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.

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.

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.

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.

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.

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...

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…

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.

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...

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...

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...

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....

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 ...

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...

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

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...

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.

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...

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...

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

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…

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...

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.

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...

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...

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...

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...

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.

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)

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...

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.

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.

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.

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.

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...

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...

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...

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...

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...

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...

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.

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...

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.

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.

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.

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...

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...

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.

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

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

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.

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.

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.

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...

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.

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.

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...

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.

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…

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.

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.

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.

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.

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.

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.

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,…

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...

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...

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...

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...

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

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

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...

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.

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…

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.

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...

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.

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.

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.

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.

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.

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...

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

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

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.

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

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...

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....

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.

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...

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.

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.

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...

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.

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...

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...

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.

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

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.

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…

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.

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

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.

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.

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

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.

[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.

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.

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 ...

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

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...

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.

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.

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.

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.

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.

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...

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.

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...

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.

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.

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.

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.

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.

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.

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

Geographic Ontologies, Gazetteers and Multilingualism

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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.

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...

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

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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.

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

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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

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

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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

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

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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

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

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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.

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

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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

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

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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.

Antioxidant properties of Mediterranean food plant extracts: geographical differences.

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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.

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

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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.

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

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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.

Physical Activity in the Lives of Hong Kong Chinese Children

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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…

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,...

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

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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

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...

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

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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

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

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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.

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

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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

Regional cost differences of hospital supply in Germany

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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.

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

Cost implications of PSA screening differ by age.

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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

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

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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.

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.

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

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.

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

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.

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.

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

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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.

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.

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

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...

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.

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.

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...

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.

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.

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.

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.

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...

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

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

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.

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.

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.

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.

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

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.

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

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

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

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

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...

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...

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

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.

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...

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.

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

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

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.

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.

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.

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

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.

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.

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

Unit cost of medical services at different hospitals in India.

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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

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

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

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

[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.

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.

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...

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

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�

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

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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

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

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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.

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.

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

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)

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

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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.

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

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 ...

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…

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.

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

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

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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.

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

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.

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

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.

WAYS TO IMPROVE THE TRANSPORT OF LIVE FISH

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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.

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

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.

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.

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

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

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

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...

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....

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

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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.

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.

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

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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

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)

REVIEW OF METHODOLOGIES FOR COSTS CALCULATING OF RUMINANTS IN SLOVAKIA

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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�

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.

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

[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.

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

IL FENOMENO VOLUNTEERED GEOGRAPHIC INFORMATION

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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.

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

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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

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

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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.

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

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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.

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

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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.

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

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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.

ROMANIA: GEOGRAPHICAL AND GEOPOLITICAL POSITION

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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

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 ...

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

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

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

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.

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.

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.

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...

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.

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.

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.

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.…

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.

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.

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.

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....

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.

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...

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.

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...

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

OpenAIRE

Yu, Wei; Bradford, Garnett L.