals that are constructed to span gaps in the colony's foraging trail. How these living structures adjust themselves to varied and changing conditions remains poorly understood. Our field experiments show that the ants continuously modify their bridges, such that these structures lengthen, widen, and change position in response to traffic levels and environmental geometry. Ants initiate bridges where their path deviates from their incoming direction and move the bridges over time to create shortcuts over large gaps. The final position of the structure depended on the intensity of the traffic and the extent of path deviation and was influenced by a cost-benefit trade-off at the colony level, where the benefit of increased foraging trail efficiency was balanced by the cost of removing workers from the foraging pool to form the structure. To examine this trade-off, we quantified the geometric relationship between costs and benefits revealed by our experiments. We then constructed a model to determine the bridge location that maximized foraging rate, which qualitatively matched the observed movement of bridges. Our results highlight how animal self-assemblages can be dynamically modified in response to a group-level cost-benefit trade-off, without any individual unit's having information on global benefits or costs.

  1. Geographic mobility of Korean new graduate nurses from their first to subsequent jobs and metropolitan-nonmetropolitan differences in their job satisfaction.

    Science.gov (United States)

    Cho, Sung-Hyun; Lee, Ji Yun; Mark, Barbara A; Jones, Cheryl B

    2014-01-01

    Nurses are known to migrate from rural to urban areas, which may cause geographic imbalances in the workforce. The aim of this study was to compare new graduate nurse retention based on the type of geographic area (capital, metropolitan, and nonmetropolitan) of their first job and their job satisfaction by geographic location. The sample included 533 nursing graduates working full-time as registered nurses in hospitals or clinics. Survival analysis was conducted to compare nurse retention in three geographic locations. Survival curves for nurses in capital and nonmetropolitan areas were significantly different. The 1-, 2-, and 3-year survival probabilities of nurses in the capital were .923, .881, and .872, respectively, whereas those in nonmetropolitan areas were .887, .776, and .672, respectively. Nurses in nonmetropolitan areas were more dissatisfied with pay (odd ratio [OR] = 1.820, p = .009), fringe benefits (OR =1.893, p = .015), employment security (OR =2.640, p = .033), and personal growth (OR =1.626, p = .045) than those in the capital. Nurses employed in nonmetropolitan areas were more mobile and less satisfied with their jobs than those in the capital. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. New Technologies: Real-time Telepathology Systems-Novel Cost-effective Tools for Real-time Consultation and Data Sharing.

    Science.gov (United States)

    Siegel, Gabriel; Regelman, Dan; Maronpot, Robert; Rosenstock, Moti; Nyska, Abraham

    2017-12-01

    Real-time telepathology for use in investigative and regulated preclinical toxicology studies is now feasible. Newly developed microscope-integrated telepathology systems enable geographically remote stakeholders to view the live histopathology slide as seen by the study pathologist within the microscope. Simultaneous online viewing and dialog between study pathologist and remote colleagues is an efficient and cost-effective means for consultation, pathology working groups, and peer review, facilitating good science and economic benefits by enabling more timely and informed clinical decisions.

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

    Directory of Open Access Journals (Sweden)

    White Michael T

    2011-11-01

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

  4. Genetic polymorphism in Taenia solium metacestodes from different Brazilian geographic areas

    Directory of Open Access Journals (Sweden)

    Ivanildes Solange da Costa Barcelos

    2012-02-01

    Full Text Available The aim of the present study is to investigate genetic polymorphisms in Taenia solium metacestodes from different Brazilian geographical areas and to relate them to antibody recognition in serum samples of neurocysticercosis (NC patients. Metacestodes were obtained from the Distrito Federal (DF, Bahia, Minas Gerais (MG and São Paulo (SP regions of Brazil. Samples of human sera from 49 individuals with NC, 68 individuals with other helminthiasis and 40 healthy volunteers were analysed (157 individuals in total. Antigens were prepared and used in enzyme-linked immunosorbent assay and western blotting assays to detect specific immunoglobulin G antibodies. Genetic distances between metacestode populations were analysed using random amplified polymorphic DNA (RAPD analysis. Our results show that there was a higher frequency of reactivity in the DF region in the sera from NC patients (p < 0.05, while discrimination between active and inactive NC was seen only in extracts from the MG and SP regions (p < 0.05. Using RAPD, the sample from the DF region presented a greater increase compared to the other regions. A relationship between genetic polymorphisms among T. solium metacestodes from different areas in Brazil and the differences in antibody detection in patients with NC were established.

  5. Geographical, Ethnic and Socio-Economic Differences in Utilization of Obstetric Care in the Netherlands.

    Science.gov (United States)

    Posthumus, Anke G; Borsboom, Gerard J; Poeran, Jashvant; Steegers, Eric A P; Bonsel, Gouke J

    2016-01-01

    All women in the Netherlands should have equal access to obstetric care. However, utilization of care is shaped by demand and supply factors. Demand is increased in high risk groups (non-Western women, low socio-economic status (SES)), and supply is influenced by availability of hospital facilities (hospital density). To explore the dynamics of obstetric care utilization we investigated the joint association of hospital density and individual characteristics with prototype obstetric interventions. A logistic multi-level model was fitted on retrospective data from the Netherlands Perinatal Registry (years 2000-2008, 1.532.441 singleton pregnancies). In this analysis, the first level comprised individual maternal characteristics, the second of neighbourhood SES and hospital density. The four outcome variables were: referral during pregnancy, elective caesarean section (term and post-term breech pregnancies), induction of labour (term and post-term pregnancies), and birth setting in assumed low-risk pregnancies. Higher hospital density is not associated with more obstetric interventions. Adjusted for maternal characteristics and hospital density, living in low SES neighbourhoods, and non-Western ethnicity were generally associated with a lower probability of interventions. For example, non-Western women had considerably lower odds for induction of labour in all geographical areas, with strongest effects in the more rural areas (non-Western women: OR 0.78, 95% CI 0.77-0.80, pNetherlands, and more specifically a relative underservice to the deprived, independent of level of supply.

  6. A Snapshot of Gender in Brazil Today : Institutions, Outcomes, and a Closer Look at Racial and Geographic Differences

    OpenAIRE

    Gukovas, Renata; Muller, Miriam; Pereira, Ana Claudia; Reimao, Maira Emy

    2016-01-01

    The Gender Diagnostic: ‘A Snapshot of Gender in Brazil Today: Institutions, Outcomes, and a Closer Look at Racial and Geographic Differences Gender issues in Brazil’ highlights progress on gender equality in the country and lays out the main areas of persisting challenges. It details gender outcomes beyond the national aggregate and emphasizes that gender inequality in Brazil has to be und...

  7. Differences in Attitudes Toward Living Kidney Donation Among Dominican Immigrants Living in Spain and the United States.

    Science.gov (United States)

    Ríos, A; López-Navas, A I; Sánchez, Á; Flores-Medina, J; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcón, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

    2018-03-01

    The Dominican population has a double-emigration pathway: one is to the USA, by proximity, and the other is to Spain, by sociocultural identification. Our aim was to determine attitudes toward living organ donation among Dominicans residing in Florida (USA) and Spain. All study participants were at least 15 years old and living in either Florida (USA) or Spain, and stratified by gender and age. A questionnaire on attitudes toward living kidney donation ("PCID-LKD Ríos") was used. The support of immigrant associations in Florida and Spain was required to advise on survey locations. Data obtained were anonymized and self-administered. The study questionnaire was completed by 123 Dominicans, 68% of whom were in favor of living related kidney donation. There were differences (P = .004) according to the country of residence. Eighty-one percent of Spain's Dominican residents were in favor, compared with 56% of Florida's residents. Factors associated with attitude toward donation were level of education (P donation (P = .006), attitude toward cadaveric organ donation (P donation (P = .046). Attitudes toward living kidney donation among immigrant Dominicans varies between Spain and the USA, with the former showing a more positive view. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Medicaid expenditures for children living with smokers

    Directory of Open Access Journals (Sweden)

    Levy Douglas E

    2011-05-01

    Full Text Available Abstract Background Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers. Conclusions Living with at least one smoker (a proxy for secondhand smoke exposure is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

  9. The costs of living at the edge: Seasonal stress in wild savanna-dwelling chimpanzees.

    Science.gov (United States)

    Wessling, Erin G; Kühl, Hjalmar S; Mundry, Roger; Deschner, Tobias; Pruetz, Jill D

    2018-04-20

    Adaptations associated with shifting from a predominately forested habitat to a more open environment are considered a crucial step in hominin evolution. Understanding how chimpanzees, one of our closest-living relatives, are exposed to the selection pressures associated with living in a relatively sparse, hot, and dry environment can inform us about the relative importance of potential environmental stressors involved in adaptations to drier environments. We investigated the extent to which chimpanzees living in an extreme savanna habitat experience seasonal variability in either energy balance or thermoregulation (dehydration and heat exposure), as well as whether these potential environmental constraints are taxing to chimpanzee individuals. Specifically, we tested the hypothesis that savanna environments impose seasonally-relevant costs to chimpanzees. To this end, we collected 368 urine samples from one community of chimpanzees at Fongoli, Senegal, and measured c-peptide, creatinine, and cortisol as measures of physiological responses to environmental food, water, and heat constraints, respectively. We then evaluated the influence of climatic and phenological factors on these indicators. Results illustrated significant seasonal variation in all biomarkers, which corresponded to relevant ecological correlates. Furthermore, creatinine but not c-peptide correlated with cortisol levels, suggesting that chimpanzees in this environment endure periods of heat and dehydration stress, but are able to avoid stressful levels of negative energy balance. Using savanna chimpanzees as a referential model, our research lends support to the notion that thermoregulatory challenges were a significant factor in hominin evolution, and suggests these challenges may have overshadowed the challenges of maintaining adequate energetic balance during the expansion of the hominin range from wetter to drier environments. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. The policy implications of the different interpretations of the cost-effectiveness of renewable electricity support

    International Nuclear Information System (INIS)

    Río, Pablo del; Cerdá, Emilio

    2014-01-01

    The cost-effectiveness of support for renewable electricity is a main criterion to assess the success of policy instruments, together with effectiveness. The costs of support are also a source of significant concern for governments all over the world. However, significant confusion exists in the literature on the cost-effectiveness of public support for renewable electricity. While some authors define the concept of cost-effectiveness as that which complies with the equimarginality principle, many others, including documents from relevant organisations (European Commission, International Energy Agency, Intergovernmental Panel on Climate Change) define it as “the lowest costs of support”, generally equating it with the minimisation of consumer costs. The aim of this paper is to clarify the differences between both approaches and their policy implications regarding the choice of instruments and design elements. It is shown that they partly overlap and that their policy implications clearly differ, leading to very different policy prescriptions. While the former favours technology neutral instruments and design elements, the “minimisation of consumer costs” approach favours instruments and design elements which adjust support levels to the costs of the technologies. - Highlights: • Significant confusion exists in the literature on the cost-effectiveness of public support for renewable electricity. • Clarify the differences between two main approaches to cost-effectiveness. • Policy implications clearly differ, leading to very different policy prescriptions

  11. Variability in chemical composition of Vitis vinifera cv Mencía from different geographic areas and vintages in Ribeira Sacra (NW Spain).

    Science.gov (United States)

    Vilanova, M; Rodríguez, I; Canosa, P; Otero, I; Gamero, E; Moreno, D; Talaverano, I; Valdés, E

    2015-02-15

    A chemical study was conducted from 2009 to 2012 to examine spatial and seasonal variability of red Vitis vinifera Mencía located in different geographic areas (Amandi, Chantada, Quiroga-Bibei, Ribeiras do Sil and Ribeiras do Miño) from NW Spain. Mencía samples were analysed for phenolic, (flavan-3-ols, flavonols, anthocyanins, acids and resveratrol), nitrogen (TAC, TAN, YAN and TAS) and volatiles compounds (alcohols, C6 compounds, ethyl esters, terpenes, aldehydes, acids, lactones, volatile phenols and carbonyl compounds) by GC-MS and HPLC. Results showed that the composition of Mencía cultivar was more affected by the vintage than the geographic area. The amino acid composition was less affected by both geographic origin and vintage, showing more varietal stability. Application of Principal Component Analysis (PCA) to experimental data showed a good separation of Mencía grape according to geographical origin and vintages. PCA also showed high correlations between the ripening ratio and C6 compounds, resveratrol and carbonyl compounds. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Differences in hospital casemix, and the relationship between casemix and hospital costs.

    Science.gov (United States)

    Söderlund, N; Milne, R; Gray, A; Raftery, J

    1995-03-01

    The aim of the study was to examine the relationship between hospital costs and casemix, and after adjustment for casemix differences, between cost and institutional size, number of specialties, occupancy and teaching status. A retrospective analysis of all admissions to nine acute-care NHS hospitals in the Oxford region during the 1991-1992 financial year was undertaken. All episodes were assigned to a diagnosis-related group (DRG) and a cost weight assigned accordingly. Costs per finished consultant episode, before and after adjustment for casemix differences, were analysed at the hospital and specialty level. Casemix differences were significant, and accounted for approximately 77 per cent of the difference in costs between providers. Costs per casemix-adjusted episode were not significantly associated with differences in hospital size, scope, occupancy levels or teaching status, but sample size was insufficient to investigate these relationships adequately. Specialty costs were poorly correlated with specialty casemix. This was probably due to poor apportionment of specialty costs in hospital accounting returns. Casemix differences need to be taken into account when comparing providers for the purposes of contracting, as unadjusted unit costs may be misleading. Although the methods used may currently be applied to most NHS hospitals, widespread use would be greatly facilitated by the development of indigenous cost weights and better routine hospital data coding and collection.

  13. Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups

    Directory of Open Access Journals (Sweden)

    Deaudelin Isabelle

    2006-07-01

    Full Text Available Abstract Background Telesurveillance is a technologically based modality that allows the surveillance of patients in the natural setting, mainly home. It is based on communication technologies to relay information between a patient and a central call center where services are coordinated. Different types of telesurveillance systems have been implemented, some being staffed with non-health professionals and others with health professional, mainly nurses. Up to now, only telesurveillance services staffed with non-health professionals have been shown to be effective and efficient. The objective of this study was to document outcomes and cost evolution of a nurse-staffed telesurveillance system for frail elderly living at home. Methods A quasi experimental design over a nine-month period was done. Patients (n = 38 and caregivers (n = 38 were selected by health professionals from two local community health centers. To be eligible, elders had to be over 65, live at home with a permanent physical, slight cognitive or motor disability or both and have a close relative (the caregiver willing to participate to the study. These disabilities had to hinder the accomplishment of daily life activities deemed essential to continue living at home safely. Three data sources were used: patient files, telesurveillance center's quarterly reports and personal questionnaires (Modified Mini-Mental State, Functional Autonomy Measurement System, Life Event Checklist, SF-12, Life-H, Quebec User Evaluation of Satisfaction with Assistive Technology, Caregiver Burden. The telesurveillance technology permitted, among various functionalities, bi-directional communication (speaker-receiver between the patient and the response center. Results A total of 957 calls for 38 registered clients over a 6-month period was recorded. Only 48 (5.0% of the calls were health-related. No change was reported in the elders' quality of life and daily activity abilities. Satisfaction was very

  14. The impact of travel time on geographic distribution of dialysis patients.

    Science.gov (United States)

    Kashima, Saori; Matsumoto, Masatoshi; Ogawa, Takahiko; Eboshida, Akira; Takeuchi, Keisuke

    2012-01-01

    The geographic disparity of prevalence rates among dialysis patients is unclear. We evaluate the association between travel time to dialysis facilities and prevalence rates of dialysis patients living in 1,867 census areas of Hiroshima, Japan. Furthermore, we study the effects of geographic features (mainland or island) on the prevalence rates and assess if these effects modify the association between travel time and prevalence. The study subjects were all 7,374 people that were certified as the "renal disabled" by local governments in 2011. The travel time from each patient to the nearest available dialysis facility was calculated by incorporating both travel time and the capacity of all 98 facilities. The effect of travel time on the age- and sex-adjusted standard prevalence rate (SPR) and 95% confidence intervals (CIs) at each census area was evaluated in two-level Poisson regression models with 1,867 census areas (level 1) nested within 35 towns or cities (level 2). The results were adjusted for area-based parameters of socioeconomic status, urbanity, and land type. Furthermore, the SPR of dialysis patients was calculated in each specific subgroup of population for travel time, land type, and combination of land type and travel time. In the regression analysis, SPR decreased by 5.2% (95% CI: -7.9--2.3) per 10-min increase in travel time even after adjusting for potential confounders. The effect of travel time on prevalence was different in the mainland and island groups. There was no travel time-dependent SPR disparity on the islands. The SPR among remote residents (>30 min from facilities) in the mainland was lower (0.77, 95% CI: 0.71-0.85) than that of closer residents (≤ 30 min; 0.95, 95% CI: 0.92-0.97). The prevalence of dialysis patients was lower among remote residents. Geographic difficulties for commuting seem to decrease the prevalence rate.

  15. Virulence Studies of Different Sequence Types and Geographical Origins of Streptococcus suis Serotype 2 in a Mouse Model of Infection

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Auger

    2016-07-01

    Full Text Available Multilocus sequence typing previously identified three predominant sequence types (STs of Streptococcus suis serotype 2: ST1 strains predominate in Eurasia while North American (NA strains are generally ST25 and ST28. However, ST25/ST28 and ST1 strains have also been isolated in Asia and NA, respectively. Using a well-standardized mouse model of infection, the virulence of strains belonging to different STs and different geographical origins was evaluated. Results demonstrated that although a certain tendency may be observed, S. suis serotype 2 virulence is difficult to predict based on ST and geographical origin alone; strains belonging to the same ST presented important differences of virulence and did not always correlate with origin. The only exception appears to be NA ST28 strains, which were generally less virulent in both systemic and central nervous system (CNS infection models. Persistent and high levels of bacteremia accompanied by elevated CNS inflammation are required to cause meningitis. Although widely used, in vitro tests such as phagocytosis and killing assays require further standardization in order to be used as predictive tests for evaluating virulence of strains. The use of strains other than archetypal strains has increased our knowledge and understanding of the S. suis serotype 2 population dynamics.

  16. Characterization of the human DNA gut virome across populations with different subsistence strategies and geographical origin.

    Science.gov (United States)

    Rampelli, Simone; Turroni, Silvia; Schnorr, Stephanie L; Soverini, Matteo; Quercia, Sara; Barone, Monica; Castagnetti, Andrea; Biagi, Elena; Gallinella, Giorgio; Brigidi, Patrizia; Candela, Marco

    2017-11-01

    It is a matter of fact that the human gut microbiome also includes a non-bacterial fraction represented by eukaryotic cells and viruses. To further explore the gut microbiome variation in human populations, here we characterized the human DNA viral community from publicly available gut metagenome data sets from human populations with different geographical origin and lifestyle. In particular, such data sets encompass microbiome information from two western urban societies (USA and Italy), as well as two traditional hunter-gatherer communities (the Hadza from Tanzania and Matses from Peru) and one pre-agricultural tribe (Tunapuco from Peru). Our results allowed for the first taxonomic reconstruction of the complex viral metacommunities within the human gut. The core virome structure included herpesviruses, papillomaviruses, polyomaviruses, adenoviruses and anelloviruses. Using Random Forests and a co-occurrence analysis approach, we identified the viruses that distinguished populations according to their geographical origin and/or lifestyle. This paves the way for new research aimed at investigating the biological role of the gut virome in human physiology, and the importance of our viral counterpart in the microbiome-host co-evolutionary process. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  17. A novel method to rapidly distinguish the geographical origin of traditional fermented-salted vegetables by mass fingerprinting.

    Science.gov (United States)

    Yoon, So-Ra; Kim, Sung Hyun; Lee, Hae-Won; Ha, Ji-Hyoung

    2017-01-01

    The geographical origin of kimchi is of interest to consumers and producers because the prices of commercial kimchi products can vary significantly according to the geographical origin. Hence, social issues related to the geographical origin of kimchi in Korea have emerged as a major problem. In this study, the geographical origin of kimchi was determined by comparing the mass fingerprints obtained for Korean and Chinese kimchi samples by MALDI-TOF MS with multivariate analysis. The results obtained herein provide an accurate, powerful tool to clearly discriminate kimchi samples based on their geographical origin within a short time and to ensure food authenticity, which is of significance in the kimchi industry. Furthermore, our MALDI-TOF MS method could be applied to determining the geographical origin of other fermented-salted vegetables at a reduced cost in shorter times.

  18. Geographical differences in maternal basking behaviour and offspring growth rate in a climatically widespread viviparous reptile.

    Science.gov (United States)

    Cadby, Chloé D; Jones, Susan M; Wapstra, Erik

    2014-04-01

    In reptiles, the thermal environment during embryonic development affects offspring phenotypic traits and potentially offspring fitness. In viviparous species, mothers can potentially manipulate the embryonic thermal environment through their basking behaviour and, thus, may be able to manipulate offspring phenotype and increase offspring fitness. One way in which mothers can maximise offspring phenotype (and thus potentially affect offspring fitness) is by fine-tuning their basking behaviour to the environment in order to buffer the embryo from deleterious developmental temperatures. In widespread species, it is unclear whether populations that have evolved under different climatic conditions will exhibit different maternal behaviours and/or thermal effects on offspring phenotype. To test this, we provided extended or reduced basking opportunity to gravid spotted skinks (Niveoscincus ocellatus) and their offspring from two populations at the climatic extremes of the species' distribution. Gravid females fine-tuned their basking behaviour to the basking opportunity, which allowed them to buffer their embryos from potentially negative thermal effects. This fine-tuning of female basking behaviour appears to have led to the expression of geographical differences in basking behaviour, with females from the cold alpine regions being more opportunistic in their basking behaviour than females from the warmer regions. However, those differences in maternal behaviour did not preclude the evolution of geographic differences in thermal effects: offspring growth varied between populations, potentially suggesting local adaptation to basking conditions. Our results demonstrate that maternal effects and phenotypic plasticity can play a significant role in allowing species to cope in changing environmental conditions, which is particularly relevant in the context of climate change.

  19. Concentration and correlations of perfluoroalkyl substances in whole blood among subjects from three different geographical areas in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Chon Rae; Lam, Nguyen Hoang [College of Fisheries and Ocean Sciences, Chonnam National University, Yeosu 550-749 (Korea, Republic of); Cho, Byung Mann [Department of Preventive Medicine and Occupational Medicine, School of Medicine, Pusan National University, Yangsan 626-770 (Korea, Republic of); Kannan, Kurunthachalam [Wadsworth Center, New York State Department of Health and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Empire State Plaza PO Box 509, Albany, NY 12201-0509 (United States); Cho, Hyeon Seo, E-mail: hscho@jnu.ac.kr [College of Fisheries and Ocean Sciences, Chonnam National University, Yeosu 550-749 (Korea, Republic of)

    2015-04-15

    Toxicity and persistence of perfluorinated alkyl substances (PFASs) in human have raised considerable concern and several biomonitoring studies throughout the world reported the widespread occurrence of these compounds in human tissues. However, information regarding influence of geographic, lifestyle and demographic factor on PFAS levels in human blood tissues is limited. In this study, whole blood samples collected in 2006–2007 from 319 donors from suburban Seoul (Suwon and Yongin), Busan and Yeosu in Korea were analyzed for perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHxS) and perfluorooctane sulfonamide (PFOSA). Blood donors classified into seven age groups with ages ranging from 8 to 82 years, and different lifestyles and socio-economic status. PFOS (median = 4.15 ng/mL) was found at the highest concentration with a maximum concentration of 59.1 ng/mL. The concentrations of other PFASs were in the decreasing order of; PFOA (median = 1.30 ng/mL) > PFNA (median = 0.85 ng/mL) > PFHxS (median = 0.47 ng/mL) > PFOSA (median = 0.12 ng/mL). Geographical differences in the concentrations of five target PFASs were found. Significant positive relationships between PFAS concentrations and the age of the donors were found. Gender-related differences were found in the concentrations of PFOA, PFNA, PFHxS and PFOSA. No association was found between PFAS levels and several lifestyle factors and socio-economic status which included drinking habit, furniture/carpet in an indoor environment and monthly income. Occupation was an important determinant for PFNA and PFHxS concentrations in the whole blood. Except for PFOSA, significant associations were noted between PFASs concentrations and smoking habit. The results of this study provide information for further public health monitoring and safety management for PFASs in Korea. - Highlights: • Significant geographical differences in PFAS levels in whole

  20. Concentration and correlations of perfluoroalkyl substances in whole blood among subjects from three different geographical areas in Korea

    International Nuclear Information System (INIS)

    Cho, Chon Rae; Lam, Nguyen Hoang; Cho, Byung Mann; Kannan, Kurunthachalam; Cho, Hyeon Seo

    2015-01-01

    Toxicity and persistence of perfluorinated alkyl substances (PFASs) in human have raised considerable concern and several biomonitoring studies throughout the world reported the widespread occurrence of these compounds in human tissues. However, information regarding influence of geographic, lifestyle and demographic factor on PFAS levels in human blood tissues is limited. In this study, whole blood samples collected in 2006–2007 from 319 donors from suburban Seoul (Suwon and Yongin), Busan and Yeosu in Korea were analyzed for perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHxS) and perfluorooctane sulfonamide (PFOSA). Blood donors classified into seven age groups with ages ranging from 8 to 82 years, and different lifestyles and socio-economic status. PFOS (median = 4.15 ng/mL) was found at the highest concentration with a maximum concentration of 59.1 ng/mL. The concentrations of other PFASs were in the decreasing order of; PFOA (median = 1.30 ng/mL) > PFNA (median = 0.85 ng/mL) > PFHxS (median = 0.47 ng/mL) > PFOSA (median = 0.12 ng/mL). Geographical differences in the concentrations of five target PFASs were found. Significant positive relationships between PFAS concentrations and the age of the donors were found. Gender-related differences were found in the concentrations of PFOA, PFNA, PFHxS and PFOSA. No association was found between PFAS levels and several lifestyle factors and socio-economic status which included drinking habit, furniture/carpet in an indoor environment and monthly income. Occupation was an important determinant for PFNA and PFHxS concentrations in the whole blood. Except for PFOSA, significant associations were noted between PFASs concentrations and smoking habit. The results of this study provide information for further public health monitoring and safety management for PFASs in Korea. - Highlights: • Significant geographical differences in PFAS levels in whole

  1. International differences in health care costs in Europe and the United States: Do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?

    International Nuclear Information System (INIS)

    Erkel, A.R. van; Pattynama, P.M.T.; Hout, W.B. van den

    1999-01-01

    The aim of this study was to assess whether potential differences in costs for diagnostic procedures and treatment of pulmonary embolism (PE) among European and U. S. hospitals alter the optimal cost-effective diagnostic strategy for PE. A standardized questionnaire was used to obtain cost data for the diagnosis and treatment of PE in participating European and U. S. hospitals. Costs for diagnostic tests and treatment of PE were then calculated in a standardized manner for all participating hospitals, from the hospital perspective. Costs were used in an existing cost-effectiveness analysis (CEA) model to determine the most cost-effective diagnostic strategy in participating hospitals. There were considerable differences in costs for diagnostic and therapeutic procedures for PE among the participating centers. These differences, however, did not affect the most cost-effective strategy based on incremental cost-effectiveness. In all hospitals the most cost-effective strategy appeared to be ultrasound followed by helical CT. International differences in cost of diagnostic and therapeutic procedures certainly exist and should be considered before applying a published CEA. Nevertheless, despite these cost differences, the diagnostic strategy for PE of ultrasound followed by helical CT appears most cost-effective. (orig.)

  2. Accessible Transportation, Geographic Elevation, and Masticatory Ability Among Elderly Residents of a Rural Area.

    Science.gov (United States)

    Hamano, Tsuyoshi; Tominaga, Kazumichi; Takeda, Miwako; Sundquist, Kristina; Nabika, Toru

    2015-06-26

    Given that public transportation networks are often worse in rural areas than in urban areas, rural residents who do not drive can find it difficult to access health-promoting goods, services, and resources related to masticatory ability. Moreover, geographical location, assessed by elevation, could modify this association. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Data were collected from a cross-sectional study conducted in Mizuho and Iwami counties, Japan. Objective masticatory ability was evaluated using a test gummy jelly and elevation was estimated by the geographic information systems according to the participant's address. After excluding subjects with missing data, 672 subjects (Mizuho = 401 and Iwami = 271) were analyzed. After adjustment for potential confounders, being a driver was not significantly associated with masticatory ability among elderly people living at low elevation (≤313 m) in Mizuho county. However, after the same adjustment, being a driver remained significantly associated with increased masticatory ability among elderly at high elevations. Similar findings were observed in Iwami county. Accessible transportation was significantly associated with increased mastication ability in elderly people living at high elevations, but not in those living at low elevations.

  3. Accessible Transportation, Geographic Elevation, and Masticatory Ability Among Elderly Residents of a Rural Area

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Hamano

    2015-06-01

    Full Text Available Given that public transportation networks are often worse in rural areas than in urban areas, rural residents who do not drive can find it difficult to access health-promoting goods, services, and resources related to masticatory ability. Moreover, geographical location, assessed by elevation, could modify this association. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Data were collected from a cross-sectional study conducted in Mizuho and Iwami counties, Japan. Objective masticatory ability was evaluated using a test gummy jelly and elevation was estimated by the geographic information systems according to the participant’s address. After excluding subjects with missing data, 672 subjects (Mizuho = 401 and Iwami = 271 were analyzed. After adjustment for potential confounders, being a driver was not significantly associated with masticatory ability among elderly people living at low elevation (≤313 m in Mizuho county. However, after the same adjustment, being a driver remained significantly associated with increased masticatory ability among elderly at high elevations. Similar findings were observed in Iwami county. Accessible transportation was significantly associated with increased mastication ability in elderly people living at high elevations, but not in those living at low elevations.

  4. Costes asociados a las horas de cuidado informal de los mayores dependientes en un ámbito rural Costs associated to informal caregiving hours for older people living in rural communities [Spain

    Directory of Open Access Journals (Sweden)

    Pablo Moya Martínez

    2009-04-01

    informal care among people living at home with some level of dependency for activities of daily living (ADL.Methods: We performed a crosssectional observational study of 241 men and women aged more than 64 years old living in rural communities (men 37.8%, women 62.2%. The mean (standard deviation age was 81.07 (7.07 years. Through the Resident Assessment Instrument Home Care (RAI-HC questionnaire, sociodemographic variables, ADL dependencies and caregiving hours were assessed. Multiple linear regression analysis was applied.Results: The predictive variables in the multiple linear regression model were living alone and requiring assistance for eating, meal preparation, bed mobility, and outdoor mobility. These predictive variables explained 46.3% of the total variation in caregiving hours. Standardized b coefficients were obtained from needing help to eat (0.272 and prepare meals (0.205. Needing help to eat represented an increment of 275 annual caregiving hours and its associated cost was 2,406.15 €/year. Becoming dependent for meal preparation represented an increment of 307.2h and a cost of 2688.18€/year. Dependency had a cost of between 4,972.72 and 21,479.15€/year, depending on ADL limitations.Conclusions: Almost 50% of the costs related to the care giving hours that may be required by an elderly person with some degree of dependency can be attributed to the fact of living alone and to some ADL that can be easily evaluated, such as eating, cooking, bed mobility, and outdoor mobility.

  5. Live birth sex ratios and father's geographic origins in Jerusalem, 1964-1976.

    Science.gov (United States)

    Groeger, J; Opler, M; Kleinhaus, K; Perrin, M C; Calderon-Margalit, R; Manor, O; Paltiel, O; Conley, D; Harlap, S; Malaspina, D

    2017-05-06

    To examine whether ancestry influenced sex ratios of offspring in a birth cohort before parental antenatal sex selection influenced offspring sex. We measured the sex ratio as the percent of males according to countries of birth of paternal and maternal grandfathers in 91,459 live births from 1964 to 1976 in the Jerusalem Perinatal Study. Confidence limits (CI) were computed based on an expected sex ratio of 1.05, which is 51.4% male. Of all live births recorded, 51.4% were male. Relative to Jewish ancestry (51.4% males), significantly more males (1,761) were born to Muslim ancestry (54.5, 95% CI = 52.1-56.8, P = 0.01). Among the former, sex ratios were not significantly associated with paternal or maternal age, education, or offspring's birth order. Consistent with a preference for male offspring, the sex ratio decreased despite increasing numbers of births over the 13-year period. Sex ratios were not affected by maternal or paternal origins in North Africa or Europe. However, the offspring whose paternal grandfathers were born in Western Asia included fewer males than expected (50.7, 50.1-51.3, P = 0.02), whether the father was born abroad (50.7) or in Israel (50.8). This was observed for descendents of paternal grandfathers born in Lebanon (47.6), Turkey (49.9), Yemen & Aden (50.2), Iraq (50.5), Afghanistan (50.5), Syria (50.6), and Cyprus (50.7); but not for those from India (51.5) or Iran (51.9). The West Asian group showed the strongest decline in sex ratios with increasing paternal family size. A decreased sex ratio associated with ancestry in Western Asia is consistent with reduced ability to bear sons by a subset of Jewish men in the Jerusalem cohort. Lower sex ratios may be because of pregnancy stress, which may be higher in this subgroup. Alternatively, a degrading Y chromosome haplogroup or other genetic or epigenetic differences on male germ lines could affect birth ratios, such as differential exposure to an environmental agent, dietary

  6. Sequential optimization of matrix chain multiplication relative to different cost functions

    KAUST Repository

    Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail

    2011-01-01

    In this paper, we present a methodology to optimize matrix chain multiplication sequentially relative to different cost functions such as total number of scalar multiplications, communication overhead in a multiprocessor environment, etc. For n matrices our optimization procedure requires O(n 3) arithmetic operations per one cost function. This work is done in the framework of a dynamic programming extension that allows sequential optimization relative to different criteria. © 2011 Springer-Verlag Berlin Heidelberg.

  7. The impact of socioeconomic status and geographic remoteness on access to pre-emptive kidney transplantation and transplant outcomes among children.

    Science.gov (United States)

    Francis, Anna; Didsbury, Madeleine; Lim, Wai H; Kim, Siah; White, Sarah; Craig, Jonathan C; Wong, Germaine

    2016-06-01

    Low socioeconomic status (SES) and geographic disparity have been associated with worse outcomes and poorer access to pre-emptive transplantation in the adult end-stage kidney disease (ESKD) population, but little is known about their impact in children with ESKD. The aim of our study was to determine whether access to pre-emptive transplantation and transplant outcomes differ according to SES and geographic remoteness in Australia. Using data from the Australia and New Zealand Dialysis and Transplant Registry (1993-2012), we compared access to pre-emptive transplantation, the risk of acute rejection and graft failure, based on SES and geographic remoteness among Australian children with ESKD (≤ 18 years), using adjusted logistic and Cox proportional hazard modelling. Of the 768 children who commenced renal replacement therapy, 389 (50.5%) received living donor kidney transplants and 28.5% of these (111/389) were pre-emptive. There was no significant association between SES quintiles and access to pre-emptive transplantation, acute rejection or allograft failure. Children residing in regional or remote areas were 35% less likely to receive a pre-emptive transplant compared to those living in major cities [adjusted odds ratio (OR) 0.65, 95% confidence interval (CI) 0.45-1.0]. There was no significant association between geographic disparity and acute rejection (adjusted OR 1.03, 95% CI 0.68-1.57) or graft loss (adjusted hazard ratio 1.05, 95% CI 0.74-1.41). In Australia, children from regional or remote regions are much less likely to receive pre-emptive kidney transplantation. Strategies such as improved access to nephrology services through expanding the scope of outreach clinics, and support for regional paediatricians to promote early referral may ameliorate this inequity.

  8. New arrivals: an indicator for non-indigenous species introductions at different geographical scales

    Directory of Open Access Journals (Sweden)

    Sergej Olenin

    2016-10-01

    Full Text Available Several legal and administrative instruments aimed to reduce the spread of non-indigenous species, that may pose harm to the environment, economy and/or human health, were developed in recent years at international and national levels, such as the International Convention for the Control and Management of Ship’s Ballast Water and Sediments, the International Council for the Exploration of the Sea Code of Practice on the Introductions and Transfers of Marine Organisms, the EU Regulation on Invasive Alien Species and the Marine Strategy Framework Directive, the US Invasive Species Act, the Biosecurity Act of New Zealand, etc. The effectiveness of these instruments can only be measured by successes in the prevention of new introductions. We propose an indicator, the arrival of new non-indigenous species (nNIS, which helps to assess introduction rates, especially in relation to pathways and vectors of introduction, and is aimed to support management. The technical precondition for the calculation of nNIS is the availability of a global, continuously updated and verified source of information on aquatic non-indigenous species. Such a database is needed, because the indicator should be calculated at different geographical scales: 1 for a particular area, such as port or coast of a country within a Large Marine Ecosystem (LME; 2 for a whole LME; and 3 for a larger biogeographical region, including two or more neighboring LMEs. The geographical scale of nNIS helps to distinguish between a primary introduction and secondary spread, which may involve different pathways and vectors. This, in turn, determines the availability of management options, because it is more feasible to prevent a primary introduction than to stop subsequent secondary spread. The definition of environmental target, size of assessment unit and possible limitations of the indicator are also discussed.

  9. CONTEMPORARY TRENDS IN GEOGRAPHICAL EDUCATION

    Directory of Open Access Journals (Sweden)

    M. Wasileva

    2017-01-01

    Full Text Available The geography includes rich, diverse and comprehensive themes that give us an understanding of our changing environment and interconnected world. It includes the study of the physical environment and resources; cultures, economies and societies; people and places; and global development and civic participation. As a subject, geography is particularly valuable because it provides information for exploring contemporary issues from a different perspective. This geographical information affects us all at work and in our daily lives and helps us make informed decisions that shape our future. All these facts result in a wide discussion on many topical issues in contemporary geography didactics. Subjects of research are the new geography and economics curriculum as well as construction of modern learning process. The paper presents briefly some of the current trends and key issues of geodidactics. As central notions we consider and analyze the training/educational goals, geography curriculum, target groups and environment of geography training, training methods as well as the information sources used in geography education. We adhere that all the above-mentioned finds its reflection in planning, analysis and assessment of education and thus in its quality and effectiveness.

  10. Variation in Antioxidant Attributes at Three Ripening Stages of Guava (Psidium guajava L. Fruit from Different Geographical Regions of Pakistan

    Directory of Open Access Journals (Sweden)

    Muhammad Ashraf

    2012-03-01

    Full Text Available The present investigation was carried out to appraise the levels of total phenols and vitamin C as well as antioxidant potential at three different ripening stages (un-ripe, semi-ripe and fully-ripe of guava (Psidium guajava L. fruit collected from three different geographical regions of Pakistan (Islamabad, Faisalabad and Bhakkar. The antioxidant potential of guava fruit extracts was assessed by means of different in-vitro antioxidant assays, namely inhibition of peroxidation in linoleic acid system, reducing power and radical scavenging capability. Overall, fruit at the un-ripe stage (G1 exhibited the highest levels of TPC, TFC, reducing power and DPPH radical scavenging activity, followed by the semi-ripe (G2 and fully-ripe (G3 stages. On the other hand, vitamin C content increased as the fruit maturity progressed, with highest value seen at the fully-ripe stage (G3 followed by the semi-ripe (G2 and un-ripe stage (G1. The concentration of vitamin C in fruits varied as: Faisalabad (136.4–247.9 mg 100 g−1, Islamabad (89.7–149.7 mg 100 g−1 and Bhakkar (73.1–129.5 mg 100 g−1. The results showed that different stages of maturation and geographical locations had profound effects on the antioxidant activity and vitamin C contents of guava fruit.

  11. Variation in antioxidant attributes at three ripening stages of guava (Psidium guajava L.) fruit from different geographical regions of Pakistan.

    Science.gov (United States)

    Gull, Javaria; Sultana, Bushra; Anwar, Farooq; Naseer, Rehana; Ashraf, Muhammad; Ashrafuzzaman, M

    2012-03-14

    The present investigation was carried out to appraise the levels of total phenols and vitamin C as well as antioxidant potential at three different ripening stages (un-ripe, semi-ripe and fully-ripe) of guava (Psidium guajava L.) fruit collected from three different geographical regions of Pakistan (Islamabad, Faisalabad and Bhakkar). The antioxidant potential of guava fruit extracts was assessed by means of different in-vitro antioxidant assays, namely inhibition of peroxidation in linoleic acid system, reducing power and radical scavenging capability. Overall, fruit at the un-ripe stage (G1) exhibited the highest levels of TPC, TFC, reducing power and DPPH radical scavenging activity, followed by the semi-ripe (G2) and fully-ripe (G3) stages. On the other hand, vitamin C content increased as the fruit maturity progressed, with highest value seen at the fully-ripe stage (G3) followed by the semi-ripe (G2) and un-ripe stage (G1). The concentration of vitamin C in fruits varied as: Faisalabad (136.4-247.9 mg 100 g⁻¹), Islamabad (89.7-149.7 mg 100 g⁻¹) and Bhakkar (73.1-129.5 mg 100 g⁻¹). The results showed that different stages of maturation and geographical locations had profound effects on the antioxidant activity and vitamin C contents of guava fruit.

  12. [Geographical coverage of the Mexican Healthcare System and a spatial analysis of utilization of its General Hospitals in 1998].

    Science.gov (United States)

    Hernández-Avila, Juan E; Rodríguez, Mario H; Rodríguez, Norma E; Santos, René; Morales, Evangelina; Cruz, Carlos; Sepúlveda-Amor, Jaime

    2002-01-01

    To describe the geographical coverage of the Mexican Healthcare System (MHS) services and to assess the utilization of its General Hospitals. A Geographic Information System (GIS) was used to include sociodemographic data by locality, the geographical location of all MHS healthcare services, and data on hospital discharge records. A maximum likelihood estimation model was developed to assess the utilization levels of 217 MHS General Hospitals. The model included data on human resources, additional infrastructure, and the population within a 25 km radius. In 1998, 10,806 localities with 72 million inhabitants had at least one public healthcare unit, and 97.2% of the population lived within 50 km of a healthcare unit; however, over 18 million people lived in rural localities without a healthcare unit. The mean annual hospital occupation rate was 48.5 +/- 28.5 per 100 bed/years, with high variability within and between states. Hospital occupation was significantly associated with the number of physicians in the unit, and in the Mexican Institute of Social Security units utilization was associated with additional health infrastructure, and with the population's poverty index. GIS analysis allows improved estimation of the coverage and utilization of MHS hospitals.

  13. Integrated and Person-Centered Care for Community-Living Older Adults: A Cost-Effectiveness Study.

    Science.gov (United States)

    Uittenbroek, Ronald J; van Asselt, Antoinette D I; Spoorenberg, Sophie L W; Kremer, Hubertus P H; Wynia, Klaske; Reijneveld, Sijmen A

    2018-03-24

    To assess the cost-effectiveness of Embrace, an integrated primary care service for older adults. Care and support claims from health care insurers, long-term care administration, and municipalities for enrolled older adults between 2011 and 2013. A total of 1,456 older adults, listed with 15 general practitioners practices in the Netherlands, were stratified into risk profiles ("Robust," "Frail," and "Complex care needs") and randomized to Embrace or care-as-usual groups. Incremental costs were calculated per quality-adjusted life year, per day able to age in place, and per percentage point risk profile improvement. Total average costs were higher for Embrace compared to care-as-usual. Differences in health-associated outcomes were small and not statistically significant. Probabilities that Embrace is cost-effective were below 80 percent, except for "risk profile improvements" within risk profile "Complex care needs." Complete case analysis resulted in smaller differences in total average costs across conditions and differences in health-associated outcomes remained small. According to current standards, Embrace is not considered cost effective after 12 months. However, it could be considered worthwhile in terms of "risk profile improvements" for older adults with "Complex care needs," if society is willing to invest substantially. © Health Research and Educational Trust.

  14. Use of remotely sensed data to evaluate the relationship between living environment and blood pressure.

    Science.gov (United States)

    Estes, Maurice G; Al-Hamdan, Mohammad Z; Crosson, William; Estes, Sue M; Quattrochi, Dale; Kent, Shia; McClure, Leslie Ain

    2009-12-01

    Urbanization has been correlated with hypertension (HTN) in developing countries undergoing rapid economic and environmental transitions. We examined the relationships among living environment (urban, suburban, and rural), day/night land surface temperatures (LST), and blood pressure in selected regions from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Also, the linking of data on blood pressure from REGARDS with National Aeronautics and Space Administration (NASA) science data is relevant to NASA's strategic goals and missions, particularly as a primary focus of the agency's Applied Sciences Program. REGARDS is a national cohort of 30,228 people from the 48 contiguous United States with self-reported and measured blood pressure levels. Four metropolitan regions (Philadelphia, PA; Atlanta, GA; Minneapolis, MN; and Chicago, IL) with varying geographic and health characteristics were selected for study. Satellite remotely sensed data were used to characterize the LST and land cover/land use (LCLU) environment for each area. We developed a method for characterizing participants as living in urban, suburban, or rural living environments, using the LCLU data. These data were compiled on a 1-km grid for each region and linked with the REGARDS data via an algorithm using geocoding information. REGARDS participants in urban areas have higher systolic and diastolic blood pressure than do those in suburban or rural areas, and also a higher incidence of HTN. In univariate models, living environment is associated with HTN, but after adjustment for known HTN risk factors, the relationship was no longer present. Further study regarding the relationship between HTN and living environment should focus on additional environmental characteristics, such as air pollution. The living environment classification method using remotely sensed data has the potential to facilitate additional research linking environmental variables to public health concerns.

  15. Blood trace metals in a sporadic amyotrophic lateral sclerosis geographical cluster.

    Science.gov (United States)

    De Benedetti, Stefano; Lucchini, Giorgio; Del Bò, Cristian; Deon, Valeria; Marocchi, Alessandro; Penco, Silvana; Lunetta, Christian; Gianazza, Elisabetta; Bonomi, Francesco; Iametti, Stefania

    2017-06-01

    Amyotrophic lateral sclerosis (ALS) is a fatal disorder with unknown etiology, in which genetic and environmental factors interplay to determine the onset and the course of the disease. Exposure to toxic metals has been proposed to be involved in the etiology of the disease either through a direct damage or by promoting oxidative stress. In this study we evaluated the concentration of a panel of metals in serum and whole blood of a small group of sporadic patients, all living in a defined geographical area, for which acid mine drainage has been reported. ALS prevalence in this area is higher than in the rest of Italy. Results were analyzed with software based on artificial neural networks. High concentrations of metals (in particular Se, Mn and Al) were associated with the disease group. Arsenic serum concentration resulted lower in ALS patients, but it positively correlated with disease duration. Comet assay was performed to evaluate endogenous DNA damage that resulted not different between patients and controls. Up to now only few studies considered geographically well-defined clusters of ALS patients. Common geographical origin among patients and controls gave us the chance to perform metallomic investigations under comparable conditions of environmental exposure. Elaboration of these data with software based on machine learning processes has the potential to be extremely useful to gain a comprehensive view of the complex interactions eventually leading to disease, even in a small number of subjects.

  16. Geographical, Ethnic and Socio-Economic Differences in Utilization of Obstetric Care in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Anke G Posthumus

    Full Text Available All women in the Netherlands should have equal access to obstetric care. However, utilization of care is shaped by demand and supply factors. Demand is increased in high risk groups (non-Western women, low socio-economic status (SES, and supply is influenced by availability of hospital facilities (hospital density. To explore the dynamics of obstetric care utilization we investigated the joint association of hospital density and individual characteristics with prototype obstetric interventions.A logistic multi-level model was fitted on retrospective data from the Netherlands Perinatal Registry (years 2000-2008, 1.532.441 singleton pregnancies. In this analysis, the first level comprised individual maternal characteristics, the second of neighbourhood SES and hospital density. The four outcome variables were: referral during pregnancy, elective caesarean section (term and post-term breech pregnancies, induction of labour (term and post-term pregnancies, and birth setting in assumed low-risk pregnancies.Higher hospital density is not associated with more obstetric interventions. Adjusted for maternal characteristics and hospital density, living in low SES neighbourhoods, and non-Western ethnicity were generally associated with a lower probability of interventions. For example, non-Western women had considerably lower odds for induction of labour in all geographical areas, with strongest effects in the more rural areas (non-Western women: OR 0.78, 95% CI 0.77-0.80, p<0.001.Our results suggest inequalities in obstetric care utilization in the Netherlands, and more specifically a relative underservice to the deprived, independent of level of supply.

  17. Sustainability: Living within One’s Own Ecological Means

    Directory of Open Access Journals (Sweden)

    Lee Liu

    2009-12-01

    Full Text Available This paper provides a critical review of sustainability, including its definitions, dimensions, measurements, and practices, as well as approaches to achieve sustainability. It raises questions about conventional definitions and argues for taking into account the geographic dimension of sustainability for better understanding of the regional differences in sustainability and transition to sustainability. The paper proposes that sustainability should be defined as "living within one’s own ecological means." This definition pays attention to regional disparities in biocapacity and ecological footprint. It realizes that not all people’s present and future needs may be met in all regions of the world.

  18. Supply-cost curves for geographically distributed renewable-energy resources

    International Nuclear Information System (INIS)

    Izquierdo, Salvador; Dopazo, Cesar; Fueyo, Norberto

    2010-01-01

    The supply-cost curves of renewable-energy sources are an essential tool to synthesize and analyze large-scale energy-policy scenarios, both in the short and long terms. Here, we suggest and test a parametrization of such curves that allows their representation for modeling purposes with a minimal set of information. In essence, an economic potential is defined based on the mode of the marginal supply-cost curves; and, using this definition, a normalized log-normal distribution function is used to model these curves. The feasibility of this proposal is assessed with data from a GIS-based analysis of solar, wind and biomass technologies in Spain. The best agreement is achieved for solar energy.

  19. Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modelling study.

    Science.gov (United States)

    Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy

    2011-01-04

    To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. England. Population Individuals eligible for the National Chlamydia Screening Programme. Cost effectiveness of National Chlamydia Screening Programme in 2008-9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions-(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. In 2008-9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely

  20. Response of microbial community and catabolic genes to simulated petroleum hydrocarbon spills in soils/sediments from different geographic locations.

    Science.gov (United States)

    Liu, Q; Tang, J; Liu, X; Song, B; Zhen, M; Ashbolt, N J

    2017-10-01

    Study the response of microbial communities and selected petroleum hydrocarbon (PH)-degrading genes on simulated PH spills in soils/sediments from different geographic locations. A microcosm experiment was conducted by spiking mixtures of petroleum hydrocarbons (PHs) to soils/sediments collected from four different regions of China, including the Dagang Oilfield (DG), Sand of Bohai Sea (SS), Northeast China (NE) and Xiamen (XM). Changes in bacterial community and the abundance of PH-degrading genes (alkB, nah and phe) were analysed by denaturing gradient electrophoresis (DGGE) and qPCR, respectively. Degradation of alkanes and PAHs in SS and NE materials were greater (P < 0·05) than those in DG and XM. Clay content was negatively correlated with the degradation of total alkanes by 112 days and PAHs by 56 days, while total organic carbon content was negatively correlated with initial degradation of total alkanes as well as PAHs. Abundances of alkB, nah and phe genes increased 10- to 100-fold and varied by soil type over the incubation period. DGGE fingerprints identified the dominance of α-, β- and γ-Proteobacteria (Gram -ve) and Actinobacteria (Gram +ve) bacteria associated with degradation of PHs in the materials studied. The geographic divergence resulting from the heterogeneity of physicochemical properties of soils/sediments appeared to influence the abundance of metabolic genes and community structure of microbes capable of degrading PHs. When developing practical in-situ bioremediation approaches for PHs contamination of soils/sediment, appropriate microbial community structures and the abundance of PH-degrading genes appear to be influenced by geographic location. © 2017 The Society for Applied Microbiology.

  1. Emerging approach for analytical characterization and geographical classification of Moroccan and French honeys by means of a voltammetric electronic tongue.

    Science.gov (United States)

    El Alami El Hassani, Nadia; Tahri, Khalid; Llobet, Eduard; Bouchikhi, Benachir; Errachid, Abdelhamid; Zine, Nadia; El Bari, Nezha

    2018-03-15

    Moroccan and French honeys from different geographical areas were classified and characterized by applying a voltammetric electronic tongue (VE-tongue) coupled to analytical methods. The studied parameters include color intensity, free lactonic and total acidity, proteins, phenols, hydroxymethylfurfural content (HMF), sucrose, reducing and total sugars. The geographical classification of different honeys was developed through three-pattern recognition techniques: principal component analysis (PCA), support vector machines (SVMs) and hierarchical cluster analysis (HCA). Honey characterization was achieved by partial least squares modeling (PLS). All the PLS models developed were able to accurately estimate the correct values of the parameters analyzed using as input the voltammetric experimental data (i.e. r>0.9). This confirms the potential ability of the VE-tongue for performing a rapid characterization of honeys via PLS in which an uncomplicated, cost-effective sample preparation process that does not require the use of additional chemicals is implemented. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Comparative effectiveness of non-print media and live CME

    Directory of Open Access Journals (Sweden)

    Kuldeep Singh

    2015-01-01

    Full Text Available Continuing Medical Education is an integral ingredient of professional development of health care providers. The educational activity can be delivered by different modes. Here we share our experience of using Digital Video Disc (DVD of a CME on Sleep Medicine as an alternative and cost effective mode.Objective: To assess improvement in knowledge and competencies in terms of comparative effectiveness of a model CME program using validated non-print medium for medical education.Methods: Recorded and validated DVD of talks delivered at NAMS-AIIMS Regional Symposium on Sleep Medicine was played to the participants in presence of one of the content experts. Video scripts of talk were also distributed to the participants. The assessment of participants and program evaluation of this CME was compared to the previously held live CME.Results: Eighty nine participants completed both pre and post test. Mean score increased from 9.91± 3.5 to 14.09 ± 2.85. Pass percentage based on an arbitrary cut off of 50%, increased from 8.3 to 43.8 (p< 0.001. Among the live CME group, mean score improved from 12.1±4.6 to 18.3 ± 3.8. Comparative analysis between live and DVD based CME showed improvement in scores of 6.17 and 4.18 respectively while pass percentage of 84.7 and 43.8 post CME among two modes were significant. The program evaluation showed identical level of satisfaction in all parameters except they were less satisfied vis-a-vis 'organizers made use of any critical comments I made' since all locally available resource persons were not present. Activity could be completed at just half the cost of live CME.Conclusions: The educational background and selection process of UG students between two medical institutes were strikingly different. While students at one institute were selected by highly competitive exam at All India level, the students at other institute were selected through state level competitive examination. In spite of that, results showed

  3. Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

    Science.gov (United States)

    Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

    2018-01-18

    Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and  Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases.  Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.

  4. [Geographical variation and related factors in prediabetes prevalence in Chinese adults in 2013].

    Science.gov (United States)

    Zhao, Z P; Li, Y C; Wang, L M; Zhang, M; Huang, Z J; Zhang, X; Li, C; Deng, Q; Zhou, M G

    2018-02-06

    Objective: To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes. Methods: Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level. Results: The prevalence of prediabetes among residents aged 18 and above was 16.6% (95 %CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant ( P= 0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level ( MOR : 1.60 (95 %CI: 1.53-1.67)) was more diverse than the province level ( MOR : 1.21(95 %CI :1.08-1.29)) and higher than the street level (1.23 (95 %CI :1.14-1.30)). Several factors increased risk of pre-diabetes, including

  5. Geographic delivery models for radiotherapy services

    International Nuclear Information System (INIS)

    Roberts, G.H.; Dunscombe, P.B.; Samant, R.S.

    2002-01-01

    The study described here was undertaken to quantify the societal cost of radiotherapy in idealized urban and rural populations and, hence, to generate a measure of impediment to access. The costs of centralized, distributed comprehensive and satellite radiotherapy delivery formats were examined by decomposing them into institutional, productivity and geographical components. Our results indicate that centralized radiotherapy imposes the greatest financial burden on the patient population in both urban and rural scenarios. The financial burden faced by patients who must travel for radiotherapy can be interpreted as one component of the overall impediment to access. With advances in remote-monitoring systems, it is possible to maintain technical quality while enhancing patient access. However, the maintenance of professional competence will remain a challenge with a distributed service-delivery format. Copyright (2002) Blackwell Science Pty Ltd

  6. Does the association between leisure activities and survival in old age differ by living arrangement?

    Science.gov (United States)

    Nilsen, Charlotta; Agahi, Neda; Shaw, Benjamin A

    2018-01-01

    Government policies to promote ageing in place have led to a growing frail population living at home in advanced old age, many of whom live alone. Living alone in old age is associated with adverse health outcomes, but we know little about whether it moderates the health impact of other risk and protective factors. Engagement in leisure activities is considered critical to successful ageing. We investigated whether the association between different types of leisure activities and survival in non-institutionalised older adults (aged 76 and above) differs by living arrangement and gender. We used the Swedish Panel Study of Living Conditions of the Oldest Old study from 2011 and the Swedish Cause of Death Register (until 30 June 2014) to conduct Cox regression analyses (n=669). Incident mortality was 30.2% during the follow-up period. Overall level of leisure activity was not significantly associated with survival in either living arrangement, but some specific leisure activities, and associations, were different across gender and living arrangement. More specifically, certain social activities (participation in organisations and having relatives visit) were associated with longer survival, but only in men living alone. In women, most results were statistically non-significant, with the exception of solving crosswords being associated with longer survival in women living with someone. In order to facilitate engagement with life, interventions focusing on leisure activities in the oldest age groups should take gender and living arrangement into consideration when determining the type of activity most needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. The application of geographic information system (GIS) in forensics geoscience

    OpenAIRE

    McKinley, Jennifer

    2017-01-01

    Advances in technological developments in Geographic Information Systems (GIS) has enabled the application of GIS in landscape mapping, environmental management, natural hazard risk and disaster management. As geographi- cal information becomes more widely available through satel- lite and aerial imagery, the cost of software decreases and GIS expertise expands, it is most likely that the use of GIS will increase. The methodology has practical applications for police, crime scene investigator...

  8. Socially just publishing: implications for geographers and their journals

    Directory of Open Access Journals (Sweden)

    Simon Batterbury

    2017-12-01

    Full Text Available There have been a range of protests against the high journal subscription costs, and author processing charges (APCs levied for publishing in the more prestigious and commercially run journals that are favoured by geographers. But open protests across the sector like the ‘Academic Spring’ of 2012, and challenges to commercial copyright agreements, have been fragmented and less than successful. I renew the argument for ‘socially just’ publishing in geography. For geographers this is not limited to choosing alternative publication venues. It also involves a considerable effort by senior faculty members that are assessing hiring and promotion cases, to read and assess scholarship independently of its place of publication, and to reward the efforts of colleagues that offer their work as a public good. Criteria other than the citation index and prestige of a journal need to be foregrounded. Geographers can also be publishers, and I offer my experience editing the free online Journal of Political Ecology.

  9. Joint Costs in Electricity and Natural Gas Distribution Infrastructures: The Role of Urban Factors

    Directory of Open Access Journals (Sweden)

    Muzeyyen Anil Senyel

    2018-04-01

    Full Text Available This paper analyzes the joint cost structure of electricity and natural gas distribution investments. Assessing the joint costs is critical for urban development and public policy regarding competition at the local level. The paper accounts for the urban and geographic factors at the local level, while the previous literature primarily used company-level data with a few or no site-specific variables in joint cost analyses. An empirical analysis of the multi-utility capital costs suggests that the local urban and geographic conditions affect such costs, with economies of scope present in electricity and natural gas both in terms of total costs and underground investment costs. Hence, the joint service provision makes economic and environmental sense for urban policy makers.

  10. Change of Job and Change of Residence - Geographical Mobility of the Labour Force

    DEFF Research Database (Denmark)

    Deding, Mette; Filges, Trine

    Solving regional labour market discrepancies through geographical mobility has gained increased political interest. The decision of changing job is closely related to the decision of changing residence as either change may imply a change in commuting cost. In this paper we set up a search model...... for mobility inducing policies are especially found through the housing market parameters....

  11. Solar cell options based on different geographical locations and wall inclination

    Science.gov (United States)

    Ma, Jie

    2018-05-01

    Two major trends in the development of contemporary solar energy science and technology [1]: First, the combination of light and point, the second is the combination of solar energy and construction. A large number of houses at the top of the installation of solar water heaters and other primary solar energy utilization equipment can no longer meet the needs of the majority of users, people pay more attention to the ventilation and heating of housing and solar power supply and other integrated multi-purpose building construction. Under the condition of simplification, this model gives the options of laying suitable solar cells for houses with different geographical positions and different inclination angles according to the actual situation. Based on our model, firstly we calculate the wall radiation according to the model (WRCM) to get the light radiation of the wall of the house, and then according to the power generation model (PGM), we can calculate the output of several types of batteries in the selected range. Finally, through the economic benefits mode l (EBM), we get the economic benefits of each type of battery in different places, and then we can choose the most suitable battery type. At the end of the article, we take Datong, Shanxi Province as an example, and substitute the relevant data from online search into the model. Compared with the actual situation, we verify that the model has good applicability.

  12. Cost analysis of different protocols for imaging a patient with acute flank pain

    International Nuclear Information System (INIS)

    Grisi, G.; Stacul, F.; Cuttin, R.; Rimondini, A.; Meduri, S.; Dalla Palma, L.

    2000-01-01

    The aim of this study was to analyse the costs of different diagnostic approaches to patients with acute flank pain. Four different diagnostic approaches were considered: (a) spiral CT without contrast medium (CM); (b) plain film, ultrasonography (US) and intravenous urography (IVU) - the latter procedure is used in our department in cases still unsolved following the former investigations (28 % in our experience); (c) plain film, US and spiral CT without CM (as an alternative to IVU in 28 % of cases); and (d) IVU. The cost of each procedure in a university hospital was calculated, following analysis of the differential costs of each investigation (equipment, depreciation and maintenance costs, related materials and services, radiologists, radiographers, nurses) and their common costs (auxiliary personnel and indirect internal costs). Finally, we calculated the full cost of each procedure and applied it to the different diagnostic approaches. The full cost of each approach was: (a) spiral CT without CM = 74 Euro; (b) plain film, US and IVU (28 %) = 66.89 Euro; (c) plain film, US and spiral CT without CM (28 %) = 64.93 Euro; (d) IVU = 80.90 Euro. Intravenous urography alone or in unsolved cases is not to be considered because it provides higher costs and worse diagnostic results, whereas X-ray dose to patient is almost equal between IVU and spiral CT. Spiral CT integrated to plain film and US in unsolved cases could be preferred because of lower cost and dose to patient, though reaching a diagnostic conclusion may take longer than an immediate spiral CT. (orig.)

  13. Maternal education and micro-geographic disparities in nutritional status among school-aged children in rural northwestern China.

    Science.gov (United States)

    Wang, Cuili; Kane, Robert L; Xu, Dongjuan; Li, Lingui; Guan, Weihua; Li, Hui; Meng, Qingyue

    2013-01-01

    Prior evidence suggests geographic disparities in the effect of maternal education on child nutritional status between countries, between regions and between urban and rural areas. We postulated its effect would also vary by micro-geographic locations (indicated by mountain areas, plain areas and the edge areas) in a Chinese minority area. A cross-sectional study was conducted with a multistage random sample of 1474 school children aged 5-12 years in Guyuan, China. Child nutritional status was measured by height-for-age z scores (HAZ). Linear mixed models were used to examine its association with place of residence and maternal education. Micro-geographic disparities in child nutritional status and the level of socioeconomic composition were found. Children living in mountain areas had poorer nutritional status, even after adjusting for demographic (plain versus mountain, β = 0.16, P = 0.033; edge versus mountain, β = 0.29, P = 0.002) and socioeconomic factors (plain versus mountain, β = 0.12, P = 0.137; edge versus mountain, β = 0.25, P = 0.009). The disparities significantly widened with increasing years of mothers' schooling (maternal education*plain versus mountain: β = 0.06, P = 0.007; maternal education*edge versus mountain: β = 0.07, P = 0.005). Moreover, the association between maternal education and child nutrition was negative (β = -0.03, P = 0.056) in mountain areas but positive in plain areas (β = 0.02, P = 0.094) or in the edge areas (β = 0.04, P = 0.055). Micro-geographic disparities in child nutritional status increase with increasing level of maternal education and the effect of maternal education varies by micro-geographic locations, which exacerbates child health inequity. Educating rural girls alone is not sufficient; improving unfavorable conditions in mountain areas might make such investments more effective in promoting child health. Nutrition programs targeting to the least educated groups in plain and in edge areas would be

  14. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

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

    2013-01-01

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

  15. Comprehensive analysis of Polygoni Multiflori Radix of different geographical origins using ultra-high-performance liquid chromatography fingerprints and multivariate chemometric methods

    Directory of Open Access Journals (Sweden)

    Li-Li Sun

    2018-01-01

    Full Text Available Polygoni Multiflori Radix (PMR is increasingly being used not just as a traditional herbal medicine but also as a popular functional food. In this study, multivariate chemometric methods and mass spectrometry were combined to analyze the ultra-high-performance liquid chromatograph (UPLC fingerprints of PMR from six different geographical origins. A chemometric strategy based on multivariate curve resolution–alternating least squares (MCR–ALS and three classification methods is proposed to analyze the UPLC fingerprints obtained. Common chromatographic problems, including the background contribution, baseline contribution, and peak overlap, were handled by the established MCR–ALS model. A total of 22 components were resolved. Moreover, relative species concentrations were obtained from the MCR–ALS model, which was used for multivariate classification analysis. Principal component analysis (PCA and Ward's method have been applied to classify 72 PMR samples from six different geographical regions. The PCA score plot showed that the PMR samples fell into four clusters, which related to the geographical location and climate of the source areas. The results were then corroborated by Ward's method. In addition, according to the variance-weighted distance between cluster centers obtained from Ward's method, five components were identified as the most significant variables (chemical markers for cluster discrimination. A counter-propagation artificial neural network has been applied to confirm and predict the effects of chemical markers on different samples. Finally, the five chemical markers were identified by UPLC–quadrupole time-of-flight mass spectrometer. Components 3, 12, 16, 18, and 19 were identified as 2,3,5,4′-tetrahydroxy-stilbene-2-O-β-d-glucoside, emodin-8-O-β-d-glucopyranoside, emodin-8-O-(6′-O-acetyl-β-d-glucopyranoside, emodin, and physcion, respectively. In conclusion, the proposed method can be applied for the

  16. Geographic pathology of Helicobacter pylori gastritis

    NARCIS (Netherlands)

    Liu, Yi; Ponsioen, Cyriel I. J.; Xiao, Shu-Dong; Tytgat, Guido N. J.; ten Kate, Fiebo J. W.

    2005-01-01

    Background and aim. Helicobacter pylori is etiologically associated with gastritis and gastric cancer. There are significant geographical differences between the clinical manifestation of H. pylori infections. The aim of this study was to compare gastric mucosal histology in relation to age among H.

  17. Comparison of immunization strategies in geographical networks

    Energy Technology Data Exchange (ETDEWEB)

    Wang Bing; Aihara, Kazuyuki [Institute of Industrial Science, The University of Tokyo, Tokyo (Japan)] [ERATO Aihara Complexity Modelling Project, JST, Institute of Industrial Science, University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505 (Japan); Kim, Beom Jun, E-mail: beomjun@skku.ed [BK21 Physics Research Division and Department of Energy Science, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of)] [Department of Computational Biology, School of Computer Science and Communication, Royal Institute of Technology, 100 44 Stockholm (Sweden)

    2009-10-12

    The epidemic spread and immunizations in geographically embedded scale-free (SF) and Watts-Strogatz (WS) networks are numerically investigated. We make a realistic assumption that it takes time which we call the detection time, for a vertex to be identified as infected, and implement two different immunization strategies: one is based on connection neighbors (CN) of the infected vertex with the exact information of the network structure utilized and the other is based on spatial neighbors (SN) with only geographical distances taken into account. We find that the decrease of the detection time is crucial for a successful immunization in general. Simulation results show that for both SF networks and WS networks, the SN strategy always performs better than the CN strategy, especially for more heterogeneous SF networks at long detection time. The observation is verified by checking the number of the infected nodes being immunized. We found that in geographical space, the distance preferences in the network construction process and the geographically decaying infection rate are key factors that make the SN immunization strategy outperforms the CN strategy. It indicates that even in the absence of the full knowledge of network connectivity we can still stop the epidemic spread efficiently only by using geographical information as in the SN strategy, which may have potential applications for preventing the real epidemic spread.

  18. Comparison of immunization strategies in geographical networks

    International Nuclear Information System (INIS)

    Wang Bing; Aihara, Kazuyuki; Kim, Beom Jun

    2009-01-01

    The epidemic spread and immunizations in geographically embedded scale-free (SF) and Watts-Strogatz (WS) networks are numerically investigated. We make a realistic assumption that it takes time which we call the detection time, for a vertex to be identified as infected, and implement two different immunization strategies: one is based on connection neighbors (CN) of the infected vertex with the exact information of the network structure utilized and the other is based on spatial neighbors (SN) with only geographical distances taken into account. We find that the decrease of the detection time is crucial for a successful immunization in general. Simulation results show that for both SF networks and WS networks, the SN strategy always performs better than the CN strategy, especially for more heterogeneous SF networks at long detection time. The observation is verified by checking the number of the infected nodes being immunized. We found that in geographical space, the distance preferences in the network construction process and the geographically decaying infection rate are key factors that make the SN immunization strategy outperforms the CN strategy. It indicates that even in the absence of the full knowledge of network connectivity we can still stop the epidemic spread efficiently only by using geographical information as in the SN strategy, which may have potential applications for preventing the real epidemic spread.

  19. Geographical Mobility of Danish Dual-Earner Couples

    DEFF Research Database (Denmark)

    Deding, Mette; Filges, Trine

    In this paper, we analyse the empirical relationship between geographical residence mobility and geographical job mobility for Danish dual-earner couples. Based on register data from Statistics Denmark from 1999 and 2000, we estimate three probabilities, taking the interdependence between...... the work region matters for the determination of the residence region. Furthermore, although the model stresses the importance of looking at both spouses, we do not find marked differences between the men and the women. Thus, our results do not indicate that one spouse is more important than the other...

  20. The Relationship between Costs and Quality in Veterans Health Administration Community Living Centers: An Analysis Using Longitudinal Data.

    Science.gov (United States)

    Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L

    2018-05-18

    To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  1. CYBERNETICS AND GEOGRAPHICAL EDUCATION: CYBERNETICS OF LEARNING AND LEARNING OF CYBERNETICS

    Directory of Open Access Journals (Sweden)

    M. R. Arpentieva

    2017-01-01

    Full Text Available Modern geographical education implies a broad implementation of innovative technologies, allowing students to fully and deeply understand the subject and methods of professional activity, and effectively and productively act upon this understanding. Therefore, in the work of modern geographer computer and media technologies occupy a significant place, and geographic education occupies an important place in learning cybernetic disciplines: computer technologies act as an important condition for obtaining high quality professional education, as well as an important tool of professional activity of modern specialist-geographer. The article is devoted to comparing three modern approaches to the study and optimization of training Cybernetics and programming in the framework of geographical education: an approach devoted to the study of “learning styles”; the metacognitive approach to learning computer science and programming; and intersubjective, evergetic or actually cybernetic, approach. It describes their advantages and limitations in the context of geographical education, as well as the internal unity as different forms of study of productivity and conditions of the dialogical interaction between teacher and student in the context of obtaining high-quality geographical education.

  2. Geographic Names

    Data.gov (United States)

    Minnesota Department of Natural Resources — The Geographic Names Information System (GNIS), developed by the United States Geological Survey in cooperation with the U.S. Board of Geographic Names, provides...

  3. Geographical gradients in selection can reveal genetic constraints for evolutionary responses to ocean acidification.

    Science.gov (United States)

    Gaitán-Espitia, Juan Diego; Marshall, Dustin; Dupont, Sam; Bacigalupe, Leonardo D; Bodrossy, Levente; Hobday, Alistair J

    2017-02-01

    Geographical gradients in selection can shape different genetic architectures in natural populations, reflecting potential genetic constraints for adaptive evolution under climate change. Investigation of natural pH/pCO 2 variation in upwelling regions reveals different spatio-temporal patterns of natural selection, generating genetic and phenotypic clines in populations, and potentially leading to local adaptation, relevant to understanding effects of ocean acidification (OA). Strong directional selection, associated with intense and continuous upwellings, may have depleted genetic variation in populations within these upwelling regions, favouring increased tolerances to low pH but with an associated cost in other traits. In contrast, diversifying or weak directional selection in populations with seasonal upwellings or outside major upwelling regions may have resulted in higher genetic variances and the lack of genetic correlations among traits. Testing this hypothesis in geographical regions with similar environmental conditions to those predicted under climate change will build insights into how selection may act in the future and how populations may respond to stressors such as OA. © 2017 The Author(s).

  4. Cost Effectiveness of Influenza Vaccine for U.S. Children: Live Attenuated and Inactivated Influenza Vaccine.

    Science.gov (United States)

    Shim, Eunha; Brown, Shawn T; DePasse, Jay; Nowalk, Mary Patricia; Raviotta, Jonathan M; Smith, Kenneth J; Zimmerman, Richard K

    2016-09-01

    Prior studies showed that live attenuated influenza vaccine (LAIV) is more effective than inactivated influenza vaccine (IIV) in children aged 2-8 years, supporting the Centers for Disease Control and Prevention (CDC) recommendations in 2014 for preferential LAIV use in this age group. However, 2014-2015 U.S. effectiveness data indicated relatively poor effectiveness of both vaccines, leading CDC in 2015 to no longer prefer LAIV. An age-structured model of influenza transmission and vaccination was developed, which incorporated both direct and indirect protection induced by vaccination. Based on this model, the cost effectiveness of influenza vaccination strategies in children aged 2-8 years in the U.S. was estimated. The base case assumed a mixed vaccination strategy where 33.3% and 66.7% of vaccinated children aged 2-8 years receive LAIV and IIV, respectively. Analyses were performed in 2014-2015. Using published meta-analysis vaccine effectiveness data (83% LAIV and 64% IIV), exclusive LAIV use would be a cost-effective strategy when vaccinating children aged 2-8 years, whereas IIV would not be preferred. However, when 2014-2015 U.S. effectiveness data (0% LAIV and 15% IIV) were used, IIV was likely to be preferred. The cost effectiveness of influenza vaccination in children aged 2-8 years is highly dependent on vaccine effectiveness; the vaccine type with higher effectiveness is preferred. In general, exclusive IIV use is preferred over LAIV use, as long as vaccine effectiveness is higher for IIV than for LAIV. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Application of the TDABC model in the logistics process using different capacity cost rates

    Directory of Open Access Journals (Sweden)

    Paulo Afonso

    2016-12-01

    Full Text Available Purpose: The understanding of logistics process in terms of costs and profitability is a complex task and there is a need of more research and applied work on these issues. In this research project, the concepts underlying Time-Driven Activity Based Costing (TDABC have been used in the context of logistics costs. Design/methodology/approach: A Distribution Centre of wood and carpentry related materials has been studied. A multidisciplinary team has been composed to support the project including the researchers and three employees of the company responsible for accounting, logistics and warehousing. The design and implementation of the costing model asked for a deep understanding of the different tasks and processes that should be considered. Accordingly, a TDABC model for the logistics function was developed. Findings: The cost model presented here is supported on a series of time equations designed for the logistics function which allow the analysis and discussion of costs and profitability of different cost objects namely, products, clients, distribution channels, processes and activities. The cost of unused capacity and the effectiveness of logistics processes are also highlighted in this model. Research limitations/implications: In a case study, results and implications cannot be directly or immediately generalized. Nevertheless, the proposed time equations and cost model can be easily adapted to explain other types of logistics functions and it gives the foundations or other TDABC models with more than one capacity cost rate. Practical implications: The TDABC model developed in this case study can be used in similar cases and as a basis for the analysis of logistics costs in other logistics processes. Furthermore, managers can rely on the proposed approach to analyze products’ profitability and logistics cost structure.  Originality/value: In this case, different capacity cost rates were computed in order to reflect appropriately the

  6. Application of the TDABC model in the logistics process using different capacity cost rates

    International Nuclear Information System (INIS)

    Afonso, Paulo; Santana, Alex

    2016-01-01

    Purpose: The understanding of logistics process in terms of costs and profitability is a complex task and there is a need of more research and applied work on these issues. In this research project, the concepts underlying Time-Driven Activity Based Costing (TDABC) have been used in the context of logistics costs. Design/methodology/approach: A Distribution Centre of wood and carpentry related materials has been studied. A multidisciplinary team has been composed to support the project including the researchers and three employees of the company responsible for accounting, logistics and warehousing. The design and implementation of the costing model asked for a deep understanding of the different tasks and processes that should be considered. Accordingly, a TDABC model for the logistics function was developed. Findings: The cost model presented here is supported on a series of time equations designed for the logistics function which allow the analysis and discussion of costs and profitability of different cost objects namely, products, clients, distribution channels, processes and activities. The cost of unused capacity and the effectiveness of logistics processes are also highlighted in this model. Research limitations/implications: In a case study, results and implications cannot be directly or immediately generalized. Nevertheless, the proposed time equations and cost model can be easily adapted to explain other types of logistics functions and it gives the foundations or other TDABC models with more than one capacity cost rate. Practical implications: The TDABC model developed in this case study can be used in similar cases and as a basis for the analysis of logistics costs in other logistics processes. Furthermore, managers can rely on the proposed approach to analyze products’ profitability and logistics cost structure. Originality/value: In this case, different capacity cost rates were computed in order to reflect appropriately the logistics function which

  7. Application of the TDABC model in the logistics process using different capacity cost rates

    Energy Technology Data Exchange (ETDEWEB)

    Afonso, Paulo; Santana, Alex

    2016-07-01

    Purpose: The understanding of logistics process in terms of costs and profitability is a complex task and there is a need of more research and applied work on these issues. In this research project, the concepts underlying Time-Driven Activity Based Costing (TDABC) have been used in the context of logistics costs. Design/methodology/approach: A Distribution Centre of wood and carpentry related materials has been studied. A multidisciplinary team has been composed to support the project including the researchers and three employees of the company responsible for accounting, logistics and warehousing. The design and implementation of the costing model asked for a deep understanding of the different tasks and processes that should be considered. Accordingly, a TDABC model for the logistics function was developed. Findings: The cost model presented here is supported on a series of time equations designed for the logistics function which allow the analysis and discussion of costs and profitability of different cost objects namely, products, clients, distribution channels, processes and activities. The cost of unused capacity and the effectiveness of logistics processes are also highlighted in this model. Research limitations/implications: In a case study, results and implications cannot be directly or immediately generalized. Nevertheless, the proposed time equations and cost model can be easily adapted to explain other types of logistics functions and it gives the foundations or other TDABC models with more than one capacity cost rate. Practical implications: The TDABC model developed in this case study can be used in similar cases and as a basis for the analysis of logistics costs in other logistics processes. Furthermore, managers can rely on the proposed approach to analyze products’ profitability and logistics cost structure. Originality/value: In this case, different capacity cost rates were computed in order to reflect appropriately the logistics function which

  8. Chemical Composition and Biological Activities of Mono- and Heterofloral Bee Pollen of Different Geographical Origins

    Directory of Open Access Journals (Sweden)

    Jucilene Silva Araújo

    2017-04-01

    Full Text Available Recent research shows variations in pollen chemical constituents and, consequently, in their therapeutic properties. Mono and multifloral bee pollen extracts were investigated for antioxidant and enzyme inhibitory activity properties, phenolic compounds and fatty acid composition. Generally, Eucalyptus spp. and multifloral extracts exhibited potent inhibitory activity against α-amylase, acetylcholinesterase, tyrosinase, lipoxygenase, lipase and hyaluronidase. On the other hand, Miconia spp. demonstrated higher antihemolytic activity. Cocos nucifera and Miconia spp. extracts exhibited important antioxidant properties in the different assays (ABTS, DPPH, β-carotene/linoleic acid and reducing power. Moreover, these extracts had greater amounts of total phenols and flavonoids in comparison to others. The increase in antioxidant activity (decrease in EC50 values was accompanied by an increase in the amount of total phenols in the extracts. The pollen extracts contained linoleic acid and α-linolenic acid as major fatty acids, followed by palmitic acid, and oleic acid. In this study, differences were observed in both chemical constituents and biological activities of the samples related to the geographical and botanical origin of bee pollen.

  9. Geographic proximity to specialized pediatric neurosurgical care in the contiguous United States.

    Science.gov (United States)

    Ahmed, Abdul-Kareem; Duhaime, Ann-Christine; Smith, Timothy R

    2018-04-01

    neurosurgeon is 63.3 miles (SE 0.3, range 0.0-499.7 miles). Geographic analysis showed that 27.1% of children live farther than 60 miles from an ABPNS-certified neurosurgeon and 19.7% from either an ABPNS-certified neurosurgeon or a JPS member. ZCTAs with children who live farther than 60 miles from a neurosurgeon providing pediatric care had a marginally higher rate of uninsured children, a higher percentage of families with children living below the federal poverty level, and a higher proportion of persons living in rural areas compared with ZCTAs with children who live within 60 miles of care (p neurosurgeons per pediatric population and their geographic distribution could be important in determining appropriate subspecialty supply factors (e.g., the number of accredited pediatric neurosurgical fellowship training programs), as well as being important drivers of neurosurgical patient outcomes.

  10. Using geographical information systems to explore disparities in preterm birth rates among foreign-born and U.S.-born Black mothers.

    Science.gov (United States)

    Bloch, Joan Rosen

    2011-01-01

    To examine spatial patterns of neighborhood contextual factors of stress with preterm birth (PTB) and nativity (foreign-born and U.S.-born) among Black mothers. Descriptive geographic-spatial research. Births to Philadelphia residents during 2003-2005 in the context of Philadelphia residential neighborhoods (N = 350) were studied. All data were aggregated to neighborhood levels (census tracts). Maps were created to assess geographic-spatial patterns. A geographic information system (GIS) database was created that imported geo-coded data on births, crime (assaults with guns and domestic abuse), poverty, race, and nativity (foreign-born vs. U.S.-born). Clear visual patterns of "bad" neighborhoods emerged and were significantly associated with higher prevalence of PTB for foreign-born Black and U.S.-born Black mothers (p < .0001). This study demonstrated how GIS visually clarified important spatial patterns of adverse living conditions and PTB prevalence. Nurses can use GIS to better understand living environments of mothers and their families and to target interventions in geographical areas with the greatest service needs. Further research on individual and contextual factors is warranted to address the observed health disparities among the heterogeneous groups of foreign-born Black mothers. Despite limitations of aggregate data, it is clear that where mothers live matters. This has important implications for nursing practice and policy. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  11. Using Geographical Information Systems to Explore Disparities in Preterm Birth Rates Among Foreign-born and U.S.-born Black Mothers

    Science.gov (United States)

    Bloch, Joan Rosen

    2012-01-01

    Objective To examine spatial patterns of neighborhood contextual factors of stress with preterm birth (PTB) and nativity (foreign-born and U.S.-born) among Black mothers. Design Descriptive geographic-spatial research. Setting & Participants Births to Philadelphia residents during 2003–2005 in the context of Philadelphia residential neighborhoods (N = 350) were studied. Methods All data were aggregated to neighborhood levels (census tracts). Maps were created to assess geographic-spatial patterns. A geographic information system (GIS) database was created that imported geo-coded data on births, crime (assaults with guns and domestic abuse), poverty, race, and nativity (foreign-born vs. U.S.-born). Results Clear visual patterns of “bad” neighborhoods emerged and were significantly associated with higher prevalence of PTB for foreign-born Black and U.S.-born Black mothers (p GIS visually clarified important spatial patterns of adverse living conditions and PTB prevalence. Nurses can use GIS to better understand living environments of mothers and their families and to target interventions in geographical areas with the greatest service needs. Further research on individual and contextual factors is warranted to address the observed health disparities among the heterogeneous groups of foreign-born Black mothers. Despite limitations of aggregate data, it is clear that where mothers live matters. This has important implications for nursing practice and policy. PMID:22273411

  12. Geography, private costs and uptake of screening for abdominal aortic aneurysm in a remote rural area.

    Science.gov (United States)

    Lindsay, Sandra M; Duncan, John L; Cairns, John; Godden, David J

    2006-03-29

    The relationship between geographical location, private costs, health provider costs and uptake of health screening is unclear. This paper examines these relationships in a screening programme for abdominal aortic aneurysm in the Highlands and Western Isles of Scotland, a rural and remote area of over 10,000 square miles. Men aged 65-74 (n = 9323) were invited to attend screening at 51 locations in 50 settlements. Effects of geography, deprivation and age on uptake were examined. Among 8,355 attendees, 8,292 completed a questionnaire detailing mode of travel and costs incurred, time travelled, whether accompanied, whether dependants were cared for, and what they would have been doing if not attending screening, thus allowing private costs to be calculated. Health provider (NHS) costs were also determined. Data were analysed by deprivation categories, using the Scottish Indices of Deprivation (2003), and by settlement type ranging from urban to very remote rural. Uptake of screening was high in all settlement types (mean 89.6%, range 87.4-92.6%). Non-attendees were more deprived in terms of income, employment, education and health but there was no significant difference between non-attendees and attendees in terms of geographical access to services. Age was similar in both groups. The highest private costs (median 7.29 pound sterling per man) and NHS screening costs (18.27 pound sterling per man invited) were observed in very remote rural areas. Corresponding values for all subjects were: private cost 4.34 pound sterling and NHS cost 15.72 pound sterling per man invited. Uptake of screening for abdominal aortic aneurysm in is remote and rural setting was high in comparison with previous studies, and this applied across all settlement types. Geographical location did not affect uptake, most likely due to the outreach approach adopted. Private and NHS costs were highest in very remote settings but still compared favourably with other published studies.

  13. Geography, private costs and uptake of screening for abdominal aortic aneurysm in a remote rural area

    Directory of Open Access Journals (Sweden)

    Cairns John

    2006-03-01

    Full Text Available Abstract Background The relationship between geographical location, private costs, health provider costs and uptake of health screening is unclear. This paper examines these relationships in a screening programme for abdominal aortic aneurysm in the Highlands and Western Isles of Scotland, a rural and remote area of over 10,000 square miles. Methods Men aged 65–74 (n = 9323 were invited to attend screening at 51 locations in 50 settlements. Effects of geography, deprivation and age on uptake were examined. Among 8,355 attendees, 8,292 completed a questionnaire detailing mode of travel and costs incurred, time travelled, whether accompanied, whether dependants were cared for, and what they would have been doing if not attending screening, thus allowing private costs to be calculated. Health provider (NHS costs were also determined. Data were analysed by deprivation categories, using the Scottish Indices of Deprivation (2003, and by settlement type ranging from urban to very remote rural. Results Uptake of screening was high in all settlement types (mean 89.6%, range 87.4 – 92.6%. Non-attendees were more deprived in terms of income, employment, education and health but there was no significant difference between non-attendees and attendees in terms of geographical access to services. Age was similar in both groups. The highest private costs (median £7.29 per man and NHS screening costs (£18.27 per man invited were observed in very remote rural areas. Corresponding values for all subjects were: private cost £4.34 and NHS cost £15.72 per man invited. Conclusion Uptake of screening for abdominal aortic aneurysm in this remote and rural setting was high in comparison with previous studies, and this applied across all settlement types. Geographical location did not affect uptake, most likely due to the outreach approach adopted. Private and NHS costs were highest in very remote settings but still compared favourably with other published studies.

  14. Exploring differences in inpatient drug purchasing cost between two pediatric hospitals.

    Science.gov (United States)

    Nydert, Per; Poole, Robert

    2012-10-01

    In this study, the hospital cost of purchasing drugs at two children's hospitals is explored with respect to high-cost drugs and drug classes and discussed with regard to differences in hospital setting, drug price, or number of treatments. The purchasing costs of drugs at the two hospitals were retrieved and analyzed. All information was connected to the Anatomic Therapeutic Chemical code and compared in a Microsoft Access database. The 6-month drug purchasing costs at Astrid Lindgren Children's Hospital (ALCH), Stockholm, Sweden, and Lucile Packard Children's Hospital at Stanford (LPCH), Palo Alto, California, are similar and result in a cost per patient day of US $149 and US $136, respectively. The hospital setting and choice of drug products are factors that influence the drug cost in product-specific ways. Several problems are highlighted when only drug costs are compared between hospitals. For example, the comparison does not take into account the amount of waste, risk of adverse drug events, local dosing strategies, disease prevalence, and national drug-pricing models. The difference in cost per inpatient day at ALCH may indicate that cost could be redistributed in Sweden to support pediatric pharmacy services. Also, when introducing new therapies seen at the comparison hospital, it may be possible to extrapolate the estimated increase in cost.

  15. Geographic variation in gorilla limb bones.

    Science.gov (United States)

    Jabbour, Rebecca S; Pearman, Tessa L

    2016-06-01

    Gorilla systematics has received increased attention over recent decades from primatologists, conservationists, and paleontologists. Studies of geographic variation in DNA, skulls, and teeth have led to new taxonomic proposals, such as recognition of two gorilla species, Gorilla gorilla (western gorilla) and Gorilla beringei (eastern gorilla). Postcranial differences between mountain gorillas (G. beringei beringei) and western lowland gorillas (G. g. gorilla) have a long history of study, but differences between the limb bones of the eastern and western species have not yet been examined with an emphasis on geographic variation within each species. In addition, proposals for recognition of the Cross River gorilla as Gorilla gorilla diehli and gorillas from Tshiaberimu and Kahuzi as G. b. rex-pymaeorum have not been evaluated in the context of geographic variation in the forelimb and hindlimb skeletons. Forty-three linear measurements were collected from limb bones of 266 adult gorillas representing populations of G. b. beringei, Gorilla beringei graueri, G. g. gorilla, and G. g. diehli in order to investigate geographic diversity. Skeletal elements included the humerus, radius, third metacarpal, third proximal hand phalanx, femur, tibia, calcaneus, first metatarsal, third metatarsal, and third proximal foot phalanx. Comparisons of means and principal components analyses clearly differentiate eastern and western gorillas, indicating that eastern gorillas have absolutely and relatively smaller hands and feet, among other differences. Gorilla subspecies and populations cluster consistently by species, although G. g. diehli may be similar to the eastern gorillas in having small hands and feet. The subspecies of G. beringei are distinguished less strongly and by different variables than the two gorilla species. Populations of G. b. graueri are variable, and Kahuzi and Tshiaberimu specimens do not cluster together. Results support the possible influence of

  16. Sequence Variation in Toxoplasma gondii rop17 Gene among Strains from Different Hosts and Geographical Locations

    Directory of Open Access Journals (Sweden)

    Nian-Zhang Zhang

    2014-01-01

    Full Text Available Genetic diversity of T. gondii is a concern of many studies, due to the biological and epidemiological diversity of this parasite. The present study examined sequence variation in rhoptry protein 17 (ROP17 gene among T. gondii isolates from different hosts and geographical regions. The rop17 gene was amplified and sequenced from 10 T. gondii strains, and phylogenetic relationship among these T. gondii strains was reconstructed using maximum parsimony (MP, neighbor-joining (NJ, and maximum likelihood (ML analyses. The partial rop17 gene sequences were 1375 bp in length and A+T contents varied from 49.45% to 50.11% among all examined T. gondii strains. Sequence analysis identified 33 variable nucleotide positions (2.1%, 16 of which were identified as transitions. Phylogeny reconstruction based on rop17 gene data revealed two major clusters which could readily distinguish Type I and Type II strains. Analyses of sequence variations in nucleotides and amino acids among these strains revealed high ratio of nonsynonymous to synonymous polymorphisms (>1, indicating that rop17 shows signs of positive selection. This study demonstrated the existence of slightly high sequence variability in the rop17 gene sequences among T. gondii strains from different hosts and geographical regions, suggesting that rop17 gene may represent a new genetic marker for population genetic studies of T. gondii isolates.

  17. The geosystems of complex geographical atlases

    Directory of Open Access Journals (Sweden)

    Jovanović Jasmina

    2012-01-01

    Full Text Available Complex geographical atlases represent geosystems of different hierarchical rank, complexity and diversity, scale and connection. They represent a set of large number of different pieces of information about geospace. Also, they contain systematized, correlative and in the apparent form represented pieces of information about space. The degree of information revealed in the atlas is precisely explained by its content structure and the form of presentation. The quality of atlas depends on the method of visualization of data and the quality of geodata. Cartographic visualization represents cognitive process. The analysis converts geospatial data into knowledge. A complex geographical atlas represents information complex of spatial - temporal coordinated database on geosystems of different complexity and territorial scope. Each geographical atlas defines a concrete geosystem. Systemic organization (structural and contextual determines its complexity and concreteness. In complex atlases, the attributes of geosystems are modeled and pieces of information are given in systematized, graphically unique form. The atlas can be considered as a database. In composing a database, semantic analysis of data is important. The result of semantic modeling is expressed in structuring of data information, in emphasizing logic connections between phenomena and processes and in defining their classes according to the degree of similarity. Accordingly, the efficiency of research of needed pieces of information in the process of the database use is enabled. An atlas map has a special power to integrate sets of geodata and present information contents in user - friendly and understandable visual and tactile way using its visual ability. Composing an atlas by systemic cartography requires the pieces of information on concrete - defined geosystems of different hierarchical level, the application of scientific methods and making of adequate number of analytical, synthetic

  18. Public and private dental services in NSW: a geographic information system analysis of access to care for 7 million Australians.

    Science.gov (United States)

    Willie-Stephens, Jenny; Kruger, Estie; Tennant, Marc

    2014-06-01

    To investigate the distribution of public and private dental practices in NSW in relation to population distribution and socioeconomic status. Dental practices (public and private) were mapped and overlayed with Census data on Collection District population and Socio-Economic Indexes for Areas (SEIFA). Overall, there was an uneven geographic distribution of public and private dental practices across NSW. When the geographic distribution was compared to population socioeconomics it was found that in rural NSW, 12% of the most disadvantaged residents lived further than 50km from a public dental practice, compared to 0% of the least disadvantaged. In Sydney, 9% of the three most disadvantaged groups lived greater than 7.5km from a public dental practice, compared to 21% of the three least disadvantaged groups. The findings of this study can contribute to informing decisions to determine future areas for focus of dental resource development (infrastructure and workforce) and identifying subgroups in the population (who are geographically isolated from accessing care) where public health initiatives focused on amelioration of disease consequences should be a focus.

  19. Multiple sclerosis: a geographical hypothesis.

    Science.gov (United States)

    Carlyle, I P

    1997-12-01

    Multiple sclerosis remains a rare neurological disease of unknown aetiology, with a unique distribution, both geographically and historically. Rare in equatorial regions, it becomes increasingly common in higher latitudes; historically, it was first clinically recognized in the early nineteenth century. A hypothesis, based on geographical reasoning, is here proposed: that the disease is the result of a specific vitamin deficiency. Different individuals suffer the deficiency in separate and often unique ways. Evidence to support the hypothesis exists in cultural considerations, in the global distribution of the disease, and in its historical prevalence.

  20. The Moderating Effect of Geographic Area on the Relationship Between Age, Gender, and Information and Communication Technology Literacy and Problematic Internet Use.

    Science.gov (United States)

    Yu, Liang; Recker, Mimi; Chen, Shijian; Zhao, Nan; Yang, Qiuyan

    2018-06-01

    This study investigated the relationship between adolescents' problematic Internet use (PIU) and demographic characteristics such as age, gender, and information and communication technology (ICT) literacy and the moderating effect of geographic area on this relationship using a cross-sectional research design. The study sample comprised 2160 adolescents from the Chongqing area of China and consisted of 47.3 percent boys (N = 1022) and 52.7 percent girls (N = 1138). Participants anonymously completed a 38-item questionnaire that examined their Internet use, behaviors, and attitudes, ICT literacy, parents' education level, and other demographic information. The results showed that the geographic area in which respondents lived (urban vs. rural), gender, age, father's education, mother's education, and ICT literacy had significant relationships with PIU. Moreover, hierarchical multiple regression analyses indicated that geographic area was found to be a significant moderator for both age and gender in their relationship with PIU. These findings suggest that it is essential to address differences between urban and rural areas when seeking to mitigate PIU among adolescents.

  1. Capital-cost behavior: is nuclear different

    International Nuclear Information System (INIS)

    Lotze, C.D.; Riordan, B.J.

    1978-01-01

    The capital costs of coal-fired and nuclear power plants are found to be comparable when costs for pollution control are included. Trends in capital costs reveal a similar rate gain that retains the same economic balance. Graphs of selected cost indices are used to show that the rapid increase in direct construction costs is not unique to nuclear plants, those of hydroelectric plants as well as coal-fired having the same pattern. Comparisons of indirect capital costs, based on analyses of direct capital and total capital costs, show estimated average growth rates of total costs to be 14% for coal and 13.6% for nuclear, while direct cost growth rates are 10.2% and 10.4%. The economics of market competition can be expected to push alternative energy source projects into balance

  2. Geographic Media Literacy

    Science.gov (United States)

    Lukinbeal, Chris

    2014-01-01

    While the use of media permeates geographic research and pedagogic practice, the underlying literacies that link geography and media remain uncharted. This article argues that geographic media literacy incorporates visual literacy, information technology literacy, information literacy, and media literacy. Geographic media literacy is the ability…

  3. Identification of geographical origin of sesame seeds by near infrared spectroscopy

    International Nuclear Information System (INIS)

    Kwon, Y.K.; Cho, R.K.

    1998-01-01

    Geographical origin of the Korean, Chinese and Japanese sesame seeds were identified very high accuracy by NIR spectroscopy. The NIR instrument of filter type showed the same accuracy of the monochromator scanning type to identify the geographical origin of the sesame seeds. in case of adulteration between the Korean and Chinese sesame seeds, the ratio of addition could be determined about 10% error level. The reason of identification of geographical origin by NIR spectroscopy, it was supposed to the difference of oil cake substance

  4. Adjusted Poverty Measures and the Distribution of Title I Aid: Does Title I Really Make the Rich States Richer?

    Science.gov (United States)

    Baker, Bruce D.; Taylor, Lori; Levin, Jesse; Chambers, Jay; Blankenship, Charles

    2013-01-01

    Federal and state governments in the United States make extensive use of student poverty rates in compensatory aid programs like Title I. Unfortunately, the measures of student poverty that drive funding allocations under such programs are biased because they fail to reflect geographic differences in the cost of living. In this study, we construct…

  5. Comparison of average global exposure of population induced by a macro 3G network in different geographical areas in France and Serbia.

    Science.gov (United States)

    Huang, Yuanyuan; Varsier, Nadège; Niksic, Stevan; Kocan, Enis; Pejanovic-Djurisic, Milica; Popovic, Milica; Koprivica, Mladen; Neskovic, Aleksandar; Milinkovic, Jelena; Gati, Azeddine; Person, Christian; Wiart, Joe

    2016-09-01

    This article is the first thorough study of average population exposure to third generation network (3G)-induced electromagnetic fields (EMFs), from both uplink and downlink radio emissions in different countries, geographical areas, and for different wireless device usages. Indeed, previous publications in the framework of exposure to EMFs generally focused on individual exposure coming from either personal devices or base stations. Results, derived from device usage statistics collected in France and Serbia, show a strong heterogeneity of exposure, both in time, that is, the traffic distribution over 24 h was found highly variable, and space, that is, the exposure to 3G networks in France was found to be roughly two times higher than in Serbia. Such heterogeneity is further explained based on real data and network architecture. Among those results, authors show that, contrary to popular belief, exposure to 3G EMFs is dominated by uplink radio emissions, resulting from voice and data traffic, and average population EMF exposure differs from one geographical area to another, as well as from one country to another, due to the different cellular network architectures and variability of mobile usage. Bioelectromagnetics. 37:382-390, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Measuring rural allied health workforce turnover and retention: what are the patterns, determinants and costs?

    Science.gov (United States)

    Chisholm, Marita; Russell, Deborah; Humphreys, John

    2011-04-01

    To measure variations in patterns of turnover and retention, determinants of turnover, and costs of recruitment of allied health professionals in rural areas. Data were collected on health service characteristics, recruitment costs and de-identified individual-level employment entry and exit data for dietitians, occupational therapists, physiotherapists, podiatrists, psychologists, social workers and speech pathologists employed between 1 January 2004 and 31 December 2009. Health services providing allied health services within Western Victoria were stratified by geographical location and town size. Eighteen health services were sampled, 11 participated. Annual turnover rates, stability rates, median length of stay in current position, survival probabilities, turnover hazards and median costs of recruitment were calculated. Analysis of commencement and exit data from 901 allied health professionals indicated that differences in crude workforce patterns according to geographical location emerge 12 to 24 months after commencement of employment, although the results were not statistically significant. Proportional hazards modelling indicated profession and employee age and grade upon commencement were significant determinants of turnover risk. Costs of replacing allied health workers are high. An opportunity for implementing comprehensive retention strategies exists in the first year of employment in rural and remote settings. Benchmarks to guide workforce retention strategies should take account of differences in patterns of allied health turnover and retention according to geographical location. Monitoring allied health workforce turnover and retention through analysis of routinely collected data to calculate selected indicators provides a stronger evidence base to underpin workforce planning by health services and regional authorities. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  7. Modelling cost-effectiveness of different vasectomy methods in India, Kenya, and Mexico

    Directory of Open Access Journals (Sweden)

    Seamans Yancy

    2007-07-01

    Full Text Available Abstract Background Vasectomy is generally considered a safe and effective method of permanent contraception. The historical effectiveness of vasectomy has been questioned by recent research results indicating that the most commonly used method of vasectomy – simple ligation and excision (L and E – appears to have a relatively high failure rate, with reported pregnancy rates as high as 4%. Updated methods such as fascial interposition (FI and thermal cautery can lower the rate of failure but may require additional financial investments and may not be appropriate for low-resource clinics. In order to better compare the cost-effectiveness of these different vasectomy methods, we modelled the costs of different vasectomy methods using cost data collected in India, Kenya, and Mexico and effectiveness data from the latest published research. Methods The costs associated with providing vasectomies were determined in each country through interviews with clinic staff. Costs collected were economic, direct, programme costs of fixed vasectomy services but did not include large capital expenses or general recurrent costs for the health care facility. Estimates of the time required to provide service were gained through interviews and training costs were based on the total costs of vasectomy training programmes in each country. Effectiveness data were obtained from recent published studies and comparative cost-effectiveness was determined using cost per couple years of protection (CYP. Results In each country, the labour to provide the vasectomy and follow-up services accounts for the greatest portion of the overall cost. Because each country almost exclusively used one vasectomy method at all of the clinics included in the study, we modelled costs based on the additional material, labour, and training costs required in each country. Using a model of a robust vasectomy program, more effective methods such as FI and thermal cautery reduce the cost per

  8. Investigation of different modifications of the modular high temperature reactor for cost reduction

    International Nuclear Information System (INIS)

    Heek, A. van.

    1993-06-01

    Regarding the specific costs reactor with low power output have disadvantages compared to large reactors. In this study it was investigated for the HTR Module how to reduce the specific investment costs and consequently the electricity production costs by modification of the reactor and the power plant design. To reduce the investment costs different design changes were investigated, e.g. possible alternatives for the arrangement of the reactors and the steam generators and a different building layout. The cost reduction gained by a more compact type of construction and a reduction of the number of large components remains below 10%. The use of a gas turbine instead of a steam turbine with steam generator would result in a more efficient cost reduction. The increase in the power output has a much bigger potential to reduce the electricity production costs. The best way to realize this is the changing of the core geometry from cylindric to annular. A module concept with a power maximized under certain boundary conditions (limitation of the core temperatures in case of accident, use of proven technology) was worked out in detail. The optimum core geometry and power density, determined by tolerable accident temperatures and core pressure loss, make a thermal power of 350 MW possible. The physical properties and the accident behaviour in case of pressure release and water ingress were investigated. The specific investment costs and the electricity production costs of a 4-Modular Plant for pure electricity production are reduced about 28% resp. 19% compared with the 200 MWth-Module (KWU/Interatom). (orig.) [de

  9. The interaction between reproductive cost and individual quality is mediated by oceanic conditions in a long-lived bird.

    Science.gov (United States)

    Robert, Alexandre; Paiva, Vitor H; Bolton, Mark; Jiguet, Frédéric; Bried, Joël

    2012-08-01

    Environmental variability, costs of reproduction, and heterogeneity in individual quality are three important sources of the temporal and interindividual variations in vital rates of wild populations. Based on an 18-year monitoring of an endangered, recently described, long-lived seabird, Monteiro's Storm-Petrel (Oceanodroma monteiroi), we designed multistate survival models to separate the effects of the reproductive cost (breeders vs. nonbreeders) and individual quality (successful vs. unsuccessful breeders) in relation to temporally variable demographic and oceanographic properties. The analysis revealed a gradient of individual quality from nonbreeders, to unsuccessful breeders, to successful breeders. The survival rates of unsuccessful breeders (0.90 +/- 0.023, mean +/- SE) tended to decrease in years of high average breeding success and were more sensitive to oceanographic variation than those of both (high-quality) successful breeders (0.97 +/- 0.015) and (low-quality) nonbreeders (0.83 +/- 0.028). Overall, our results indicate that reproductive costs act on individuals of intermediate quality and are mediated by environmental harshness.

  10. Interoperability of Geographic Information: A Communication Process –Based Prototype

    Directory of Open Access Journals (Sweden)

    Jean Brodeur

    2005-04-01

    Full Text Available Since 1990, municipal, state/provincial, and federal governments have developed numerous geographic databases over the years to fulfill organizations' specific needs. As such, same real world topographic phenomena have been abstracted differently, for instance vegetation (surface, trees (surface, wooded area (line, wooded area (point and line, milieu boisé (surface, zone boisée (unknown geometry. Today, information about these geographic phenomena is accessible on the Internet from Web infrastructures specially developed to simplify their access. Early in the nineties, the development of interoperability of geographic information has been undertaken to solve syntactic, structural, and semantic heterogeneities as well as spatial and temporal heterogeneities to facilitate sharing and integration of such data. Recently, we have proposed a new conceptual framework for interoperability of geographic information based on the human communication process, cognitive science, and ontology, and introduced geosemantic proximity, a reasoning methodology to qualify dynamically the semantic similarity between geographic abstractions. This framework could be of interest to other disciplines. This paper presents the details of our framework for interoperability of geographic information as well as a prototype.

  11. COMPARATIVE INDICATORS OF THE PHYSICAL DEVELOPMENT OF BOYS IN REPUBLIC OF DAGESTAN IN THE VARIOUS ECO-GEOGRAPHICAL ZONES

    Directory of Open Access Journals (Sweden)

    K. G. Kamalov

    2015-01-01

    Full Text Available Abstract:Purpose. The examination of the comparative aspect of the physical parameters of the boys in the pre - and puberty in different ecological zones (EZ of the Republic of Dagestan (RD: mountain, foothills and plains of the taxiway.Materials and Methods. The study in 3 eco-geographic zones of the Republic of Dagestan in 2641 a boy aged 11 to 17 years. Inclusion criteria were: age of onset of puberty and the completion of 11-17 years, male gender and residence in the territory (extragenital diseases. We compared the following anthropometric indicators: height, weight, body mass index.Results and conclusions. The analysing of the physical parameters of development in different areas of extragenital diseases RD identifies the following pattern: the lowest height and weight were boys living in the foothills of the taxiway. Their peers living in highland and lowland extragenital diseases taxiway growth were similar and statistically significant differences were found statistically significant differences are particularly evident with 13-14 years in boys from foothills of RD, especially when compared with their peers plain COPIES. Thus, the overall physical development of boys RD closes to those boys Russia, although the tendency to reduce them was determined. Comparative physical development of boys in various extragenital diseases RD, the worst performance demonstrated teenagers from foothill extragenital diseases.

  12. Relation Between Estimated Cardiorespiratory Fitness and Atrial Fibrillation (from the Reasons for Geographic and Racial Differences in Stroke Study).

    Science.gov (United States)

    Bose, Abhishek; O'Neal, Wesley T; Bennett, Aleena; Judd, Suzanne E; Qureshi, Waqas T; Sui, Xuemei; Howard, Virginia J; Howard, George; Soliman, Elsayed Z

    2017-06-01

    Estimated cardiorespiratory fitness (e-CRF) based on readily available clinical and self-reported data is a promising alternative to the costly traditional assessment of CRF using exercise equipment, but its role as a predictor for incident atrial fibrillation (AF) is unclear. This study included 10,126 participants (54.5% women, 35% African-American, mean age 63.2 years) from the Reasons for Geographic and Racial Differences in Stroke study who were free of AF at baseline. Baseline (2003 to 2007) e-CRF was determined using a previously validated nonexercise algorithm. Incident AF cases were identified at a follow-up examination by electrocardiogram and self-reported medical history of previous physician diagnosis. After a median follow-up of 9.4 years, 906 participants (8.9%) developed AF. In a multivariable logistic regression model adjusted for sociodemographics and baseline cardiovascular disease risk factors as well as incident coronary heart disease, heart failure, and stroke, each 1-metabolic equivalent of task increase in e-CRF was associated with a 5% lower risk of AF development (odds ratio [95% CI] 0.95 [0.92 to 0.99]; p = 0.0129). This association was stronger in women (OR [95% CI] 0.85 (0.79, 0.92) than in men (OR (95% CI) 0.88 (0.84, 0.93), interaction p value = 0.05. No significant interactions by age, race, history of cardiovascular disease, or physical limitations were observed. In conclusion, e-CRF using a nonexercise algorithm is a useful predictor of incident AF, which is consistent with previous reports using traditional CRF. This suggests that e-CRF using nonexercise algorithms may serve as a useful alternative to CRF measured by costly and time-consuming exercise testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. [Temporal variation and geographical distribution: congenital heart defects in the Comunitat Valenciana].

    Science.gov (United States)

    Cavero Carbonell, C; Zurriaga, O; Pérez Panadés, J; Barona Vilar, C; Martos Jiménez, C

    2013-09-01

    The objective of this study is to estimate the prevalence of congenital heart defects (CHD) in the Comunitat Valenciana (CV) in children less than one year old and identify whether there are temporal and geographic variations within this prevalence. The minimum basic data set from hospital discharge reports was used to select patients, who were born between 1999-2008, were less than one year old, and who lived in the CV with at least one hospital admission in which the primary diagnosis and/or any of the events were coded as CHD (codes 745-747 of the International Classification of Diseases 9th Revision Clinical Modification). The first hospital discharge report with CHD was selected, using the health card number to detect duplication. The prevalence and 95% confidence intervals were calculated, and the prevalence ratio (PR) and smoothed PR was obtained for each municipality to identify geographic patterns. In the period 1999-2008 there were 6.377 patients younger than one year with some CHD, representing the 43.2% of cases of congenital anomalies. The prevalence was 134.3 per 10.000 live births (95% CI: 131.1-137.6). There was a significant increase in the prevalence, from 115.8 in the 1999-2003 period to 149.5 in the 2004-2008 period. A higher risk was identified in the north of the CV, and in some municipalities of the province of Alicante, in the south. The observed increase in CHD agrees with the findings in other countries and it can be explained, at least in part, by improved diagnostic techniques. The geographic pattern identified requires a more detailed analysis that could explain the geographic variations found. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  14. Concentration of trace elements in feathers of three Antarctic penguins: Geographical and interspecific differences

    Energy Technology Data Exchange (ETDEWEB)

    Jerez, Silvia [Area de Toxicologia, Facultad de Veterinaria, Universidad de Murcia, Campus de Espinardo, 30100 Murcia (Spain); Motas, Miguel, E-mail: motas@um.es [Area de Toxicologia, Facultad de Veterinaria, Universidad de Murcia, Campus de Espinardo, 30100 Murcia (Spain); Palacios, Maria Jose; Valera, Francisco [Departamento de Ecologia Funcional y Evolutiva, Estacion Experimental de Zonas Aridas, CSIC, Carretera de Sacramento s/n, 04120 La Canada de San Urbano, Almeria (Spain); Cuervo, Jose Javier; Barbosa, Andres [Departamento de Ecologia Funcional y Evolutiva, Estacion Experimental de Zonas Aridas, CSIC, Carretera de Sacramento s/n, 04120 La Canada de San Urbano, Almeria (Spain); Departamento de Ecologia Evolutiva, Museo Nacional de Ciencias Naturales, CSIC, C/Jose Gutierrez Abascal 2, 28006 Madrid (Spain)

    2011-10-15

    Antarctica is often considered as one of the last pristine regions, but it could be affected by pollution at global and local scale. Concentrations of Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Cd and Pb were determinated by ICP-MS in feathers (n = 207 individuals) of gentoo, chinstrap and Adelie penguin collected in 8 locations throughout the Antarctic Peninsula (2006-2007). The highest levels of several elements were found in samples from King George Island (8.08, 20.29 and 1.76 {mu}g g{sup -1} dw for Cr, Cu and Pb, respectively) and Deception Island (203.13, 3.26 and 164.26 {mu}g g{sup -1} dw for Al, Mn and Fe, respectively), where probably human activities and large-scale transport of pollutants contribute to increase metal levels. Concentrations of Cr, Mn, Cu, Se or Pb, which are similar to others found in different regions of the world, show that some areas in Antarctica are not utterly pristine. - Highlights: > We study levels of trace elements in feathers of Antarctic penguins. > Eight different rookeries throughout the Antarctic Peninsula were sampled. > Interspecific (gentoo, chinstrap, Adelie) and geographical differences were tested. > Relatively high metal levels were found in areas with major human presence. > Penguin feather can be useful for metals monitoring in the Antarctic environment. - Trace element levels in feathers of three penguin species from the Antarctic Peninsula indicate the presence of pollution in certain locations.

  15. Concentration of trace elements in feathers of three Antarctic penguins: Geographical and interspecific differences

    International Nuclear Information System (INIS)

    Jerez, Silvia; Motas, Miguel; Palacios, Maria Jose; Valera, Francisco; Cuervo, Jose Javier; Barbosa, Andres

    2011-01-01

    Antarctica is often considered as one of the last pristine regions, but it could be affected by pollution at global and local scale. Concentrations of Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Cd and Pb were determinated by ICP-MS in feathers (n = 207 individuals) of gentoo, chinstrap and Adelie penguin collected in 8 locations throughout the Antarctic Peninsula (2006-2007). The highest levels of several elements were found in samples from King George Island (8.08, 20.29 and 1.76 μg g -1 dw for Cr, Cu and Pb, respectively) and Deception Island (203.13, 3.26 and 164.26 μg g -1 dw for Al, Mn and Fe, respectively), where probably human activities and large-scale transport of pollutants contribute to increase metal levels. Concentrations of Cr, Mn, Cu, Se or Pb, which are similar to others found in different regions of the world, show that some areas in Antarctica are not utterly pristine. - Highlights: → We study levels of trace elements in feathers of Antarctic penguins. → Eight different rookeries throughout the Antarctic Peninsula were sampled. → Interspecific (gentoo, chinstrap, Adelie) and geographical differences were tested. → Relatively high metal levels were found in areas with major human presence. → Penguin feather can be useful for metals monitoring in the Antarctic environment. - Trace element levels in feathers of three penguin species from the Antarctic Peninsula indicate the presence of pollution in certain locations.

  16. Dietary intakes differ between renal transplant recipients living in patient hotels versus home.

    Science.gov (United States)

    Kahra, Terhi; Jenssen, Trond; Løvik, Astrid

    2004-04-01

    To compare dietary intake and health-related quality of life approximately 6 to 10 weeks after renal transplantation in patients living at home and at a patient hotel, and how the patients were following a heart-healthy diet according to the current American Heart Association guidelines. Cross-sectional observational study. Outpatient clinic at Rikshospitalet University Hospital, Norway. Forty renal transplant patients, 20 patients (14 men and 6 women) in both groups. There were 4 diabetic patients in each group. Dietary intake was assessed by 4-day dietary records. Health-related quality of life was investigated by the SF-36 questionnaire. The main outcome variables were daily energy intake and intakes of protein, total fat, saturated fat, cholesterol, fiber, and fruit and vegetables. The variables were tested by 2-sample t-tests, and significance was set at.05. There was no statistically significant difference in daily energy intake between the groups (P =.08), but there were significantly higher daily intakes of protein (P =.003), total fat (P =.03), monounsaturated fat (P =.02), cholesterol (P =.04), fiber (P =.02), calcium (P =.03), and fruit and vegetables (P =.03) in the group living at the patient hotel. The mean intake of saturated fat was 14.5% of total energy in the group living at home and 14.6% in the group living at the patient hotel. There were no significant differences in health-related quality of life between the groups. The results suggest that there are differences in dietary intake in renal transplant patients living at home compared with those at a patient hotel. It seems that neither of the groups follows current guidelines for reducing the risk of cardiovascular disease.

  17. Do Cost Functions for Tracking Error Generalize across Tasks with Different Noise Levels?

    Directory of Open Access Journals (Sweden)

    Jonathon Sensinger

    Full Text Available Control of human-machine interfaces are well modeled by computational control models, which take into account the behavioral decisions people make in estimating task dynamics and state for a given control law. This control law is optimized according to a cost function, which for the sake of mathematical tractability is typically represented as a series of quadratic terms. Recent studies have found that people actually use cost functions for reaching tasks that are slightly different than a quadratic function, but it is unclear which of several cost functions best explain human behavior and if these cost functions generalize across tasks of similar nature but different scale. In this study, we used an inverse-decision-theory technique to reconstruct the cost function from empirical data collected on 24 able-bodied subjects controlling a myoelectric interface. Compared with previous studies, this experimental paradigm involved a different control source (myoelectric control, which has inherently large multiplicative noise, a different control interface (control signal was mapped to cursor velocity, and a different task (the tracking position dynamically moved on the screen throughout each trial. Several cost functions, including a linear-quadratic; an inverted Gaussian, and a power function, accurately described the behavior of subjects throughout this experiment better than a quadratic cost function or other explored candidate cost functions (p<0.05. Importantly, despite the differences in the experimental paradigm and a substantially larger scale of error, we found only one candidate cost function whose parameter was consistent with the previous studies: a power function (cost ∝ errorα with a parameter value of α = 1.69 (1.53-1.78 interquartile range. This result suggests that a power-function is a representative function of user's error cost over a range of noise amplitudes for pointing and tracking tasks.

  18. The Influence of Technology on Geographic Cognition and Tourism Experience

    DEFF Research Database (Denmark)

    Tussyadiah, Iis; Zach, Florian

    2011-01-01

    Tourists today have access to retrieve voluminous geographic information about destinations while travelling as various context-aware geographic technologies have become increasingly ubiquitous. These technologies are suggested to aid tourists in the process of destination consumption to gain...... meaningful tourism experiences. This study found that people using different types of technologies for everyday routine perceive that these technologies help them with spatial inference to acquire geographic information; making sense of direction and orientation, and interacting with and within places....... Further, within the travel context, geographic technology was found to influence the dimensions of sensory, affective and social experience, as well as the cognitive and bodily experience. The type of technology used for travel was also found to be a significant predictor of the sensory, affective...

  19. Discrimination of Medicine Radix Astragali from Different Geographic Origins Using Multiple Spectroscopies Combined with Data Fusion Methods

    Science.gov (United States)

    Wang, Hai-Yan; Song, Chao; Sha, Min; Liu, Jun; Li, Li-Ping; Zhang, Zheng-Yong

    2018-05-01

    Raman spectra and ultraviolet-visible absorption spectra of four different geographic origins of Radix Astragali were collected. These data were analyzed using kernel principal component analysis combined with sparse representation classification. The results showed that the recognition rate reached 70.44% using Raman spectra for data input and 90.34% using ultraviolet-visible absorption spectra for data input. A new fusion method based on Raman combined with ultraviolet-visible data was investigated and the recognition rate was increased to 96.43%. The experimental results suggested that the proposed data fusion method effectively improved the utilization rate of the original data.

  20. Differences in self-reported morbidity by marital status and by living arrangement

    NARCIS (Netherlands)

    Joung, I. M.; van de Mheen, H.; Stronks, K.; van Poppel, F. W.; Mackenbach, J. P.

    1994-01-01

    It has frequently been shown that the never married, divorced and widowed have higher rates of self-reported morbidity than married people. The purpose of this study was to assess to what extent morbidity differences by marital status can be explained by differences in living arrangement (i.e.

  1. Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST).

    Science.gov (United States)

    Nkonki, Lungiswa Ll; Chola, Lumbwe L; Tugendhaft, Aviva A; Hofman, Karen K

    2017-08-28

    To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality. DemProj Based on National South African Data. A total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition. Reducing child mortality. A total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs. The use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Differences in occupational, transportation, domestic, and leisure-time physical activities: do geographical location and socio-cultural status matter?

    Science.gov (United States)

    Gauthier, Alain P; Lariviere, Michel; Pong, Raymond; Snelling, Susan; Young, Nancy

    2012-02-01

    Researchers have recently expressed their concern for the health of Francophones and rural dwellers in Canada. Their levels of physical activity may explain part of the observed differences. However, little is known about the physical activity levels of these 2 groups. The purpose of this study was to assess levels of physical activity among a sample of Francophones and rural dwellers. The study also assessed the associations of various types of physical activity to measures of health status. A quota-based convenience sample of 256 adults from Northern Ontario was surveyed using the IPAQ and the SF-12. There were no significant differences in activity levels between language groups (P = .06) or geographical groups (P = .22) on the combined dependent variables based on MANOVA. Leisure-time physical activity scores were consistently associated to better physical component summary scores of the SF-12. Implications for practice include that leisure-time physical activities have been at the forefront of public health promotion, and our findings support this approach. Further, population specific interventions are indeed important, however, within this Canadian context when identifying target groups one must look beyond sociocultural status or geographical location.

  3. Extension of the COSYMA-ECONOMICS module - cost calculations based on different economic sectors

    International Nuclear Information System (INIS)

    Faude, D.

    1994-12-01

    The COSYMA program system for evaluating the off-site consequences of accidental releases of radioactive material to the atmosphere includes an ECONOMICS module for assessing economic consequences. The aim of this module is to convert various consequences (radiation-induced health effects and impacts resulting from countermeasures) caused by an accident into the common framework of economic costs; this allows different effects to be expressed in the same terms and thus to make these effects comparable. With respect to the countermeasure 'movement of people', the dominant cost categories are 'loss-of-income costs' and 'costs of lost capital services'. In the original version of the ECONOMICS module these costs are calculated on the basis of the total number of people moved. In order to take into account also regional or local economic peculiarities of a nuclear site, the ECONOMICS module has been extended: Calculation of the above mentioned cost categories is now based on the number of employees in different economic sectors in the affected area. This extension of the COSYMA ECONOMICS module is described in more detail. (orig.)

  4. Referral bias in hospital register studies of geographical and industrial differences in health.

    Science.gov (United States)

    Soll-Johanning, Helle; Hannerz, Harald; Tüchsen, Finn

    2004-05-01

    The Danish National Hospital Register contains four patient types: full-time inpatients, part-time inpatients, outpatients and emergency ward patients. The aim of the present study was to investigate whether results from comparative hospital register studies depend on which patient types we choose to include in the analysis. The hospital register was linked to the centralised civil register and the employment classification module. All economically active persons in Denmark aged 20-59 years 1st January 1995 (N = 2,281,480) were followed for six years. We calculated SIRs, first by county then by industry and finally by industry adjusted for county, for a variety of diagnostic groups and for each of the following types of cases: A) full-time inpatients, B) all inpatients, C) all inpatients and outpatients, D) all patients. The ratio between the maximum and the minimum of the four types of SIRs was calculated for each combination of the examined population groups and diseases. A max/min ratio was regarded as a sign of referral bias if it was above 1.2 and statistically significant. When calculating SIRs by county 46.7 percent of the max/min ratios signified referral bias. The percentage was 5.5 when calculating SIRs by industry and only 1.7 when they were calculated by industry adjusted for county. Estimates of geographical health differences are often distorted by differences in the health care organisation. Estimates of industrial health differences tend to be robust with a few identifiable exceptions. Standardisation for county will eliminate bias.

  5. Genomic fingerprinting and serotyping of Salmonella from Galápagos iguanas demonstrates island differences in strain diversity.

    Science.gov (United States)

    Wheeler, Emily; Cann, Isaac K O; Mackie, Roderick I

    2011-04-01

    Salmonella carriage patterns in wild and captive reptiles suggest that both geographical proximity and host ecological differences may determine bacterial diversity among reptile populations. In this study, we explore the relative importance of these factors on Salmonella diversity in free-living Galápagos iguanas. We isolated Salmonella enterica from marine iguanas (Amblyrhynchus cristatus) and land iguanas (Conolophus subcristatus and C. pallidus) living on two islands (Plaza Sur and Santa Fe). We evaluated Salmonella population patterns using genomic fingerprints, sequence typing and serotyping. Rep-PCR fingerprinting revealed significant grouping of isolates by iguana population. Island residence had the strongest effect on isolate similarity, but a smaller divergence among Salmonella isolates from different iguana ecotypes (land versus marine) was detected within each island. In contrast, sequence typing detected a marginal difference in isolate genotypes between islands. Sequence types corresponded strongly to serotype identity, with both islands hosting a unique serovar pool. Our findings suggest that both geographical location and host ecotype differences (either from within host strain selection or from differences in habitat use) contribute to Salmonella population patterns in the Galápagos Islands. © 2010 Society for Applied Microbiology and Blackwell Publishing Ltd.

  6. Principles of logic and the use of digital geographic information systems

    Science.gov (United States)

    Robinove, Charles Joseph

    1986-01-01

    Digital geographic information systems allow many different types of data to be spatially and statistically analyzed. Logical operations can be performed on individual or multiple data planes by algorithms that can be implemented in computer systems. Users and creators of the systems should fully understand these operations. This paper describes the relationships of layers and features in geographic data bases and the principles of logic that can be applied by geographic information systems and suggests that a thorough knowledge of the data that are entered into a geographic data base and of the logical operations will produce results that are most satisfactory to the user. Methods of spatial analysis are reduced to their primitive logical operations and explained to further such understanding.

  7. Stress associated with group living in a long-lived bird

    OpenAIRE

    Selva, Nuria; Cortés-Avizanda, Ainara; Lemus, Jesús A.; Blanco, Guillermo; Mueller, Thomas; Heinrich, Bernd; Donázar, José A.

    2011-01-01

    Many long-lived avian species adopt life strategies that involve a gregarious way of life at juvenile and sub-adult stages and territoriality during adulthood. However, the potential associated costs of these life styles, such as stress, are poorly understood. We examined the effects of group living, sex and parasite load on the baseline concentration of faecal stress hormone (corticosterone) metabolites in a wild population of common ravens (Corvus corax). Corticosterone concentrations were ...

  8. Energy gradients and the geographic distribution of local ant diversity.

    Science.gov (United States)

    Kaspari, Michael; Ward, Philip S; Yuan, May

    2004-08-01

    Geographical diversity gradients, even among local communities, can ultimately arise from geographical differences in speciation and extinction rates. We evaluated three models--energy-speciation, energy-abundance, and area--that predict how geographic trends in net diversification rates generate trends in diversity. We sampled 96 litter ant communities from four provinces: Australia, Madagascar, North America, and South America. The energy-speciation hypothesis best predicted ant species richness by accurately predicting the slope of the temperature diversity curve, and accounting for most of the variation in diversity. The communities showed a strong latitudinal gradient in species richness as well as inter-province differences in diversity. The former vanished in the temperature-diversity residuals, suggesting that the latitudinal gradient arises primarily from higher diversification rates in the tropics. However, inter-province differences in diversity persisted in those residuals--South American communities remained more diverse than those in North America and Australia even after the effects of temperature were removed.

  9. Indices of methylation in sperm DNA from fertile men differ between distinct geographical regions

    DEFF Research Database (Denmark)

    Consales, C; Leter, G; Bonde, Jens Peter

    2014-01-01

    STUDY QUESTION: Which are the main determinants, if any, of sperm DNA methylation levels? SUMMARY ANSWER: Geographical region resulted associated with the sperm methylation status assessed on genome-wide repetitive sequences. WHAT IS KNOWN ALREADY: DNA methylation level, assessed on repetitive se...

  10. Feature Types and Object Categories: Is Sensorimotoric Knowledge Different for Living and Nonliving Things?

    Science.gov (United States)

    Ankerstein, Carrie A.; Varley, Rosemary A.; Cowell, Patricia E.

    2012-01-01

    Some models of semantic memory claim that items from living and nonliving domains have different feature-type profiles. Data from feature generation and perceptual modality rating tasks were compared to evaluate this claim. Results from two living (animals, fruits/vegetables) and two nonliving (tools, vehicles) categories showed that…

  11. Imbalance costs in the Swedish system with large amounts of wind power

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson, Fredrik; Neimane, Viktoria [Vattenfall Research and Development AB, Stockholm (Sweden)

    2009-07-01

    The well-known concerns about wind power are related to its intermittent nature and difficulty to make exact forecasts. The expected increase in balancing and reserve requirements due to wind power has been investigated in several studies. This paper takes the next step in studying integration of large amounts of wind power in Sweden. Several wind power producers' and corresponding balance providers' perspective is taken and their imbalance costs modeled. Larger producers having wind power spread over larger geographical areas will have lower relative costs than producers having their units concentrated within limited geographical area. Possibilities of the wind power producers to reduce the imbalance costs by acting on after sales market are exposed and compared. (orig.)

  12. Cost-effectiveness analysis of lifestyle intervention in obese infertile women.

    Science.gov (United States)

    van Oers, A M; Mutsaerts, M A Q; Burggraaff, J M; Kuchenbecker, W K H; Perquin, D A M; Koks, C A M; van Golde, R; Kaaijk, E M; Schierbeek, J M; Klijn, N F; van Kasteren, Y M; Land, J A; Mol, B W J; Hoek, A; Groen, H

    2017-07-01

    What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women birth rates were 27 and 35% in the intervention group and the control group, respectively (effect difference of -8.1%, P birth rate. Mean costs per healthy live birth event were €15 932 in the intervention group and €15 912 in the

  13. Sartans: differences, similitudes and costs

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2008-06-01

    Full Text Available The search for a more specific and complete blockade of the hypertensive effects of angiotensin and of better tolerability than ACE-inhibitors has led to the development of angiotensin II receptor blockers (ARBs, which were introduced about 10 years ago. During this period they have been evaluated in several large studies in terms of efficacy and safety in reducing blood pressure, as well as for cardiovascular and renal protection. In patients with heart failure, valsartan, candesartan and, partially, losartan have been shown to be associated with positive outcomes both as monotherapy, when ACE-inhibitors are contraindicated or not tolerated, and in combination with ACE-inhibitors standard therapy. Among ARBs, valsartan is the only that is also approved for treatment of patients with both heart failure and recent myocardial infarction. In light of the high costs related to cardiovascular disorders, agents that reduce cardiovascular risk, like ARBs, represent a potential long-term health cost saving strategy, if used according to guidelines in approved indications. Valsartan has a daily cost which is lower than the mean cost of the class. Furthermore, this drug shows one of the lowest costs for patient brought to blood pressure goals in its class. In this paper, economic evaluations conducted on the results of large trials were reviewed. Their results add economic rationale to the therapeutic algorithms recommended by clinical guidelines on heart failure management; using valsartan, or other evaluated ARBs, in heart failure patients who are intolerant or contraindicated to ACE-inhibitors therapy, is expected to be highly cost/effective. In combination with ACE-inhibitors in those patients not on beta-blocker therapy, its cost/effectiveness is somewhat worse, but still acceptable, with an estimated cost of 15,000 USDs for life year saved. In summary, when used for approved indications, valsartan offers attractive economic features for the

  14. The Canadian elder standard - pricing the cost of basic needs for the Canadian elderly.

    Science.gov (United States)

    MacDonald, Bonnie-Jeanne; Andrews, Doug; Brown, Robert L

    2010-03-01

    We determined the after-tax income required to finance basic needs for Canadian elders living with different circumstances in terms of age, gender, city of residence, household size, homeowner or renter status, means of transportation, and health status. Using 2001 as our base year, we priced the typical expenses for food, shelter, medical, transportation, miscellaneous basic living items and home-based long-term care for elders living in five Canadian cities. This is the first Canadian study of basic living expenses tailored to elders instead of adults in general, prepared on an absolute rather than a relative basis. We also accounted for an individual's unique life circumstances and established the varying effect that they have on the cost of basic expenses, particularly for home care. We found that the maximum Guaranteed Income Supplement and Old Age Security benefit did not meet the cost of basic needs for an elder living in poor circumstances.

  15. REFLECTING ABOUT THE EXPERIENCE OF LIVED SPACE: THE PLACE IN CONSTRUCTION OF KNOWLEDGE GEOGRAPHIC

    Directory of Open Access Journals (Sweden)

    Helenize Carlos de Macêdo

    2015-12-01

    Full Text Available The teaching of geography in schools of elementary education has as objective the citizenship training, that is, provide the spatial reading, understanding the socio-spatial relations derives from history and its implications in today's world, so that students have a critical view about their reality and to intervene on it. However, for the teaching of Geography reach your goals, it is necessary that teachers seek to incorporate methodologies that favor the construction of knowledge and suited to the reality of students. In this sense, the study of Geography from the place it seems appropriate, in order to approximate the daily knowledge and school knowledge, contributing to a significant learning. Thus, this paper discusses the importance of the study of place in Geography lessons, and relate an experience lived in the classroom with students of the 6th year of the Municipal School of Basic Education Severino Marinheiro, Juazeirinho - PB. Was used as methodology, literature review and analysis of the texts produced by the students. The results were satisfactory and demonstrated the importance of the study of the place, the experiences of students in the construction of geographical knowledge and on the theme environmental problems. O ensino de Geografia nas escolas da educação básica tem como objetivo a formação para a cidadania, ou seja, proporcionar a leitura espacial, entendendo as relações socioespaciais no decorrer da história e suas implicações no mundo atual, de forma que os discentes tenham uma visão crítica sobre sua realidade e possam intervir sobre ela. Porém, para que o ensino da Geografia alcance os seus objetivos, se faz necessário que os professores busquem incorporar metodologias que privilegiem a construção de conhecimentos, e que estes privilegiem a realidade dos alunos. Nesse sentido, o estudo da Geografia a partir do lugar se mostra oportuno, tendo em vista aproximar os saberes cotidianos e os saberes

  16. Personality Homophily and Geographic Distance in Facebook.

    Science.gov (United States)

    Noë, Nyala; Whitaker, Roger M; Allen, Stuart M

    2018-05-24

    Personality homophily remains an understudied aspect of social networks, with the traditional focus concerning sociodemographic variables as the basis for assortativity, rather than psychological dispositions. We consider the effect of personality homophily on one of the biggest constraints to human social networks: geographic distance. We use the Big five model of personality to make predictions for each of the five facets: Openness to experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism. Using a network of 313,669 Facebook users, we investigate the difference in geographic distance between homophilous pairs, in which both users scored similarly on a particular facet, and mixed pairs. In accordance with our hypotheses, we find that pairs of open and conscientious users are geographically further apart than mixed pairs. Pairs of extraverts, on the other hand, tend to be geographically closer together. We find mixed results for the Neuroticism facet, and no significant effects for the Agreeableness facet. The results are discussed in the context of personality homophily and the impact of geographic distance on social connections.

  17. Gender and Geographic Differences in the Prevalence of Autism Spectrum Disorders in Children: Analysis of Data from the National Disability Registry of Taiwan

    Science.gov (United States)

    Lai, Der-Chung; Tseng, Yen-Cheng; Hou, Yuh-Ming; Guo, How-Ran

    2012-01-01

    The prevalence of autism spectrum disorders (ASD) in the world has increased dramatically in the recent decades. However, data at the national level are limited, and geographic differences are seldom evaluated. According to the law, the local governments in Taiwan began to certify disabled residents and provide various services in 1980, and the…

  18. Using a 'value-added' approach for contextual design of geographic information.

    Science.gov (United States)

    May, Andrew J

    2013-11-01

    The aim of this article is to demonstrate how a 'value-added' approach can be used for user-centred design of geographic information. An information science perspective was used, with value being the difference in outcomes arising from alternative information sets. Sixteen drivers navigated a complex, unfamiliar urban route, using visual and verbal instructions representing the distance-to-turn and junction layout information presented by typical satellite navigation systems. Data measuring driving errors, navigation errors and driver confidence were collected throughout the trial. The results show how driver performance varied considerably according to the geographic context at specific locations, and that there are specific opportunities to add value with enhanced geographical information. The conclusions are that a value-added approach facilitates a more explicit focus on 'desired' (and feasible) levels of end user performance with different information sets, and is a potentially effective approach to user-centred design of geographic information. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Supporting Geographic Investigations and Visualizations and Engaging Students as Citizen Scientists

    Science.gov (United States)

    Takaki, E.

    2011-12-01

    Historically, citizen science projects have had to provide their own technical infrastructure to handle the data they collect. National Geographic Education Programs (funded by the National Science Foundation) has developed a free (or low cost for large projects) online data visualization and analysis tool called FieldScope, which is available to any person or group doing studies that involve geographically dispersed data. FieldScope can house and scaffold the analysis of authentic environmental data as well as augment it with other helpful layers such as precipitation, population density, water quality parameters, etc. During the session, participants will come to understand the basics of GIS, the history of FieldScope, and its unique educational features. We will spend the majority of the time exploring specific tools for analyzing authentic data, the different types of layers that make FieldScope powerful in its educational and research capacities, and examining various questions that can be addressed in a classroom or citizen science setting. We'll conclude the hands-on portion by sharing what was learned and how they were able to make meaning from the myriad of ways that data can be displayed.

  20. Quality Inspection and Analysis of Three-Dimensional Geographic Information Model Based on Oblique Photogrammetry

    Science.gov (United States)

    Dong, S.; Yan, Q.; Xu, Y.; Bai, J.

    2018-04-01

    In order to promote the construction of digital geo-spatial framework in China and accelerate the construction of informatization mapping system, three-dimensional geographic information model emerged. The three-dimensional geographic information model based on oblique photogrammetry technology has higher accuracy, shorter period and lower cost than traditional methods, and can more directly reflect the elevation, position and appearance of the features. At this stage, the technology of producing three-dimensional geographic information models based on oblique photogrammetry technology is rapidly developing. The market demand and model results have been emerged in a large amount, and the related quality inspection needs are also getting larger and larger. Through the study of relevant literature, it is found that there are a lot of researches on the basic principles and technical characteristics of this technology, and relatively few studies on quality inspection and analysis. On the basis of summarizing the basic principle and technical characteristics of oblique photogrammetry technology, this paper introduces the inspection contents and inspection methods of three-dimensional geographic information model based on oblique photogrammetry technology. Combined with the actual inspection work, this paper summarizes the quality problems of three-dimensional geographic information model based on oblique photogrammetry technology, analyzes the causes of the problems and puts forward the quality control measures. It provides technical guidance for the quality inspection of three-dimensional geographic information model data products based on oblique photogrammetry technology in China and provides technical support for the vigorous development of three-dimensional geographic information model based on oblique photogrammetry technology.

  1. QUALITY INSPECTION AND ANALYSIS OF THREE-DIMENSIONAL GEOGRAPHIC INFORMATION MODEL BASED ON OBLIQUE PHOTOGRAMMETRY

    Directory of Open Access Journals (Sweden)

    S. Dong

    2018-04-01

    Full Text Available In order to promote the construction of digital geo-spatial framework in China and accelerate the construction of informatization mapping system, three-dimensional geographic information model emerged. The three-dimensional geographic information model based on oblique photogrammetry technology has higher accuracy, shorter period and lower cost than traditional methods, and can more directly reflect the elevation, position and appearance of the features. At this stage, the technology of producing three-dimensional geographic information models based on oblique photogrammetry technology is rapidly developing. The market demand and model results have been emerged in a large amount, and the related quality inspection needs are also getting larger and larger. Through the study of relevant literature, it is found that there are a lot of researches on the basic principles and technical characteristics of this technology, and relatively few studies on quality inspection and analysis. On the basis of summarizing the basic principle and technical characteristics of oblique photogrammetry technology, this paper introduces the inspection contents and inspection methods of three-dimensional geographic information model based on oblique photogrammetry technology. Combined with the actual inspection work, this paper summarizes the quality problems of three-dimensional geographic information model based on oblique photogrammetry technology, analyzes the causes of the problems and puts forward the quality control measures. It provides technical guidance for the quality inspection of three-dimensional geographic information model data products based on oblique photogrammetry technology in China and provides technical support for the vigorous development of three-dimensional geographic information model based on oblique photogrammetry technology.

  2. Geographical data structures supporting regional analysis

    International Nuclear Information System (INIS)

    Edwards, R.G.; Durfee, R.C.

    1978-01-01

    In recent years the computer has become a valuable aid in solving regional environmental problems. Over a hundred different geographic information systems have been developed to digitize, store, analyze, and display spatially distributed data. One important aspect of these systems is the data structure (e.g. grids, polygons, segments) used to model the environment being studied. This paper presents eight common geographic data structures and their use in studies of coal resources, power plant siting, population distributions, LANDSAT imagery analysis, and landuse analysis

  3. Geographic factors as determinants of food security: a Western Australian food pricing and quality study.

    Science.gov (United States)

    Pollard, Christina Mary; Landrigan, Timothy John; Ellies, Pernilla Laila; Kerr, Deborah Anne; Lester, Matthew Langdon Underwood; Goodchild, Stanley Edward

    2014-01-01

    Food affordability and quality can influence food choice. This research explores the impact of geographic factors on food pricing and quality in Western Australia (WA). A Healthy Food Access Basket (HFAB) was cost and a visual and descriptive quality assessment of 13 commonly consumed fresh produce items was conducted in-store on a representative sample of 144 food grocery stores. The WA retail environment in 2010 had 447 grocery stores servicing 2.9 million people: 38% of stores the two major chains (Coles® Supermarkets Australia and Woolworths ® Limited) in population dense areas, 50% were smaller independently owned stores (Independent Grocers Association®) in regional areas as well, and 12% Indigenous community stores in very remote areas. The HFAB cost 24% (pfoods cost more and the quality of fresh produce was lower. Food affordability and quality may deter healthier food choice in geographically isolated communities. Improving affordability and quality of nutritious foods in remote communities may positively impact food choices, improve food security and prevent diet-sensitive chronic disease. Policy makers should consider influencing agriculture, trade, commerce, transport, freight, and modifying local food economies.

  4. Dietary intakes of energy and macronutrients by lactating women of different ethnic groups living in Yakutia.

    Science.gov (United States)

    Burtseva, Tatiana; Solodkova, Irina; Savvina, Maya; Dranaeva, Galina; Shadrin, Victor; Avrusin, Sergei; Sinelnikova, Elena; Chasnyk, Vyacheslav

    2013-01-01

    There should be a substantial increase in the intake of dietary energy, protein and other nutrients by lactating women, though these special increments can be different in different ethnic groups. To evaluate the influence of maternal ethnicity and diet on the quality of breast milk and its potential effect on early childhood development. A total of 185 mothers (150 Native and 35 Russian) living in settlements and small towns of rural Yakutia and 54 mothers (26 Native and 28 Russian) living in Yakutsk were surveyed and average food intake was recorded during 3 successive days before the survey was analyzed. The amount of protein varied from 18 to 168.3 g/day, fat--from 12 to 176.1 g/day, energy--from 900 to 3680.4 kcal/day. Protein intake was at the level of current recommended dietary allowances (RDA) in Russians and was higher than in Natives living in rural settlements and small towns (p = 0.02) and in Yakutsk (p = 0.03). Carbohydrate intake was higher, though not significantly, in both ethnic groups compared with the current recommendations. Protein, fat, carbohydrates and, therefore, energy intake were lower (p macronutrients depended on the place where a woman lived rather than on her ethnicity. Overall, energy intake was considered to be at the lower limit (basal energy expenditure 2002/2005) for lactating women, with the exception of Native women living in Yakutsk whose energy intake was below the lower limit.

  5. Pavement Management Systems Application with Geographic Information System Method

    Directory of Open Access Journals (Sweden)

    Nihat MOROVA

    2016-04-01

    Full Text Available In this study, performance models were developed. Software in Visual Basic programming language was used for the developed model. Using the software, both the present condition of the pavement can be examined and future performance based on expected traffic values can be predicted. So, the software can be used at both network and project level. Cost and benefit values taken from the literature were used in determining the cost-benefit ratio. Using the genetic algorithm approach, a computer program in Visual Basic programming language was written. Using the model developed, a five-year maintenance and rehabilitation program can be planned for a given database considering budget restraints. The developed models were merged by writing Geographic Information System (GIS software in order to show the effectiveness of models and adopt the models into a GIS. For this purpose, a case study of GIS was exposed. The control of the overall system can be applied in addition to the application of the model at network level. The developed software allows data to be transferred to the database, analyses and different scenario applications for showing GIS results.

  6. Sequential Optimization of Paths in Directed Graphs Relative to Different Cost Functions

    KAUST Repository

    Mahayni, Malek A.

    2011-07-01

    Finding optimal paths in directed graphs is a wide area of research that has received much of attention in theoretical computer science due to its importance in many applications (e.g., computer networks and road maps). Many algorithms have been developed to solve the optimal paths problem with different kinds of graphs. An algorithm that solves the problem of paths’ optimization in directed graphs relative to different cost functions is described in [1]. It follows an approach extended from the dynamic programming approach as it solves the problem sequentially and works on directed graphs with positive weights and no loop edges. The aim of this thesis is to implement and evaluate that algorithm to find the optimal paths in directed graphs relative to two different cost functions ( , ). A possible interpretation of a directed graph is a network of roads so the weights for the function represent the length of roads, whereas the weights for the function represent a constraint of the width or weight of a vehicle. The optimization aim for those two functions is to minimize the cost relative to the function and maximize the constraint value associated with the function. This thesis also includes finding and proving the relation between the two different cost functions ( , ). When given a value of one function, we can find the best possible value for the other function. This relation is proven theoretically and also implemented and experimented using Matlab®[2].

  7. Geographically distinct Ceratophyllum demersum populations differ in growth, photosynthetic responses and phenotypic plasticity to nitrogen availability

    DEFF Research Database (Denmark)

    Hyldgaard, Benita; Sorrell, Brian Keith; Olesen, Birgit

    2012-01-01

    from New Zealand (NZ) and a noninvasive population from Denmark (DK). The populations were compared with a focus on both morphological and physiological traits. The NZ population had higher relative growth rates (RGRs) and photosynthesis rates (Pmax) (range: RGR, 0.06–0.08 per day; Pmax, 200–395 µmol O......2 g–1 dry mass (DM) h–1) compared with the Danish population (range: RGR, 0.02–0.05 per day; Pmax, 88–169 µmol O2 g–1 DM h–1). The larger, faster-growing NZ population also showed higher plasticity than the DK population in response to nitrogen in traits important for growth. Hence, the observed...... differences in growth behaviour between the two populations are a result of genetic differences and differences in their level of plasticity. Here, we show that two populations of the same species from similar climates but different geographical areas can differ in several ecophysiological traits after growth...

  8. Classification of Tempranillo wines according to geographic origin: Combination of mass spectrometry based electronic nose and chemometrics

    Energy Technology Data Exchange (ETDEWEB)

    Cynkar, Wies, E-mail: wies.cynkar@awri.com.au [Australian Wine Research Institute, PO Box 197, Glen Osmond, SA 5064 (Australia); Dambergs, Robert [Australian Wine Research Institute, Tasmanian Institute of Agricultural Research, University of Tasmania, Private Bag 98, Hobart Tasmania 7001 (Australia); Smith, Paul; Cozzolino, Daniel [Australian Wine Research Institute, PO Box 197, Glen Osmond, SA 5064 (Australia)

    2010-02-15

    Rapid methods employing instruments such as electronic noses (EN) or gas sensors are used in the food and beverage industries to monitor and assess the composition and quality of products. Similar to other food industries, the wine industry has a clear need for simple, rapid and cost effective techniques for objectively evaluating the quality of grapes, wine and spirits. In this study a mass spectrometry based electronic nose (MS-EN) instrument combined with chemometrics was used to predict the geographical origin of Tempranillo wines produced in Australia and Spain. The MS-EN data generated were analyzed using principal components analysis (PCA), partial least squares discriminant analysis (PLS-DA) and stepwise linear discriminant analysis (SLDA) with full cross validation (leave-one-out method). The SLDA classified correctly 86% of the samples while PLS-DA 85% of Tempranillo wines according to their geographical origin. The relative benefits of using MS-EN will provide capability for rapid screening of wines. However, this technique does not provide the identification and quantitative determination of individual compounds responsible for the different aroma notes in the wine.

  9. Classification of Tempranillo wines according to geographic origin: Combination of mass spectrometry based electronic nose and chemometrics

    International Nuclear Information System (INIS)

    Cynkar, Wies; Dambergs, Robert; Smith, Paul; Cozzolino, Daniel

    2010-01-01

    Rapid methods employing instruments such as electronic noses (EN) or gas sensors are used in the food and beverage industries to monitor and assess the composition and quality of products. Similar to other food industries, the wine industry has a clear need for simple, rapid and cost effective techniques for objectively evaluating the quality of grapes, wine and spirits. In this study a mass spectrometry based electronic nose (MS-EN) instrument combined with chemometrics was used to predict the geographical origin of Tempranillo wines produced in Australia and Spain. The MS-EN data generated were analyzed using principal components analysis (PCA), partial least squares discriminant analysis (PLS-DA) and stepwise linear discriminant analysis (SLDA) with full cross validation (leave-one-out method). The SLDA classified correctly 86% of the samples while PLS-DA 85% of Tempranillo wines according to their geographical origin. The relative benefits of using MS-EN will provide capability for rapid screening of wines. However, this technique does not provide the identification and quantitative determination of individual compounds responsible for the different aroma notes in the wine.

  10. [Species composition and geographical distribution of threatened fishes in Yunnan Province of Southwest China].

    Science.gov (United States)

    Zhang, Qian; Zhong, Jin-Xin

    2013-05-01

    Based on the related published papers, and by using Geographic Information System (ArcGIS 9.3), this paper analyzed the species composition and geographical distribution of threatened fishes in Yunnan Province of Southwest China. There were 83 threatened species living in the Province, belonging to 5 orders, 13 families, and 47 genera. Cypriniformes was absolutely dominant, with 64 species, followed by Siluriformes, with 16 species. Cyprinidae fishes had 51 species, accounting for 79.7% of Cypriniformes. The most species of Cyprinid fishes were of Barbinae (14 species), Cyprininae (10 species), and Cultrinae (10 species). The threatened fishes could be divided into two zoogeographical regions, i. e., Tibetan Plateau region and Oriental region, and their species composition and geographical distribution were resulted from the historical evolution adapted to the related environments. Whatever in rivers and in lakes, the Cyprinid fishes were both absolutely dominant, occupying 36.1% and 31.3% of the total, respectively. The Cyprinid fishes in rivers were mostly of endangered species, while those in lakes were mostly of vulnerable species. The factors affecting the threatened fishes in the Province were discussed from the two aspects of geodynamic evolution and present situation.

  11. The financial and quality-of-life cost to patients living with a chronic wound in the community.

    Science.gov (United States)

    Kapp, Suzanne; Santamaria, Nick

    2017-12-01

    Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds. A questionnaire incorporating the Cardiff Wound Impact Schedule and purpose-designed instruments was completed by a non-probability, convenience sample of 113 people in Australia and Wales. Data was analysed using descriptive statistics. The sample was on average 63·6 years of age and had wounds that were on an average 109 weeks duration. Participants had spent on average AU$2475 on wound dressing products since the wound started, and AU$121·82 in the most recent 28 days which represented 10% of their disposable income. Health-related quality of life was sub-optimal, 6/10 (ave) according to the Cardiff Wound Impact Schedule. Younger participants reported significantly poorer quality of life on all CWIS sub-scales when compared to older participants. This study found that chronic wounds present a significant financial cost to individuals who must self-fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub-optimal quality of life therefore this condition is also costly to the individual's well-being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurrent condition. Continued action is

  12. The Geographic Extent of Global Supply Chains

    DEFF Research Database (Denmark)

    Machikita, Tomohiro; Ueki, Yasushi

    2012-01-01

    We study the extent to which inter-firm relationships are locally concentrated and what determines firm differences in geographic proximity to domestic or foreign suppliers and customers. From micro-data on selfreported customer and supplier data of firms in Indonesia, the Philippines, Thailand, ...

  13. Evaluating the effectiveness of different approaches to home support for people in later stage dementia: a protocol for an observational study.

    Science.gov (United States)

    Chester, Helen; Clarkson, Paul; Hughes, Jane; Russell, Ian; Beresford, Joan; Davies, Linda; Jolley, David; Peconi, Julie; Poland, Fiona; Roberts, Chris; Sutcliffe, Caroline; Challis, David

    2017-07-01

    Dementia is a major health problem with a growing number of people affected by the condition, both directly and indirectly through caring for someone with dementia. Many live at home but little is known about the range and intensity of the support they receive. Previous studies have mainly reported on discrete services within a single geographical area. This paper presents a protocol for study of different services across several sites in England. The aim is to explore the presence, effects, and cost-effectiveness of approaches to home support for people in later stage dementia and their carers. This is a prospective observational study employing mixed methods. At least 300 participants (people with dementia and their carers) from geographical areas with demonstrably different ranges of services available for people with dementia will be selected. Within each area, participants will be recruited from a range of services. Participants will be interviewed on two occasions and data will be collected on their characteristics and circumstances, quality of life, carer health and burden, and informal and formal support for the person with dementia. The structured interviews will also collect qualitative data to explore the perceptions of older people and carers. This national study will explore the components of appropriate and effective home support fo