Innovative High-Performance Deposition Technology for Low-Cost Manufacturing of OLED Lighting

Energy Technology Data Exchange (ETDEWEB)

Scott, David; Hamer, John

2017-06-30

In this project, OLEDWorks developed and demonstrated the innovative high-performance deposition technology required to deliver dramatic reductions in the cost of manufacturing OLED lighting in production equipment. The current high manufacturing cost of OLED lighting is the most urgent barrier to its market acceptance. The new deposition technology delivers solutions to the two largest parts of the manufacturing cost problem – the expense per area of good product for organic materials and for the capital cost and depreciation of the equipment. Organic materials cost is the largest expense item in the bill of materials and is predicted to remain so through 2020. The high-performance deposition technology developed in this project, also known as the next generation source (NGS), increases material usage efficiency from 25% found in current Gen2 deposition technology to 60%. This improvement alone results in a reduction of approximately $25/m2 of good product in organic materials costs, independent of production volumes. Additionally, this innovative deposition technology reduces the total depreciation cost from the estimated value of approximately $780/m2 of good product for state-of-the-art G2 lines (at capacity, 5-year straight line depreciation) to $170/m2 of good product from the OLEDWorks production line.

Internet-delivered psychological treatments for mood and anxiety disorders: a systematic review of their efficacy, safety, and cost-effectiveness.

Directory of Open Access Journals (Sweden)

Filip K Arnberg

Full Text Available Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07 and social phobia (d = 0.85; 95% CI 0.66, 1.05, and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d =  -0.04; 95% CI -0.24, 0.35. The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would

Cost of delivering secondary-level health care services through public sector district hospitals in India

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Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

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Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Challenges in Delivering Green Building Projects: Unearthing the Transaction Costs (TCs

Directory of Open Access Journals (Sweden)

Queena K. Qian

2015-03-01

Full Text Available Delivering green building (GB projects involve some activities that are atypical in comparison with conventional buildings. Such new activities are characterized by uncertainty, and they incur hidden costs that have not been expected nor are they readily appreciated among the stakeholders. This paper develops a typology and chronology to examine the new activities that are associated with transaction costs (TCs in the real estate development process (REDP of green building. Through in-depth interviews with representatives from the major developers in Hong Kong who have experiences in GB practice, this study aims to unearth TCs involved at the critical stages of the REDP. Apart from reconfirming the early project planning stage as the most critical in the consideration of TCs, the study results also identified “extra legal liability risk of the GB product” as the major concern for any GB developer in Hong Kong. The key additional activities that bring significant TCs in developing GB are identified and compared to their traditional counterparts. In turn, project managers not only have to pursue overall cost management whilst winning more business, but they also have to pay particular attention to sustainability in order to minimize hidden societal costs. The study also provides a reference for governments and professionals that will aid in forming policy as well as advance the practice of the GB market by optimizing the societal costs.

A randomized controlled trial testing an Internet delivered cost-benefit approach to weight loss maintenance.

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Leahey, Tricia M; Fava, Joseph L; Seiden, Andrew; Fernandes, Denise; Doyle, Caroline; Kent, Kimberly; La Rue, Molly; Mitchell, Marc; Wing, Rena R

2016-11-01

Weight loss maintenance is a significant challenge in obesity treatment. During maintenance the "costs" of adhering to weight management behaviors may outweigh the "benefits." This study examined the efficacy of a novel approach to weight loss maintenance based on modifying the cost-benefit ratio. Individuals who achieved a 5% weight loss (N=75) were randomized to one of three, 10-month maintenance interventions. All interventions were delivered primarily via the Internet. The Standard arm received traditional weight maintenance strategies. To increase benefits, or rewards, for maintenance behaviors, the two cost-benefit intervention conditions received weekly monetary rewards for self-monitoring and social reinforcement via e-coaching. To decrease behavioral costs (boredom) and increase novelty, participants in the cost-benefit conditions also monitored different evidence-based behaviors every two weeks (e.g., Weeks 1 & 2: steps; Week 3 & 4: red foods). The primary difference between the cost-benefit interventions was type of e-coach providing social reinforcement: Professional (CB Pro) or Peer (CB Peer). Study procedures took place in Providence, RI from 2013 to 2014. Retention was 99%. There were significant group differences in weight regain (p=.01). The Standard arm gained 3.5±5.7kg. In contrast, participants in CB Pro and CB Peer lost an additional 1.8±7.0kg and 0.5±6.4kg, respectively. These results suggest that an Internet delivered cost-benefit approach to weight loss maintenance may be effective for long-term weight control. In addition, using peer coaches to provide reinforcement may be a particularly economic alternative to professionals. These data are promising and provide support for a larger, longer trial. Copyright © 2016 Elsevier Inc. All rights reserved.

The effect of location and facility demand on the marginal cost of delivered wood chips from energy crops: A case study of the state of Tennessee

International Nuclear Information System (INIS)

Graham, R.L.; Liu, W.; Downing, M.; Noon, C.; Daly, M.; Moore, A.

1995-01-01

Cost-supply curves for delivered wood chips from short rotation woody crops were calculated for 21 regularly-spaced locations spanning the state of Tennessee. These curves were used to systematically evaluate the combined effects of location and facility demand on wood chip feedstock costs in Tennessee. The cost-supply curves were developed using BRAVO, a GIS-based decision support system which calculates marginal cost of delivering wood chips to a specific location given road network maps and maps of farmgate prices and supplies of woody chips from short rotation energy crops. Marginal costs of delivered chips varied by both facility location in the state and facility demand. Marginal costs were lowest in central Tennessee unless the facility demand was greater than 2.7 million dry Mg per year (3 million dry tons per year) in which case west Tennessee was the lowest cost region. Marginal costs rose rapidly with increasing facility demand in the mountainous eastern portion of the state. Transportation costs accounted for 18 to 29% of the delivered cost and ranged between $8 and $18/dry Mg ($7 and $16/dry ton). Reducing the expected farmer participation rate from 100% to 50% or 25% dramatically raised the marginal costs of feedstock supply in the east and central regions of the state. The analysis demonstrates the need to use geographically-specific information when projecting the potential costs and supplies of biomass feedstock

Joining forces: collaborating internationally to deliver high-quality, online postgraduate education in pain management.

Science.gov (United States)

Devonshire, Elizabeth; Siddall, Philip

2011-01-01

The effective management of pain is a complex and costly global issue, requiring a range of innovative educational strategies to enable culturally appropriate and high-quality health care provision. In response to this issue, the Pain Management Research Institute at the University of Sydney (Sydney, Australia) has established several strategic alliances with other overseas universities to deliver online postgraduate education in pain management. The present article discusses the rationale for joining forces, and the approach adopted in creating and maintaining these alliances. It also provides insights into the benefits, challenges and opportunities associated with collaborative educational initiatives of this nature, from institutional, academic and student perspectives.

Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

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Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

2016-01-19

Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

Science.gov (United States)

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Cost-effectiveness of peer-delivered interventions for cocaine and alcohol abuse among women: a randomized controlled trial.

Directory of Open Access Journals (Sweden)

Jennifer Prah Ruger

Full Text Available To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M and 12 months (12 M from baseline.We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1 NIDA's Standard intervention (SI; (2 SI plus a Well Woman Exam (WWE; and, (3 SI, WWE, plus four Educational Sessions (4ES.To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and $3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and $7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective by WWE for abstinence outcomes.To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.ClinicalTrials.gov NCT01235091.

Cost-effectiveness of nurse-delivered cognitive behavioural therapy (CBT) compared to supportive listening (SL) for adjustment to multiple sclerosis.

Science.gov (United States)

Mosweu, I; Moss-Morris, R; Dennison, L; Chalder, T; McCrone, P

2017-10-10

Cognitive Behavioural Therapy (CBT) reduces distress in multiple sclerosis, and helps manage adjustment, but cost-effectiveness evidence is lacking. An economic evaluation was conducted within a multi-centre trial. 94 patients were randomised to either eight sessions of nurse-led CBT or supportive listening (SL). Costs were calculated from the health, social and indirect care perspectives, and combined with additional quality-adjusted life years (QALY) or improvement on the GHQ-12 score, to explore cost-effectiveness at 12 months. CBT had higher mean health costs (£1610, 95% CI, -£187 to 3771) and slightly better QALYs (0.0053, 95% CI, -0.059 to 0.103) compared to SL but these differences were not statistically significant. This yielded £301,509 per QALY improvement, indicating that CBT is not cost-effective according to established UK NHS thresholds. The extra cost per patient improvement on the GHQ-12 scale was £821 from the same perspective. Using a £20,000, threshold, CBT in this format has a 9% probability of being cost effective. Although subgroup analysis of patients with clinical levels of distress at baseline showed an improvement in the position of CBT compared to SL, CBT was still not cost-effective. Nurse delivered CBT is more effective in reducing distress among MS patients compared to SL, but is highly unlikely to be cost-effective using a preference-based measure of health (EQ-5D). Results from a disease-specific measure (GHQ-12) produced comparatively lower Incremental Cost-Effectiveness Ratios, but there is currently no acceptable willingness-to-pay threshold for this measure to guide decision-making.

Effect of Dead Volume on the Efficiency and the Cost to Deliver Medications in Cystic Fibrosis with Four Disposable Nebulizers

Directory of Open Access Journals (Sweden)

Sharon L Ho

1999-01-01

Full Text Available OBJECTIVES: To evaluate the factors that affect nebulizer efficiency and to compare the relative cost effectiveness of nebulized medications used in the treatment of cystic fibrosis (CF, delivered by four types of disposable jet nebulizers that are widely used in hospitals.

The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop.

Science.gov (United States)

Guerriero, Carla; Cairns, John; Roberts, Ian; Rodgers, Anthony; Whittaker, Robyn; Free, Caroline

2013-10-01

The txt2stop trial has shown that mobile-phone-based smoking cessation support doubles biochemically validated quitting at 6 months. This study examines the cost-effectiveness of smoking cessation support delivered by mobile phone text messaging. The lifetime incremental costs and benefits of adding text-based support to current practice are estimated from a UK NHS perspective using a Markov model. The cost-effectiveness was measured in terms of cost per quitter, cost per life year gained and cost per QALY gained. As in previous studies, smokers are assumed to face a higher risk of experiencing the following five diseases: lung cancer, stroke, myocardial infarction, chronic obstructive pulmonary disease, and coronary heart disease (i.e. the main fatal or disabling, but by no means the only, adverse effects of prolonged smoking). The treatment costs and health state values associated with these diseases were identified from the literature. The analysis was based on the age and gender distribution observed in the txt2stop trial. Effectiveness and cost parameters were varied in deterministic sensitivity analyses, and a probabilistic sensitivity analysis was also performed. The cost of text-based support per 1,000 enrolled smokers is £16,120, which, given an estimated 58 additional quitters at 6 months, equates to £278 per quitter. However, when the future NHS costs saved (as a result of reduced smoking) are included, text-based support would be cost saving. It is estimated that 18 LYs are gained per 1,000 smokers (0.3 LYs per quitter) receiving text-based support, and 29 QALYs are gained (0.5 QALYs per quitter). The deterministic sensitivity analysis indicated that changes in individual model parameters did not alter the conclusion that this is a cost-effective intervention. Similarly, the probabilistic sensitivity analysis indicated a >90 % chance that the intervention will be cost saving. This study shows that under a wide variety of conditions, personalised

The costs and cost-efficiency of providing food through schools in areas of high food insecurity.

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Gelli, Aulo; Al-Shaiba, Najeeb; Espejo, Francisco

2009-03-01

The provision of food in and through schools has been used to support the education, health, and nutrition of school-aged children. The monitoring of financial inputs into school health and nutrition programs is critical for a number of reasons, including accountability, transparency, and equity. Furthermore, there is a gap in the evidence on the costs, cost-efficiency, and cost-effectiveness of providing food through schools, particularly in areas of high food insecurity. To estimate the programmatic costs and cost-efficiency associated with providing food through schools in food-insecure, developing-country contexts, by analyzing global project data from the World Food Programme (WFP). Project data, including expenditures and number of schoolchildren covered, were collected through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The average yearly expenditure per child, standardized over a 200-day on-site feeding period and an average ration, excluding school-level costs, was US$21.59. The costs varied substantially according to choice of food modality, with fortified biscuits providing the least costly option of about US$11 per year and take-home rations providing the most expensive option at approximately US$52 per year. Comparisons across the different food modalities suggested that fortified biscuits provide the most cost-efficient option in terms of micronutrient delivery (particularly vitamin A and iodine), whereas on-site meals appear to be more efficient in terms of calories delivered. Transportation and logistics costs were the main drivers for the high costs. The choice of program objectives will to a large degree dictate the food modality

International bioenergy transport costs and energy balance

International Nuclear Information System (INIS)

Hamelinck, Carlo N.; Suurs, Roald A.A.; Faaij, Andre P.C.

2005-01-01

To supply biomass from production areas to energy importing regions, long-distance international transport is necessary, implying additional logistics, costs, energy consumption and material losses compared to local utilisation. A broad variety of bioenergy chains can be envisioned, comprising different biomass feedstock production systems, pre-treatment and conversion operations, and transport of raw and refined solid biomass and liquid bio-derived fuels. A tool was developed to consistently compare the possible bioenergy supply chains and assess the influence of key parameters, such as distance, timing and scale on performance. Chains of European and Latin American bioenergy carriers delivered to Western Europe were analysed using generic data. European biomass residues and crops can be delivered at 90 and 70 euros/tonne dry (4.7 and 3.7 euros/GJ HHV ) when shipped as pellets. South American crops are produced against much lower costs. Despite the long shipping distance, the costs in the receiving harbour can be as low as 40 euros/tonne dry or 2.1 euros/GJ HHV ; the crop's costs account for 25-40% of the delivered costs. The relatively expensive truck transport from production site to gathering point restricts the size of the production area; therefore, a high biomass yield per hectare is vital to enable large-scale systems. In all, 300 MW HHV Latin American biomass in biomass integrated gasification/combined cycle plants may result in cost of electricity as little as 3.5 euros cent/kWh, competitive with fossil electricity. Methanol produced in Latin America and delivered to Europe may cost 8-10 euros/GJ HHV , when the pellets to methanol conversion is done in Europe the delivered methanol costs are higher. The energy requirement to deliver solid biomass from both crops and residues from the different production countries is 1.2-1.3 MJ primary /MJ delivered (coal ∼ 1.1 MJ/MJ). International bioenergy trade is possible against low costs and modest energy loss

49 CFR 192.197 - Control of the pressure of gas delivered from high-pressure distribution systems.

Science.gov (United States)

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Control of the pressure of gas delivered from high-pressure distribution systems. 192.197 Section 192.197 Transportation Other Regulations Relating to... STANDARDS Design of Pipeline Components § 192.197 Control of the pressure of gas delivered from high...

What does it cost to deliver information using position-based beaconless forwarding protocols?

KAUST Repository

Bader, Ahmed

2012-04-01

Beaconless position-based forwarding protocols have recently evolved as a promising solution for packet forwarding in wireless sensor networks. Quite a few variants of this class of forwarding protocols have been proposed over the years. One common observation is that they have all been evaluated from the perspective of a single node. Although useful, but a solid understanding of the end-to-end performance is still necessary. In this paper, we shed light on the end-to-end performance of beaconless position-based protocols along three distinct dimensions: energy, latency, and back-off probability. The latter is used as a direct indicator of the network\\'s transport capacity. Consequently, we are able to provide an elaborate response to the question: what does it really cost to deliver a packet in a wireless sensor network using position-based beaconless forwarding protocols? In responding to this question, we highlighted the different performance tradeoffs inherent to beaconless position-based protocols. Furthermore, some operational recommendations are also provided. © 2012 IEEE.

What does it cost to deliver information using position-based beaconless forwarding protocols?

KAUST Repository

Bader, Ahmed; Abed-Meraim, Karim; Alouini, Mohamed-Slim

2012-01-01

Beaconless position-based forwarding protocols have recently evolved as a promising solution for packet forwarding in wireless sensor networks. Quite a few variants of this class of forwarding protocols have been proposed over the years. One common observation is that they have all been evaluated from the perspective of a single node. Although useful, but a solid understanding of the end-to-end performance is still necessary. In this paper, we shed light on the end-to-end performance of beaconless position-based protocols along three distinct dimensions: energy, latency, and back-off probability. The latter is used as a direct indicator of the network's transport capacity. Consequently, we are able to provide an elaborate response to the question: what does it really cost to deliver a packet in a wireless sensor network using position-based beaconless forwarding protocols? In responding to this question, we highlighted the different performance tradeoffs inherent to beaconless position-based protocols. Furthermore, some operational recommendations are also provided. © 2012 IEEE.

Automated packaging platform for low-cost high-performance optical components manufacturing

Science.gov (United States)

Ku, Robert T.

2004-05-01

Delivering high performance integrated optical components at low cost is critical to the continuing recovery and growth of the optical communications industry. In today's market, network equipment vendors need to provide their customers with new solutions that reduce operating expenses and enable new revenue generating IP services. They must depend on the availability of highly integrated optical modules exhibiting high performance, small package size, low power consumption, and most importantly, low cost. The cost of typical optical system hardware is dominated by linecards that are in turn cost-dominated by transmitters and receivers or transceivers and transponders. Cost effective packaging of optical components in these small size modules is becoming the biggest challenge to be addressed. For many traditional component suppliers in our industry, the combination of small size, high performance, and low cost appears to be in conflict and not feasible with conventional product design concepts and labor intensive manual assembly and test. With the advent of photonic integration, there are a variety of materials, optics, substrates, active/passive devices, and mechanical/RF piece parts to manage in manufacturing to achieve high performance at low cost. The use of automation has been demonstrated to surpass manual operation in cost (even with very low labor cost) as well as product uniformity and quality. In this paper, we will discuss the value of using an automated packaging platform.for the assembly and test of high performance active components, such as 2.5Gb/s and 10 Gb/s sources and receivers. Low cost, high performance manufacturing can best be achieved by leveraging a flexible packaging platform to address a multitude of laser and detector devices, integration of electronics and handle various package bodies and fiber configurations. This paper describes the operation and results of working robotic assemblers in the manufacture of a Laser Optical Subassembly

Resource Requirements and Costs of Developing and Delivering MOOCs

Directory of Open Access Journals (Sweden)

Fiona M. Hollands

2014-11-01

Full Text Available Given the ongoing alarm regarding uncontrollable costs of higher education, it would be reasonable to expect not only concern about the impact of MOOCs on educational outcomes, but also systematic efforts to document the resources expended on their development and delivery. However, there is little publicly available information on MOOC costs that is based on rigorous analysis. In this article, we first address what institutional resources are required for the development and delivery of MOOCs, based on interviews conducted with 83 administrators, faculty members, researchers, and other actors in the MOOCspace. Subsequently, we use the ingredients method to present cost analyses of MOOC production and delivery at four institutions. We find costs ranging from $38,980 to $325,330 per MOOC, and costs per completer of $74-$272, substantially lower than costs per completer of regular online courses, by merit of scalability. Based on this metric, MOOCs appear more cost-effective than online courses, but we recommend judging MOOCs by impact on learning and caution that they may only be cost-effective for the most self-motivated learners. By demonstrating the methods of cost analysis as applied to MOOCs, we hope that future assessments of the value of MOOCs will combine both cost information and effectiveness data to yield cost-effectiveness ratios that can be compared with the cost-effectiveness of alternative modes of education delivery. Such information will help decision-makers in higher education make rational decisions regarding the most productive use of limited educational resources, to the benefit of both learners and taxpayers.

Simply delivered meals: a tale of collaboration.

Science.gov (United States)

Martin, Sarah L; Connelly, Nancy; Parsons, Cassandra; Blackstone, Katlyn

2018-06-01

Western medicine is undergoing a transition toward transparency of quality and costs, and healthcare systems are striving to achieve the Triple Aim, a framework for improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare. Meanwhile, there is growing recognition of the impact of social determinants of health and a new federal requirement for nonprofit hospitals to implement prevention strategies. A specialized meal delivery program called Simply Delivered for ME (SDM) was formed in an effort to improve care and reduce 30-day hospital readmission rates.The Maine Medical Center (MMC) partnered with the Southern Maine Agency on Aging to offer SDM on a voluntary basis to high-risk Medicare patients already enrolled in the Community-based Care Transition Program (CCTP) at MMC. We report the results of the 2-year intervention in terms of 30-day hospital readmission rates and cost measures (ie, return on investment and cost savings).Of the 622 MMC patients who received SDM during the 24 months, the 30-day readmission rate was 10.3% (compared with the 16.6% 30-day rate of hospital readmission at baseline [ie, before the adoption of CCTP]) for all-cause readmissions. The cost savings for reduced readmissions were $212,160. The return on investment was 387%, or a benefit-cost ratio of $3.87 for every $1.00 spent on meals. Programs such as SDM may reduce the rate of hospital readmission among high-risk older adults and, thereby, yield lower healthcare costs.

Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard.

Science.gov (United States)

Charalel, Resmi A; McGinty, Geraldine; Brant-Zawadzki, Michael; Goodwin, Scott C; Khilnani, Neil M; Matsumoto, Alan H; Min, Robert J; Soares, Gregory M; Cook, Philip S

2015-05-01

Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative and effective minimally invasive treatments, which have decreased morbidity, mortality, and overall cost. The clinical practice of interventional radiology embodies many of the features of Imaging 3.0, the program recently launched by the ACR. We provide a review of some of the major contributions made by interventional radiology and offer general principles from that experience, which are applicable to all radiologists. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

COST QUALITY MANAGEMENT

Directory of Open Access Journals (Sweden)

Vitanova Gordana

2009-05-01

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

Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial.

Science.gov (United States)

Creswell, Cathy; Violato, Mara; Fairbanks, Hannah; White, Elizabeth; Parkinson, Monika; Abitabile, Gemma; Leidi, Alessandro; Cooper, Peter J

2017-07-01

Half of all lifetime anxiety disorders emerge before age 12 years; however, access to evidence-based psychological therapies for affected children is poor. We aimed to compare the clinical outcomes and cost-effectiveness of two brief psychological treatments for children with anxiety referred to routine child mental health settings. We hypothesised that brief guided parent-delivered cognitive behavioural therapy (CBT) would be associated with better clinical outcomes than solution-focused brief therapy and would be cost-effective. We did this randomised controlled trial at four National Health Service primary child and mental health services in Oxfordshire, UK. Children aged 5-12 years referred for anxiety difficulties were randomly allocated (1:1), via a secure online minimisation tool, to receive brief guided parent-delivered CBT or solution-focused brief therapy, with minimisation for age, sex, anxiety severity, and level of parental anxiety. The allocation sequence was not accessible to the researcher enrolling participants or to study assessors. Research staff who obtained outcome measurements were masked to group allocation and clinical staff who delivered the intervention did not measure outcomes. The primary outcome was recovery, on the basis of Clinical Global Impressions of Improvement (CGI-I). Parents recorded patient-level resource use. Quality-adjusted life-years (QALYs) for use in cost-utility analysis were derived from the Child Health Utility 9D. Assessments were done at baseline (before randomisation), after treatment (primary endpoint), and 6 months after treatment completion. We did analysis by intention to treat. This trial is registered with the ISCRTN registry, number ISRCTN07627865. Between March 23, 2012, and March 31, 2014, we randomly assigned 136 patients to receive brief guided parent-delivered CBT (n=68) or solution-focused brief therapy (n=68). At the primary endpoint assessment (June, 2012, to September, 2014), 40 (59%) children in

Using technology to deliver cost-effective Continuing Professional Development (CPD

Directory of Open Access Journals (Sweden)

Kuldeep Singh

2015-01-01

Full Text Available The work is based on engineering the audio video contents of the didactic presentations at the Regional Symposium on Sleep Medicine delivered to the target audience at NAMSCON 2013. The audio was extracted and then synchronized with Power Points, re-synthesized as SCORM (Sharable Content Object Reference Model compliant packages and integrated with Moodle (Modular Object-Oriented Dynamic Learning Environment as Learning Management System (LMS. The preliminary evaluation results showed high satisfaction with the content, its short loading time and smooth playback. These attributes were demonstrated to be effective in enhancing learning. The Moodle as LMS also allows tracking the participants' progress, involving them in social groups and open discussion forum for further enriching the online content and also helps in statistical analysis through its inbuilt web analytics. The technology is not only flexible and economical but also an effective delivery method for Continuing Professional Development Programmes.Key words: Continuing Professional Development, Learning Management System

Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive–compulsive disorder: results from a randomised controlled trial

OpenAIRE

Lenhard, Fabian; Ssegonja, Richard; Andersson, Erik; Feldman, Inna; Rück, Christian; Mataix-Cols, David; Serlachius, Eva

2017-01-01

Objectives To evaluate the cost-effectiveness of a therapist-guided internet-delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive-compulsive disorder (OCD) compared with untreated patients on a waitlist. Design Single-blinded randomised controlled trial. Setting A research clinic within the regular child and adolescent mental health service in Stockholm, Sweden. Participants Sixty-seven adolescents (12-17 years) with a Diagnostic and Statistical Manual of M...

Cost variation in diabetes care delivered in English hospitals

DEFF Research Database (Denmark)

Kristensen, Troels

2009-01-01

the hospital fixed effect and adjust for hospital characteristics such as number of patients treated, factor prices and number of specialties involved in diabetes care. We rank hospitals by their adjusted fixed effect, which measures the extent to which their costs vary from the average after controlling......Background: Many diabetic patients are admitted to hospital, where care is costly and where there may be scope to improve efficiency. Aims: We analyse the costs and characteristics of diabetic patients admitted to English hospitals and aim to assess what proportions of cost variation are explained...... by patient and hospital characteristics. Methods: We apply a multilevel approach recognising that patients are clustered in hospitals. We first analyse the relationship between patient costs and their characteristics, such as HRG, age, gender, diagnostic markers and socio-economic status. We derive...

Cardiac rehabilitation costs.

Science.gov (United States)

Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

2017-10-01

Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

The costs of delivering human papillomavirus vaccination to Grade 4 ...

African Journals Online (AJOL)

in a marginal increase in costs. Discussion. This costing study ... A cost utility study conducted in New Zealand[17] found that it was .... programs to include school-aged boys likely to be value-for-money: A cost-utility analysis in a country with ...

e-Calibrations: using the Internet to deliver calibration services in real time at lower cost

International Nuclear Information System (INIS)

Desrosiers, Marc; Nagy, Vitaly; Puhl, James; Glenn, Robert; Densock, Robert; Stieren, David; Lang, Brian; Kamlowski, Andreas; Maier, Diether; Heiss, Arthur

2002-01-01

The National Institute of Standards and Technology (NIST) is expanding into a new frontier in the delivery of measurement services. The Internet will be employed to provide industry with electronic traceability to national standards. This is a radical departure from the traditional modes of traceability and presents many new challenges. The traditional mail-based calibration service relies on sending artifacts to the user, who then mails them back to NIST for evaluation. The new service will deliver calibration results to the industry customer on-demand, in real-time, at a lower cost. The calibration results can be incorporated rapidly into the production process to ensure the highest quality manufacturing. The service would provide the US radiation processing industry with a direct link to the NIST calibration facilities and its expertise, and provide an interactive feedback process between industrial processing and the national measurement standard. Moreover, an Internet calibration system should contribute to the removal of measurement-related trade barriers

Delivering advanced therapies: the big pharma approach.

Science.gov (United States)

Tarnowski, J; Krishna, D; Jespers, L; Ketkar, A; Haddock, R; Imrie, J; Kili, S

2017-09-01

After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can have a vital role in industrializing CGT by focusing on diseases with high unmet medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high-quality therapies at a commercially viable cost. Owing to the fast pace of innovation in this field proactive engagement with regulators is critical. It is also vital to understand the needs of patients all along the patient care pathway and to establish product pricing that is accepted by prescribers, payers and patients.

Is International Accounting Education Delivering Pedagogical Value?

Science.gov (United States)

Patel, Chris; Millanta, Brian; Tweedie, Dale

2016-01-01

This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

A cost-effective evaluation of biomass district heating in rural communities

International Nuclear Information System (INIS)

Hendricks, Aaron M.; Wagner, John E.; Volk, Timothy A.; Newman, David H.; Brown, Tristan R.

2016-01-01

Highlights: • Develop a cost-effective model using secondary data examining delivering heat through Biomass District Heating (BDH). • Eight of ten rural villages studied could cost-effectively deliver heat through BDH below the 2013 price of heating oil. • 80% of the annual cost of BDH was attributable to capital expenses. • Erratic fuel oil prices substantially impact future feasibility. • Village level feasibility is highly-influenced by the presence of large heat demanders. - Abstract: The economic feasibility of Biomass District Heating (BDH) networks in rural villages is largely unknown. A cost-effective evaluation tool is developed to examine the feasibility of BDH in rural communities using secondary data sources. The approach is unique in that it accounts for all the major capital expenses: energy center, distribution network, and energy transfer stations, as well as biomass procurement. BDH would deliver heat below #2 fuel oil in eight of the ten rural study villages examined, saving nearly $500,000 per year in heating expenses while demanding less than 5% of the forest residues sustainably available regionally. Capital costs comprised over 80% of total costs, illuminating the importance of reaching a sufficient heat density. Reducing capital costs by 1% lowers total cost by $93,000 per year. Extending capital payment period length five years or lowering interest rates has the next highest influence decreasing delivered heat price 0.49% and 0.35% for each 1% change, respectively. This highlights that specific building heat is a strong determinant of feasibility given the relative influence of high-demanding users on the overall village heat-density. Finally, we use a stochastic analysis projecting future #2 fuel oil prices, incorporating historical variability, to determine the probability of future BDH feasibility. Although future oil prices drop below the BDH feasibility threshold, the villages retain a 22–53% probability of feasibility after

Supply Chain Analysis, Delivered Cost, and Life Cycle Assessment of Oil Palm Empty Fruit Bunch Biomass for Green Chemical Production in Malaysia

Directory of Open Access Journals (Sweden)

Carter Walker Reeb

2014-07-01

Full Text Available Financial, environmental, and supply chain analyses of empty fruit bunch (EFB biomass are needed for the development of a sustainable green chemicals industry in Malaysia. Herein, holistic analysis of the supply system and EFB life cycle cradle-to-gate are analyzed in an effort to make recommendations for the commercial-scale collection and delivery of EFB from crude palm oil (CPO extraction facilities to biorefineries in Malaysia. Supply chain modeling tracked inputs and outputs for financial analysis. The openLCA software was used for life cycle assessment (LCA. Allocation scenarios were used to explore the impact of accounting methodologies on the competitiveness of EFB compared to other feedstocks. Sensitivity analysis on the effect of transportation distance, emission flows, and allocation methods on resulting environmental impacts were conducted. The No Burden, Economic, and Mass allocation scenarios resulted in 17, -2.3, and -265 kg CO2-eq. BD tonne-1 EFB global warming impacts (GW, respectively. Delivered cost for EFB was calculated to be approximately 45 US$ BD tonne-1. Environmental burdens were sensitive to allocation scenario, covered area, and land use change. Delivered cost was sensitive to transport distance, covered area, and yield. It was shown that there is sufficient Malaysia EFB available for between 9 and 28 biorefineries, depending upon the scale of production.

Highly reusable space transportation: Approaches for reducing ETO launch costs to $100 - $200 per pound of payload

Science.gov (United States)

Olds, John R.

1995-01-01

The Commercial Space Transportation Study (CSTS) suggests that considerable market expansion in earth-to-orbit transportation would take place if current launch prices could be reduced to around $400 per pound of payload. If these low prices can be achieved, annual payload delivered to low earth orbit (LEO) is predicted to reach 6.7 million pounds. The primary market growth will occur in communications, government missions, and civil transportation. By establishing a cost target of $100-$200 per pound of payload for a new launch system, the Highly Reusable Space Transportation (HRST) program has clearly set its sights on removing the current restriction on market growth imposed by today's high launch costs. In particular, achieving the goal of $100-$200 per pound of payload will require significant coordinated efforts in (1) marketing strategy development, (2) business planning, (3) system operational strategy, (4) vehicle technical design, and (5) vehicle maintenance strategy.

Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

Science.gov (United States)

Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

2016-04-01

Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

Science.gov (United States)

Vijayaraghavan, Maya; Wallace, Aaron; Mirza, Imran Raza; Kamadjeu, Raoul; Nandy, Robin; Durry, Elias; Everard, Marthe

2012-03-01

Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010. We use program costs and population estimates reported by the World Health Organization and United Nations Children's Fund to estimate the average cost per beneficiary for each of 9 interventions delivered during 2 rounds of CHDs implemented during the periods of December 2008 to May 2009 and August 2009 to April 2010. Because unstable areas were unreachable, we calculated costs for targeted and accessible beneficiaries. We model the impact of the CHDs on child mortality using the Lives Saved Tool, convert these estimates of mortality reduction to life years saved, and derive the cost-effectiveness ratio and the return on investment. The estimated average incremental cost per intervention for each targeted beneficiary was $0.63, with the cost increasing to $0.77 per accessible beneficiary. The CHDs were estimated to save the lives of at least 10,000, or 500,000 life years for both rounds combined. The CHDs were cost-effective at $34.00/life year saved. For every $1 million invested in the strategy, an estimated 615 children's lives, or 29,500 life years, were saved. If the pentavalent vaccine had been delivered during the CHDs instead of diphtheria-pertussis-tetanus vaccine, an additional 5000 children's lives could have been saved. Despite high operational costs, CHDs are a very cost-effective service delivery strategy for addressing the leading causes of child mortality in a conflict setting like Somalia and compare

Patient-delivered partner treatment for Trichomonas vaginalis infection: a randomized controlled trial.

Science.gov (United States)

Kissinger, Patricia; Schmidt, Norine; Mohammed, Hamish; Leichliter, Jami S; Gift, Thomas L; Meadors, Bernadette; Sanders, Cheryl; Farley, Thomas A

2006-07-01

Infections with Trichomonas vaginalis (TV) are common and recurrence rates are high. Better methods of treating partners of women with trichomoniasis are needed. To determine if patient-delivered partner treatment (PDPT) is better and more cost-effective than partner referral. Women attending a family planning clinic who were culture-positive and treated for TV (N = 463) were randomized to either standard partner referral (PR), booklet-enhanced partner referral (BEPR), or PDPT. At baseline and 1 month, women were interviewed and cultured for TV. Detailed cost information was also collected. Most women had 1 partner, were less than 24 years old, and were black. The percentage of women reporting that their partners were treated was similar for PDPT but significantly lower for BEPR compared to PR. TV follow-up rates were similar. PDPT cost less and was cost saving compared to PR and BEPR. Among women with TV, PDPT did not result in more partners taking the medicine or lower follow-up rates than PR but was less costly.

Implementation of a Cost-Accounting System for Visibility of Weapon Systems Life-Cycle Costs

National Research Council Canada - National Science Library

Ugone, Mary

2001-01-01

... costs through activity-based costing and management. The system must deliver timely, integrated data for management purposes to permit understanding of total weapon costs, provide a basis for estimating costs of future systems, and feed other tools for life-cycle cost management.

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

Science.gov (United States)

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

2018-05-10

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

International Nuclear Information System (INIS)

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-01-01

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

Science.gov (United States)

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-10-01

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.

Science.gov (United States)

Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John

2018-03-20

No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.

Science.gov (United States)

Leland, Natalie E; Lepore, Michael; Wong, Carin; Chang, Sun Hwa; Freeman, Lynn; Crum, Karen; Gillies, Heather; Nash, Paul

2018-03-01

The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach. Seven themes emerged: objectives of care; first 72 h; positioning, pain, and precautions; use of standardized assessments; episode of care practices; facilitating insight into progress; and interdisciplinary collaboration. Clinical guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The findings of this study highlight the practitioners' perspective on what constitutes high quality hip fracture rehabilitation. This work provides critical information to advance the development of stakeholder-driven rehabilitation clinical guidelines. Future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes. Implications for Rehabilitation This study highlights occupational and physiotherapy therapy practitioners' perspectives on the cumulative best

Low-cost high purity production

Science.gov (United States)

Kapur, V. K.

1978-01-01

Economical process produces high-purity silicon crystals suitable for use in solar cells. Reaction is strongly exothermic and can be initiated at relatively low temperature, making it potentially suitable for development into low-cost commercial process. Important advantages include exothermic character and comparatively low process temperatures. These could lead to significant savings in equipment and energy costs.

Using smartphone technology to deliver a virtual pedestrian environment: usability and validation.

Science.gov (United States)

Schwebel, David C; Severson, Joan; He, Yefei

2017-09-01

Various programs effectively teach children to cross streets more safely, but all are labor- and cost-intensive. Recent developments in mobile phone technology offer opportunity to deliver virtual reality pedestrian environments to mobile smartphone platforms. Such an environment may offer a cost- and labor-effective strategy to teach children to cross streets safely. This study evaluated usability, feasibility, and validity of a smartphone-based virtual pedestrian environment. A total of 68 adults completed 12 virtual crossings within each of two virtual pedestrian environments, one delivered by smartphone and the other a semi-immersive kiosk virtual environment. Participants completed self-report measures of perceived realism and simulator sickness experienced in each virtual environment, plus self-reported demographic and personality characteristics. All participants followed system instructions and used the smartphone-based virtual environment without difficulty. No significant simulator sickness was reported or observed. Users rated the smartphone virtual environment as highly realistic. Convergent validity was detected, with many aspects of pedestrian behavior in the smartphone-based virtual environment matching behavior in the kiosk virtual environment. Anticipated correlations between personality and kiosk virtual reality pedestrian behavior emerged for the smartphone-based system. A smartphone-based virtual environment can be usable and valid. Future research should develop and evaluate such a training system.

High-power diode-end-pumped Tm:YLF slab laser delivering 189 W at 1890 nm

CSIR Research Space (South Africa)

Koen, W

2010-09-01

Full Text Available Laser Delivering 189 W at 1890 nm W. Koen, H.J. Strauss, C. Bollig and M.J.D. Esser CSIR National Laser Centre, Meiring Naude Road, Brummeria, Pretoria, 0001 wkoen@csir.co.za Abstract: We present a high-power Tm:YLF slab laser double...

Innovative care models for high-cost Medicare beneficiaries: delivery system and payment reform to accelerate adoption.

Science.gov (United States)

Davis, Karen; Buttorff, Christine; Leff, Bruce; Samus, Quincy M; Szanton, Sarah; Wolff, Jennifer L; Bandeali, Farhan

2015-05-01

About a third of Medicare beneficiaries are covered by Medicare Advantage (MA) plans or accountable care organizations (ACOs). As a result of assuming financial risk for Medicare services and/or being eligible for shared savings, these organizations have an incentive to adopt models of delivering care that contribute to better care, improved health outcomes, and lower cost. This paper identifies innovative care models across the care continuum for high-cost Medicare beneficiaries that MA plans and ACOs could adopt to improve care while potentially achieving savings. It suggests policy changes that would accelerate testing and spread of promising care delivery model innovations. Targeted review of the literature to identify care delivery models focused on high-cost or high-risk Medicare beneficiaries. This paper presents select delivery models for high-risk Medicare beneficiaries across the care continuum that show promise of yielding better care at lower cost that could be considered for adoption by MA plans and ACOs. Common to these models are elements of the Wagner Chronic Care Model, including practice redesign to incorporate a team approach to care, the inclusion of nonmedical personnel, efforts to promote patient engagement, supporting provider education on innovations,and information systems allowing feedback of information to providers. The goal of these models is to slow the progression to long-term care, reduce health risks, and minimize adverse health impacts, all while achieving savings.These models attempt to maintain the ability of high-risk individuals to live in the home or a community-based setting, thereby avoiding costly institutional care. Identifying and implementing promising care delivery models will become increasingly important in launching successful population health initiatives. MA plans and ACOs stand to benefit financially from adopting care delivery models for high-risk Medicare beneficiaries that reduce hospitalization. Spreading

Reduced cost and improved figure of sapphire optical components

Science.gov (United States)

Walters, Mark; Bartlett, Kevin; Brophy, Matthew R.; DeGroote Nelson, Jessica; Medicus, Kate

2015-10-01

Sapphire presents many challenges to optical manufacturers due to its high hardness and anisotropic properties. Long lead times and high prices are the typical result of such challenges. The cost of even a simple 'grind and shine' process can be prohibitive. The high precision surfaces required by optical sensor applications further exacerbate the challenge of processing sapphire thereby increasing cost further. Optimax has demonstrated a production process for such windows that delivers over 50% time reduction as compared to traditional manufacturing processes for sapphire, while producing windows with less than 1/5 wave rms figure error. Optimax's sapphire production process achieves significant improvement in cost by implementation of a controlled grinding process to present the best possible surface to the polishing equipment. Following the grinding process is a polishing process taking advantage of chemical interactions between slurry and substrate to deliver excellent removal rates and surface finish. Through experiments, the mechanics of the polishing process were also optimized to produce excellent optical figure. In addition to reducing the cost of producing large sapphire sensor windows, the grinding and polishing technology Optimax has developed aids in producing spherical sapphire components to better figure quality. In addition to reducing the cost of producing large sapphire sensor windows, the grinding and polishing technology Optimax has developed aids in producing spherical sapphire components to better figure quality. Through specially developed polishing slurries, the peak-to-valley figure error of spherical sapphire parts is reduced by over 80%.

High-cost users of medical care

OpenAIRE

Garfinkel, Steven A.; Riley, Gerald F.; Iannacchione, Vincent G.

1988-01-01

Based on data from the National Medical Care Utilization and Expenditure Survey, the 10 percent of the noninstitutionalized U.S. population that incurred the highest medical care charges was responsible for 75 percent of all incurred charges. Health status was the strongest predictor of high-cost use, followed by economic factors. Persons 65 years of age or over incurred far higher costs than younger persons and had higher out-of-pocket costs, absolutely and as a percentage of income, althoug...

Costing in Radiology and Health Care: Rationale, Relativity, Rudiments, and Realities.

Science.gov (United States)

Rubin, Geoffrey D

2017-02-01

Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value. This begins with the development of an understanding of the providers' own costs, as well as the complex interrelationships and imaging-associated costs of other participants across the imaging value chain. Controlling the costs of imaging necessitates understanding them at a procedural level and quantifying the costs of delivering specific imaging services. Effective product-level costing is dependent on a bottom-up approach, which is supported through recent innovations in time-dependent activity-based costing. Once the costs are understood, they can be managed. Within the high fixed cost and high overhead cost environment of health care provider organizations, stakeholders must understand the implications of misaligned top-down cost management approaches that can both paradoxically shift effort from low-cost workers to much costlier professionals and allocate overhead costs counterproductively. Radiology's engagement across a broad spectrum of care provides an excellent opportunity for radiology providers to take a leading role within the health care organizations to enhance value and margin through principled and effective cost management. Following a discussion of the rationale for measuring costs, this review contextualizes costs from the perspectives of a variety of stakeholders (relativity), discusses core concepts in how costs are classified (rudiments), presents common and improved methods for measuring

Cost variation in diabetes care delivered in English hospitals

DEFF Research Database (Denmark)

Kristensen, Troels; Laudicella, Mauro; Ejersted, Charlotte

2010-01-01

are transferred between hospitals, suffer infections and other complications, or for those who die in hospital. Even so, around 8-9% of the variation in costs is related to the hospital in which the patient is treated, with geographical variation in factor prices being the prime reason for this variation...

Using mobile electronic devices to deliver educational resources in developing countries.

Science.gov (United States)

Mazal, Jonathan Robert; Ludwig, Rebecca

2015-01-01

Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for

Operational challenges in delivering CD4 diagnostics in sub-Saharan Africa.

Science.gov (United States)

Thairu, L; Katzenstein, D; Israelski, D

2011-07-01

Access to reliable and low cost CD4 T-cell enumeration to stage illness and monitor anti-retroviral therapy remains elusive in resource-limited settings. We report challenges in delivering CD4 testing using the microcapillary Fluorescence-Activated Cell Sorter (FACS) methodology (Guava EasyCD4 instrument Guava Technologies, Hayward) in Burkina Faso and Zimbabwe. Resources, instruments, reagents, and training were provided to local laboratories within the existing infrastructure and data on CD4 were collected from routine laboratory testing. Challenges encountered included frequent instrument breakdown; poor manufacturer maintenance; difficulties in managing reagent stocks; high technician turnover; reliance on antiquated data management systems; redundant service provision; and lack of repeat testing in male HIV+ patients and in patients with higher CD4 counts after initial staging. While adopting newer, less expensive technologies such as fluorescent platforms and point of care tests can facilitate access to lower cost CD4 testing, our experience suggests that supply chain, corporate commitment to implementation, and community factors also require consideration.

The cost of screening and brief intervention in employee assistance programs.

Science.gov (United States)

Cowell, Alexander J; Bray, Jeremy W; Hinde, Jesse M

2012-01-01

Few studies examine the costs of conducting screening and brief intervention (SBI) in settings outside health care. This study addresses this gap in knowledge by examining the employer-incurred costs of SBI in an employee assistance program (EAP) when delivered by counselors. Screening was self-administered as part of the intake paperwork, and the brief intervention (BI) was delivered during a regular counseling session. Training costs were $83 per counselor. The cost of a screen to the employer was $0.64; most of this cost comprised the cost of the time the client spent completing the screen. The cost of a BI was $2.52. The cost of SBI is lower than cost estimates of SBI conducted in a health care setting. The low costs for the current study suggest that only modest gains in outcomes would likely be needed to justify delivering SBI in an EAP setting.

Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series.

Science.gov (United States)

Pagoto, Sherry L; Waring, Molly E; Schneider, Kristin L; Oleski, Jessica L; Olendzki, Effie; Hayes, Rashelle B; Appelhans, Bradley M; Whited, Matthew C; Busch, Andrew M; Lemon, Stephenie C

2015-10-23

Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. Future research should evaluate the efficacy and cost-effectiveness of online

A simple circuit to deliver bubbling CPAP.

Science.gov (United States)

Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

2008-04-01

Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

Predicting Future High-Cost Schizophrenia Patients Using High-Dimensional Administrative Data

Directory of Open Access Journals (Sweden)

Yajuan Wang

2017-06-01

Full Text Available BackgroundThe burden of serious and persistent mental illness such as schizophrenia is substantial and requires health-care organizations to have adequate risk adjustment models to effectively allocate their resources to managing patients who are at the greatest risk. Currently available models underestimate health-care costs for those with mental or behavioral health conditions.ObjectivesThe study aimed to develop and evaluate predictive models for identification of future high-cost schizophrenia patients using advanced supervised machine learning methods.MethodsThis was a retrospective study using a payer administrative database. The study cohort consisted of 97,862 patients diagnosed with schizophrenia (ICD9 code 295.* from January 2009 to June 2014. Training (n = 34,510 and study evaluation (n = 30,077 cohorts were derived based on 12-month observation and prediction windows (PWs. The target was average total cost/patient/month in the PW. Three models (baseline, intermediate, final were developed to assess the value of different variable categories for cost prediction (demographics, coverage, cost, health-care utilization, antipsychotic medication usage, and clinical conditions. Scalable orthogonal regression, significant attribute selection in high dimensions method, and random forests regression were used to develop the models. The trained models were assessed in the evaluation cohort using the regression R2, patient classification accuracy (PCA, and cost accuracy (CA. The model performance was compared to the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC model.ResultsAt top 10% cost cutoff, the final model achieved 0.23 R2, 43% PCA, and 63% CA; in contrast, the CMS-HCC model achieved 0.09 R2, 27% PCA with 45% CA. The final model and the CMS-HCC model identified 33 and 22%, respectively, of total cost at the top 10% cost cutoff.ConclusionUsing advanced feature selection leveraging detailed

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

Science.gov (United States)

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

2018-07-01

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

Orion: Design of a system for assured low-cost human access to space

Science.gov (United States)

Elvander, Josh; Heifetz, Andy; Hunt, Teresa; Zhu, Martin

1994-01-01

In recent years, Congress and the American people have begun to seriously question the role and importance of future manned spaceflight. This is mainly due to two factors: a decline in technical competition caused by the collapse of communism, and the high costs associated with the Space Shuttle transportation system. With these factors in mind, the ORION system was designed to enable manned spaceflight at a low cost, while maintaining the ability to carry out diverse missions, each with a high degree of flexibility. It is capable of performing satellite servicing missions, supporting a space station via crew rotation and resupply, and delivering satellites into geosynchronous orbit. The components of the system are a primary launch module, an upper stage, and a manned spacecraft capable of dynamic reentry. For satellite servicing and space station resupply missions, the ORION system utilizes three primary modules, an upper stage, and the spacecraft, which is delivered to low earth orbit and used to rendezvous, transfer materials, and make repairs. For launching a geosynchronous satellite, one primary module and an upper stage are used to deliver the satellite, along with an apogee kick motor, into orbit. The system is designed with reusability and modularity in mind in an attempt to lower cost.

Delivering IT and eBusiness value

CERN Document Server

Willcocks, Leslie

2001-01-01

Delivering Business Value from IT' is focused on the evaluation issue in IT and how IT evaluation can proceed across the life-cycle of any IT investment and be linked positively to improving business performance. .Chapters 1,2 and 3 detail an approach to IT evaluation whilst chapters 4 and 5 build on these by showing two distinctive approaches to linking IT to business performance. The remaining three chapters deal with a range of evaluation issues emerging as important - specifically Internet evaluation, Y2K and beyond, EMU, quality outsourcing, infrastructure, role of benchmarking, and cost

The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

Science.gov (United States)

Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

2018-01-01

People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

North West Surrey's locality hubs - delivering integrated care

OpenAIRE

Compton, Lisa; Wilkinson, Peter; Lawn, Liz

2017-01-01

Introduction: North West Surrey CCG (NWSCCG) is establishing Locality Hubs – physical buildings offering a fully integrated GP-led, multi-disciplinary ‘one-stop-shop’ services in the community for a defined cohort of frail elderly patients with multiple core morbidities. Hubs will ultimately deliver proactive and reactive care, available 24 hours a day, 365 days a year.The key drivers are;Ageing population, people living longer & more people living with chronic conditionsCost & demand...

An Examination of Peer-Delivered Parenting Skills Programs Across New York State.

Science.gov (United States)

Acri, Mary C; Craig, Nancy; Adler, Josh

2018-03-24

Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce.

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

Science.gov (United States)

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

The cost of universal health care in India: a model based estimate.

Science.gov (United States)

Prinja, Shankar; Bahuguna, Pankaj; Pinto, Andrew D; Sharma, Atul; Bharaj, Gursimer; Kumar, Vishal; Tripathy, Jaya Prasad; Kaur, Manmeet; Kumar, Rajesh

2012-01-01

As high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed. We developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers. We estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18-73) per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%-6.8%) of the GDP for universalizing health care services. The cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored.

Capital cost: high and low sulfur coal plants-1200 MWe. [High sulfur coal

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

This Commercial Electric Power Cost Study for 1200 MWe (Nominal) high and low sulfur coal plants consists of three volumes. The high sulfur coal plant is described in Volumes I and II, while Volume III describes the low sulfur coal plant. The design basis and cost estimate for the 1232 MWe high sulfur coal plant is presented in Volume I, and the drawings, equipment list and site description are contained in Volume II. The reference design includes a lime flue gas desulfurization system. A regenerative sulfur dioxide removal system using magnesium oxide is also presented as an alternate in Section 7 Volume II. The design basis, drawings and summary cost estimate for a 1243 MWe low sulfur coal plant are presented in Volume III. This information was developed by redesigning the high sulfur coal plant for burning low sulfur sub-bituminous coal. These coal plants utilize a mechanical draft (wet) cooling tower system for condenser heat removal. Costs of alternate cooling systems are provided in Report No. 7 in this series of studies of costs of commercial electrical power plants.

LIFE Cost of Electricity, Capital and Operating Costs

International Nuclear Information System (INIS)

Anklam, T.

2011-01-01

Successful commercialization of fusion energy requires economic viability as well as technical and scientific feasibility. To assess economic viability, we have conducted a pre-conceptual level evaluation of LIFE economics. Unit costs are estimated from a combination of bottom-up costs estimates, working with representative vendors, and scaled results from previous studies of fission and fusion plants. An integrated process model of a LIFE power plant was developed to integrate and optimize unit costs and calculate top level metrics such as cost of electricity and power plant capital cost. The scope of this activity was the entire power plant site. Separately, a development program to deliver the required specialized equipment has been assembled. Results show that LIFE power plant cost of electricity and plant capital cost compare favorably to estimates for new-build LWR's, coal and gas - particularly if indicative costs of carbon capture and sequestration are accounted for.

COST OF ADDRESSING TARGETS OF UNEQUAL VALUE; FINAL

International Nuclear Information System (INIS)

G.H. CANAVAN

2001-01-01

The formalism for evaluating first strike costs and incentives for military targeting generalize to include higher value targets. That introduces two new allocations to the usual allocation between missiles and military targets, but they can be performed analytically. As the number of weapons on each side decreases, the optimal fraction of second strike weapons allocated to military values falls. The shift to high value targets is more pronounced below about 1,000 weapons for nominal parameters. Below 500 weapons the first striker's cost of action drops below its cost of inaction. A strike would induce a second strike of about 250 weapons on high value targets. An increase in the first striker's preference for damage to the other's high value targets increases or a decrease in its preference for preventing damage to its own high value targets decreases first strike costs and stability margins. Including defenses complicates allocations slightly. The main effect is increased attrition of second strikes, particularly at larger defenses, which makes it possible to significantly reduce damage to high value targets. At 1,000 weapons, by 300 to 400 interceptors the first striker's costs are reduced to 30% below that of inaction and the number of weapons delivered on the first striker's high value targets is reduced to about 100

Delivering Science from Big Data

Science.gov (United States)

Quinn, Peter Joseph

2015-08-01

The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this paper we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for the SKA project and broader community to consider the effort and process needed to design and implement a distributed science data system that leans on the lessons of other projects and looks to recent developments in Cloud technologies to ensure an affordable, effective and global achievement of science goals.

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

OpenAIRE

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

2006-01-01

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

Advances in low-cost long-wave infrared polymer windows

Science.gov (United States)

Weimer, Wayne A.; Klocek, Paul

1999-07-01

Recent improvements in engineered polymeric material compositions and advances in processing methodologies developed and patented at Raytheon Systems Company have produced long wave IR windows at exceptionally low costs. These UV stabilized, high strength windows incorporating subwavelength structured antireflection surfaces are enabling IR imaging systems to penetrate commercial markets and will reduce the cost of systems delivered to the military. The optical and mechanical properties of these windows will be discussed in detail with reference to the short and long-term impact on military IR imaging systems.

The cost of universal health care in India: a model based estimate.

Directory of Open Access Journals (Sweden)

Shankar Prinja

Full Text Available INTRODUCTION: As high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed. METHODS: We developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers. RESULTS: We estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18-73 per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%-6.8% of the GDP for universalizing health care services. CONCLUSION: The cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored.

High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions.

Science.gov (United States)

Owens, Douglas K; Qaseem, Amir; Chou, Roger; Shekelle, Paul

2011-02-01

Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides high value depends on assessing whether its health benefits justify its costs. High-cost interventions may provide good value because they are highly beneficial; conversely, low-cost interventions may have little or no value if they provide little benefit. Thus, the challenge becomes determining how to slow the rate of increase in costs while preserving high-value, high-quality care. A first step is to decrease or eliminate care that provides no benefit and may even be harmful. A second step is to provide medical interventions that provide good value: medical benefits that are commensurate with their costs. This article discusses 3 key concepts for understanding how to assess the value of health care interventions. First, assessing the benefits, harms, and costs of an intervention is essential to understand whether it provides good value. Second, assessing the cost of an intervention should include not only the cost of the intervention itself but also any downstream costs that occur because the intervention was performed. Third, the incremental cost-effectiveness ratio estimates the additional cost required to obtain additional health benefits and provides a key measure of the value of a health care intervention.

Distribution costs -- the cost of local delivery

International Nuclear Information System (INIS)

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

2000-01-01

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

Delivered Pricing, FOB Pricing, and Collusion in Spatial Markets

OpenAIRE

Maria Paz Espinosa

1992-01-01

This article examines price discrimination and collusion in spatial markets. The problem is analyzed in the context of a repeated duopoly game. I conclude that the prevailing pricing systems depend on the structural elements of the market. Delivered pricing systems emerge in equilibrium in highly monopolistic and highly competitive industries, while FOB is used in intermediate market structures. The fact driving this result is that delivered pricing policies allow spatial price discrimination...

Use of continuous ambulatory infusions of concentrated subcutaneous (s.q.) hydromorphone versus intravenous (i.v.) morphine: cost implications for palliative care.

Science.gov (United States)

Fudin, J; Smith, H S; Toledo-Binette, C S; Kenney, E; Yu, A B; Boutin, R

2000-01-01

Health care practitioners are increasingly under pressure to curtail spending while trying to deliver excellent patient care. These issues are also affecting palliative care, particularly now that palliative care programs are expanding. A comparison of cost-effectiveness and feasibility of using continuous subcutaneous (s.q.) ambulatory infusion of hydromorphone versus intravenous (i.v.) ambulatory morphine is illustrated in this study. With the high doses of morphine required in chronic cancer pain, the use of subcutaneous morphine is not feasible due to the volume of solution required to be delivered. Hydromorphone can be prepared in concentrated solutions enabling it to be delivered by the subcutaneous route. Morphine stability data are available. However, hydromorphone stability has only been verified for seven days; thus, stability data were needed post-seven days. Concentrations of 10 mg/ml, 20 mg/ml, 50 mg/ml, and 100 mg/ml, in 0.9 percent normal saline or dextrose 5 percent water, were analyzed via high-performance liquid chromatography (HPLC) at seven and 28 days. Cost comparisons of supplies and associated costs with subcutaneous versus intravenous solutions were obtained. Hydromorphone was found to be stable for 28 days in both dilutants. Cost analysis of a hydromorphone 28-day supply resulted in substantial savings over the equivalent costs of morphine infusions.

IoT-Based Image Recognition System for Smart Home-Delivered Meal Services

Directory of Open Access Journals (Sweden)

Hsiao-Ting Tseng

2017-07-01

Full Text Available Population ageing is an important global issue. The Taiwanese government has used various Internet of Things (IoT applications in the “10-year long-term care program 2.0”. It is expected that the efficiency and effectiveness of long-term care services will be improved through IoT support. Home-delivered meal services for the elderly are important for home-based long-term care services. To ensure that the right meals are delivered to the right recipient at the right time, the runners need to take a picture of the meal recipient when the meal is delivered. This study uses the IoT-based image recognition system to design an integrated service to improve the management of image recognition. The core technology of this IoT-based image recognition system is statistical histogram-based k-means clustering for image segmentation. However, this method is time-consuming. Therefore, we proposed using the statistical histogram to obtain a probability density function of pixels of a figure and segmenting these with weighting for the same intensity. This aims to increase the computational performance and achieve the same results as k-means clustering. We combined histogram and k-means clustering in order to overcome the high computational cost for k-means clustering. The results indicate that the proposed method is significantly faster than k-means clustering by more than 10 times.

Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial

Directory of Open Access Journals (Sweden)

Paxling Björn

2011-04-01

Full Text Available Abstract Background Irritable Bowel Syndrome (IBS is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises. Methods Participants (N = 85 with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up. Results Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up. Conclusions Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

Delivering Sustainability Through Supply Chain Distribution Network Redesign

Directory of Open Access Journals (Sweden)

Denise Ravet

2013-09-01

Full Text Available Purpose - Companies could gain (cost, service, green/sustainable competitive advantage through the supply chain network. The goal of this article is to study how to deliver sustainability through the supply chain distribution network redesign.Design/methodology/approach - A literature review is conducted to examine research relating to sustainable supply chain strategies and supply chain distribution network redesign.Findings - A study of the supply chain literature reveals the importance to rethink the supply chain distribution network design and to treat sustainability as integral to operations.

The Cost Effectiveness of Psychological and Pharmacological Interventions for Social Anxiety Disorder: A Model-Based Economic Analysis.

Directory of Open Access Journals (Sweden)

Ifigeneia Mavranezouli

Full Text Available Social anxiety disorder is one of the most persistent and common anxiety disorders. Individually delivered psychological therapies are the most effective treatment options for adults with social anxiety disorder, but they are associated with high intervention costs. Therefore, the objective of this study was to assess the relative cost effectiveness of a variety of psychological and pharmacological interventions for adults with social anxiety disorder.A decision-analytic model was constructed to compare costs and quality adjusted life years (QALYs of 28 interventions for social anxiety disorder from the perspective of the British National Health Service and personal social services. Efficacy data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published literature and national sources, supplemented by expert opinion.Individual cognitive therapy was the most cost-effective intervention for adults with social anxiety disorder, followed by generic individual cognitive behavioural therapy (CBT, phenelzine and book-based self-help without support. Other drugs, group-based psychological interventions and other individually delivered psychological interventions were less cost-effective. Results were influenced by limited evidence suggesting superiority of psychological interventions over drugs in retaining long-term effects. The analysis did not take into account side effects of drugs.Various forms of individually delivered CBT appear to be the most cost-effective options for the treatment of adults with social anxiety disorder. Consideration of side effects of drugs would only strengthen this conclusion, as it would improve even further the cost effectiveness of individually delivered CBT relative to phenelzine, which was the next most cost-effective option, due to the serious side effects associated with phenelzine. Further research needs to determine more accurately the long

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

Directory of Open Access Journals (Sweden)

Williams Brian G

2005-12-01

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

Aquifer thermal-energy-storage costs with a seasonal-chill source

Science.gov (United States)

Brown, D. R.

1983-01-01

The cost of energy supplied by an aquifer thermal energy storage (ATES) ystem from a seasonal chill source was investigated. Costs were estimated for point demand and residential development ATES systems using the computer code AQUASTOR. AQUASTOR was developed at PNL specifically for the economic analysis of ATES systems. In this analysis the cost effect of varying a wide range of technical and economic parameters was examined. Those parameters exhibiting a substantial influence on the costs of ATES delivered chill were: system size; well flow rate; transmission distance; source temperature; well depth; and cost of capital. The effects of each parameter are discussed. Two primary constraints of ATES chill systems are the extremely low energy density of the storage fluid and the prohibitive costs of lengthly pipelines for delivering chill to residential users. This economic analysis concludes that ATES-delivered chill will not be competitive for residential cooling applications. The otherwise marginal attractiveness of ATES chill systems vanishes under the extremely low load factors characteristic of residential cooling systems. (LCL)

WHAT DRIVES HIGH COST OF FINANCE IN MOLDOVA?

Directory of Open Access Journals (Sweden)

Alexandru Stratan

2012-03-01

Full Text Available Why there are high costs to finance in Republic of Moldova? Is it a problem for business environment?These are the questions discussed in this paper. Following the well know Growth Diagnostics approach byHausmann, Rodrik and Velasco, authors assess the barriers and impediments to access to finance in Republic ofMoldova. Guided by international and national statistics we found evidence of poor intermediation, poorinstitutions, high level of inflation, and high collateral as major causes of high cost of financial resources inRepublic of Moldova. At the end of the study authors give policy recommendations identifying other related fieldsto be addressed.

Cost optimisation studies of high power accelerators

Energy Technology Data Exchange (ETDEWEB)

McAdams, R.; Nightingale, M.P.S.; Godden, D. [AEA Technology, Oxon (United Kingdom)] [and others

1995-10-01

Cost optimisation studies are carried out for an accelerator based neutron source consisting of a series of linear accelerators. The characteristics of the lowest cost design for a given beam current and energy machine such as power and length are found to depend on the lifetime envisaged for it. For a fixed neutron yield it is preferable to have a low current, high energy machine. The benefits of superconducting technology are also investigated. A Separated Orbit Cyclotron (SOC) has the potential to reduce capital and operating costs and intial estimates for the transverse and longitudinal current limits of such machines are made.

An Agrobacterium-delivered CRISPR/Cas9 system for high-frequency targeted mutagenesis in maize.

Science.gov (United States)

Char, Si Nian; Neelakandan, Anjanasree K; Nahampun, Hartinio; Frame, Bronwyn; Main, Marcy; Spalding, Martin H; Becraft, Philip W; Meyers, Blake C; Walbot, Virginia; Wang, Kan; Yang, Bing

2017-02-01

CRISPR/Cas9 is a powerful genome editing tool in many organisms, including a number of monocots and dicots. Although the design and application of CRISPR/Cas9 is simpler compared to other nuclease-based genome editing tools, optimization requires the consideration of the DNA delivery and tissue regeneration methods for a particular species to achieve accuracy and efficiency. Here, we describe a public sector system, ISU Maize CRISPR, utilizing Agrobacterium-delivered CRISPR/Cas9 for high-frequency targeted mutagenesis in maize. This system consists of an Escherichia coli cloning vector and an Agrobacterium binary vector. It can be used to clone up to four guide RNAs for single or multiplex gene targeting. We evaluated this system for its mutagenesis frequency and heritability using four maize genes in two duplicated pairs: Argonaute 18 (ZmAgo18a and ZmAgo18b) and dihydroflavonol 4-reductase or anthocyaninless genes (a1 and a4). T 0 transgenic events carrying mono- or diallelic mutations of one locus and various combinations of allelic mutations of two loci occurred at rates over 70% mutants per transgenic events in both Hi-II and B104 genotypes. Through genetic segregation, null segregants carrying only the desired mutant alleles without the CRISPR transgene could be generated in T 1 progeny. Inheritance of an active CRISPR/Cas9 transgene leads to additional target-specific mutations in subsequent generations. Duplex infection of immature embryos by mixing two individual Agrobacterium strains harbouring different Cas9/gRNA modules can be performed for improved cost efficiency. Together, the findings demonstrate that the ISU Maize CRISPR platform is an effective and robust tool to targeted mutagenesis in maize. © 2016 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.

Equivalent weight loss for weight management programs delivered by phone and clinic

Science.gov (United States)

Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

2013-01-01

Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

Randomized Controlled Trial of Nurse-Delivered Cognitive Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain.

Science.gov (United States)

Rutledge, Thomas; Atkinson, J Hampton; Holloway, Rachael; Chircop-Rollick, Tatiana; D'Andrea, John; Garfin, Steven R; Patel, Shetal; Penzien, Donald B; Wallace, Mark; Weickgenant, Anne L; Slater, Mark

2018-04-16

This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes included the Numerical Rating Scale (NRS) and the Patient Global Impressions Scale (CGI). CBT participants (n=30) showed significant improvements on the RMDQ (means=11.4[5.9] vs. 9.4[6.1] at baseline and post-treatment, respectively, p.10). The results suggest that telehealth, nurse-delivered CBT and SC treatments for chronic back pain can offer significant and relatively comparable benefits. ClinicalTrials.gov: NCT00608530. This article describes the benefits of training primary care nurses to deliver evidence-based behavioral therapies for low back pain. Due to the high prevalence of chronic pain and the growing emphasis on non-opioid therapies, training nurses to provide behavior therapies could be a cost-effective way to improve pain management. Copyright © 2018. Published by Elsevier Inc.

Medicaid care management: description of high-cost addictions treatment clients.

Science.gov (United States)

Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon

2013-09-01

High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2008-04-01

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

Estimating the cost-savings associated with bundling maternal and child health interventions: a proposed methodology.

Science.gov (United States)

Adesina, Adebiyi; Bollinger, Lori A

2013-01-01

There is a pressing need to include cost data in the Lives Saved Tool (LiST). This paper proposes a method that combines data from both the WHO CHOosing Interventions that are Cost-Effective (CHOICE) database and the OneHealth Tool (OHT) to develop unit costs for delivering child and maternal health services, both alone and bundled. First, a translog cost function is estimated to calculate factor shares of personnel, consumables, other direct (variable or recurrent costs excluding personnel and consumables) and indirect (capital or investment) costs. Primary source facility level data from Kenya, Namibia, South Africa, Uganda, Zambia and Zimbabwe are utilized, with separate analyses for hospitals and health centres. Second, the resulting other-direct and indirect factor shares are applied to country unit costs from the WHO CHOICE unit cost database to calculate those portions of unit cost. Third, the remainder of the costs is calculated using default data from the OHT. Fourth, we calculate the effect of bundling services by assuming that a LiST intervention visit takes an average of 20 minutes when delivered alone but only incremental time in addition to the basic visit when delivered in a bundle. Personnel costs account for the greatest share of costs for both hospitals and health centres at 50% and 38%, respectively. The percentages differ between hospitals and health centres for consumables (21% versus 17%), other direct (7.5% versus 6.75%), and indirect (22% versus 23%) costs. Combining the other-direct and indirect factor shares with the WHO CHOICE database and the other costs from OHT provides a comprehensive cost estimate of LiST interventions. Finally, the cost of six recommended antenatal care (ANC) interventions is $69.76 when delivered alone, but $61.18 when delivered as a bundle, a savings of $8.58 (12.2%). This paper proposes a method for estimating a comprehensive cost of providing child and maternal health interventions by combining labor

How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

Science.gov (United States)

Xin, Haichang; Harman, Jeffrey S; Yang, Zhou

2014-01-01

This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.

Comparison of the Ministry of Health's tariffs with the cost of radiology services using the activity-based costing method.

Science.gov (United States)

Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

2016-02-01

Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital's information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services.

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

Nassar, Joanna M.

2014-06-16

High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.

Low-cost high-quality crystalline germanium based flexible devices

KAUST Repository

Nassar, Joanna M.; Hussain, Aftab M.; Rojas, Jhonathan Prieto; Hussain, Muhammad Mustafa

2014-01-01

High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.

Cost/benefit of high technology in diagnostic radiology

Energy Technology Data Exchange (ETDEWEB)

Goethlin, J.H.

1987-08-01

High technology is frequently blamed as a main cause for the last decade's disproportionate rise in health expenditure. Total costs for all large diagnostic and therapeutic appliances are typically less than 1% of annual expenditure on health care. CT, DSA, MRI, interventional radiology, ESWL, US, mammography, computers in radiology and PACS may save 10-80% of total cost for diagnosis and treatment of disease. Expenditure on high technology is in general vastly overestimated. Because of its medical utility, a slower deployment cannot be desirable. (orig.)

Cost/benefit of high technology in diagnostic radiology

International Nuclear Information System (INIS)

Goethlin, J.H.

1987-01-01

High technology is frequently blamed as a main cause for the last decade's disproportionate rise in health expenditure. Total costs for all large diagnostic and therapeutic appliances are typically less than 1% of annual expenditure on health care. CT, DSA, MRI, interventional radiology, ESWL, US, mammography, computers in radiology and PACS may save 10-80% of total cost for diagnosis and treatment of disease. Expenditure on high technology is in general vastly overestimated. Because of its medical utility, a slower deployment cannot be desirable. (orig.)

Low Cost Lithography Tool for High Brightness LED Manufacturing

Energy Technology Data Exchange (ETDEWEB)

Andrew Hawryluk; Emily True

2012-06-30

The objective of this activity was to address the need for improved manufacturing tools for LEDs. Improvements include lower cost (both capital equipment cost reductions and cost-ofownership reductions), better automation and better yields. To meet the DOE objective of $1- 2/kilolumen, it will be necessary to develop these highly automated manufacturing tools. Lithography is used extensively in the fabrication of high-brightness LEDs, but the tools used to date are not scalable to high-volume manufacturing. This activity addressed the LED lithography process. During R&D and low volume manufacturing, most LED companies use contact-printers. However, several industries have shown that these printers are incompatible with high volume manufacturing and the LED industry needs to evolve to projection steppers. The need for projection lithography tools for LED manufacturing is identified in the Solid State Lighting Manufacturing Roadmap Draft, June 2009. The Roadmap states that Projection tools are needed by 2011. This work will modify a stepper, originally designed for semiconductor manufacturing, for use in LED manufacturing. This work addresses improvements to yield, material handling, automation and throughput for LED manufacturing while reducing the capital equipment cost.

High-Efficient Low-Cost Photovoltaics Recent Developments

CERN Document Server

Petrova-Koch, Vesselinka; Goetzberger, Adolf

2009-01-01

A bird's-eye view of the development and problems of recent photovoltaic cells and systems and prospects for Si feedstock is presented. High-efficient low-cost PV modules, making use of novel efficient solar cells (based on c-Si or III-V materials), and low cost solar concentrators are in the focus of this book. Recent developments of organic photovoltaics, which is expected to overcome its difficulties and to enter the market soon, are also included.

Improvement of the cost-benefit analysis algorithm for high-rise construction projects

Directory of Open Access Journals (Sweden)

Gafurov Andrey

2018-01-01

Full Text Available The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the “Project analysis scenario” flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

Improvement of the cost-benefit analysis algorithm for high-rise construction projects

Science.gov (United States)

Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

2018-03-01

The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

Low-Cost Superconducting Wire for Wind Generators: High Performance, Low Cost Superconducting Wires and Coils for High Power Wind Generators

Energy Technology Data Exchange (ETDEWEB)

None

2012-01-01

REACT Project: The University of Houston will develop a low-cost, high-current superconducting wire that could be used in high-power wind generators. Superconducting wire currently transports 600 times more electric current than a similarly sized copper wire, but is significantly more expensive. The University of Houston’s innovation is based on engineering nanoscale defects in the superconducting film. This could quadruple the current relative to today’s superconducting wires, supporting the same amount of current using 25% of the material. This would make wind generators lighter, more powerful and more efficient. The design could result in a several-fold reduction in wire costs and enable their commercial viability of high-power wind generators for use in offshore applications.

Cost to deliver sweet sorghum fermentables to a central plant

International Nuclear Information System (INIS)

Cundiff, J.S.

1991-01-01

The major obstacle to a sweet sorghum-for-ethanol industry in the Piedmont of Virginia is the short harvest season of eight weeks. A Piedmont harvesting system is described that will enable the Piedmont to compete with Louisiana in production of sweet sorghum for ethanol. The cost to supply feedstock (up to the point fermentation begins) for a one million GPY ethanol plant was estimated to be $2.35/gal expected ethanol yield. This amount compared favorably with two other options

Training radiographers to deliver an intervention to promote early presentation of breast cancer

International Nuclear Information System (INIS)

Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

2012-01-01

Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

Critical operations capabilities in a high cost environment: a multiple case study

Science.gov (United States)

Sansone, C.; Hilletofth, P.; Eriksson, D.

2018-04-01

Operations capabilities have been a popular research area for many years and several frameworks have been proposed in the literature. The current frameworks do not take specific contexts into consideration, for instance a high cost environment. This research gap is of particular interest since a manufacturing relocation process has been ongoing the last decades, leading to a huge amount of manufacturing being moved from high to low cost environments. The purpose of this study is to identify critical operations capabilities in a high cost environment. The two research questions were: What are the critical operations capabilities dimensions in a high cost environment? What are the critical operations capabilities in a high cost environment? A multiple case study was conducted and three Swedish manufacturing firms were selected. The study was based on the investigation of an existing framework of operations capabilities. The main dimensions of operations capabilities included in the framework were: cost, quality, delivery, flexibility, service, innovation and environment. Each of the dimensions included two or more operations capabilities. The findings confirmed the validity of the framework and its usefulness in a high cost environment and a new operations capability was revealed (employee flexibility).

Low-Cost Bio-Based Carbon Fibers for High Temperature Processing

Energy Technology Data Exchange (ETDEWEB)

Paul, Ryan Michael [GrafTech International, Brooklyn Heights, OH (United States); Naskar, Amit [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-08-03

GrafTech International Holdings Inc. (GTI), under Award No. DE-EE0005779, worked with Oak Ridge National Laboratory (ORNL) under CRADA No. NFE-15-05807 to develop lignin-based carbon fiber (LBCF) technology and to demonstrate LBCF performance in high-temperature products and applications. This work was unique and different from other reported LBCF work in that this study was application-focused and scalability-focused. Accordingly, the executed work was based on meeting criteria based on technology development, cost, and application suitability. High-temperature carbon fiber based insulation is used in energy intensive industries, such as metal heat treating and ceramic and semiconductor material production. Insulation plays a critical role in achieving high thermal and process efficiency, which is directly related to energy usage, cost, and product competitiveness. Current high temperature insulation is made with petroleum based carbon fibers, and one goal of this protect was to develop and demonstrate an alternative lignin (biomass) based carbon fiber that would achieve lower cost, CO2 emissions, and energy consumption and result in insulation that met or exceeded the thermal efficiency of current commercial insulation. In addition, other products were targeted to be evaluated with LBCF. As the project was designed to proceed in stages, the initial focus of this work was to demonstrate lab-scale LBCF from at least 4 different lignin precursor feedstock sources that could meet the estimated production cost of $5.00/pound and have ash level of less than 500 ppm in the carbonized insulation-grade fiber. Accordingly, a preliminary cost model was developed based on publicly available information. The team demonstrated that 4 lignin samples met the cost criteria. In addition, the ash level for the 4 carbonized lignin samples was below 500 ppm. Processing as-received lignin to produce a high purity lignin fiber was a significant accomplishment in that most industrial

Long-term corporate climate change targets: What could they deliver?

International Nuclear Information System (INIS)

Gouldson, Andy; Sullivan, Rory

2013-01-01

Highlights: ► Increasingly, companies are setting long-term greenhouse gas emission reduction targets. ► Many of these corporate targets appear to exceed those being set by national governments. ► Achieving these corporate targets relies on energy prices remaining high. ► Weaknesses in corporate reporting make it difficult to tell whether targets are being achieved. -- Abstract: Driven by the rising cost of energy, stakeholder pressure and the expectation that governments will continue to implement policy measures directed at reducing greenhouse gas emissions, an increasing number of companies have set targets to reduce their greenhouse gas emissions. These commitments raise two important questions. The first is whether they can be considered – individually or collectively – to be an appropriate response to the threat presented by climate change. The second is whether they are dependable; that is, can policy makers and other stakeholders can rely on companies to deliver on the commitments that they have made? This article examines these two questions using the case of the UK supermarket sector to illustrate and explain the issues at stake and, more generally, to examine the contribution that these types of voluntary commitments can make to wider public policy goals on climate change. The reasons for focusing on the UK supermarket sector are that the companies in this sector are some of the largest retailers in the world, they are significant emitters (their direct emissions account for 0.9% of UK carbon emissions, and some indications suggest that their indirect emissions account for ten times as much), and they are less heavily regulated that other sectors with comparable carbon footprints. The article concludes that the targets being set voluntarily by companies in this sector align with, or may even exceed, the climate change policy goals being set by national governments. Moreover, the article concludes that the companies targets are plausible and

Low–Cost Bio-Based Carbon Fiber for High-Temperature Processing

Energy Technology Data Exchange (ETDEWEB)

Naskar, Amit K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Akato, Kokouvi M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Tran, Chau D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Paul, Ryan M. [GrafTech International Holdings, Inc., Brooklyn Heights, OH (United States); Dai, Xuliang [GrafTech International Holdings, Inc., Brooklyn Heights, OH (United States)

2017-02-01

GrafTech International Holdings Inc. (GTI), worked with Oak Ridge National Laboratory (ORNL) under CRADA No. NFE-15-05807 to develop lignin-based carbon fiber (LBCF) technology and to demonstrate LBCF performance in high-temperature products and applications. This work was unique and different from other reported LBCF work in that this study was application-focused and scalability-focused. Accordingly, the executed work was based on meeting criteria based on technology development, cost, and application suitability. The focus of this work was to demonstrate lab-scale LBCF from at least 4 different precursor feedstock sources that could meet the estimated production cost of $5.00/pound and have ash level of less than 500 ppm in the carbonized insulation-grade fiber. Accordingly, a preliminary cost model was developed based on publicly available information. The team demonstrated that 4 lignin samples met the cost criteria, as highlighted in Table 1. In addition, the ash level for the 4 carbonized lignin samples were below 500 ppm. Processing asreceived lignin to produce a high purity lignin fiber was a significant accomplishment in that most industrial lignin, prior to purification, had greater than 4X the ash level needed for this project, and prior to this work there was not a clear path of how to achieve the purity target. The lab scale development of LBCF was performed with a specific functional application in mind, specifically for high temperature rigid insulation. GTI is currently a consumer of foreignsourced pitch and rayon based carbon fibers for use in its high temperature insulation products, and the motivation was that LBCF had potential to decrease costs and increase product competitiveness in the marketplace through lowered raw material costs, lowered energy costs, and decreased environmental footprint. At the end of this project, the Technology Readiness Level (TRL) remained at 5 for LBCF in high temperature insulation.

Survey of stranded gas and delivered costs to Europe of selected gas resources

Science.gov (United States)

Attanasi, E.D.; Freeman, P.A.

2011-01-01

Two important trends affecting the expected growth of global gas markets are (1) the shift by many industrialized countries from coal-fired electricity generation to the use of natural gas to generate electricity and (2) the industrialization of the heavily populated Asian countries of India and China. This paper surveys discovered gas in stranded conventional gas accumulations and presents estimates of the cost of developing and producing stranded gas in selected countries. Stranded gas is natural gas in discovered or identified fields that is not currently commercially producible for either physical or economic reasons. Published reserves of gas at the global level do not distinguish between volumes of gas in producing fields and volumes in nonproducing fields. Data on stranded gas reported here-that is the volumes, geographical distribution, and size distributions of stranded gas fields at the country and regional level-are based on the examination of individual-field data and represent a significant improvement in information available to industry and government decision makers. Globally, stranded gas is pervasive, but large volumes in large accumulations are concentrated in only a few areas. The cost component of the paper focuses on stranded conventional gas accumulations in Africa and South America that have the potential to augment supplies to Europe. The methods described for the computation of extraction and transport costs are innovative in that they use information on the sizes and geographical distribution of the identified stranded gas fields. The costs are based on industry data specific to the country and geologic basin where the stranded gas is located. Gas supplies to Europe can be increased significantly at competitive costs by the development of stranded gas. Net extraction costs of producing the identified gas depend critically on the natural-gas-liquids (NGLs) content, the prevailing prices of liquids, the size of the gas accumulation, and the

Development of low-cost high-performance multispectral camera system at Banpil

Science.gov (United States)

Oduor, Patrick; Mizuno, Genki; Olah, Robert; Dutta, Achyut K.

2014-05-01

Banpil Photonics (Banpil) has developed a low-cost high-performance multispectral camera system for Visible to Short- Wave Infrared (VIS-SWIR) imaging for the most demanding high-sensitivity and high-speed military, commercial and industrial applications. The 640x512 pixel InGaAs uncooled camera system is designed to provide a compact, smallform factor to within a cubic inch, high sensitivity needing less than 100 electrons, high dynamic range exceeding 190 dB, high-frame rates greater than 1000 frames per second (FPS) at full resolution, and low power consumption below 1W. This is practically all the feature benefits highly desirable in military imaging applications to expand deployment to every warfighter, while also maintaining a low-cost structure demanded for scaling into commercial markets. This paper describes Banpil's development of the camera system including the features of the image sensor with an innovation integrating advanced digital electronics functionality, which has made the confluence of high-performance capabilities on the same imaging platform practical at low cost. It discusses the strategies employed including innovations of the key components (e.g. focal plane array (FPA) and Read-Out Integrated Circuitry (ROIC)) within our control while maintaining a fabless model, and strategic collaboration with partners to attain additional cost reductions on optics, electronics, and packaging. We highlight the challenges and potential opportunities for further cost reductions to achieve a goal of a sub-$1000 uncooled high-performance camera system. Finally, a brief overview of emerging military, commercial and industrial applications that will benefit from this high performance imaging system and their forecast cost structure is presented.

Delivering on Industry Equipment Reliability Goals By Leveraging an Integration Platform and Decision Support Environment

International Nuclear Information System (INIS)

Coveney, Maureen K.; Bailey, W. Henry; Parkinson, William

2004-01-01

Utilities have invested in many costly enterprise systems - computerized maintenance management systems, document management systems, enterprise grade portals, to name but a few - and often very specialized systems, like data historians, high end diagnostic systems, and other focused and point solutions. From recent industry reports, we now know that the average nuclear power utilizes on average 1900 systems to perform daily work, of which 250 might facilitate the equipment reliability decision-making process. The time has come to leverage the investment in these systems by providing a common platform for integration and decision-making that will further the collective industry aim of enhancing the reliability of our nuclear generation assets to maintain high plant availability and to deliver on plant life extension goals without requiring additional large scale investment in IT infrastructure. (authors)

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

Science.gov (United States)

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

2013-10-01

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

Summit Station Skiway Cost Analysis

Science.gov (United States)

2016-07-01

of fuel delivered to Summit via LC-130 at a price of $32/gal. (Lever et al. 2016), the cost for constructing and maintaining the skiway for the 2014...CRREL TR-16-9 18 The costs associated with the Twin Otter include a day rate plus an hourly mission rate, a per passenger rate, airport fees, fuel, a...ER D C/ CR RE L TR -1 6- 9 Engineering for Polar Operations, Logistics, and Research (EPOLAR) Summit Station Skiway Cost Analysis Co ld

Simulation of the cost-effectiveness of malaria vaccines

Directory of Open Access Journals (Sweden)

Tediosi Fabrizio

2009-06-01

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

Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

Science.gov (United States)

Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

2015-02-01

Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

High costs of female choice in a lekking lizard.

Directory of Open Access Journals (Sweden)

Maren N Vitousek

2007-06-01

Full Text Available Although the cost of mate choice is an essential component of the evolution and maintenance of sexual selection, the energetic cost of female choice has not previously been assessed directly. Here we report that females can incur high energetic costs as a result of discriminating among potential mates. We used heart rate biologging to quantify energetic expenditure in lek-mating female Galápagos marine iguanas (Amblyrhynchus cristatus. Receptive females spent 78.9+/-23.2 kJ of energy on mate choice over a 30-day period, which is equivalent to approximately (3/4 of one day's energy budget. Females that spent more time on the territories of high-quality, high-activity males displayed greater energetic expenditure on mate choice, lost more mass, and showed a trend towards producing smaller follicles. Choosy females also appear to face a reduced probability of survival if El Niño conditions occur in the year following breeding. These findings indicate that female choice can carry significant costs, and suggest that the benefits that lek-mating females gain through mating with a preferred male may be higher than previously predicted.

Supplier managed inventory in the OEM supply chain : the impact of relationship types on total costs and cost distribution

NARCIS (Netherlands)

Nyen, van P.L.M.; Bertrand, J.W.M.; Ooijen, van H.P.G.; Vandaele, N.J.

2009-01-01

We investigate the impact of four variants of supplier managed inventory on total costs and cost distribution in a capital goods supply chain consisting of a parts supplier who delivers parts to an original equipment manufacturer’s assembly plant. The four supplier managed inventory variants differ

A randomized trial of Internet-delivered treatment for social anxiety disorder in high school students.

Science.gov (United States)

Tillfors, Maria; Andersson, Gerhard; Ekselius, Lisa; Furmark, Tomas; Lewenhaupt, Susanne; Karlsson, Anders; Carlbring, Per

2011-01-01

Internet-based cognitive behavior therapy (CBT) has been shown effective for university students with social anxiety disorder (SAD) and public speaking fears. The aim of this study was to investigate whether the promising results can be transferred to high school students suffering from this condition. A total of 19 speech-anxious high school students with SAD were randomized either into 9 weeks of Internet-delivered CBT or to a wait-list control group. Significant improvements were found on measures of social anxiety, general anxiety, and depression. Effects were maintained at 1-year follow-up. The average within- and between-group effect sizes (Cohen's d) for the primary social anxiety scales at posttest were 0.98 and 1.38, respectively. However, the average number of completed modules in the CBT program was low. Although compliance can be improved, the results suggest that Internet-based guided self-help is effective in the treatment of high school students with SAD.

Low Cost, High Efficiency, High Pressure Hydrogen Storage

Energy Technology Data Exchange (ETDEWEB)

Mark Leavitt

2010-03-31

A technical and design evaluation was carried out to meet DOE hydrogen fuel targets for 2010. These targets consisted of a system gravimetric capacity of 2.0 kWh/kg, a system volumetric capacity of 1.5 kWh/L and a system cost of $4/kWh. In compressed hydrogen storage systems, the vast majority of the weight and volume is associated with the hydrogen storage tank. In order to meet gravimetric targets for compressed hydrogen tanks, 10,000 psi carbon resin composites were used to provide the high strength required as well as low weight. For the 10,000 psi tanks, carbon fiber is the largest portion of their cost. Quantum Technologies is a tier one hydrogen system supplier for automotive companies around the world. Over the course of the program Quantum focused on development of technology to allow the compressed hydrogen storage tank to meet DOE goals. At the start of the program in 2004 Quantum was supplying systems with a specific energy of 1.1-1.6 kWh/kg, a volumetric capacity of 1.3 kWh/L and a cost of $73/kWh. Based on the inequities between DOE targets and Quantum’s then current capabilities, focus was placed first on cost reduction and second on weight reduction. Both of these were to be accomplished without reduction of the fuel system’s performance or reliability. Three distinct areas were investigated; optimization of composite structures, development of “smart tanks” that could monitor health of tank thus allowing for lower design safety factor, and the development of “Cool Fuel” technology to allow higher density gas to be stored, thus allowing smaller/lower pressure tanks that would hold the required fuel supply. The second phase of the project deals with three additional distinct tasks focusing on composite structure optimization, liner optimization, and metal.

Capacity utilization and the cost of primary care visits: Implications for the costs of scaling up health interventions

Directory of Open Access Journals (Sweden)

Johns Benjamin

2008-11-01

Full Text Available Abstract Objective A great deal of international attention has been focussed recently on how much additional funding is required to scale up health interventions to meet global targets such as the Millennium Development Goals (MDGs. Most of the cost estimates that have been made in response have assumed that unit costs of delivering services will not change as coverage increases or as more and more interventions are delivered together. This is most unlikely. The main objective of this paper is to measure the impact of patient load on the cost per visit at primary health care facilities and the extent to which this would influence estimates of the costs and financial requirements to scale up interventions. Methods Multivariate regression analysis was used to explore the determinants of variability in unit costs using data for 44 countries with a total of 984 observations. Findings Controlling for other possible determinants, we find that the cost of an outpatient visit is very sensitive to the number of patients seen by providers each day at primary care facilities. Each 1% increase in patient through-put results, on average, in a 27% reduction in the cost per visit (p Conclusion Variability in capacity utilization, therefore, need to be taken into account in cost estimates, and the paper develops a method by which this can be done.

Afraid of Delivering at the Hospital or Afraid of Delivering at Home: A Qualitative Study of Thai Hmong Families' Decision-Making About Maternity Services.

Science.gov (United States)

Culhane-Pera, Kathleen A; Sriphetcharawut, Sarinya; Thawsirichuchai, Rasamee; Yangyuenkun, Wirachon; Kunstadter, Peter

2015-11-01

Thailand has high rates of maternity services; both antenatal care (ANC) and hospital delivery are widely used by its citizens. A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates. Our objectives were to identify Hmong families' socio-cultural reasons for using and not using maternity services, and suggest ways to improve Hmong women's use of maternity services. In one Hmong village, we classified all 98 pregnancies in the previous 5 years into four categories: no ANC/home birth, ANC/home, no ANC/hospital, ANC/hospital. We conducted life-history case studies of 4 women from each category plus their 12 husbands, and 17 elders. We used grounded theory to guide qualitative analysis. Families not using maternity services considered pregnancy a normal process that only needed traditional home support. In addition, they disliked institutional processes that interfered with cultural birth practices, distrusted discriminatory personnel, and detested invasive, involuntary hospital procedures. Families using services perceived physical needs or potential delivery risks that could benefit from obstetrical assistance not available at home. While they disliked aspects of hospital births, they tolerated these conditions for access to obstetrical care they might need. Families also considered cost, travel distance, and time as structural issues. The families ultimately balanced their fear of delivering at home with their fear of delivering at the hospital. Providing health education about pregnancy risks, and changing healthcare practices to accommodate Hmong people's desires for culturally-appropriate family-centered care, which are consistent with evidence-based obstetrics, might improve Hmong women's use of maternity services.

The role of mental health and addiction among high-cost patients: a population-based study.

Science.gov (United States)

de Oliveira, Claire; Cheng, Joyce; Rehm, Jürgen; Kurdyak, Paul

2018-04-01

Previous work found that, among high-cost patients, those with a majority of mental health and addiction (MHA)-related costs (>50%) incur over 30% more costs than other high-cost patients. However, this work did not examine other high-cost patients in depth or whether they had any MHA-related costs. The objective of this analysis was to examine the role of MHA-related care among other high-cost patients. Using administrative healthcare data from Ontario, Canada, this study selected all patients in the 90th percentile of the cost distribution in 2012. It focused primarily on two groups based on the percentage of MHA-related costs relative to total costs: (1) high-cost patients with some MHA-related costs (0% > and cost patients with no MHA-related costs (0%). We examined socio-demographic and clinical characteristics, utilization and costs for both groups, and modeled patient-level costs using appropriate regression techniques. We also compared these groups with high-cost patients with a majority of MHA-related costs (>50%). High-cost patients with some MHA-related costs incurred over 40% more costs than those without ($27,883 vs $19,702). Patients with some MHA-related costs were older, lived in poorer neighborhoods, and had higher levels of comorbidity compared to those without. After controlling for relevant variables, having any type of MHA-related utilization increased costs by $2,698. Having a diagnosis of psychosis had a large impact on costs. This study did not examine children and adolescents. We were only able to account for 91% of all costs incurred by the public third-party payer; addiction-related costs from community-based agencies were not available. High-cost patients with MHA incur higher costs compared to those without. When considering interventions aimed at high-cost patients, policy-makers should consider their complex nature, specifically both their physical and MHA-related comorbidities.

Toward Low-Cost, High-Energy Density, and High-Power Density Lithium-Ion Batteries

Science.gov (United States)

Li, Jianlin; Du, Zhijia; Ruther, Rose E.; AN, Seong Jin; David, Lamuel Abraham; Hays, Kevin; Wood, Marissa; Phillip, Nathan D.; Sheng, Yangping; Mao, Chengyu; Kalnaus, Sergiy; Daniel, Claus; Wood, David L.

2017-09-01

Reducing cost and increasing energy density are two barriers for widespread application of lithium-ion batteries in electric vehicles. Although the cost of electric vehicle batteries has been reduced by 70% from 2008 to 2015, the current battery pack cost (268/kWh in 2015) is still >2 times what the USABC targets (125/kWh). Even though many advancements in cell chemistry have been realized since the lithium-ion battery was first commercialized in 1991, few major breakthroughs have occurred in the past decade. Therefore, future cost reduction will rely on cell manufacturing and broader market acceptance. This article discusses three major aspects for cost reduction: (1) quality control to minimize scrap rate in cell manufacturing; (2) novel electrode processing and engineering to reduce processing cost and increase energy density and throughputs; and (3) material development and optimization for lithium-ion batteries with high-energy density. Insights on increasing energy and power densities of lithium-ion batteries are also addressed.

Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.

Science.gov (United States)

Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin

2018-03-14

Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative

Alginate-Based Edible Films Delivering Probiotic Bacteria to Sliced Ham Pretreated with High Pressure Processing

Directory of Open Access Journals (Sweden)

Foteini Pavli

2017-08-01

Full Text Available The aim of the present work was to evaluate the efficacy of Na-alginate edible films as vehicles for delivering probiotic bacteria to sliced ham with or without pretreatment using high pressure processing (HPP. Three strains of probiotic bacteria were incorporated in Na-alginate forming solution. Ham slices (with or without pretreatment using HPP at 500 MPa for 2 min were packed under vacuum in contact with the films and then stored at 4, 8 and 12 °C for 66, 47 and 40 days, respectively. Microbiological analysis was performed in parallel with pH and color measurements. Sensory characteristics were assessed, while the presence and the relative abundance of each probiotic strain during storage was evaluated using pulsed field gel electrophoresis. In ham slices without HPP treatment, probiotic bacteria were enumerated above 106 CFU/g during storage at all temperatures. Same results were obtained in cases of HPP treated samples, but pH measurements showed differences with the latter ones exhibiting higher values. Sensory evaluation revealed that probiotic samples had a more acidic taste and odor than the control ones, however these characteristics were markedly compromised in samples treated with HPP. Overall, the results of the study are promising since probiotic bacteria were successfully delivered in the products by edible films regardless of the HPP treatment.

Alginate-Based Edible Films Delivering Probiotic Bacteria to Sliced Ham Pretreated with High Pressure Processing.

Science.gov (United States)

Pavli, Foteini; Kovaiou, Ioanna; Apostolakopoulou, Georgia; Kapetanakou, Anastasia; Skandamis, Panagiotis; Nychas, George-John E; Tassou, Chrysoula; Chorianopoulos, Nikos

2017-08-29

The aim of the present work was to evaluate the efficacy of Na-alginate edible films as vehicles for delivering probiotic bacteria to sliced ham with or without pretreatment using high pressure processing (HPP). Three strains of probiotic bacteria were incorporated in Na-alginate forming solution. Ham slices (with or without pretreatment using HPP at 500 MPa for 2 min) were packed under vacuum in contact with the films and then stored at 4, 8 and 12 °C for 66, 47 and 40 days, respectively. Microbiological analysis was performed in parallel with pH and color measurements. Sensory characteristics were assessed, while the presence and the relative abundance of each probiotic strain during storage was evaluated using pulsed field gel electrophoresis. In ham slices without HPP treatment, probiotic bacteria were enumerated above 10⁶ CFU/g during storage at all temperatures. Same results were obtained in cases of HPP treated samples, but pH measurements showed differences with the latter ones exhibiting higher values. Sensory evaluation revealed that probiotic samples had a more acidic taste and odor than the control ones, however these characteristics were markedly compromised in samples treated with HPP. Overall, the results of the study are promising since probiotic bacteria were successfully delivered in the products by edible films regardless of the HPP treatment.

The variation of acute treatment costs of trauma in high-income countries.

Science.gov (United States)

Willenberg, Lynsey; Curtis, Kate; Taylor, Colman; Jan, Stephen; Glass, Parisa; Myburgh, John

2012-08-21

In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age. The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the

The variation of acute treatment costs of trauma in high-income countries

Directory of Open Access Journals (Sweden)

Willenberg Lynsey

2012-08-01

Full Text Available Abstract Background In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. Methods A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS, per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. Results A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1% or charge estimate (25.9% for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701. However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS, surgical intervention, hospital and intensive care, length of stay, polytrauma and age. Conclusion The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied

Integrated cost estimation methodology to support high-performance building design

Energy Technology Data Exchange (ETDEWEB)

Vaidya, Prasad; Greden, Lara; Eijadi, David; McDougall, Tom [The Weidt Group, Minnetonka (United States); Cole, Ray [Axiom Engineers, Monterey (United States)

2007-07-01

Design teams evaluating the performance of energy conservation measures (ECMs) calculate energy savings rigorously with established modelling protocols, accounting for the interaction between various measures. However, incremental cost calculations do not have a similar rigor. Often there is no recognition of cost reductions with integrated design, nor is there assessment of cost interactions amongst measures. This lack of rigor feeds the notion that high-performance buildings cost more, creating a barrier for design teams pursuing aggressive high-performance outcomes. This study proposes an alternative integrated methodology to arrive at a lower perceived incremental cost for improved energy performance. The methodology is based on the use of energy simulations as means towards integrated design and cost estimation. Various points along the spectrum of integration are identified and characterized by the amount of design effort invested, the scheduling of effort, and relative energy performance of the resultant design. It includes a study of the interactions between building system parameters as they relate to capital costs. Several cost interactions amongst energy measures are found to be significant.The value of this approach is demonstrated with alternatives in a case study that shows the differences between perceived costs for energy measures along various points on the integration spectrum. These alternatives show design tradeoffs and identify how decisions would have been different with a standard costing approach. Areas of further research to make the methodology more robust are identified. Policy measures to encourage the integrated approach and reduce the barriers towards improved energy performance are discussed.

CONSTRUCTION OF A DIFFERENTIAL ISOTHERMAL CALORIMETER OF HIGH SENSITIVITY AND LOW COST.

OpenAIRE

Trinca, RB; Perles, CE; Volpe, PLO

2009-01-01

CONSTRUCTION OF A DIFFERENTIAL ISOTHERMAL CALORIMETER OF HIGH SENSITIVITY AND LOW COST The high cost of sensitivity commercial calorimeters may represent an obstacle for many calorimetric research groups. This work describes (fie construction and calibration of a batch differential heat conduction calorimeter with sample cells volumes of about 400 mu L. The calorimeter was built using two small high sensibility square Peltier thermoelectric sensors and the total cost was estimated to be about...

The business of radiology: cost accounting.

Science.gov (United States)

Camponovo, Ernest J

2004-08-01

Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

Directory of Open Access Journals (Sweden)

Ørner Roderick

2009-01-01

Full Text Available Abstract Background Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for managing sleep problems, including cognitive behavioural therapy for insomnia (CBTi have been shown to be effective and cost effective but have not been widely implemented or evaluated in a general practice setting where they are most likely to be needed and most appropriately delivered. This paper outlines the protocol for a pilot study designed to evaluate the effectiveness and cost-effectiveness of an educational intervention for general practitioners, primary care nurses and other members of the primary care team to deliver problem focused therapy to adult patients presenting with sleep problems due to lifestyle causes, pain or mild to moderate depression or anxiety. Methods and design This will be a pilot cluster randomised controlled trial of a complex intervention. General practices will be randomised to an educational intervention for problem focused therapy which includes a consultation approach comprising careful assessment (using assessment of secondary causes, sleep diaries and severity and use of modified CBTi for insomnia in the consultation compared with usual care (general advice on sleep hygiene and pharmacotherapy with hypnotic drugs. Clinicians randomised to the intervention will receive an educational intervention (2 × 2 hours to implement a complex intervention of problem focused therapy. Clinicians randomised to the control group will receive reinforcement of usual care with sleep hygiene advice. Outcomes will be assessed via self-completion questionnaires and telephone interviews of patients and staff as well as clinical records for interventions and prescribing. Discussion Previous studies in adults

High-cost users of hospital beds in Western Australia: a population-based record linkage study.

Science.gov (United States)

Calver, Janine; Brameld, Kate J; Preen, David B; Alexia, Stoney J; Boldy, Duncan P; McCaul, Kieran A

2006-04-17

To describe how high-cost users of inpatient care in Western Australia differ from other users in age, health problems and resource use. Secondary analysis of hospital data and linked mortality data from the WA Data Linkage System for 2002, with cost data from the National Hospital Cost Data Collection (2001-02 financial year). Comparison of high-cost users and other users of inpatient care in terms of age, health profile (major diagnostic category) and resource use (annualised costs, separations and bed days). Older high-cost users (> or = 65 years) were not more expensive to treat than younger high-cost users (at the patient level), but were costlier as a group overall because of their disproportionate representation (n = 8466; 55.9%). Chronic stable and unstable conditions were a key feature of high-cost users, and included end stage renal disease, angina, depression and secondary malignant neoplasms. High-cost users accounted for 38% of both inpatient costs and inpatient days, and 26% of inpatient separations. Ageing of the population is associated with an increase in the proportion of high-cost users of inpatient care. High costs appear to be needs-driven. Constraining high-cost inpatient use requires more focus on preventing the onset and progression of chronic disease, and reducing surgical complications and injuries in vulnerable groups.

Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

Science.gov (United States)

Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

2017-02-01

The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Chimpanzees return favors at a personal cost.

Science.gov (United States)

Schmelz, Martin; Grueneisen, Sebastian; Kabalak, Alihan; Jost, Jürgen; Tomasello, Michael

2017-07-11

Humans regularly provide others with resources at a personal cost to themselves. Chimpanzees engage in some cooperative behaviors in the wild as well, but their motivational underpinnings are unclear. In three experiments, chimpanzees ( Pan troglodytes ) always chose between an option delivering food both to themselves and a partner and one delivering food only to themselves. In one condition, a conspecific partner had just previously taken a personal risk to make this choice available. In another condition, no assistance from the partner preceded the subject's decision. Chimpanzees made significantly more prosocial choices after receiving their partner's assistance than when no assistance was given (experiment 1) and, crucially, this was the case even when choosing the prosocial option was materially costly for the subject (experiment 2). Moreover, subjects appeared sensitive to the risk of their partner's assistance and chose prosocially more often when their partner risked losing food by helping (experiment 3). These findings demonstrate experimentally that chimpanzees are willing to incur a material cost to deliver rewards to a conspecific, but only if that conspecific previously assisted them, and particularly when this assistance was risky. Some key motivations involved in human cooperation thus may have deeper phylogenetic roots than previously suspected.

PhysioDirect: Supporting physiotherapists to deliver telephone assessment and advice services within the context of a randomised trial

Science.gov (United States)

Bishop, Annette; Gamlin, Jill; Hall, Jeanette; Hopper, Cherida; Foster, Nadine E.

2013-01-01

Physiotherapy-led telephone assessment and advice services for patients with musculoskeletal problems have been developed in many services in the UK, but high quality trial data on clinical and cost effectiveness has been lacking. In order to address this ‘The PhysioDirect trial’ (ISRCTN55666618), was a pragmatic randomised trial of a PhysioDirect telephone assessment and advice service. This paper describes the PhysioDirect system used in the trial and how physiotherapists were trained and supported to use the system and deliver the PhysioDirect service. The PhysioDirect system used in the trial was developed in Huntingdon and now serves a population of 350,000 people. When initiating or providing physiotherapy-led telephone assessment and advice services training and support for physiotherapists delivering care in this way is essential. An enhanced skill set is required for telephone assessment and advice particularly in listening and communication skills. In addition to an initial training programme, even experienced physiotherapists benefit from a period of skill consolidation to become proficient and confident in assessing patients and delivering care using the telephone. A computer-based system assists the delivery of a physiotherapy-led musculoskeletal assessment and advice service. Clinical Trials Registration Number (ISRCTN55666618). PMID:23219629

Costing in Radiotherapy. Chapter 18

International Nuclear Information System (INIS)

Zubizarreta, E.; Lievens, Y.; Levin, V.C.; Van Der Merwe, D.

2017-01-01

The available literature on the cost of radiotherapy yields a large variation in data related to the specifics of the methodology used (the viewpoint of the analysis, time frame, health care system, etc.) and to the cost components and radiotherapy activities included. To overcome this difficulty, the reimbursement paid by medical insurance is commonly used as a proxy for the actual radiotherapy costs. Costs, however, generally bear little or no resemblance to charges, as the latter also include allowances for non-capacity use and profit margins. Accurate resource cost data are therefore more valid and should ideally be used in the context of economic evaluations and public health provisions. In addition to the theoretical problems related to obtaining accurate costs, it is difficult to interpret cost data across country borders because of differences in economics. If this is already the case for high income countries, using these cost data for low and middle income countries (LMICs) is even more problematic. Thus, there clearly is a need for calculations performed from the viewpoint of LMICs to prevent misapprehensions based on conclusions derived from data from their high income counterparts. The IAEA endeavours to assist Member States in accumulating appropriate and sufficient cost data for the initiation or expansion of radiation oncology services. Although relatively simple and easy to understand, the IAEA has found that in many countries where it has been involved in the establishment of new radiotherapy departments, the basic principles of cost calculation for radiotherapy facilities were not followed by the local planners. Radiotherapy needs careful planning, organization and a strong quality assurance (QA) programme in order to deliver safe treatments, due to the complexity of the planning and treatment process and the possibility of systematic errors. Administrators should be aware that the cost of building a radiotherapy facility and buying machines

Preliminary estimates of cost savings for defense high level waste vitrification options

International Nuclear Information System (INIS)

Merrill, R.A.; Chapman, C.C.

1993-09-01

The potential for realizing cost savings in the disposal of defense high-level waste through process and design modificatins has been considered. Proposed modifications range from simple changes in the canister design to development of an advanced melter capable of processing glass with a higher waste loading. Preliminary calculations estimate the total disposal cost (not including capital or operating costs) for defense high-level waste to be about $7.9 billion dollars for the reference conditions described in this paper, while projected savings resulting from the proposed process and design changes could reduce the disposal cost of defense high-level waste by up to $5.2 billion

Social cost of heavy drinking and alcohol dependence in high-income countries.

Science.gov (United States)

Mohapatra, Satya; Patra, Jayadeep; Popova, Svetlana; Duhig, Amy; Rehm, Jürgen

2010-06-01

A comprehensive review of cost drivers associated with alcohol abuse, heavy drinking, and alcohol dependence for high-income countries was conducted. The data from 14 identified cost studies were tabulated according to the potential direct and indirect cost drivers. The costs associated with alcohol abuse, alcohol dependence, and heavy drinking were calculated. The weighted average of the total societal cost due to alcohol abuse as percent gross domestic product (GDP)--purchasing power parity (PPP)--was 1.58%. The cost due to heavy drinking and/or alcohol dependence as percent GDP (PPP) was estimated to be 0.96%. On average, the alcohol-attributable indirect cost due to loss of productivity is more than the alcohol-attributable direct cost. Most of the countries seem to incur 1% or more of their GDP (PPP) as alcohol-attributable costs, which is a high toll for a single factor and an enormous burden on public health. The majority of alcohol-attributable costs incurred as a consequence of heavy drinking and/or alcohol dependence. Effective prevention and treatment measures should be implemented to reduce these costs.

Cost-Optimal Pathways to 75% Fuel Reduction in Remote Alaskan Villages: Preprint

Energy Technology Data Exchange (ETDEWEB)

Simpkins, Travis; Cutler, Dylan; Hirsch, Brian; Olis, Dan; Anderson, Kate

2015-10-28

There are thousands of isolated, diesel-powered microgrids that deliver energy to remote communities around the world at very high energy costs. The Remote Communities Renewable Energy program aims to help these communities reduce their fuel consumption and lower their energy costs through the use of high penetration renewable energy. As part of this program, the REopt modeling platform for energy system integration and optimization was used to analyze cost-optimal pathways toward achieving a combined 75% reduction in diesel fuel and fuel oil consumption in a select Alaskan village. In addition to the existing diesel generator and fuel oil heating technologies, the model was able to select from among wind, battery storage, and dispatchable electric heaters to meet the electrical and thermal loads. The model results indicate that while 75% fuel reduction appears to be technically feasible it may not be economically viable at this time. When the fuel reduction target was relaxed, the results indicate that by installing high-penetration renewable energy, the community could lower their energy costs by 21% while still reducing their fuel consumption by 54%.

Beyond free electricity: the costs of electric cooking in poor households and a market-friendly alternative

International Nuclear Information System (INIS)

Howells, M.; Alfstad, T.; Victor, D.G.; Elias, R.J.; Gaunt, T.

2006-01-01

The South African government is introducing a poverty-reduction policy that will supply households with a monthly 50 kWh free basic electricity (FBE) subsidy. We show that FBE distorts the energy choices of poor households by encouraging them to cook with electricity, whereas alternatives such as liquefied petroleum gas (LPG) can deliver a similar cooking service at a much lower cost to society. An alternative energy scheme, such as providing households with clean energy credits equivalent in value to the FBE's cost, could deliver additional energy services worth at least 6% of total household welfare (and probably much more) at no additional public cost; those benefits are so large that they would cover the entire cost of LPG fuel needed to implement the scheme. The analysis is extremely sensitive to the coincidence of electric cooking with peak power demand on the South African grid and to assumptions regarding how South Africa will meet its looming shortfall in peak power capacity. One danger of FBE is that actual peak coincidence and the costs of supplying peak power could be much less favorable than we assume, and such uncertainties expose the South African power system to potentially very high costs of service. (author)

Beyond free electricity: The costs of electric cooking in poor households and a market-friendly alternative

International Nuclear Information System (INIS)

Howells, Mark; Victor, David G.; Gaunt, Trevor; Elias, Rebecca J.; Alfstad, Thomas

2006-01-01

The South African government is introducing a poverty-reduction policy that will supply households with a monthly 50 kWh free basic electricity (FBE) subsidy. We show that FBE distorts the energy choices of poor households by encouraging them to cook with electricity, whereas alternatives such as liquefied petroleum gas (LPG) can deliver a similar cooking service at a much lower cost to society. An alternative energy scheme, such as providing households with clean energy credits equivalent in value to the FBE's cost, could deliver additional energy services worth at least 6% of total household welfare (and probably much more) at no additional public cost; those benefits are so large that they would cover the entire cost of LPG fuel needed to implement the scheme. The analysis is extremely sensitive to the coincidence of electric cooking with peak power demand on the South African grid and to assumptions regarding how South Africa will meet its looming shortfall in peak power capacity. One danger of FBE is that actual peak coincidence and the costs of supplying peak power could be much less favorable than we assume, and such uncertainties expose the South African power system to potentially very high costs of service

Delivering energy efficiency and carbon reduction schemes in England: Lessons from Green Deal Pioneer Places

International Nuclear Information System (INIS)

Marchand, Robert D.; Koh, S.C. Lenny; Morris, Jonathan C.

2015-01-01

Against a background of growing international and national carbon reduction legislation, the UK government introduced the “Green Deal” to deliver a significant increase in housing energy efficiency and reduction in carbon emissions. This paper reflects on one English local authority's experience delivering a programme intended to foster local interest in the Green Deal. Drawing on social surveys and pre and post Green Deal intervention interviews with five demonstrator homes (households that applied to receive a Green Deal package fully funded by the scheme, providing a test bed for the Green Deal recruitment and installation process), this paper shows that awareness and understanding of the Green Deal scheme is low. There is opposition to the cost of finance offered but a strong interest in improving household warmth and for funding improvements through payments added to the electricity bill. Demonstrator home residents perceived Green Deals had improved the warmth and quality of their home, but saving money was the primary motivator for their involvement, not increasing warmth. Whilst Green Deal has not delivered the level of success that was hoped, much can be learned from the scheme to improve future energy efficiency schemes that will be necessary to deliver emission reduction commitments. -- Highlights: •Resident awareness and understanding of the Green Deal is low. •Green Deal assessment costs and loan interest rates are biggest barriers to uptake. •Funding energy improvements via a charge on electricity bill welcomed by residents. •Saving money rather than increasing warmth main motivator for scheme involvement. •Insights from this work should be used to inform future emission reduction schemes

High Thermal Conductivity and High Wear Resistance Tool Steels for cost-effective Hot Stamping Tools

Science.gov (United States)

Valls, I.; Hamasaiid, A.; Padré, A.

2017-09-01

In hot stamping/press hardening, in addition to its shaping function, the tool controls the cycle time, the quality of the stamped components through determining the cooling rate of the stamped blank, the production costs and the feasibility frontier for stamping a given component. During the stamping, heat is extracted from the stamped blank and transported through the tool to the cooling medium in the cooling lines. Hence, the tools’ thermal properties determine the cooling rate of the blank, the heat transport mechanism, stamping times and temperature distribution. The tool’s surface resistance to adhesive and abrasive wear is also an important cost factor, as it determines the tool durability and maintenance costs. Wear is influenced by many tool material parameters, such as the microstructure, composition, hardness level and distribution of strengthening phases, as well as the tool’s working temperature. A decade ago, Rovalma developed a hot work tool steel for hot stamping that features a thermal conductivity of more than double that of any conventional hot work tool steel. Since that time, many complimentary grades have been developed in order to provide tailored material solutions as a function of the production volume, degree of blank cooling and wear resistance requirements, tool geometries, tool manufacturing method, type and thickness of the blank material, etc. Recently, Rovalma has developed a new generation of high thermal conductivity, high wear resistance tool steel grades that enable the manufacture of cost effective tools for hot stamping to increase process productivity and reduce tool manufacturing costs and lead times. Both of these novel grades feature high wear resistance and high thermal conductivity to enhance tool durability and cut cycle times in the production process of hot stamped components. Furthermore, one of these new grades reduces tool manufacturing costs through low tool material cost and hardening through readily

The cost-effectiveness and cost-utility of high-dose palliative radiotherapy for advanced non-small-cell lung cancer

International Nuclear Information System (INIS)

Coy, Peter; Schaafsma, Joseph; Schofield, John A.

2000-01-01

Purpose: To compute cost-effectiveness/cost-utility (CE/CU) ratios, from the treatment clinic and societal perspectives, for high-dose palliative radiotherapy treatment (RT) for advanced non-small-cell lung cancer (NSCLC) against best supportive care (BSC) as comparator, and thereby demonstrate a method for computing CE/CU ratios when randomized clinical trial (RCT) data cannot be generated. Methods and Materials: Unit cost estimates based on an earlier reported 1989-90 analysis of treatment costs at the Vancouver Island Cancer Centre, Victoria, British Columbia, Canada, are updated to 1997-1998 and then used to compute the incremental cost of an average dose of high-dose palliative RT. The incremental number of life days and quality-adjusted life days (QALDs) attributable to treatment are from earlier reported regression analyses of the survival and quality-of-life data from patients who enrolled prospectively in a lung cancer management cost-effectiveness study at the clinic over a 2-year period from 1990 to 1992. Results: The baseline CE and CU ratios are $9245 Cdn per life year (LY) and $12,836 per quality-adjusted life year (QALY), respectively, from the clinic perspective; and $12,253/LY and $17,012/QALY, respectively, from the societal perspective. Multivariate sensitivity analysis for the CE ratio produces a range of $5513-28,270/LY from the clinic perspective, and $7307-37,465/LY from the societal perspective. Similar calculations for the CU ratio produce a range of $7205-37,134/QALY from the clinic perspective, and $9550-49,213/QALY from the societal perspective. Conclusion: The cost effectiveness and cost utility of high-dose palliative RT for advanced NSCLC compares favorably with the cost effectiveness of other forms of treatment for NSCLC, of treatments of other forms of cancer, and of many other commonly used medical interventions; and lies within the US $50,000/QALY benchmark often cited for cost-effective care

Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

Science.gov (United States)

Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

2014-01-01

In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

The business value and cost-effectiveness of genomic medicine.

Science.gov (United States)

Crawford, James M; Aspinall, Mara G

2012-05-01

Genomic medicine offers the promise of more effective diagnosis and treatment of human diseases. Genome sequencing early in the course of disease may enable more timely and informed intervention, with reduced healthcare costs and improved long-term outcomes. However, genomic medicine strains current models for demonstrating value, challenging efforts to achieve fair payment for services delivered, both for laboratory diagnostics and for use of molecular information in clinical management. Current models of healthcare reform stipulate that care must be delivered at equal or lower cost, with better patient and population outcomes. To achieve demonstrated value, genomic medicine must overcome many uncertainties: the clinical relevance of genomic variation; potential variation in technical performance and/or computational analysis; management of massive information sets; and must have available clinical interventions that can be informed by genomic analysis, so as to attain more favorable cost management of healthcare delivery and demonstrate improvements in cost-effectiveness.

Cost calculation and financial measures for high-level waste disposal business

International Nuclear Information System (INIS)

Sekiguchi, Hiromasa.

1987-01-01

A study is made on the costs for disposal of high-level wastes, centering on financial problems involving cost calculation for disposal business and methods and systems for funding the business. The first half of the report is focused on calculation of costs for disposal business. Basic equations are shown to calculate the total costs required for a disposal plant and the costs for disposal of one unit of high-level wastes. A model is proposed to calculate the charges to be paid by electric power companies to the plant for disposal of their wastes. Another equation is derived to calculate the disposal charge per kWh of power generation in a power plant. The second half of the report is focused on financial measures concerning expenses for disposal. A financial basis should be established for the implementation of high-level waste disposal. It is insisted that a reasonable method for estimating the disposal costs should be set up and it should be decided who will pay the expenses. Discussions are made on some methods and systems for funding the disposal business. An additional charge should be included in the electricity bill to be paid by electric power users, or it should be included in tax. (Nogami, K.)

Sliver Solar Cells: High-Efficiency, Low-Cost PV Technology

Directory of Open Access Journals (Sweden)

Evan Franklin

2007-01-01

Full Text Available Sliver cells are thin, single-crystal silicon solar cells fabricated using standard fabrication technology. Sliver modules, composed of several thousand individual Sliver cells, can be efficient, low-cost, bifacial, transparent, flexible, shadow tolerant, and lightweight. Compared with current PV technology, mature Sliver technology will need 10% of the pure silicon and fewer than 5% of the wafer starts per MW of factory output. This paper deals with two distinct challenges related to Sliver cell and Sliver module production: providing a mature and robust Sliver cell fabrication method which produces a high yield of highly efficient Sliver cells, and which is suitable for transfer to industry; and, handling, electrically interconnecting, and encapsulating billions of sliver cells at low cost. Sliver cells with efficiencies of 20% have been fabricated at ANU using a reliable, optimised processing sequence, while low-cost encapsulation methods have been demonstrated using a submodule technique.

Variation in the cost of care for primary total knee arthroplasties.

Science.gov (United States)

Haas, Derek A; Kaplan, Robert S

2017-03-01

The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

Scalable Light Module for Low-Cost, High-Efficiency Light- Emitting Diode Luminaires

Energy Technology Data Exchange (ETDEWEB)

Tarsa, Eric [Cree, Inc., Goleta, CA (United States)

2015-08-31

During this two-year program Cree developed a scalable, modular optical architecture for low-cost, high-efficacy light emitting diode (LED) luminaires. Stated simply, the goal of this architecture was to efficiently and cost-effectively convey light from LEDs (point sources) to broad luminaire surfaces (area sources). By simultaneously developing warm-white LED components and low-cost, scalable optical elements, a high system optical efficiency resulted. To meet program goals, Cree evaluated novel approaches to improve LED component efficacy at high color quality while not sacrificing LED optical efficiency relative to conventional packages. Meanwhile, efficiently coupling light from LEDs into modular optical elements, followed by optimally distributing and extracting this light, were challenges that were addressed via novel optical design coupled with frequent experimental evaluations. Minimizing luminaire bill of materials and assembly costs were two guiding principles for all design work, in the effort to achieve luminaires with significantly lower normalized cost ($/klm) than existing LED fixtures. Chief project accomplishments included the achievement of >150 lm/W warm-white LEDs having primary optics compatible with low-cost modular optical elements. In addition, a prototype Light Module optical efficiency of over 90% was measured, demonstrating the potential of this scalable architecture for ultra-high-efficacy LED luminaires. Since the project ended, Cree has continued to evaluate optical element fabrication and assembly methods in an effort to rapidly transfer this scalable, cost-effective technology to Cree production development groups. The Light Module concept is likely to make a strong contribution to the development of new cost-effective, high-efficacy luminaries, thereby accelerating widespread adoption of energy-saving SSL in the U.S.

Comparison of radiation delivered by current diagnostic procedures for herniated disc

International Nuclear Information System (INIS)

Gasquet, C.; Drouineau, J.; Goubault, F.; Hurmic, A.; Lavigne, B.; Vandermarcq, P.

1983-01-01

Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations [fr

Patents associated with high-cost drugs in Australia.

Directory of Open Access Journals (Sweden)

Andrew F Christie

Full Text Available Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent register to identify all the granted patents that cover the active pharmaceutical ingredient of the high-cost drugs. Then, we classify the patents by type, and identify their owners. We find a mean of 49 patents associated with each drug. Three-quarters of these patents are owned by companies other than the drug's originator. Surprisingly, the majority of all patents are owned by companies that do not have a record of developing top-selling drugs. Our findings show that a multitude of players seek monopoly control over innovations to blockbuster drugs. Consequently, attempts to control drug costs by mitigating misuse of the patent system are likely to miss the mark if they focus only on the patenting activities of originators.

Patents associated with high-cost drugs in Australia.

Science.gov (United States)

Christie, Andrew F; Dent, Chris; McIntyre, Peter; Wilson, Lachlan; Studdert, David M

2013-01-01

Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent register to identify all the granted patents that cover the active pharmaceutical ingredient of the high-cost drugs. Then, we classify the patents by type, and identify their owners. We find a mean of 49 patents associated with each drug. Three-quarters of these patents are owned by companies other than the drug's originator. Surprisingly, the majority of all patents are owned by companies that do not have a record of developing top-selling drugs. Our findings show that a multitude of players seek monopoly control over innovations to blockbuster drugs. Consequently, attempts to control drug costs by mitigating misuse of the patent system are likely to miss the mark if they focus only on the patenting activities of originators.

Ultra High Brightness/Low Cost Fiber Coupled Packaging, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — High peak power, high efficiency, high reliability lightweight, low cost QCW laser diode pump modules with up to 1000W of QCW output become possible with nLight's...

The high cost of low-acuity ICU outliers.

Science.gov (United States)

Dahl, Deborah; Wojtal, Greg G; Breslow, Michael J; Holl, Randy; Huguez, Debra; Stone, David; Korpi, Gloria

2012-01-01

Direct variable costs were determined on each hospital day for all patients with an intensive care unit (ICU) stay in four Phoenix-area hospital ICUs. Average daily direct variable cost in the four ICUs ranged from $1,436 to $1,759 and represented 69.4 percent and 45.7 percent of total hospital stay cost for medical and surgical patients, respectively. Daily ICU cost and length of stay (LOS) were higher in patients with higher ICU admission acuity of illness as measured by the APACHE risk prediction methodology; 16.2 percent of patients had an ICU stay in excess of six days, and these LOS outliers accounted for 56.7 percent of total ICU cost. While higher-acuity patients were more likely to be ICU LOS outliers, 11.1 percent of low-risk patients were outliers. The low-risk group included 69.4 percent of the ICU population and accounted for 47 percent of all LOS outliers. Low-risk LOS outliers accounted for 25.3 percent of ICU cost and incurred fivefold higher hospital stay costs and mortality rates. These data suggest that severity of illness is an important determinant of daily resource consumption and LOS, regardless of whether the patient arrives in the ICU with high acuity or develops complications that increase acuity. The finding that a substantial number of long-stay patients come into the ICU with low acuity and deteriorate after ICU admission is not widely recognized and represents an important opportunity to improve patient outcomes and lower costs. ICUs should consider adding low-risk LOS data to their quality and financial performance reports.

Cost accounting for end-of-life care: recommendations to the field by the Cost Accounting Workgroup.

Science.gov (United States)

Seninger, Stephen; Smith, Dean G

2004-01-01

Accurate measurement of economic costs is prerequisite to progress in improving the care delivered to Americans during the last stage of life. The Robert Wood Johnson Excellence in End-of-Life Care national program assembled a Cost Accounting Workgroup to identify accurate and meaningful methods to measure palliative and end-of-life health care use and costs. Eight key issues were identified: (1) planning the cost analysis; (2) identifying the perspective for cost analysis; (3) describing the end-of-life care program; (4) identifying the appropriate comparison group; (5) defining the period of care to be studied; (6) identifying the units of health care services; (7) assigning monetary values to health care service units; and (8) calculating costs. Economic principles of cost measurement and cost measurement issues encountered by practitioners were reviewed and incorporated into a set of recommendations.

Delivering at the right price - the costs of primary maternity care at ...

African Journals Online (AJOL)

This paper reports on a study of the costs of primary maternity care services at the Diepkloof Conmmnity Health Centre (DK) in Soweto. DK, the Soweto connnunity health centre system as a whole and nmnerous other non-hospital settings provide a wide range of Illaternal health services to substantial numbers of women, ...

New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

Science.gov (United States)

Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

2011-12-01

School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these

27 CFR 72.23 - Type and conditions of cost bond.

Science.gov (United States)

2010-04-01

... PROPERTY Seizures and Forfeitures § 72.23 Type and conditions of cost bond. The cost bond delivered by a claimant to effect removal of the forfeiture status of the property or carrier claimed to the jurisdiction... individual sureties the claimant may deposit collateral as provided in § 72.25. The cost bond shall be...

Costs and effects of the Tanzanian national voucher scheme for insecticide-treated nets

Directory of Open Access Journals (Sweden)

Hanson Kara

2008-02-01

Full Text Available Abstract Background The cost-effectiveness of insecticide-treated nets (ITNs in reducing morbidity and mortality is well established. International focus has now moved on to how best to scale up coverage and what financing mechanisms might be used to achieve this. The approach in Tanzania has been to deliver a targeted subsidy for those most vulnerable to the effects of malaria while at the same time providing support to the development of the commercial ITN distribution system. In October 2004, with funds from the Global Fund to Fight AIDS Tuberculosis and Malaria, the government launched the Tanzania National Voucher Scheme (TNVS, a nationwide discounted voucher scheme for ITNs for pregnant women and their infants. This paper analyses the costs and effects of the scheme and compares it with other approaches to distribution. Methods Economic costs were estimated using the ingredients approach whereby all resources required in the delivery of the intervention (including the user contribution are quantified and valued. Effects were measured in terms of number of vouchers used (and therefore nets delivered and treated nets years. Estimates were also made for the cost per malaria case and death averted. Results and Conclusion The total financial cost of the programme represents around 5% of the Ministry of Health's total budget. The average economic cost of delivering an ITN using the voucher scheme, including the user contribution, was $7.57. The cost-effectiveness results are within the benchmarks set by other malaria prevention studies. The Government of Tanzania's approach to scaling up ITNs uses both the public and private sectors in order to achieve and sustain the level of coverage required to meet the Abuja targets. The results presented here suggest that the TNVS is a cost-effective strategy for delivering subsidized ITNs to targeted vulnerable groups.

SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

International Nuclear Information System (INIS)

Feng, Y

2014-01-01

Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets

Air quality management: challenges and solutions in delivering air quality action plans

Energy Technology Data Exchange (ETDEWEB)

Beattie, C.I.; Longhurst, J.W.S.; Woodfield, N.K.

2000-07-01

The Air Quality Strategy for England, Scotland, Wales and Northern Ireland (DETR, 2001) has the aim of showing how improved local air quality in the UK may be delivered. Through a process of reviewing and assessing local air quality in both urban and rural localities, a clear picture is emerging of areas of the UK where air quality objectives are not likely to be met. The next challenge will be the identification of the required actions and new ways of working to achieve specific air quality objectives. The declaration of air quality management areas, where objectives are not predicted to be met by their target years, involves co-ordinated local action and collaborative working, which can only be effective with support across local authority departments and external stake holders. This paper provides a background to the relevant legislation underpinning, local air quality management and summarises the review and assessment process. It then comments on future directions in relation to the designation of Air Quality Management Areas and considers the requirements of action plans to deliver the goal of cleaner air in the UK. It is concluded that the UK has developed a highly sophisticated system of air quality management over a relatively short period of time, and with it has brought a new way of local authority working. The challenge of the next stage of the process is likely to be in implementing cost effective and proportional solutions to identified problems at the local level. (Author)

Cost-saving treatment strategies in in vitro fertilization: a combined economic evaluation of two large randomized clinical trials comparing highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone alpha.

Science.gov (United States)

Wechowski, Jaroslaw; Connolly, Mark; Schneider, Dirk; McEwan, Philip; Kennedy, Richard

2009-04-01

To assess the cost-effectiveness of two gonadotropin treatments that are available in the United Kingdom in light of limited public funding and the fundamental role of costs in IVF treatment decisions. An economic evaluation based on two large randomized clinical trials in IVF patients using a simulation model. Fifty-three fertility clinics in 13 European countries and Israel. Women indicated for treatment with IVF (N = 986), aged 18-38, participating in double-blind, randomized controlled trials. Highly purified menotropin (HP-hMG, Menopur) or recombinant follitropin alpha (rFSH, Gonal-F). Cost per IVF cycle and cost per live birth for HP-hMG and rFSH alpha. HP-hMG was more effective and less costly versus rFSH for both IVF cost per live birth and for IVF cost per baby (incremental cost-effectiveness ratio was negative). The mean costs per IVF treatment for HP-hMG and rFSH were 2408 pounds (95% confidence interval [CI], 2392 pounds, 2421 pounds) and 2660 pounds (95% CI 2644 pounds, 2678 pounds), respectively. The mean cost saving of 253 pounds per cycle using HP-hMG allows one additional cycle to be delivered for every 9.5 cycles. Treatment with HP-hMG was dominant compared with rFSH in the United Kingdom. Gonadotropin costs should be considered alongside live-birth rates to optimize outcomes using scarce health-care resources.

High Efficiency, Low Cost Scintillators for PET

International Nuclear Information System (INIS)

Kanai Shah

2007-01-01

Inorganic scintillation detectors coupled to PMTs are an important element of medical imaging applications such as positron emission tomography (PET). Performance as well as cost of these systems is limited by the properties of the scintillation detectors available at present. The Phase I project was aimed at demonstrating the feasibility of producing high performance scintillators using a low cost fabrication approach. Samples of these scintillators were produced and their performance was evaluated. Overall, the Phase I effort was very successful. The Phase II project will be aimed at advancing the new scintillation technology for PET. Large samples of the new scintillators will be produced and their performance will be evaluated. PET modules based on the new scintillators will also be built and characterized

Photonic crystal fiber technology for compact fiber-delivered high-power ultrafast fiber lasers

Science.gov (United States)

Triches, Marco; Michieletto, Mattia; Johansen, Mette M.; Jakobsen, Christian; Olesen, Anders S.; Papior, Sidsel R.; Kristensen, Torben; Bondue, Magalie; Weirich, Johannes; Alkeskjold, Thomas T.

2018-02-01

Photonic crystal fiber (PCF) technology has radically impacted the scientific and industrial ultrafast laser market. Reducing platform dimensions are important to decrease cost and footprint while maintaining high optical efficiency. We present our recent work on short 85 μm core ROD-type fiber amplifiers that maintain single-mode performance and excellent beam quality. Robust long-term performance at 100 W average power and 250 kW peak power in 20 ps pulses at 1030 nm wavelength is presented, exceeding 500 h with stable performance in terms of both polarization and power. In addition, we present our recent results on hollow-core ultrafast fiber delivery maintaining high beam quality and polarization purity.

Do accountable care organizations (ACOs) help or hinder primary care physicians' ability to deliver high-quality care?

Science.gov (United States)

Berenson, Robert A; Burton, Rachel A; McGrath, Megan

2016-09-01

Many view advanced primary care models such as the patient-centered medical home as foundational for accountable care organizations (ACOs), but it remains unclear how these two delivery reforms are complementary and how they may produce conflict. The objective of this study was to identify how joining an ACO could help or hinder a primary care practice's efforts to deliver high-quality care. This qualitative study involved interviews with a purposive sample of 32 early adopters of advanced primary care and/or ACO models, drawn from across the U.S. and conducted in mid-2014. Interview notes were coded using qualitative data analysis software, permitting topic-specific queries which were then summarized. Respondents perceived many potential benefits of joining an ACO, including care coordination staff, data analytics, and improved communication with other providers. However, respondents were also concerned about added "bureaucratic" requirements, referral restrictions, and a potential inability to recoup investments in practice improvements. Interviewees generally thought joining an ACO could complement a practice's efforts to deliver high-quality care, yet noted some concerns that could undermine these synergies. Both the advantages and disadvantages of joining an ACO seemed exacerbated for small practices, since they are most likely to benefit from additional resources yet are most likely to chafe under added bureaucratic requirements. Our identification of the potential pros and cons of joining an ACO may help providers identify areas to examine when weighing whether to enter into such an arrangement, and may help ACOs identify potential areas for improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

Fundamental understanding and development of low-cost, high-efficiency silicon solar cells

Energy Technology Data Exchange (ETDEWEB)

ROHATGI,A.; NARASIMHA,S.; MOSCHER,J.; EBONG,A.; KAMRA,S.; KRYGOWSKI,T.; DOSHI,P.; RISTOW,A.; YELUNDUR,V.; RUBY,DOUGLAS S.

2000-05-01

The overall objectives of this program are (1) to develop rapid and low-cost processes for manufacturing that can improve yield, throughput, and performance of silicon photovoltaic devices, (2) to design and fabricate high-efficiency solar cells on promising low-cost materials, and (3) to improve the fundamental understanding of advanced photovoltaic devices. Several rapid and potentially low-cost technologies are described in this report that were developed and applied toward the fabrication of high-efficiency silicon solar cells.

Internet delivered diabetes self-management education: a review.

Science.gov (United States)

Pereira, Katherine; Phillips, Beth; Johnson, Constance; Vorderstrasse, Allison

2015-01-01

Diabetes self-management education is a cornerstone of successful diabetes management. Various methods have been used to reach the increasing numbers of patients with diabetes, including Internet-based education. The purpose of this article is to review various delivery methods of Internet diabetes education that have been evaluated, as well as their effectiveness in improving diabetes-related outcomes. Literature was identified in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Medline, EBSCO, the Cochrane Library, and the Web of Science databases through searches using the following terms: "type 2 diabetes AND internet/web based AND education" and "type 2 diabetes AND diabetes self-management education (DSME) AND web-based/internet OR technology assisted education." The search was limited to English language articles published in the last 10 years. The search yielded 111 articles; of these, 14 met criteria for inclusion in this review. Nine studies were randomized controlled trials, and study lengths varied from 2 weeks to 24 months, for a total of 2,802 participants. DSME delivered via the Internet is effective at improving measures of glycemic control and diabetes knowledge compared with usual care. In addition, results demonstrate that improved eating habits and increased attendance at clinic appointments occur after the online DSME, although engagement and usage of Internet materials waned over time. Interventions that included an element of interaction with healthcare providers were seen as attractive to participants. Internet-delivered diabetes education has the added benefit of easier access for many individuals, and patients can self-pace themselves through materials. More research on the cost-benefits of Internet diabetes education and best methods to maintain patient engagement are needed, along with more studies assessing the long-term impact of Internet-delivered DSME.

The true costs of nuclear power

International Nuclear Information System (INIS)

Wallner, A.; Mraz, G.

2013-01-01

Olkiluoto 3: completion has been postponed from 2009 to 2014 and the construction costs have already more than doubled from the original estimate, currently reaching € 8.5 billion. This price is the same as that announced by the Confederation of British Industry in July 2013 for Hinkley Point: € 16.3 billion for 2 EPR á 1,600 MW - € 5 billion for 1,000 MW. Potential investors are aware of high construction costs and the high risks connected with them: new builds in Europe appear impossible without state aid-like credit guarantees, tax relief or guaranteed feed-in tariffs. The UK is currently in the midst of a heated debate about the strike price, a guaranteed minimum price for electricity delivered into the grid for decades ahead, state aid being given for nuclear energy on the basis of it being a low-carbon technology; the outcome of this will have significant impact on European new build projects. The second part of the paper focuses on the possible costs of a MCA – the Maximum Credible Accident – and the impact of full insurance for nuclear power on the costs of nuclear energy. This focus delivered the following results: several studies have shown the total cost of an MCA to reach anywhere between 71 und 5,800 billion USD. This wide range illustrates how unclear the actual costs of such an accident are. The liability sums currently used are way below this value, and cover only a fraction of the possible damage. Full insurance would cause electricity generation costs to skyrocket – even if the accumulation period was 100 years, the costs would increase 3 – 50 fold. If an accident had to be covered during the lifetime of a nuclear power plant, then costs would increase 80-1,300 fold. However, in reality a nuclear accident can never be covered by insurance. (author)

Production costs for SRIC Populus biomass

International Nuclear Information System (INIS)

Strauss, C.H.

1991-01-01

Production costs for short rotation, intensive culture (SRIC) Populus biomass were developed from commercial-sized plantations under investigation throughout the US. Populus hybrid planted on good quality agricultural sites at a density of 850 cuttings/acre was projected to yield an average of 7 ovendry (OD) tons/acre/year. Discounted cash-flow analysis of multiple rotations showed preharvest production costs of $14/ton (OD). Harvesting and transportation expenses would increase the delivered cost to $35/ton (OD). Although this total cost compared favorably with the regional market price for aspen (Populus tremuloides), future investments in SRIC systems will require the development of biomass energy markets

High current proton linear accelerators and nuclear power

International Nuclear Information System (INIS)

Tunnicliffe, P.R.; Chidley, B.G.; Fraser, J.S.

1976-01-01

This paper outlines a possible role that high-current proton linear accelerators might play as ''electrical breeders'' in the forthcoming nuclear-power economy. A high-power beam of intermediate energy protons delivered to an actinide-element target surrounded by a blanket of fertile material may produce fissile material at a competitive cost. Criteria for technical performance and, in a Canadian context, for costs are given and the major problem areas outlined not only for the accelerator and its associated rf power source but also for the target assembly. (author)

Novel Low Cost, High Reliability Wind Turbine Drivetrain

Energy Technology Data Exchange (ETDEWEB)

Chobot, Anthony; Das, Debarshi; Mayer, Tyler; Markey, Zach; Martinson, Tim; Reeve, Hayden; Attridge, Paul; El-Wardany, Tahany

2012-09-13

Clipper Windpower, in collaboration with United Technologies Research Center, the National Renewable Energy Laboratory, and Hamilton Sundstrand Corporation, developed a low-cost, deflection-compliant, reliable, and serviceable chain drive speed increaser. This chain and sprocket drivetrain design offers significant breakthroughs in the areas of cost and serviceability and addresses the key challenges of current geared and direct-drive systems. The use of gearboxes has proven to be challenging; the large torques and bending loads associated with use in large multi-MW wind applications have generally limited demonstrated lifetime to 8-10 years [1]. The large cost of gearbox replacement and the required use of large, expensive cranes can result in gearbox replacement costs on the order of $1M, representing a significant impact to overall cost of energy (COE). Direct-drive machines eliminate the gearbox, thereby targeting increased reliability and reduced life-cycle cost. However, the slow rotational speeds require very large and costly generators, which also typically have an undesirable dependence on expensive rare-earth magnet materials and large structural penalties for precise air gap control. The cost of rare-earth materials has increased 20X in the last 8 years representing a key risk to ever realizing the promised cost of energy reductions from direct-drive generators. A common challenge to both geared and direct drive architectures is a limited ability to manage input shaft deflections. The proposed Clipper drivetrain is deflection-compliant, insulating later drivetrain stages and generators from off-axis loads. The system is modular, allowing for all key parts to be removed and replaced without the use of a high capacity crane. Finally, the technology modularity allows for scalability and many possible drivetrain topologies. These benefits enable reductions in drivetrain capital cost by 10.0%, levelized replacement and O&M costs by 26.7%, and overall cost of

Bevacizumab in Treatment of High-Risk Ovarian Cancer—A Cost-Effectiveness Analysis

Science.gov (United States)

Herzog, Thomas J.; Hu, Lilian; Monk, Bradley J.; Kiet, Tuyen; Blansit, Kevin; Kapp, Daniel S.; Yu, Xinhua

2014-01-01

Objective. The objective of this study was to evaluate a cost-effectiveness strategy of bevacizumab in a subset of high-risk advanced ovarian cancer patients with survival benefit. Methods. A subset analysis of the International Collaboration on Ovarian Neoplasms 7 trial showed that additions of bevacizumab (B) and maintenance bevacizumab (mB) to paclitaxel (P) and carboplatin (C) improved the overall survival (OS) of high-risk advanced cancer patients. Actual and estimated costs of treatment were determined from Medicare payment. Incremental cost-effectiveness ratio per life-year saved was established. Results. The estimated cost of PC is $535 per cycle; PCB + mB (7.5 mg/kg) is $3,760 per cycle for the first 6 cycles and then $3,225 per cycle for 12 mB cycles. Of 465 high-risk stage IIIC (>1 cm residual) or stage IV patients, the previously reported OS after PC was 28.8 months versus 36.6 months in those who underwent PCB + mB. With an estimated 8-month improvement in OS, the incremental cost-effectiveness ratio of B was $167,771 per life-year saved. Conclusion. In this clinically relevant subset of women with high-risk advanced ovarian cancer with overall survival benefit after bevacizumab, our economic model suggests that the incremental cost of bevacizumab was approximately $170,000. PMID:24721817

The high intensity solar cell: Key to low cost photovoltaic power

Science.gov (United States)

Sater, B. L.; Goradia, C.

1975-01-01

The design considerations and performance characteristics of the 'high intensity' (HI) solar cell are presented. A high intensity solar system was analyzed to determine its cost effectiveness and to assess the benefits of further improving HI cell efficiency. It is shown that residential sized systems can be produced at less than $1000/kW peak electric power. Due to their superior high intensity performance characteristics compared to the conventional and VMJ cells, HI cells and light concentrators may be the key to low cost photovoltaic power.

Capital and operating cost estimates for high temperature superconducting magnetic energy storage

International Nuclear Information System (INIS)

Schoenung, S.M.; Meier, W.R.; Fagaly, R.L.; Heiberger, M.; Stephens, R.B.; Leuer, J.A.; Guzman, R.A.

1992-01-01

Capital and operating costs have been estimated for mid-scale (2 to 200 Mwh) superconducting magnetic energy storage (SMES) designed to use high temperature superconductors (HTS). Capital costs are dominated by the cost of superconducting materials. Operating costs, primarily for regeneration, are significantly reduced for HTS-SMES in comparison to low temperature, conventional systems. This cost component is small compared to other O and M and capital components, when levelized annual costs are projected. In this paper, the developments required for HTS-SMES feasibility are discussed

Parents and the High Cost of Child Care: 2012 Report

Science.gov (United States)

Child Care Aware of America, 2012

2012-01-01

"Parents and the High Cost of Child Care: 2012 Report" presents 2011 data reflecting what parents pay for full-time child care in America. It includes average fees for both child care centers and family child care homes. Information was collected through a survey conducted in January 2012 that asked for the average costs charged for…

Costs and effects of two public sector delivery channels for long-lasting insecticidal nets in Uganda

Directory of Open Access Journals (Sweden)

Strachan Daniel

2010-04-01

Full Text Available Abstract Background In Uganda, long-lasting insecticidal nets (LLIN have been predominantly delivered through two public sector channels: targeted campaigns or routine antenatal care (ANC services. Their combination in a mixed-model strategy is being advocated to quickly increase LLIN coverage and maintain it over time, but there is little evidence on the efficiency of each system. This study evaluated the two delivery channels regarding LLIN retention and use, and estimated the associated costs, to contribute towards the evidence-base on LLIN delivery channels in Uganda. Methods Household surveys were conducted 5-7 months after LLIN distribution, combining questionnaires with visual verification of LLIN presence. Focus groups and interviews were conducted to further investigate determinants of LLIN retention and use. Campaign distribution was evaluated in Jinja and Adjumani while ANC distribution was evaluated only in the latter district. Costs were calculated from the provider perspective through retrospective analysis of expenditure data, and effects were estimated as cost per LLIN delivered and cost per treated-net-year (TNY. These effects were calculated for the total number of LLINs delivered and for those retained and used. Results After 5-7 months, over 90% of LLINs were still owned by recipients, and between 74% (Jinja and 99% (ANC Adjumani were being used. Costing results showed that delivery was cheapest for the campaign in Jinja and highest for the ANC channel, with economic delivery cost per net retained and used of USD 1.10 and USD 2.31, respectively. Financial delivery costs for the two channels were similar in the same location, USD 1.04 for campaign or USD 1.07 for ANC delivery in Adjumani, but differed between locations (USD 0.67 for campaign delivery in Jinja. Economic cost for ANC distribution were considerably higher (USD 2.27 compared to campaign costs (USD 1.23 in Adjumani. Conclusions Targeted campaigns and routine ANC

Costs and effects of two public sector delivery channels for long-lasting insecticidal nets in Uganda.

Science.gov (United States)

Kolaczinski, Jan H; Kolaczinski, Kate; Kyabayinze, Daniel; Strachan, Daniel; Temperley, Matilda; Wijayanandana, Nayantara; Kilian, Albert

2010-04-20

In Uganda, long-lasting insecticidal nets (LLIN) have been predominantly delivered through two public sector channels: targeted campaigns or routine antenatal care (ANC) services. Their combination in a mixed-model strategy is being advocated to quickly increase LLIN coverage and maintain it over time, but there is little evidence on the efficiency of each system. This study evaluated the two delivery channels regarding LLIN retention and use, and estimated the associated costs, to contribute towards the evidence-base on LLIN delivery channels in Uganda. Household surveys were conducted 5-7 months after LLIN distribution, combining questionnaires with visual verification of LLIN presence. Focus groups and interviews were conducted to further investigate determinants of LLIN retention and use. Campaign distribution was evaluated in Jinja and Adjumani while ANC distribution was evaluated only in the latter district. Costs were calculated from the provider perspective through retrospective analysis of expenditure data, and effects were estimated as cost per LLIN delivered and cost per treated-net-year (TNY). These effects were calculated for the total number of LLINs delivered and for those retained and used. After 5-7 months, over 90% of LLINs were still owned by recipients, and between 74% (Jinja) and 99% (ANC Adjumani) were being used. Costing results showed that delivery was cheapest for the campaign in Jinja and highest for the ANC channel, with economic delivery cost per net retained and used of USD 1.10 and USD 2.31, respectively. Financial delivery costs for the two channels were similar in the same location, USD 1.04 for campaign or USD 1.07 for ANC delivery in Adjumani, but differed between locations (USD 0.67 for campaign delivery in Jinja). Economic cost for ANC distribution were considerably higher (USD 2.27) compared to campaign costs (USD 1.23) in Adjumani. Targeted campaigns and routine ANC services can both achieve high LLIN retention and use among

Development of an Exergame to Deliver a Sustained Dose of High-Intensity Training: Formative Pilot Randomized Trial.

Science.gov (United States)

McBain, Thomas; Weston, Matthew; Crawshaw, Paul; Haighton, Catherine; Spears, Iain

2018-03-27

Sport science can play a critical role in reducing health inequalities. The inverse relationship between life expectancy, cardiorespiratory fitness, and socioeconomic status could be addressed by performing high-intensity training (HIT), delivered in a class salient and accessible approach. Commercially available exergames have shown encouraging compliance rates but are primarily designed for entertainment purposes rather than focusing on health-related outcomes. A serious game tailored toward delivering an exercise stimulus, while reducing the aversive protocols associated with HIT, could be beneficial to engage and improve health outcomes in socially deprived males. The aims of this study were to develop an exergame capable of delivering HIT and evaluate the effect on selected health outcomes in men recruited in regions of socioeconomic deprivation. We conducted an exploratory trial in our target population, and participants were allocated to intervention (n=14) or control groups (n=10) by third-party minimization. The intervention was a 6-week training program consisting of three sessions of exergaming per week. The sessions involved a structured warm-up, then brief intermittent repetitions in the form of boxing rounds (10 s, 20 s, and 30 s) against their peers with a work/rest ratio of 0.25. Retention to the intervention was 87.5% (21/24). Over the duration of the intervention, session attendance was 67.5% (170/252); repetition mean and peak heart rates (% of maximal) and session ratings of perceived exertion (AU, arbitrary units) were 86.3 (5.4%), 89.9 (6.1%), and 7.5 (2.2 AU), respectively. The effect of the intervention, when compared with the control, was a likely small beneficial improvement in predicted maximum oxygen consumption (VO 2 max, 3.0; 90% confidence limits ±2.6%). Effects on body mass, waist circumference, and blood pressure were either trivial or unclear. Over the 6-week intervention, the exergame delivered a consistent and sustained dose of

From costs to prices: economic analysis of photovoltaic energy and services

International Nuclear Information System (INIS)

Chabot, Bernard

1998-01-01

A global economic analysis methodology is proposed in order to simplify the cost and the profitability assessment of energy and services delivered by photovoltaic (PV) systems. As examples, equations and graphic tools derived from this methodology give directly the overall discounted costs (ODC) of electricity delivered by grid-connected PV power plants and the ODC of water delivered by a stand-alone PV pumping system. The main criteria used for profitability analysis of PV projects are reviewed: net present value, internal rate of return and profitability index (PI). A simple method with associated equations and graphic tools is presented in order to assess the profitability of PV projects from their PI. Examples of profitability analysis of present and future grid-connected PV power plants built and operated by an independent power producers are presented and discussed, together with examples of stand-alone PV water pumping systems operated by the local community in developing countries. In both cases, equations and specific graphic tools are presented. Specific graphs can be used with different monetary units, different sizes and different investment costs of PV projects. (Author)

Re-Engineering a High Performance Electrical Series Elastic Actuator for Low-Cost Industrial Applications

Directory of Open Access Journals (Sweden)

Kenan Isik

2017-01-01

Full Text Available Cost is an important consideration when transferring a technology from research to industrial and educational use. In this paper, we introduce the design of an industrial grade series elastic actuator (SEA performed via re-engineering a research grade version of it. Cost-constrained design requires careful consideration of the key performance parameters for an optimal performance-to-cost component selection. To optimize the performance of the new design, we started by matching the capabilities of a high-performance SEA while cutting down its production cost significantly. Our posit was that performing a re-engineering design process on an existing high-end device will significantly reduce the cost without compromising the performance drastically. As a case study of design for manufacturability, we selected the University of Texas Series Elastic Actuator (UT-SEA, a high-performance SEA, for its high power density, compact design, high efficiency and high speed properties. We partnered with an industrial corporation in China to research the best pricing options and to exploit the retail and production facilities provided by the Shenzhen region. We succeeded in producing a low-cost industrial grade actuator at one-third of the cost of the original device by re-engineering the UT-SEA with commercial off-the-shelf components and reducing the number of custom-made parts. Subsequently, we conducted performance tests to demonstrate that the re-engineered product achieves the same high-performance specifications found in the original device. With this paper, we aim to raise awareness in the robotics community on the possibility of low-cost realization of low-volume, high performance, industrial grade research and education hardware.

Evolution of a nursing education program delivered to baccalaureate-prepared Haitian nurses.

Science.gov (United States)

Lev, Elise L; Lindgren, Teri G; Pearson, Gayle A; Alcindor, Hilda

2013-01-01

Haiti has high morbidity and mortality rates, a large proportion of people living in poverty, and a shortage of nurses and nursing faculty members. A partnership program between a US and Haitian university was formed to deliver a certificate program in nursing education. The authors describe their experiences developing, delivering, and evaluating the blended on-site and online program and their future goals.

Cost of Mastitis in Scottish Dairy Herds with Low and High Subclinical Mastitis Problems

OpenAIRE

YALÇIN, Cengiz

2000-01-01

The aim of this study was to estimate the cost of mastitis and the contribution of each cost component of mastitis to the total mastitis induced cost in herds with low and high levels of subclinical mastitis under Scottish field conditions. It was estimated that mastitis cost £140 per cow/year to the average Scottish dairy farmer in 1996. However, this figure was as low as £69 per cow/year in herds with lower levels of subclinical mastitis, and as high as £228 cow/year in herds with high s...

Low Cost, Low Power, High Sensitivity Magnetometer

Science.gov (United States)

2008-12-01

which are used to measure the small magnetic signals from brain. Other types of vector magnetometers are fluxgate , coil based, and magnetoresistance...concentrator with the magnetometer currently used in Army multimodal sensor systems, the Brown fluxgate . One sees the MEMS fluxgate magnetometer is...Guedes, A.; et al., 2008: Hybrid - LOW COST, LOW POWER, HIGH SENSITIVITY MAGNETOMETER A.S. Edelstein*, James E. Burnette, Greg A. Fischer, M.G

Low cost, high yield IFE reactors: Revisiting Velikhov's vaporizing blankets

International Nuclear Information System (INIS)

Logan, B.G.

1992-01-01

The performance (efficiency and cost) of IFE reactors using MHD conversion is explored for target blanket shells of various materials vaporized and ionized by high fusion yields (5 to 500 GJ). A magnetized, prestressed reactor chamber concept is modeled together with previously developed models for the Compact Fusion Advanced Rankine II (CFARII) MHD Balance-of-Plant (BoP). Using conservative 1-D neutronics models, high fusion yields (20 to 80 GJ) are found necessary to heat Flibe, lithium, and lead-lithium blankets to MHD plasma temperatures, at initial solid thicknesses sufficient to capture most of the fusion yield. Advanced drivers/targets would need to be developed to achieve a ''Bang per Buck'' figure-of-merit approx-gt 20 to 40 joules yield per driver $ for this scheme to be competitive with these blanket materials. Alternatively, more realistic neutronics models and better materials such as lithium hydride may lower the minimum required yields substantially. The very low CFARII BoP costs (contributing only 3 mills/kWehr to CoE) allows this type of reactor, given sufficient advances that non-driver costs dominate, to ultimately produce electricity at a much lower cost than any current nuclear plant

A high-performance, low-cost, leading edge discriminator

Indian Academy of Sciences (India)

Abstract. A high-performance, low-cost, leading edge discriminator has been designed with a timing performance comparable to state-of-the-art, commercially available discrim- inators. A timing error of 16 ps is achieved under ideal operating conditions. Under more realistic operating conditions the discriminator displays a ...

Many Mobile Health Apps Target High-Need, High-Cost Populations, But Gaps Remain.

Science.gov (United States)

Singh, Karandeep; Drouin, Kaitlin; Newmark, Lisa P; Lee, JaeHo; Faxvaag, Arild; Rozenblum, Ronen; Pabo, Erika A; Landman, Adam; Klinger, Elissa; Bates, David W

2016-12-01

With rising smartphone ownership, mobile health applications (mHealth apps) have the potential to support high-need, high-cost populations in managing their health. While the number of available mHealth apps has grown substantially, no clear strategy has emerged on how providers should evaluate and recommend such apps to patients. Key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources. To help stakeholders overcome barriers to reviewing and recommending apps, we evaluated 137 patient-facing mHealth apps-those intended for use by patients to manage their health-that were highly rated by consumers and recommended by experts and that targeted high-need, high-cost populations. We found that there is a wide variety of apps in the marketplace but that few apps address the needs of the patients who could benefit the most. We also found that consumers' ratings were poor indications of apps' clinical utility or usability and that most apps did not respond appropriately when a user entered potentially dangerous health information. Going forward, data privacy and security will continue to be major concerns in the dissemination of mHealth apps. Project HOPE—The People-to-People Health Foundation, Inc.

Cost-effectiveness of a randomised trial of physical activity in Alzheimer's disease

DEFF Research Database (Denmark)

Sopina, Elizaveta; Sørensen, Jan; Beyer, Nina

2017-01-01

OBJECTIVES: To explore the cost-effectiveness of a supervised moderate-to-high intensity aerobic exercise programme in people diagnosed with Alzheimer's disease (AD) and estimate incremental cost-effectiveness ratios (ICER) using participant-reported and proxy-reported measures of health......-related quality of life (HRQoL) DESIGN: A cost-effectiveness analysis of economic and HRQoL data from a randomised trial delivered over 16 weeks. SETTING: Memory clinics in Denmark. PARTICIPANTS: 200 individuals with mild AD aged 50-90 years gave informed consent to participate in the study. Participants were......-significant improvement in EQ-5D-5L and EQ-VAS after 16 weeks. The ICER was estimated at €72 000/quality-adjusted life year using participant-reported outcomes and €87000 using caregiver-reported outcomes. CONCLUSIONS: The findings suggest that the exercise intervention is unlikely to be cost-effective within...

Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data.

Science.gov (United States)

Laxy, Michael; Wilson, Edward C F; Boothby, Clare E; Griffin, Simon J

2017-12-01

There is uncertainty about the cost effectiveness of early intensive treatment versus routine care in individuals with type 2 diabetes detected by screening. To derive a trial-informed estimate of the incremental costs of intensive treatment as delivered in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Europe (ADDITION) trial and to revisit the long-term cost-effectiveness analysis from the perspective of the UK National Health Service. We analyzed the electronic primary care records of a subsample of the ADDITION-Cambridge trial cohort (n = 173). Unit costs of used primary care services were taken from the published literature. Incremental annual costs of intensive treatment versus routine care in years 1 to 5 after diagnosis were calculated using multilevel generalized linear models. We revisited the long-term cost-utility analyses for the ADDITION-UK trial cohort and reported results for ADDITION-Cambridge using the UK Prospective Diabetes Study Outcomes Model and the trial-informed cost estimates according to a previously developed evaluation framework. Incremental annual costs of intensive treatment over years 1 to 5 averaged £29.10 (standard error = £33.00) for consultations with general practitioners and nurses and £54.60 (standard error = £28.50) for metabolic and cardioprotective medication. For ADDITION-UK, over the 10-, 20-, and 30-year time horizon, adjusted incremental quality-adjusted life-years (QALYs) were 0.014, 0.043, and 0.048, and adjusted incremental costs were £1,021, £1,217, and £1,311, resulting in incremental cost-effectiveness ratios of £71,232/QALY, £28,444/QALY, and £27,549/QALY, respectively. Respective incremental cost-effectiveness ratios for ADDITION-Cambridge were slightly higher. The incremental costs of intensive treatment as delivered in the ADDITION-Cambridge trial were lower than expected. Given UK willingness-to-pay thresholds in patients with screen

Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis.

Science.gov (United States)

Park, Claire Su-Yeon

2017-08-01

To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.

Cheap imports next ordeal for Europe's high-cost producers

International Nuclear Information System (INIS)

Chynoweth, E.

1993-01-01

About one-third of Europe's 34 cracker and downstream units lost money in the final quarter of 1992, says Chem Systems (London). Average return on capital employed is negative - at the same level as in the gloomy days of the early 1980s - yet average operating rates are 80% now, compared with 65% a decade ago. Margins at what Chem Systems calls leader cracks (naphtha-based units that use good modern practices) are DM42/m.t. ethylene, DM100/m.t. less than they were in 1991. The consultant firm's recent report, European Petrochemical Strategy in the 1990s, suggests closure of 5%-10% of high-cost production. But, Chem Systems director Roger Longley states: We are not advocating wholesale closure. There are a small number (of plants) where additional investment would not payback that would be economical to shut. Cost reduction through mergers and acquisitions and operational changes is much more important, especially from an international aspect, Longley says. One thing people do not fully appreciate is that Europe is a high-cost region for petrochemical production, he adds. Traditionally, Europe exports 5% of its ethylene output, now it needs to tolerate cheap imports

Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.

Science.gov (United States)

Laviana, Aaron A; Ilg, Annette M; Veruttipong, Darlene; Tan, Hung-Jui; Burke, Michael A; Niedzwiecki, Douglas R; Kupelian, Patrick A; King, Chris R; Steinberg, Michael L; Kundavaram, Chandan R; Kamrava, Mitchell; Kaplan, Alan L; Moriarity, Andrew K; Hsu, William; Margolis, Daniel J A; Hu, Jim C; Saigal, Christopher S

2016-02-01

Given the costs of delivering care for men with prostate cancer remain poorly described, this article reports the results of time-driven activity-based costing (TDABC) for competing treatments of low-risk prostate cancer. Process maps were developed for each phase of care from the initial urologic visit through 12 years of follow-up for robotic-assisted laparoscopic prostatectomy (RALP), cryotherapy, high-dose rate (HDR) and low-dose rate (LDR) brachytherapy, intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and active surveillance (AS). The last modality incorporated both traditional transrectal ultrasound (TRUS) biopsy and multiparametric-MRI/TRUS fusion biopsy. The costs of materials, equipment, personnel, and space were calculated per unit of time and based on the relative proportion of capacity used. TDABC for each treatment was defined as the sum of its resources. Substantial cost variation was observed at 5 years, with costs ranging from $7,298 for AS to $23,565 for IMRT, and they remained consistent through 12 years of follow-up. LDR brachytherapy ($8,978) was notably cheaper than HDR brachytherapy ($11,448), and SBRT ($11,665) was notably cheaper than IMRT, with the cost savings attributable to shorter procedure times and fewer visits required for treatment. Both equipment costs and an inpatient stay ($2,306) contributed to the high cost of RALP ($16,946). Cryotherapy ($11,215) was more costly than LDR brachytherapy, largely because of increased single-use equipment costs ($6,292 vs $1,921). AS reached cost equivalence with LDR brachytherapy after 7 years of follow-up. The use of TDABC is feasible for analyzing cancer services and provides insights into cost-reduction tactics in an era focused on emphasizing value. By detailing all steps from diagnosis and treatment through 12 years of follow-up for low-risk prostate cancer, this study has demonstrated significant cost variation between competing treatments. © 2015

Considerations on a Cost Model for High-Field Dipole Arc Magnets for FCC

CERN Document Server

AUTHOR|(CDS)2078700; Durante, Maria; Lorin, Clement; Martinez, Teresa; Ruuskanen, Janne; Salmi, Tiina; Sorbi, Massimo; Tommasini, Davide; Toral, Fernando

2017-01-01

In the frame of the European Circular Collider (EuroCirCol), a conceptual design study for a post-Large Hadron Collider (LHC) research infrastructure based on an energy-frontier 100 TeV circular hadron collider [1]–[3], a cost model for the high-field dipole arc magnets is being developed. The aim of the cost model in the initial design phase is to provide the basis for sound strategic decisions towards cost effective designs, in particular: (A) the technological choice of superconducting material and its cost, (B) the target performance of Nb$_{3}$Sn superconductor, (C) the choice of operating temperature (D) the relevant design margins and their importance for cost, (E) the nature and extent of grading, and (F) the aperture’s influence on cost. Within the EuroCirCol study three design options for the high field dipole arc magnets are under study: cos − θ [4], block [5], and common-coil [6]. Here, in the advanced design phase, a cost model helps to (1) identify the cost drivers and feed-back this info...

Considerations on a Cost Model for High-Field Dipole Arc Magnets for FCC

CERN Document Server

AUTHOR|(CDS)2078700; Durante, Maria; Lorin, Clement; Martinez, Teresa; Ruuskanen, Janne; Salmi, Tiina; Sorbi, Massimo; Tommasini, Davide; Toral, Fernando

2017-01-01

In the frame of the European Circular Collider (EuroCirCol), a conceptual design study for a post-Large Hadron Collider (LHC) research infrastructure based on an energy-frontier 100 TeV circular hadron collider [1]–[3], a cost model for the high-field dipole arc magnets is being developed. The aim of the cost model in the initial design phase is to provide the basis for sound strategic decisions towards cost effective designs, in particular: (A) the technological choice of superconducting material and its cost, (B) the target performance of Nb3Sn superconductor, (C) the choice of operating temperature (D) the relevant design margins and their importance for cost, (E) the nature and extent of grading, and (F) the aperture’s influence on cost. Within the EuroCirCol study three design options for the high field dipole arc magnets are under study: cos − θ [4], block [5], and common-coil [6]. Here, in the advanced design phase, a cost model helps to (1) identify the cost drivers and feed-back this informati...

Second Generation Novel High Temperature Commercial Receiver & Low Cost High Performance Mirror Collector for Parabolic Solar Trough

Energy Technology Data Exchange (ETDEWEB)

Stettenheim, Joel [Norwich Technologies, White River Junction, VT (United States)

2016-02-29

Norwich Technologies (NT) is developing a disruptively superior solar field for trough concentrating solar power (CSP). Troughs are the leading CSP technology (85% of installed capacity), being highly deployable and similar to photovoltaic (PV) systems for siting. NT has developed the SunTrap receiver, a disruptive alternative to vacuum-tube concentrating solar power (CSP) receivers, a market currently dominated by the Schott PTR-70. The SunTrap receiver will (1) operate at higher temperature (T) by using an insulated, recessed radiation-collection system to overcome the energy losses that plague vacuum-tube receivers at high T, (2) decrease acquisition costs via simpler structure, and (3) dramatically increase reliability by eliminating vacuum. It offers comparable optical efficiency with thermal loss reduction from ≥ 26% (at presently standard T) to ≥ 55% (at high T), lower acquisition costs, and near-zero O&M costs.

Energy Management in Small Commercial Buildings: A Look at How HVAC Contractors Can Deliver Energy Efficiency to this Segment

Energy Technology Data Exchange (ETDEWEB)

Hult, Erin; Granderson, Jessica; Mathew, Paul

2014-07-01

While buildings smaller than 50,000 sq ft account for nearly half of the energy used in US commercial buildings, energy efficiency programs to-date have primarily focused on larger buildings. Interviews with stakeholders and a review of the literature indicate interest in energy efficiency from the small commercial building sector, provided solutions are simple and low-cost. An approach to deliver energy management to small commercial buildings via HVAC contractors and preliminary demonstration findings are presented. The energy management package (EMP) developed includes five technical elements: benchmarking and analysis of monthly energy use; analysis of interval electricity data (if available), a one-hour onsite walkthrough, communication with the building owner, and checking of results. This data-driven approach tracks performance and identifies low-cost opportunities, using guidelines and worksheets for each element to streamline the delivery process and minimize the formal training required. This energy management approach is unique from, but often complementary to conventional quality maintenance or retrofit-focused programs targeting the small commercial segment. Because HVAC contractors already serve these clients, the transaction cost to market and deliver energy management services can be reduced to the order of hundreds of dollars per year. This business model, outlined briefly in this report, enables the offering to benefit the contractor and client even at the modest expected energy savings in small buildings. Results from a small-scale pilot of this approach validated that the EMP could be delivered by contractors in 4-8 hours per building per year, and that energy savings of 3-5percent are feasible through this approach.

Segmentation of low‐cost high efficiency oxide‐based thermoelectric materials

DEFF Research Database (Denmark)

Le, Thanh Hung; Van Nong, Ngo; Linderoth, Søren

2015-01-01

Thermoelectric (TE) oxide materials have attracted great interest in advanced renewable energy research owing to the fact that they consist of abundant elements, can be manufactured by low-cost processing, sustain high temperatures, be robust and provide long lifetime. However, the low conversion...... efficiency of TE oxides has been a major drawback limiting these materials to broaden applications. In this work, theoretical calculations are used to predict how segmentation of oxide and semimetal materials, utilizing the benefits of both types of materials, can provide high efficiency, high temperature...... oxide-based segmented legs. The materials for segmentation are selected by their compatibility factors and their conversion efficiency versus material cost, i.e., “efficiency ratio”. Numerical modelling results showed that conversion efficiency could reach values of more than 10% for unicouples using...

The Cost-Effectiveness of Intermittent Preventive Treatment for Malaria in Infants in Sub-Saharan Africa

Science.gov (United States)

Conteh, Lesong; Sicuri, Elisa; Manzi, Fatuma; Hutton, Guy; Obonyo, Benson; Tediosi, Fabrizio; Biao, Prosper; Masika, Paul; Matovu, Fred; Otieno, Peter; Gosling, Roly D.; Hamel, Mary; Odhiambo, Frank O.; Grobusch, Martin P.; Kremsner, Peter G.; Chandramohan, Daniel; Aponte, John J.; Egan, Andrea; Schellenberg, David; Macete, Eusebio; Slutsker, Laurence; Newman, Robert D.; Alonso, Pedro; Menéndez, Clara; Tanner, Marcel

2010-01-01

Background Intermittent preventive treatment in infants (IPTi) has been shown to decrease clinical malaria by approximately 30% in the first year of life and is a promising malaria control strategy for Sub-Saharan Africa which can be delivered alongside the Expanded Programme on Immunisation (EPI). To date, there have been limited data on the cost-effectiveness of this strategy using sulfadoxine pyrimethamine (SP) and no published data on cost-effectiveness using other antimalarials. Methods We analysed data from 5 countries in sub-Saharan Africa using a total of 5 different IPTi drug regimens; SP, mefloquine (MQ), 3 days of chlorproguanil-dapsone (CD), SP plus 3 days of artesunate (SP-AS3) and 3 days of amodiaquine-artesunate (AQ3-AS3).The cost per malaria episode averted and cost per Disability-Adjusted Life-Year (DALY) averted were modeled using both trial specific protective efficacy (PE) for all IPTi drugs and a pooled PE for IPTi with SP, malaria incidence, an estimated malaria case fatality rate of 1.57%, IPTi delivery costs and country specific provider and household malaria treatment costs. Findings In sites where IPTi had a significant effect on reducing malaria, the cost per episode averted for IPTi-SP was very low, USD 1.36–4.03 based on trial specific data and USD 0.68–2.27 based on the pooled analysis. For IPTi using alternative antimalarials, the lowest cost per case averted was for AQ3-AS3 in western Kenya (USD 4.62) and the highest was for MQ in Korowge, Tanzania (USD 18.56). Where efficacious, based only on intervention costs, IPTi was shown to be cost effective in all the sites and highly cost-effective in all but one of the sites, ranging from USD 2.90 (Ifakara, Tanzania with SP) to USD 39.63 (Korogwe, Tanzania with MQ) per DALY averted. In addition, IPTi reduced health system costs and showed significant savings to households from malaria cases averted. A threshold analysis showed that there is room for the IPTi-efficacy to fall and still

From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

Directory of Open Access Journals (Sweden)

Tanner Marcel

2008-07-01

Full Text Available Abstract Background Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. Method We worked in partnership with the Ministry of Health and Social Welfare (MoHSW to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1 developing the strategy and (2 maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. Results The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. Conclusion The costs presented here show the order of magnitude of expenditures needed to initiate and to

A service model for delivering care closer to home.

Science.gov (United States)

Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

2011-04-01

Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

An extra-domiciliary method of delivering entomopathogenic fungus, Metharizium anisopliae IP 46 for controlling adult populations of the malaria vector, Anopheles arabiensis

Directory of Open Access Journals (Sweden)

Mnyone Ladslaus L

2010-03-01

Full Text Available Abstract Fungal biopesticides have the potential to significantly reduce densities of malaria vectors as well as associated malaria transmission. In previous field trials, entomopathogenic fungus was delivered from within human dwellings, where its efficacy was limited by low infection rates of target mosquitoes, high costs of spraying fungus inside houses, and potential public health concerns associated with introducing fungal conidia inside houses. Here we have demonstrated that Metarhizium anisopliae IP 46, delivered within an extra-domiciliary odor-baited station (OBS, can infect and slowly-kill a high proportion of the wild adult malaria vector, Anopheles arabiensis which entered and exited the OBS. This study, carried out in rural Tanzania, showed that by using a concentration of 3.9 × 1010 conidia/m2, more than 95% of mosquitoes that flew in and out of the OBS died within 14 days post-exposure. At least 86% infection of mosquito cadavers was recorded with a significant reduction in the probability of daily survival of exposed An. arabiensis in both treatments tested: low quantity of conidia (eave baffles plus one cotton panel; HR = 2.65, P P

Cost optimization of load carrying thin-walled precast high performance concrete sandwich panels

DEFF Research Database (Denmark)

Hodicky, Kamil; Hansen, Sanne; Hulin, Thomas

2015-01-01

and HPCSP’s geometrical parameters as well as on material cost function in the HPCSP design. Cost functions are presented for High Performance Concrete (HPC), insulation layer, reinforcement and include labour-related costs. The present study reports the economic data corresponding to specific manufacturing......The paper describes a procedure to find the structurally and thermally efficient design of load-carrying thin-walled precast High Performance Concrete Sandwich Panels (HPCSP) with an optimal economical solution. A systematic optimization approach is based on the selection of material’s performances....... The solution of the optimization problem is performed in the computer package software Matlab® with SQPlab package and integrates the processes of HPCSP design, quantity take-off and cost estimation. The proposed optimization process outcomes in complex HPCSP design proposals to achieve minimum cost of HPCSP....

High cost of nuclear power plants

International Nuclear Information System (INIS)

Bassett, C.

1978-01-01

Retroactive safety standards were found to account for over half the costs of a nuclear power plant and point up the need for an effective cost-benefit analysis of changes made by the Nuclear Regulatory Commission after construction has started. The author compared the Davis-Besse Unit No. 1 construction-cost estimates with the final-cost increases during a rate-case investigation in Ohio. He presents data furnished for ten of the largest construction contracts to illustrate the cost increases involving fixed hardware and intensive labor. The situation was found to repeat with other utilities across the country even though safeguards against irresponsible low bidding were introduced. Low bidding was found to continue, encouraged by the need for retrofitting to meet regulation changes. The average cost per kilowatt of major light-water reactors is shown to have increased from $171 in 1970 to $555 in 1977, while construction duration increased from 43.4 to 95.6 months during the same period

[Evolution of reimbursement of high-cost anticancer drugs: Financial impact within a university hospital].

Science.gov (United States)

Baudouin, Amandine; Fargier, Emilie; Cerruti, Ariane; Dubromel, Amélie; Vantard, Nicolas; Ranchon, Florence; Schwiertz, Vérane; Salles, Gilles; Souquet, Pierre-Jean; Thomas, Luc; Bérard, Frédéric; Nancey, Stéphane; Freyer, Gilles; Trillet-Lenoir, Véronique; Rioufol, Catherine

2017-06-01

In the context of health expenses control, reimbursement of high-cost medicines with a 'minor' or 'nonexistent' improvement in actual health benefit evaluated by the Haute Autorité de santé is revised by the decree of March 24, 2016 related to the procedure and terms of registration of high-cost pharmaceutical drugs. This study aims to set up the economic impact of this measure. A six months retrospective study was conducted within a French university hospital from July 1, 2015 to December 31, 2015. For each injectable high-cost anticancer drug prescribed to a patient with cancer, the therapeutic indication, its status in relation to the marketing authorization and the associated improvement in actual health benefit were examined. The total costs of these treatments, the cost per type of indication and, in the case of marketing authorization indications, the cost per improvement in actual health benefit were evaluated considering that all drugs affected by the decree would be struck off. Over six months, 4416 high-cost injectable anticancer drugs were prescribed for a total cost of 4.2 million euros. The costs of drugs with a minor or nonexistent improvement in actual benefit and which comparator is not onerous amount 557,564 euros. The reform of modalities of inscription on the list of onerous drugs represents a significant additional cost for health institutions (1.1 million euros for our hospital) and raises the question of the accessibility to these treatments for cancer patients. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

Science.gov (United States)

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

Understanding Time-driven Activity-based Costing.

Science.gov (United States)

Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

2016-03-01

Transitioning to a value-based health care system will require providers to increasingly scrutinize their outcomes and costs. Although there has been a great deal of effort to understand outcomes, cost accounting in health care has been a greater challenge. Currently the cost accounting methods used by hospitals and providers are based off a fee-for-service system. As resources become increasingly scarce and the health care system attempts to understand which services provide the greatest value, it will be critically important to understand the true costs of delivering a service. An understanding of the true costs of a particular service will help providers make smarter decisions on how to allocate and utilize resources as well as determine which activities are nonvalue added. Achieving value will require providers to have a greater focus on accurate outcome data as well as better methods of cost accounting.

A cluster randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents.

Science.gov (United States)

Stallard, P; Phillips, R; Montgomery, A A; Spears, M; Anderson, R; Taylor, J; Araya, R; Lewis, G; Ukoumunne, O C; Millings, A; Georgiou, L; Cook, E; Sayal, K

2013-10-01

Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Although this is a major problem, relatively few adolescents with, or at risk of developing, depression are identified and referred for treatment. This suggests the need to investigate alternative approaches whereby preventative interventions are made widely available in schools. To investigate the clinical effectiveness and cost-effectiveness of classroom-based cognitive-behavioural therapy (CBT) in reducing symptoms of depression in high-risk adolescents. Cluster randomised controlled trial. Year groups ( n = 28) randomly allocated on a 1 : 1 : 1 basis to one of three trial arms once all schools were recruited and balanced for number of classes, number of students, Personal, Social and Health Education (PSHE) lesson frequency, and scheduling of PSHE. Year groups 8 to 11 (ages 12-16 years) in mixed-sex secondary schools in the UK. Data were collected between 2009 and 2011. Young people who attended PSHE at participating schools were eligible ( n = 5503). Of the 5030 who agreed to participate, 1064 (21.2%) were classified as 'high risk': 392 in the classroom-based CBT arm, 374 in the attention control PSHE arm and 298 in the usual PSHE arm. Primary outcome data on the high-risk group at 12 months were available for classroom-based CBT ( n = 296), attention control PSHE ( n = 308) and usual PSHE ( n = 242). The Resourceful Adolescent Programme (RAP) is a focused CBT-based intervention adapted for the UK (RAP-UK) and delivered by two facilitators external to the school. Control groups were usual PSHE (usual school curriculum delivered by teachers) and attention control (usual school PSHE with additional support from two facilitators). Interventions were delivered universally to whole classes. Clinical effectiveness: symptoms of depression [Short Mood and Feelings Questionnaire (SMFQ)] in adolescents at high risk

The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Sun, Yu; You, Wen; Almeida, Fabio; Estabrooks, Paul; Davy, Brenda

2017-03-01

Type 2 diabetes is a significant public health concern. With the completion of the Diabetes Prevention Program, there has been a proliferation of studies attempting to translate this evidence base into practice. However, the cost, effectiveness, and cost-effectiveness of these adapted interventions is unknown. The purpose of this systematic review was to conduct a comprehensive meta-analysis to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent (dietitian vs non-dietitian) and channel (in-person vs technology-delivered). English and full-text research articles published up to July 2015 were identified using the Cochrane Library, PubMed, Education Resources Information Center, CAB Direct, Science Direct, and Google Scholar. Sixty-nine studies met inclusion criteria. Most employed both dietary and physical activity intervention components (four of 69 were diet-only interventions). Changes in weight, fasting and 2-hour blood glucose concentration, and hemoglobin A1c were extracted from each article. Heterogeneity was measured by the I 2 index, and study-specific effect sizes or mean differences were pooled using a random effects model when heterogeneity was confirmed. Participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI 1.52 to 2.62; Phemoglobin A1c level changes ranged from small to medium. The meta-regression analysis revealed a larger relative weight loss in dietitian-delivered interventions than in those delivered by nondietitians (full sample: -1.0 kg; US subsample: -2.4 kg), and did not find statistical evidence that the delivery channel was an important predictor of weight loss. The average cost per kilogram weight loss ranged from $34.06 over 6 months to $1,005.36 over 12 months. The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non

Flexible and Cost Efficient Power Consumption using Economic MPC

DEFF Research Database (Denmark)

Hovgaard, Tobias Gybel; Larsen, Lars F.S.; Jørgensen, John Bagterp

2011-01-01

the formulation of a new cost function for our proposed power management. Hereby the refrigeration system is enabled to contribute with ancillary services to the balancing power market. Since significant amounts of regulating power is needed for a higher penetration of intermittent renewable energy sources...... such as wind turbines this feature is in high demand in a future intelligent power grid (Smart Grid). Our perspective is seen from the refrigeration system but as it is demonstrated the involvement in the balancing market can be economically beneficial for the system itself while delivering crucial services...... that reduces operation costs by utilizing the thermal storage capabilities. In the study we specifically address advantages coming from daily variations in outdoor temperature and electricity prices but other aims such as peak load reduction are also considered. An important contribution of this paper is also...

Delivering Online Examinations: A Case Study

Directory of Open Access Journals (Sweden)

John MESSING

2004-07-01

Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

Science.gov (United States)

Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

2007-01-01

The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

Low-Cost High-Performance MRI

Science.gov (United States)

Sarracanie, Mathieu; Lapierre, Cristen D.; Salameh, Najat; Waddington, David E. J.; Witzel, Thomas; Rosen, Matthew S.

2015-10-01

Magnetic Resonance Imaging (MRI) is unparalleled in its ability to visualize anatomical structure and function non-invasively with high spatial and temporal resolution. Yet to overcome the low sensitivity inherent in inductive detection of weakly polarized nuclear spins, the vast majority of clinical MRI scanners employ superconducting magnets producing very high magnetic fields. Commonly found at 1.5-3 tesla (T), these powerful magnets are massive and have very strict infrastructure demands that preclude operation in many environments. MRI scanners are costly to purchase, site, and maintain, with the purchase price approaching $1 M per tesla (T) of magnetic field. We present here a remarkably simple, non-cryogenic approach to high-performance human MRI at ultra-low magnetic field, whereby modern under-sampling strategies are combined with fully-refocused dynamic spin control using steady-state free precession techniques. At 6.5 mT (more than 450 times lower than clinical MRI scanners) we demonstrate (2.5 × 3.5 × 8.5) mm3 imaging resolution in the living human brain using a simple, open-geometry electromagnet, with 3D image acquisition over the entire brain in 6 minutes. We contend that these practical ultra-low magnetic field implementations of MRI (standards for affordable (<$50,000) and robust portable devices.

Coverage, adherence and costs of intermittent preventive treatment of malaria in children employing different delivery strategies in Jasikan, Ghana.

Directory of Open Access Journals (Sweden)

Edith Patouillard

Full Text Available Intermittent preventive treatment of malaria in children (IPTc involves the administration of a course of anti-malarial drugs at specified time intervals to children at risk of malaria regardless of whether or not they are known to be infected. IPTc provides a high level of protection against uncomplicated and severe malaria, with monthly sulphadoxine-pyrimethamine plus amodiaquine (SP&AQ and sulphadoxine-pyrimethamine plus piperaquine being the most efficacious regimens. A key challenge is the identification of a cost-effective delivery strategy.A community randomized trial was undertaken in Jasikan district, Ghana to assess IPTc effectiveness and costs using SP&AQ delivered in three different ways. Twelve villages were randomly selected to receive IPTc from village health workers (VHWs or facility-based nurses working at health centres' outpatient departments (OPD or EPI outreach clinics. Children aged 3 to 59 months-old received one IPT course (three doses in May, June, September and October. Effectiveness was measured in terms of children covered and adherent to a course and delivery costs were calculated in financial and economic terms using an ingredient approach from the provider perspective.The economic cost per child receiving at least the first dose of all 4 courses was US$4.58 when IPTc was delivered by VHWs, US$4.93 by OPD nurses and US$ 5.65 by EPI nurses. The unit economic cost of receiving all 3 doses of all 4 courses was US$7.56 and US$8.51 when IPTc was delivered by VHWs or facility-based nurses respectively. The main cost driver for the VHW delivery was supervision, reflecting resources used for travelling to more remote communities rather than more intense supervision, and for OPD and EPI delivery, it was the opportunity cost of the time spent by nurses in dispensing IPTc.VHWs achieve higher IPTc coverage and adherence at lower costs than facility-based nurses in Jasikan district, Ghana.ClinicalTrials.gov NCT00119132.

Wind turbine cost of electricity and capacity factor

International Nuclear Information System (INIS)

Cavallo, A.J.

1995-01-01

Wind turbines are currently designed to minimize the cost of electricity at the wind turbine (the busbar cost) in a given wind regime, ignoring constraints on the capacitor factor (the ratio of the average power output to the maximum power output). The trade-off between these two quantities can be examined in a straightforward fashion; it is found that the capacitor factor can be increased by a factor of 1.3 above its value at the cost minimum for a 10 percent increase in the cost of electricity. This has important implications for the large scale integration of wind electricity on utility grids where the cost of transmission and storage may be a significant fraction of the cost of delivered electricity. (Author)

Highly integrated image sensors enable low-cost imaging systems

Science.gov (United States)

Gallagher, Paul K.; Lake, Don; Chalmers, David; Hurwitz, J. E. D.

1997-09-01

The highest barriers to wide scale implementation of vision systems have been cost. This is closely followed by the level of difficulty of putting a complete imaging system together. As anyone who has every been in the position of creating a vision system knows, the various bits and pieces supplied by the many vendors are not under any type of standardization control. In short, unless you are an expert in imaging, electrical interfacing, computers, digital signal processing, and high speed storage techniques, you will likely spend more money trying to do it yourself rather than to buy the exceedingly expensive systems available. Another alternative is making headway into the imaging market however. The growing investment in highly integrated CMOS based imagers is addressing both the cost and the system integration difficulties. This paper discusses the benefits gained from CMOS based imaging, and how these benefits are already being applied.

Comparison of high-speed transportation systems in special consideration of investment costs

Directory of Open Access Journals (Sweden)

R. Schach

2007-10-01

Full Text Available In this paper a substantial comparison of different high-speed transportation systems and an approach to stochastic cost estimations are provided. Starting from the developments in Europe, the high-speed traffic technical characteristics of high-speed railways and Maglev systems are compared. But for a comprehensive comparison more criterions must be included and led to a wider consideration and the development of a multi-criteria comparison of high-speed transportation systems. In the second part a stochastic approach to cost estimations of infrastructure projects is encouraged. Its advantages in comparison with the traditional proceeding are presented and exemplify the practical implementation.

Systematic review of drug administration costs and implications for biopharmaceutical manufacturing.

Science.gov (United States)

Tetteh, Ebenezer; Morris, Stephen

2013-10-01

The acquisition costs of biologic drugs are often considered to be relatively high compared with those of nonbiologics. However, the total costs of delivering these drugs also depend on the cost of administration. Ignoring drug administration costs may distort resource allocation decisions because these affect cost effectiveness. The objectives of this systematic review were to develop a framework of drug administration costs that considers both the costs of physical administration and the associated proximal costs; and, as a case example, to use this framework to evaluate administration costs for biologics within the UK National Health Service (NHS). We reviewed literature that reported estimates of administration costs for biologics within the UK NHS to identify how these costs were quantified and to examine how differences in dosage forms and regimens influenced administration costs. The literature reviewed were identified by searching the Centre for Review and Dissemination Databases (DARE, NHS EED and HTA); EMBASE (The Excerpta Medica Database); MEDLINE (using the OVID interface); Econlit (EBSCO); Tufts Medical Center Cost Effectiveness Analysis (CEA) Registry; and Google Scholar. We identified 4,344 potentially relevant studies, of which 43 studies were selected for this systematic review. We extracted estimates of the administration costs of biologics from these studies. We found evidence of variation in the way that administration costs were measured, and that this affected the magnitude of costs reported, which could then influence cost effectiveness. Our findings suggested that manufacturers of biologic medicines should pay attention to formulation issues and their impact on administration costs, because these affect the total costs of healthcare delivery and cost effectiveness.

Provision of hearing aids to children in Bangladesh: costs and cost-effectiveness of a community-based and a centre-based approach.

Science.gov (United States)

Ekman, Björn; Borg, Johan

2017-08-01

The aim of this study is to provide evidence on the costs and health effects of two alternative hearing aid delivery models, a community-based and a centre-based approach. The study is set in Bangladesh and the study population is children between 12 and 18 years old. Data on resource use by participants and their caregivers were collected by a household survey. Follow-up data were collected after two months. Data on the costs to providers of the two approaches were collected by means of key informant interviews. The total cost per participant in the community-based model was BDT 6,333 (USD 79) compared with BDT 13,718 (USD 172) for the centre-based model. Both delivery models are found to be cost-effective with an estimated cost per DALY averted of BDT 17,611 (USD 220) for the community-based model and BDT 36,775 (USD 460) for the centre-based model. Using a community-based approach to deliver hearing aids to children in a resource constrained environment is a cost-effective alternative to the traditional centre-based approach. Further evidence is needed to draw conclusions for scale-up of approaches; rigorous analysis is possible using well-prepared data collection tools and working closely with sector professionals. Implications for Rehabilitation Delivery models vary by resources needed for their implementation. Community-based deliver models of hearing aids to children in low-income countries are a cost-effective alternative. The assessment of costs and effects of hearing aids delivery models in low-income countries is possible through planned collaboration between researchers and sector professionals.

Low cost high performance uncertainty quantification

KAUST Repository

Bekas, C.

2009-01-01

Uncertainty quantification in risk analysis has become a key application. In this context, computing the diagonal of inverse covariance matrices is of paramount importance. Standard techniques, that employ matrix factorizations, incur a cubic cost which quickly becomes intractable with the current explosion of data sizes. In this work we reduce this complexity to quadratic with the synergy of two algorithms that gracefully complement each other and lead to a radically different approach. First, we turned to stochastic estimation of the diagonal. This allowed us to cast the problem as a linear system with a relatively small number of multiple right hand sides. Second, for this linear system we developed a novel, mixed precision, iterative refinement scheme, which uses iterative solvers instead of matrix factorizations. We demonstrate that the new framework not only achieves the much needed quadratic cost but in addition offers excellent opportunities for scaling at massively parallel environments. We based our implementation on BLAS 3 kernels that ensure very high processor performance. We achieved a peak performance of 730 TFlops on 72 BG/P racks, with a sustained performance 73% of theoretical peak. We stress that the techniques presented in this work are quite general and applicable to several other important applications. Copyright © 2009 ACM.

Suppression of Noise to Obtain a High-Performance Low-Cost Optical Encoder

Directory of Open Access Journals (Sweden)

Sergio Alvarez-Rodríguez

2018-01-01

Full Text Available Currently, commercial encoders endowed with high precision are expensive sensors, and optical low-cost designs to measure the positioning angle have undesirable levels of system noise which reduce the good performance of devices. This research is devoted to the designing of mathematical filters to suppress noise in polarized transducers, in order to obtain high accuracy, precision, and resolution, along with an adaptive maximum response speed for low-cost optical encoders. This design was proved through a prototype inside a research platform, and experimental results show an accuracy of 3.9, a precision of 26, and a resolution of 17 [arc seconds], at least for the specified working conditions, for the sensing of the angular position of a rotary polarizer. From this work has been obtained a high-performance low-cost polyphase optical encoder, which uses filtering mathematical principles potentially generalizable to other inventions.

Production of solidified high level wastes: a cost comparison of solidification processes

International Nuclear Information System (INIS)

1977-06-01

Differential cost estimates of the annual operating and maintenance costs and the capital costs for five HLW Waste Solidification Alternates were developed. The annual operating and maintenance cost estimates included the cost of labor, consumables, utilities, shipping casks, shipping and disposal at a federal repository. The capital cost included the cost of the component, installation and building. The differential cost estimates do not include equipment and facilities which are either shared with the reprocessing facility or are common between all of the alternates. Total annual cost differential between the five waste form alternates is summarized in tabular form. The Borosilicate Glass Alternate has the lowest total annual cost. The other alternates have higher costs which range from $6.6 M to $7.4 M per year higher than the Glass alternate with the Supercalcine being the highest cost at $7.4 M per year differential. The major items in the cost estimates are then disposal costs in the operating cost estimates and the HLW Storage Tanks in the capital cost estimates. The Supercalcine Multibarrier Alternate ships 180 canisters per year more than the other alternates and consequently has a significantly higher operating cost. However, off-setting this the Supercalcine Multibarrier Alternate does not require HLW Storage Tanks for decay because of the high heat conductivity of this product and correspondingly the capital cost for this alternate is significantly lower than the other alternates. The radiological risk values are correlated with the cost evaluation normalized to cost ($)/MWe-yr

Low-cost, high-performance and efficiency computational photometer design

Science.gov (United States)

Siewert, Sam B.; Shihadeh, Jeries; Myers, Randall; Khandhar, Jay; Ivanov, Vitaly

2014-05-01

Researchers at the University of Alaska Anchorage and University of Colorado Boulder have built a low cost high performance and efficiency drop-in-place Computational Photometer (CP) to test in field applications ranging from port security and safety monitoring to environmental compliance monitoring and surveying. The CP integrates off-the-shelf visible spectrum cameras with near to long wavelength infrared detectors and high resolution digital snapshots in a single device. The proof of concept combines three or more detectors into a single multichannel imaging system that can time correlate read-out, capture, and image process all of the channels concurrently with high performance and energy efficiency. The dual-channel continuous read-out is combined with a third high definition digital snapshot capability and has been designed using an FPGA (Field Programmable Gate Array) to capture, decimate, down-convert, re-encode, and transform images from two standard definition CCD (Charge Coupled Device) cameras at 30Hz. The continuous stereo vision can be time correlated to megapixel high definition snapshots. This proof of concept has been fabricated as a fourlayer PCB (Printed Circuit Board) suitable for use in education and research for low cost high efficiency field monitoring applications that need multispectral and three dimensional imaging capabilities. Initial testing is in progress and includes field testing in ports, potential test flights in un-manned aerial systems, and future planned missions to image harsh environments in the arctic including volcanic plumes, ice formation, and arctic marine life.

Sharing the cost of risky projects

DEFF Research Database (Denmark)

Hougaard, Jens Leth; Moulin, Hervé

2018-01-01

Users share the cost of unreliable non-rival projects (items). For instance, industry partners pay today for R&D that may or may not deliver a cure to some viruses, agents pay for the edges of a network that will cover their connectivity needs, but the edges may fail, etc. Each user has a binary...

Time-Driven Activity-Based Costing: A Comparative Cost Analysis of Whole-Breast Radiotherapy Versus Balloon-Based Brachytherapy in the Management of Early-Stage Breast Cancer.

Science.gov (United States)

Schutzer, Matthew E; Arthur, Douglas W; Anscher, Mitchell S

2016-05-01

Value in health care is defined as outcomes achieved per dollar spent, and understanding cost is critical to delivering high-value care. Traditional costing methods reflect charges rather than fundamental costs to provide a service. The more rigorous method of time-driven activity-based costing was used to compare cost between whole-breast radiotherapy (WBRT) and accelerated partial-breast irradiation (APBI) using balloon-based brachytherapy. For WBRT (25 fractions with five-fraction boost) and APBI (10 fractions twice daily), process maps were created outlining each activity from consultation to post-treatment follow up. Through staff interviews, time estimates were obtained for each activity. The capacity cost rates (CCR), defined as cost per minute, were calculated for personnel, equipment, and physical space. Total cost was calculated by multiplying the time required of each resource by its CCR. This was then summed and combined with cost of consumable materials. The total cost for WBRT was $5,333 and comprised 56% personnel costs and 44% space/equipment costs. For APBI, the total cost was $6,941 (30% higher than WBRT) and comprised 51% personnel costs, 6% space/equipment costs, and 43% consumable materials costs. The attending physician had the highest CCR of all personnel ($4.28/min), and APBI required 24% more attending time than WBRT. The most expensive activity for APBI was balloon placement and for WBRT was computed tomography simulation. APBI cost more than WBRT when using the dose/fractionation schemes analyzed. Future research should use time-driven activity-based costing to better understand cost with the aim of reducing expenditure and defining bundled payments. Copyright © 2016 by American Society of Clinical Oncology.

Repository emplacement costs for Al-clad high enriched uranium spent fuel

International Nuclear Information System (INIS)

McDonell, W.R.; Parks, P.B.

1994-01-01

A range of strategies for treatment and packaging of Al-clad high-enriched uranium (HEU) spent fuels to prevent or delay the onset of criticality in a geologic repository was evaluated in terms of the number of canisters produced and associated repository costs incurred. The results indicated that strategies in which neutron poisons were added to consolidated forms of the U-Al alloy fuel generally produced the lowest number of canisters and associated repository costs. Chemical processing whereby the HEU was removed from the waste form was also a low cost option. The repository costs generally increased for isotopic dilution strategies, because of the substantial depleted uranium added. Chemical dissolution strategies without HEU removal were also penalized because of the inert constituents in the final waste glass form. Avoiding repository criticality by limiting the fissile mass content of each canister incurred the highest repository costs

The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

Science.gov (United States)

Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen

2017-08-01

Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and

Topical delivery of low-cost protein drug candidates made in chloroplasts for biofilm disruption and uptake by oral epithelial cells.

Science.gov (United States)

Liu, Yuan; Kamesh, Aditya C; Xiao, Yuhong; Sun, Victor; Hayes, Michael; Daniell, Henry; Koo, Hyun

2016-10-01

Protein drugs (PD) are minimally utilized in dental medicine due to high cost and invasive surgical delivery. There is limited clinical advancement in disrupting virulent oral biofilms, despite their high prevalence in causing dental caries. Poor efficacy of antimicrobials following topical treatments or to penetrate and disrupt formed biofilms is a major challenge. We report an exciting low-cost approach using plant-made antimicrobial peptides (PMAMPs) retrocyclin or protegrin with complex secondary structures (cyclic/hairpin) for topical use to control biofilms. The PMAMPs rapidly killed the pathogen Streptococcus mutans and impaired biofilm formation following a single topical application of tooth-mimetic surface. Furthermore, we developed a synergistic approach using PMAMPs combined with matrix-degrading enzymes to facilitate their access into biofilms and kill the embedded bacteria. In addition, we identified a novel role for PMAMPs in delivering drugs to periodontal and gingival cells, 13-48 folds more efficiently than any other tested cell penetrating peptides. Therefore, PDs fused with protegrin expressed in plant cells could potentially play a dual role in delivering therapeutic proteins to gum tissues while killing pathogenic bacteria when delivered as topical oral formulations or in chewing gums. Recent FDA approval of plant-produced PDs augurs well for clinical advancement of this novel concept. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cost-aware request routing in multi-geography cloud data centres using software-defined networking

Science.gov (United States)

Yuan, Haitao; Bi, Jing; Li, Bo Hu; Tan, Wei

2017-03-01

Current geographically distributed cloud data centres (CDCs) require gigantic energy and bandwidth costs to provide multiple cloud applications to users around the world. Previous studies only focus on energy cost minimisation in distributed CDCs. However, a CDC provider needs to deliver gigantic data between users and distributed CDCs through internet service providers (ISPs). Geographical diversity of bandwidth and energy costs brings a highly challenging problem of how to minimise the total cost of a CDC provider. With the recently emerging software-defined networking, we study the total cost minimisation problem for a CDC provider by exploiting geographical diversity of energy and bandwidth costs. We formulate the total cost minimisation problem as a mixed integer non-linear programming (MINLP). Then, we develop heuristic algorithms to solve the problem and to provide a cost-aware request routing for joint optimisation of the selection of ISPs and the number of servers in distributed CDCs. Besides, to tackle the dynamic workload in distributed CDCs, this article proposes a regression-based workload prediction method to obtain future incoming workload. Finally, this work evaluates the cost-aware request routing by trace-driven simulation and compares it with the existing approaches to demonstrate its effectiveness.

A Costing Model for Non Traditional Education.

Science.gov (United States)

Knodle, L. L.

To facilitate college and university officials in financing the eduational needs of the nontraditional students, a method for collecting and determining the cost of providing units of instruction through various delivery mechanisms available to colleges and universities is presented. Twelve ways of delivering instructional units, eight types of…

Cost analysis of youth violence prevention.

Science.gov (United States)

Sharp, Adam L; Prosser, Lisa A; Walton, Maureen; Blow, Frederic C; Chermack, Stephen T; Zimmerman, Marc A; Cunningham, Rebecca

2014-03-01

Effective violence interventions are not widely implemented, and there is little information about the cost of violence interventions. Our goal is to report the cost of a brief intervention delivered in the emergency department that reduces violence among 14- to 18-year-olds. Primary outcomes were total costs of implementation and the cost per violent event or violence consequence averted. We used primary and secondary data sources to derive the costs to implement a brief motivational interviewing intervention and to identify the number of self-reported violent events (eg, severe peer aggression, peer victimization) or violence consequences averted. One-way and multi-way sensitivity analyses were performed. Total fixed and variable annual costs were estimated at $71,784. If implemented, 4208 violent events or consequences could be prevented, costing $17.06 per event or consequence averted. Multi-way sensitivity analysis accounting for variable intervention efficacy and different cost estimates resulted in a range of $3.63 to $54.96 per event or consequence averted. Our estimates show that the cost to prevent an episode of youth violence or its consequences is less than the cost of placing an intravenous line and should not present a significant barrier to implementation.

Low-Cost High-Speed In-Plane Stroboscopic Micro-Motion Analyzer

Directory of Open Access Journals (Sweden)

Shashank S. Pandey

2017-11-01

Full Text Available Instrumentation for high-speed imaging and laser vibrometry is essential for the understanding and analysis of microstructure dynamics, but commercial instruments are largely unaffordable for most microelectromechanical systems (MEMS laboratories. We present the implementation of a very low cost in-plane micro motion stroboscopic analyzer that can be directly attached to a conventional probe station. The low-cost analyzer has been used to characterize the harmonic motion of 52.1 kHz resonating comb drive microactuators using ~50 ns pulsed light-emitting diode (LED stroboscope exposure times, producing sharp and high resolution (~0.5 μm device images at resonance, which rivals those of several orders of magnitude more expensive systems. This paper details the development of the high-speed stroboscopic imaging system and presents experimental results of motion analysis of example microstructures and a discussion of its operating limits. The system is shown to produce stable stroboscopic LED illumination to freeze device images up to 11 MHz.

[Predicting individual risk of high healthcare cost to identify complex chronic patients].

Science.gov (United States)

Coderch, Jordi; Sánchez-Pérez, Inma; Ibern, Pere; Carreras, Marc; Pérez-Berruezo, Xavier; Inoriza, José M

2014-01-01

To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients. A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution. The predictive variables were age, sex, morbidity-based on clinical risk groups (CRG)-and selected data from previous utilization (use of hospitalization, use of high-cost drugs in ambulatory care, pharmaceutical expenditure). A univariate descriptive analysis was performed. We constructed a logistic regression model with a 95% confidence level and analyzed sensitivity, specificity, positive predictive values (PPV), and the area under the ROC curve (AUC). Individuals incurring costs >P95 accumulated 44% of total healthcare costs and were concentrated in ACRG3 (aggregated CRG level 3) categories related to multiple chronic diseases. All variables were statistically significant except for sex. The model had a sensitivity of 48.4% (CI: 46.9%-49.8%), specificity of 97.2% (CI: 97.0%-97.3%), PPV of 46.5% (CI: 45.0%-47.9%), and an AUC of 0.897 (CI: 0.892 to 0.902). High consumption of healthcare resources is associated with complex chronic morbidity. A model based on age, morbidity, and prior utilization is able to predict high-cost risk and identify a target population requiring proactive care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

DOE HIGH-POWER SLIM-HOLE DRILLING SYSTEM

Energy Technology Data Exchange (ETDEWEB)

Dr. William C. Maurer; John H. Cohen; J. Chris Hetmaniak; Curtis Leitko

1999-09-01

This project used a systems approach to improve slim-hole drilling performance. A high power mud motor, having a double-length power section, and hybrid PDC/TSP drill bit were developed to deliver maximum horsepower to the rock while providing a long life down hole. This high-power slim-hole drilling system drills much faster than conventional slim-hole motor and bit combinations and holds significant potential to reduce slim-hole drilling costs. The oil and gas industries have been faced with downward price pressures since the 1980s. These pressures are not expected to be relieved in the near future. To maintain profitability, companies have had to find ways to reduce the costs of producing oil and gas. Drilling is one of the more costly operations in the production process. One method to reduce costs of drilling is to use smaller more mobile equipment. Slim holes have been drilled in the past using this principle. These wells can save money not only from the use of smaller drilling equipment, but also from reduced tubular costs. Stepping down even one casing size results in significant savings. However, slim holes have not found wide spread use for three reasons. First, until recently, the price of oil has been high so there were no forces to move the industry in this direction. Second, small roller bits and motors were not very reliable and they drilled slowly, removing much of the economic benefit. The third and final reason was the misconception that large holes were needed everywhere to deliver the desired production. Several factors have changed that will encourage the use of slim holes. The industry now favors any method of reducing the costs of producing oil and gas. In addition, the industry now understands that large holes are not always needed. Gas, in particular, can have high production rates in smaller holes. New materials now make it possible to manufacture improved bits and motors that drill for long periods at high rates. All that remains is to

Cost analysis of public health influenza vaccine clinics in Ontario.

Science.gov (United States)

Mercer, Nicola J

2009-01-01

Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

Inactivated poliovirus type 2 vaccine delivered to rat skin via high density microprojection array elicits potent neutralising antibody responses.

Science.gov (United States)

Muller, David A; Pearson, Frances E; Fernando, Germain J P; Agyei-Yeboah, Christiana; Owens, Nick S; Corrie, Simon R; Crichton, Michael L; Wei, Jonathan C J; Weldon, William C; Oberste, M Steven; Young, Paul R; Kendall, Mark A F

2016-02-25

Polio eradication is progressing rapidly, and the live attenuated Sabin strains in the oral poliovirus vaccine (OPV) are being removed sequentially, starting with type 2 in April 2016. For risk mitigation, countries are introducing inactivated poliovirus vaccine (IPV) into routine vaccination programs. After April 2016, monovalent type 2 OPV will be available for type 2 outbreak control. Because the current IPV is not suitable for house-to-house vaccination campaigns (the intramuscular injections require health professionals), we developed a high-density microprojection array, the Nanopatch, delivered monovalent type 2 IPV (IPV2) vaccine to the skin. To assess the immunogenicity of the Nanopatch, we performed a dose-matched study in rats, comparing the immunogenicity of IPV2 delivered by intramuscular injection or Nanopatch immunisation. A single dose of 0.2 D-antigen units of IPV2 elicited protective levels of poliovirus antibodies in 100% of animals. However, animals receiving IPV2 by IM required at least 3 immunisations to reach the same neutralising antibody titres. This level of dose reduction (1/40th of a full dose) is unprecedented for poliovirus vaccine delivery. The ease of administration coupled with the dose reduction observed in this study points to the Nanopatch as a potential tool for facilitating inexpensive IPV for mass vaccination campaigns.

Low cost photomultiplier high-voltage readout system

International Nuclear Information System (INIS)

Oxoby, G.J.; Kunz, P.F.

1976-10-01

The Large Aperture Solenoid Spectrometer (LASS) at Stanford Linear Accelerator Center (SLAC) requires monitoring over 300 voltages. This data is recorded on magnetic tapes along with the event data. It must also be displayed so that operators can easily monitor and adjust the voltages. A low-cost high-voltage readout system has been implemented to offer stand-alone digital readout capability as well as fast data transfer to a host computer. The system is flexible enough to permit use of a DVM or ADC and commercially available analogue multiplexers

A low-cost, high-resolution, video-rate imaging optical radar

Energy Technology Data Exchange (ETDEWEB)

Sackos, J.T.; Nellums, R.O.; Lebien, S.M.; Diegert, C.F. [Sandia National Labs., Albuquerque, NM (United States); Grantham, J.W.; Monson, T. [Air Force Research Lab., Eglin AFB, FL (United States)

1998-04-01

Sandia National Laboratories has developed a unique type of portable low-cost range imaging optical radar (laser radar or LADAR). This innovative sensor is comprised of an active floodlight scene illuminator and an image intensified CCD camera receiver. It is a solid-state device (no moving parts) that offers significant size, performance, reliability, and simplicity advantages over other types of 3-D imaging sensors. This unique flash LADAR is based on low cost, commercially available hardware, and is well suited for many government and commercial uses. This paper presents an update of Sandia`s development of the Scannerless Range Imager technology and applications, and discusses the progress that has been made in evolving the sensor into a compact, low, cost, high-resolution, video rate Laser Dynamic Range Imager.

Marine Hydrokinetic Turbine Power-Take-Off Design for Optimal Performance and Low Impact on Cost-of-Energy: Preprint

Energy Technology Data Exchange (ETDEWEB)

Beam, M.; Kline, B.; Elbing, B.; Straka, W.; Fontaine, A.; Lawson, M.; Li, Y.; Thresher, R.; Previsic, M.

2013-02-01

Marine hydrokinetic devices are becoming a popular method for generating marine renewable energy worldwide. These devices generate electricity by converting the kinetic energy of moving water, wave motion or currents, into electrical energy through the use of a power-take-off (PTO) system. Most PTO systems incorporate a mechanical or hydraulic drivetrain, power generator, and electric control/conditioning system to deliver the generated electric power to the grid at the required state. Like wind turbine applications, the PTO system must be designed for high reliability, good efficiency, and long service life with reasonable maintenance requirements, low cost, and an appropriate mechanical design for anticipated applied steady and unsteady loads. The ultimate goal of a PTO design is high efficiency and low maintenance and cost, with a low impact on the device cost-of-energy (CoE).

Marine Hydrokinetic Turbine Power-Take-Off Design for Optimal Performance and Low Impact on Cost-of-Energy: Preprint

Energy Technology Data Exchange (ETDEWEB)

Beam, M.; Kline, B.; Elbing, B.; Straka, W.; Fontaine, A.; Lawson, M.; Li, Y.; Thresher, R.; Previsic, M.

2012-04-01

Marine hydrokinetic devices are becoming a popular method for generating marine renewable energy worldwide. These devices generate electricity by converting the kinetic energy of moving water, wave motion or currents, into electrical energy through the use of a Power-Take-Off (PTO) system. Most PTO systems incorporate a mechanical or hydraulic drive train, power generator and electric control/conditioning system to deliver the generated electric power to the grid at the required state. Like wind turbine applications, the PTO system must be designed for high reliability, good efficiency, and long service life with reasonable maintenance requirements, low cost and an appropriate mechanical design for anticipated applied steady and unsteady loads. The ultimate goal of a PTO design is high efficiency, low maintenance and cost with a low impact on the device Cost-of-Energy (CoE).

An economic evaluation of highly purified HMG and recombinant FSH based on a large randomized trial.

Science.gov (United States)

Wechowski, Jaroslaw; Connolly, Mark; McEwan, Philip; Kennedy, Richard

2007-11-01

Public funding for IVF is increasingly being challenged by health authorities in an attempt to minimize health service costs. In light of treatment rationing, the need to consider costs in relation to outcomes is paramount. To assess the cost implications of gonadotrophin treatment options, an economic evaluation comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) has been conducted. The analysis is based on individual patient data from a large randomized controlled trial (n = 731) in a long agonist IVF protocol. The economic evaluation uses a discrete event simulation model to assess treatment costs in relation to live births for both treatments based on published UK costs. After one cycle the mean costs per IVF treatment for HP-HMG and rFSH were pound2396 (95% CI pound2383-2414) and pound2633 ( pound2615-2652), respectively. The average cost-saving of pound237 per IVF cycle using HP-HMG allows one additional cycle to be delivered for every 10 cycles. With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was pound8893 compared with pound11,741 for rFSH (P cost-saving potential of HP-HMG in IVF was still apparent after varying critical cost parameters in the probabilistic sensitivity analysis.

Command vector memory systems: high performance at low cost

OpenAIRE

Corbal San Adrián, Jesús; Espasa Sans, Roger; Valero Cortés, Mateo

1998-01-01

The focus of this paper is on designing both a low cost and high performance, high bandwidth vector memory system that takes advantage of modern commodity SDRAM memory chips. To successfully extract the full bandwidth from SDRAM parts, we propose a new memory system organization based on sending commands to the memory system as opposed to sending individual addresses. A command specifies, in a few bytes, a request for multiple independent memory words. A command is similar to a burst found in...

Increasing capacity to deliver diabetes self-management education

DEFF Research Database (Denmark)

Carey, M. E.; Mandalia, P. K.; Daly, H.

2014-01-01

Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 di...... educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.......Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2...... diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months...

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare.

Science.gov (United States)

Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent

2015-10-01

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.

High level waste transport and disposal cost calculations for the United Kingdom

International Nuclear Information System (INIS)

Nattress, P.C.; Ward, R.D.

1992-01-01

Commercial nuclear power has been generated in the United Kingdom since 1962, and throughout that time fuel has been reprocessed giving rise to high level waste. This has been managed by storing fission products and related wastes as highly active liquor, and more recently by a program of vitrification and storage of the glass blocks produced. Government policy is that vitrified high level waste should be stored for at least 50 years, which has the technical advantage of allowing the heat output rate of the waste to fall, making disposal easier and cheaper. Thus, there is no immediate requirement to develop a deep geological repository in the UK, but the nuclear companies do have a requirement to make financial provision out of current revenues for high level waste disposal at a future repository. In 1991 the interested organizations undertook a new calculation of costs for such provisions, which is described here. The preliminary work for the calculation included the assumption of host geology characteristics, a compatible repository concept including overpacking, and a range of possible nuclear programs. These have differing numbers of power plants, and differing mixes of high level waste from reprocessing and spent fuel for direct disposal. An algorithm was then developed so that the cost of high level waste disposal could be calculated for any required case within a stated envelope of parameters. An Example Case was then considered in detail leading to the conclusion that a repository to meet the needs of a constant UK nuclear economy up to the middle of the next century would have a cash cost of UK Pounds 1194M (US$2011M). By simple division the cost to a kWh of electricity is UK Pounds 0.00027 (0.45 US mil). (author)

The high intensity solar cell - Key to low cost photovoltaic power

Science.gov (United States)

Sater, B. L.; Goradia, C.

1975-01-01

This paper discusses the problems associated with conventional solar cells at high intensities and presents the design considerations and performance characteristics of the 'high intensity' (HI) solar cell which appears to eliminate the major problems. Test data obtained at greater than 250 AM1 suns gave a peak output power density of 2 W per sq cm at an efficiency exceeding 6% with an unoptimized cell operating at over 100 C. It appears that operation at 1000 AM1 suns at efficiencies greater than 10% is possible. At 1000 AM1 suns and 10% efficiency, the HI cell manufacturing cost is estimated to be $0.25/watt, with multi-megawatt annual production capability already existing within the industrial sector. A high intensity solar system was also analyzed to determine its cost effectiveness and to assess the benefits of further improving HI cell efficiency.

Product platform considerations on a project that develops sustainable low-cost housing for townships

DEFF Research Database (Denmark)

Wörösch, Michael; Bonev, Martin; Mortensen, Niels Henrik

Construction companies in Denmark are often working with profit margins as little as 1-3% in situations where they deliver high-end buildings to the local market. Even though customers are willing to pay a premium price for high quality, construction companies earn very little on their products...... their new owners the possibility to take a loan in their building which is expected to contribute to more businesses being started up and thereby strengthening the domestic economy. As a consequence of this, additional research is needed in how to further optimize the economy of sustainable low-cost housing...

Patents Associated with High-Cost Drugs in Australia

OpenAIRE

Christie, Andrew F.; Dent, Chris; McIntyre, Peter; Wilson, Lachlan; Studdert, David M.

2013-01-01

Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent...

High Performance, Low Cost Hydrogen Generation from Renewable Energy

Energy Technology Data Exchange (ETDEWEB)

Ayers, Katherine [Proton OnSite; Dalton, Luke [Proton OnSite; Roemer, Andy [Proton OnSite; Carter, Blake [Proton OnSite; Niedzwiecki, Mike [Proton OnSite; Manco, Judith [Proton OnSite; Anderson, Everett [Proton OnSite; Capuano, Chris [Proton OnSite; Wang, Chao-Yang [Penn State University; Zhao, Wei [Penn State University

2014-02-05

Renewable hydrogen from proton exchange membrane (PEM) electrolysis is gaining strong interest in Europe, especially in Germany where wind penetration is already at critical levels for grid stability. For this application as well as biogas conversion and vehicle fueling, megawatt (MW) scale electrolysis is required. Proton has established a technology roadmap to achieve the necessary cost reductions and manufacturing scale up to maintain U.S. competitiveness in these markets. This project represents a highly successful example of the potential for cost reduction in PEM electrolysis, and provides the initial stack design and manufacturing development for Proton’s MW scale product launch. The majority of the program focused on the bipolar assembly, from electrochemical modeling to subscale stack development through prototyping and manufacturing qualification for a large active area cell platform. Feasibility for an advanced membrane electrode assembly (MEA) with 50% reduction in catalyst loading was also demonstrated. Based on the progress in this program and other parallel efforts, H2A analysis shows the status of PEM electrolysis technology dropping below $3.50/kg production costs, exceeding the 2015 target.

A cost of sexual attractiveness to high-fitness females.

Directory of Open Access Journals (Sweden)

Tristan A F Long

2009-12-01

Full Text Available Adaptive mate choice by females is an important component of sexual selection in many species. The evolutionary consequences of male mate preferences, however, have received relatively little study, especially in the context of sexual conflict, where males often harm their mates. Here, we describe a new and counterintuitive cost of sexual selection in species with both male mate preference and sexual conflict via antagonistic male persistence: male mate choice for high-fecundity females leads to a diminished rate of adaptive evolution by reducing the advantage to females of expressing beneficial genetic variation. We then use a Drosophila melanogaster model system to experimentally test the key prediction of this theoretical cost: that antagonistic male persistence is directed toward, and harms, intrinsically higher-fitness females more than it does intrinsically lower-fitness females. This asymmetry in male persistence causes the tails of the population's fitness distribution to regress towards the mean, thereby reducing the efficacy of natural selection. We conclude that adaptive male mate choice can lead to an important, yet unappreciated, cost of sex and sexual selection.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1966-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1965-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

Materials Delivered by Member States

International Nuclear Information System (INIS)

1968-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

Science.gov (United States)

Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

2018-01-01

To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

Network governance and capacity of local governments to deliver LED in Uganda

Directory of Open Access Journals (Sweden)

Rose B Namara

2016-02-01

Full Text Available This paper discusses network governance and its contribution to the capacity of local governments (LGs to deliver local economic development (LED in Uganda. Although a formal LED policy was only established in Uganda in February 2014, there have been LED-inspired practices in the past decade. Various scholars and practitioners have observed that the autonomy and capacity of LGs to deliver LED is limited, but have been hopeful that new governance strategies like network governance would increase the capacities of LGs. However, neither network governance arrangements among LGs, nor their potential to improve governance capacity, have been documented. In a case study of Kyenjojo District, this paper finds that existing network governance arrangements have been fundamental in improving financial autonomy at this LG, delivering some income to invest in LED activities, although no evidence was found of reduced transaction costs in transforming local economies. The study further reveals that network governance arrangements have not led to the development of specialised skills in regulation or law enforcement, and capacity gaps are evident amongst staff and members in understanding the private sector and how it works. On a positive note, there is clear evidence of attempts by the LG to be innovative. Based on these findings, this study recommends that LGs need to consider a multi-pronged or multi-network governance approach to LED, which in turn will require a refocusing of governance mechanisms to become more dynamic and responsive, and offer incentives to the various actors in the development sector.

Updating the Economic Impacts of the High/Scope Perry Preschool Program

Science.gov (United States)

Nores, Milagros; Belfield, Clive R.; Barnett, W. Steven; Schweinhart, Lawrence

2005-01-01

This article derives an updated cost-benefit ratio for the High/Scope Perry Preschool Program, an intensive preschool intervention delivered during the 1960s to at-risk children in Ypsilanti, Michigan. Because children were randomly assigned to the program or a control group, differences in outcomes are probably attributable to program status.…

The 5x1 DAFNE study protocol: a cluster randomised trial comparing a standard 5 day DAFNE course delivered over 1 week against DAFNE training delivered over 1 day a week for 5 consecutive weeks

Directory of Open Access Journals (Sweden)

Elliott Jackie

2012-11-01

Full Text Available Abstract Background Structured education programmes are now established as an essential component to assist effective self-management of diabetes. In the case of Type 1 diabetes, the Dose Adjustment For Normal Eating (DAFNE programme improves both glycaemic control and quality of life. Traditionally delivered over five consecutive days, this format has been cited as a barrier to participation by some patients, such as those who work full-time. Some centres in the UK have organised structured education programmes to be delivered one day a week over several consecutive weeks. This type of format may add benefit by allowing more time in which to practice skills between sessions, but may suffer as a result of weaker peer support being generated compared to that formed over five consecutive days. Methods/design We aim to compare DAFNE delivered over five consecutive days (1 week course with DAFNE delivered one day a week over five weeks (5 week course in a randomised controlled trial. A total of 213 patients were randomised to attend either a 1 week or a 5 week course delivered in seven participating centres. Study outcomes (measured at baseline, 6 and 12 months post-course include HbA1c, weight, self-reported rates of severe hypoglycaemia, psychosocial measures of quality of life, and cost-effectiveness. Generalisability was optimised by recruiting patients from DAFNE waiting lists at each centre, and by mailing eligible patients from hospital clinic lists. The inclusion and exclusion criteria were identical to those used to recruit to a standard DAFNE course (e.g., HbA1c Discussion This trial has been designed to test the hypothesis that the benefits of delivering a structured education programme over 5 weeks are comparable to those observed after a 1 week course. The results of the trial and the qualitative sub-study will both inform the design and delivery of future DAFNE courses, and the development of structured education programmes in other

Are PES connection costs too high?

International Nuclear Information System (INIS)

Scott, N.

1998-01-01

Windfarm developers often have good reason to question the costs they are quoted by their local distribution company for connection to the system, and these costs can now be challenged under the 'Competition in Connection' initiative. Econnect Ltd specialise in electrical connections for renewable generation throughout the UK and Europe, and have worked on many projects where alternative connections have been designed at more competitive prices. This paper provides some examples which illustrate the importance of acquiring a thorough understanding of all power system issues and PES concerns if the most cost-effective connection is to be realised. (Author)

Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

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Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

From volume to value? Can a value-based approach help deliver the ambitious aims of the NHS cardiovascular disease outcomes strategy?

Science.gov (United States)

Dunbar-Rees, Rupert; Panch, Trishan; Dancy, Mark

2014-06-01

The last year has seen the publication of two papers which will radically shape the future organisation of healthcare in general, and cardiovascular disease in particular: Cardiovascular Outcomes Strategy (Department of Health) and The Strategy That Will Fix Healthcare (Harvard Business Review). Both publications set out a health delivery mechanism based around improvement of outcomes for groups of patients with similar needs. Instead of organising care around disease categories, it is proposed that the cardiovascular diseases are treated as a single family of diseases. We are reaching the limits of what an activity-based system organised around existing provider structures can sustainably deliver. Unless we find delivery systems which reduce costs while at the same time improving outcomes that are meaningful to patients, then we will be faced with a future of healthcare rationing. The increasing burden of chronic disease and ongoing quality concerns in delivery systems has created a 'burning platform', which must be addressed if we are to maintain a system which offers high-quality care free at the point of delivery. This paper explores what an outcomes and value-based system could look like when applied to cardiovascular disease. It explores what it means for providers and patients if we start to think about outcomes by patients with similar needs, rather than by intervention, or by clinical specialty. As a specific example, the paper explores the features of an Integrated Circulation Service, what the challenges and implications might be, and whether there is any evidence that this would deliver improved outcomes, at a lower cost to the system.

High temperature metallic recuperator

Science.gov (United States)

Ward, M. E.; Solmon, N. G.; Smeltzer, C. E.

1981-06-01

An industrial 4.5 MM Btu/hr axial counterflow recuperator, fabricated to deliver 1600 F combustion air, was designed to handle rapid cyclic loading, a long life, acceptable costs, and a low maintenance requirement. A cost benefit anlysis of a high temperature waste heat recovery system utilizing the recurperator and components capable of 1600 F combustion air preheat shows that this system would have a payback period of less than two years. Fifteen companies and industrial associations were interviewed and expressed great interest in recuperation in large energy consuming industries. Determination of long term environmental effects on candidate recuperator tubing alloys was completed. Alloys found to be acceptable in the 2200 F flue gas environment of a steel billet reheat furnace, were identified.

Text and Mobile Media Smoking Cessation Service for Young Adults in South Texas: Operation and Cost-Effectiveness Estimation.

Science.gov (United States)

Ramirez, Amelie G; Chalela, Patricia; Akopian, David; Munoz, Edgar; Gallion, Kipling J; Despres, Cliff; Morales, Jafet; Escobar, Rodrigo; McAlister, Alfred L

2017-07-01

To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.

The cost of long-term follow-up of high-risk infants for research studies.

Science.gov (United States)

Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

2015-10-01

Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Utility-adjusted analysis of the cost of palliative radiotherapy for bone metastases

International Nuclear Information System (INIS)

Barton, M.B.; Jacob, S.A.

2003-01-01

Palliative radiotherapy is effective in the treatment of bone metastases but is under-utilized, possibly because it is perceived to be expensive. We performed a cost-utility analysis of palliative radiotherapy for bone metastases, evaluating both the actual cost of radiotherapy as well as its impact on quality of life by adjusting for the variation in response to treatment. Hospital records between July 1991 and July 1996 were reviewed to ascertain the number of patients treated with palliative radiotherapy for bone metastases, the average number of fields of radiation delivered to each patient and the average duration of survival. Partial and complete response rates to palliative radiotherapy were obtained from a review of all published randomized controlled trials of radiation treatment of bone metastases. Utility values were assigned to the response rates, and an overall adjusted response rate to radiotherapy was derived. The cost of delivering a field of radiation was calculated. The total cost was divided by the total number of response months to give a utility-adjusted cost per month of palliative radiotherapy. The utility-adjusted cost per month of palliative radiotherapy of bone metastases was found to be AUS$ 100 per month or AUS$ 1200 per utility-adjusted life-year. This study demonstrates that, contrary to popular perception, palliative radiotherapy is a cost-effective treatment modality for bone metastases. Copyright (2003) Blackwell Science Pty Ltd

Delivering the right dose

International Nuclear Information System (INIS)

Shaw, A

2004-01-01

For treatment with high intensity focused ultrasound (HIFU), delivering the correct amount of energy to the patient is critical. This paper describes a novel design of sensor based on the pyroelectric principle for monitoring the output power from HIFU transducers of the type used for tissue ablation. The sensor is intended to be minimally perturbing to the ultrasound field, so that it can remain in the ultrasound field throughout treatment and provide a constant monitor of ultrasound power. The main advantages of the technique are: power can be measured or monitored without dismantling the HIFU system, thus reducing equipment downtime; power can be measured immediately before or during every patient treatment, thus ensuring accurate dosimetry; power can be measured at the output levels used for treatment (whereas a radiation force balance may be damaged by overheating); the method uses components which are robust and simple to use compared to radiation force balances or hydrophone scanning systems

Enriched-uranium feed costs for the High-Temperature Gas-Cooled reactor: trends and comparison with other reactor concepts

International Nuclear Information System (INIS)

Thomas, W.E.

1976-04-01

This report discusses each of the components that affect the unit cost for enriched uranium; that is, ore costs, U 3 O 8 to UF 6 conversion cost, costs for enriching services, and changes in transaction tails assay. Historical trends and announced changes are included. Unit costs for highly enriched uranium (93.15 percent 235 U) and for low-enrichment uranium (3.0, 3.2, and 3.5 percent 235 U) are displayed as a function of changes in the above components and compared. It is demonstrated that the trends in these cost components will probably result in significantly less cost increase for highly enriched uranium than for low-enrichment uranium--hence favoring the High-Temperature Gas-Cooled Reactor

On Cost Estimate for Decommissioning of one Isotope Central

International Nuclear Information System (INIS)

Marek Vasko et al

2010-08-01

The main scope of this study has been to calculate the future cost for decommission and dismantling the Isotope central at the Studsvik site using the OMEGA CODE. Detailed empirical information is used in the study for 'bench-marking' purposes, in such cases when there is a need to supplement and correct field data from the industry. In the present study, data has been retrieved and organized such that the estimated costs for decommissioning of the Isotope Central become transparent and reliable. This approach gives a preliminary qualitative indication about the accuracy of the cost estimate delivered by the industry

On Cost Estimate for Decommissioning of one Isotope Central

Energy Technology Data Exchange (ETDEWEB)

Marek Vasko et al

2010-08-15

The main scope of this study has been to calculate the future cost for decommission and dismantling the Isotope central at the Studsvik site using the OMEGA CODE. Detailed empirical information is used in the study for 'bench-marking' purposes, in such cases when there is a need to supplement and correct field data from the industry. In the present study, data has been retrieved and organized such that the estimated costs for decommissioning of the Isotope Central become transparent and reliable. This approach gives a preliminary qualitative indication about the accuracy of the cost estimate delivered by the industry

Cost optimization of the dimensions of the antennas of a solar power satellite system

Energy Technology Data Exchange (ETDEWEB)

Vasilev, A.V.; Klassen, V.I.; Laskin, N.N.; Tobolev, A.K.

1983-05-01

The problem of the cost optimization of the dimensions of the antennas of a solar power satellite system is formulated. The optimization problem is twofold: (1) for a given power delivered to the microwave transmitting antenna (TA), to determine the dimensions Lt (the characteristic dimension of the TA) and Lr (the characteristic dimension of the rectenna) which minimize the unit-power cost function for a given amplitude-phase distribution in the aperture of the TA, and (2) for a power delivered to the TA which is proportional to the aperture area, to determine the dimensions Lt and Lr which minimize the unit-power cost function for a given amplitude-phase distribution in the aperture of the TA. Two possible variants of the solution of this problem are considered: (1) the case of a linear antenna (the two-dimensional problem), and (2) the case of square apertures (the three-dimensional problem). A specific example of optimization is considered, where the cost of the TA is $1000/sq m and the cost of the rectenna is $12/sq m. 11 references.

Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms: randomized controlled noninferiority trial.

Science.gov (United States)

Donker, Tara; Bennett, Kylie; Bennett, Anthony; Mackinnon, Andrew; van Straten, Annemieke; Cuijpers, Pim; Christensen, Helen; Griffiths, Kathleen M

2013-05-13

Face-to-face cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are both effective treatments for depressive disorders, but access is limited. Online CBT interventions have demonstrated efficacy in decreasing depressive symptoms and can facilitate the dissemination of therapies among the public. However, the efficacy of Internet-delivered IPT is as yet unknown. This study examines whether IPT is effective, noninferior to, and as feasible as CBT when delivered online to spontaneous visitors of an online therapy website. An automated, 3-arm, fully self-guided, online noninferiority trial compared 2 new treatments (IPT: n=620; CBT: n=610) to an active control treatment (MoodGYM: n=613) over a 4-week period in the general population. Outcomes were assessed using online self-report questionnaires, the Center for Epidemiological Studies Depression scale (CES-D) and the Client Satisfaction Questionnaire (CSQ-8) completed immediately following treatment (posttest) and at 6-month follow-up. Completers analyses showed a significant reduction in depressive symptoms at posttest and follow-up for both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium to large for all groups. There were no differences in clinical significant change between the programs. Reliable change was shown at posttest and follow-up for all programs, with consistently higher rates for CBT. Participants allocated to IPT showed significantly lower treatment satisfaction compared to CBT and MoodGYM. There was a dropout rate of 1294/1843 (70%) at posttest, highest for MoodGYM. Intention-to-treat analyses confirmed these findings. Despite a high dropout rate and lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective in reducing depressive symptoms, and may be noninferior to MoodGYM. The completion rates of IPT and CBT were higher than MoodGYM, indicating some progress in refining Internet-based self

Cost reduction for large turbine generator Pedestal in high seismic zone

International Nuclear Information System (INIS)

Sawhney, P.S.; Irani, P.; Pusheck, B.N.

1985-01-01

Turbine Generator Pedestals have generally been designed using reinforced concrete. For present day large turbine generators (1100 MWe class and above) with tall (about 80 feet) pedestals, the amount of reinforcing steel becomes quite large, especially for plants in high seismic zones. With the prime objective of cost reduction, an approach using steel/concrete composite design has been studied for a large BWR Turbine Generator pedestal with 0.3g peak ground acceleration. Large prefabricated steel modules were adopted for composite design and simplified construction. Design was based on the ACI and AISC codes. Costs and schedules were developed and compared with those for a conventionally designed reinforced concrete pedestal. Composite design was found to give considerable cost and schedule advantage over the conventional reinforced concrete design

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

Science.gov (United States)

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

2018-01-01

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

BoHV-4-based vector delivering Ebola virus surface glycoprotein

Directory of Open Access Journals (Sweden)

Alfonso Rosamilia

2016-11-01

Full Text Available Abstract Background Ebola virus (EBOV is a Category A pathogen that is a member of Filoviridae family that causes hemorrhagic fever in humans and non-human primates. Unpredictable and devastating outbreaks of disease have recently occurred in Africa and current immunoprophylaxis and therapies are limited. The main limitation of working with pathogens like EBOV is the need for costly containment. To potentiate further and wider opportunity for EBOV prophylactics and therapies development, innovative approaches are necessary. Methods In the present study, an antigen delivery platform based on a recombinant bovine herpesvirus 4 (BoHV-4, delivering a synthetic EBOV glycoprotein (GP gene sequence, BoHV-4-syEBOVgD106ΔTK, was generated. Results EBOV GP was abundantly expressed by BoHV-4-syEBOVgD106ΔTK transduced cells without decreasing viral replication. BoHV-4-syEBOVgD106ΔTK immunized goats produced high titers of anti-EBOV GP antibodies and conferred a long lasting (up to 6 months, detectable antibody response. Furthermore, no evidence of BoHV-4-syEBOVgD106ΔTK viremia and secondary localization was detected in any of the immunized animals. Conclusions The BoHV-4-based vector approach described here, represents: an alternative antigen delivery system for vaccination and a proof of principle study for anti-EBOV antibodies generation in goats for potential immunotherapy applications.

A scalable-low cost architecture for high gain beamforming antennas

KAUST Repository

Bakr, Omar; Johnson, Mark; Jungdong Park,; Adabi, Ehsan; Jones, Kevin; Niknejad, Ali

2010-01-01

Many state-of-the-art wireless systems, such as long distance mesh networks and high bandwidth networks using mm-wave frequencies, require high gain antennas to overcome adverse channel conditions. These networks could be greatly aided by adaptive beamforming antenna arrays, which can significantly simplify the installation and maintenance costs (e.g., by enabling automatic beam alignment). However, building large, low cost beamforming arrays is very complicated. In this paper, we examine the main challenges presented by large arrays, starting from electromagnetic and antenna design and proceeding to the signal processing and algorithms domain. We propose 3-dimensional antenna structures and hybrid RF/digital radio architectures that can significantly reduce the complexity and improve the power efficiency of adaptive array systems. We also present signal processing techniques based on adaptive filtering methods that enhance the robustness of these architectures. Finally, we present computationally efficient vector quantization techniques that significantly improve the interference cancellation capabilities of analog beamforming architectures. © 2010 IEEE.

A scalable-low cost architecture for high gain beamforming antennas

KAUST Repository

Bakr, Omar

2010-10-01

Many state-of-the-art wireless systems, such as long distance mesh networks and high bandwidth networks using mm-wave frequencies, require high gain antennas to overcome adverse channel conditions. These networks could be greatly aided by adaptive beamforming antenna arrays, which can significantly simplify the installation and maintenance costs (e.g., by enabling automatic beam alignment). However, building large, low cost beamforming arrays is very complicated. In this paper, we examine the main challenges presented by large arrays, starting from electromagnetic and antenna design and proceeding to the signal processing and algorithms domain. We propose 3-dimensional antenna structures and hybrid RF/digital radio architectures that can significantly reduce the complexity and improve the power efficiency of adaptive array systems. We also present signal processing techniques based on adaptive filtering methods that enhance the robustness of these architectures. Finally, we present computationally efficient vector quantization techniques that significantly improve the interference cancellation capabilities of analog beamforming architectures. © 2010 IEEE.

A methodology for financial evaluation of biogas technology in India using cost functions

International Nuclear Information System (INIS)

Rubab, S.; Kandpal, T.C.

1996-01-01

A methodology for financial evaluation of biogas technology for domestic use in India using recently developed cost functions is reported. Analytical expressions for the unit cost of biogas and cost per unit of useful energy delivered by a biogas plant in combination with other suitable technologies have been developed. Net present value and discounted pay-back period have been calculated. The sensitivity of the unit cost of biogas, the cost per unit of useful energy, and the net present value with respect to a number of variables is also reported. (author)

Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation.

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Treacy, Daniel; Howard, Kirsten; Hayes, Alison; Hassett, Leanne; Schurr, Karl; Sherrington, Catherine

2018-01-01

Among people admitted for inpatient rehabilitation, is usual care plus standing balance circuit classes more cost-effective than usual care alone? Cost-effectiveness study embedded within a randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. 162 rehabilitation inpatients from a metropolitan hospital in Sydney, Australia. The experimental group received a 1-hour standing balance circuit class, delivered three times a week for 2 weeks, in addition to usual therapy. The circuit classes were supervised by one physiotherapist and one physiotherapy assistant for up to eight patients. The control group received usual therapy alone. Costs were estimated from routinely collected hospital use data in the 3 months after randomisation. The functional outcome measure was mobility measured at 3 months using the Short Physical Performance Battery administered by a blinded assessor. An incremental analysis was conducted and the joint probability distribution of costs and outcomes was examined using bootstrapping. The median cost savings for the intervention group was AUD4,741 (95% CI 137 to 9,372) per participant; 94% of bootstraps showed that the intervention was both effective and cost saving. Two weeks of additional standing balance circuit classes delivered in addition to usual therapy resulted in decreased healthcare costs at 3 months in hospital inpatients admitted for rehabilitation. There is a high probability that this intervention is both cost saving and effective. ACTRN12611000412932. [Treacy D, Howard K, Hayes A, Hassett L, Schurr K, Sherrington C (2018) Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation. Journal of Physiotherapy 64: 41-47]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

Directory of Open Access Journals (Sweden)

CARDOS Ildiko Reka

2010-07-01

Full Text Available In the last years many organizations realized that market orientation is essential to their success. Satisfying the needs of customers, offering them products and services which meet their desires and demands, customer loyalty can increase profitability for long term. After analyzing the existing journal literature in this field we would like to emphasize that managerial accounting, cost calculation methods and techniques, the analysis of costs provides relevant information when analyzing the customer’s profitability. We pay special attention on cost systems. An activity based costing approach takes customer profitability to new levels of accuracy and usefulness, provides the basis for creating, communicating and delivering value to the customers.

A better way to deliver bad news.

Science.gov (United States)

Manzoni, Jean-François

2002-09-01

In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundamental attribution error and the false consensus effect--and uses real-world examples to demonstrate how bosses' critiques can go astray. Managers tend to frame difficult situations and decisions in a way that is narrow (alternatives aren't considered) and binary (there are only two possible outcomes--win or lose). And during the feedback discussion, managers' framing of the issues often remains frozen, regardless of the direction the conversation takes. Manzoni advises managers not to just settle on the first acceptable explanation for a behavior or situation they've witnessed. Bosses also need to consider an employee's circumstances rather than just attributing weak performance to a person's disposition. In short, delivering more effective feedback requires an open-minded approach, one that will convince employees that the process is fair and that the boss is ready for an honest conversation.

A Low-Cost Neutral Zinc-Iron Flow Battery with High Energy Density for Stationary Energy Storage.

Science.gov (United States)

Xie, Congxin; Duan, Yinqi; Xu, Wenbin; Zhang, Huamin; Li, Xianfeng

2017-11-20

Flow batteries (FBs) are one of the most promising stationary energy-storage devices for storing renewable energy. However, commercial progress of FBs is limited by their high cost and low energy density. A neutral zinc-iron FB with very low cost and high energy density is presented. By using highly soluble FeCl 2 /ZnBr 2 species, a charge energy density of 56.30 Wh L -1 can be achieved. DFT calculations demonstrated that glycine can combine with iron to suppress hydrolysis and crossover of Fe 3+ /Fe 2+ . The results indicated that an energy efficiency of 86.66 % can be obtained at 40 mA cm -2 and the battery can run stably for more than 100 cycles. Furthermore, a low-cost porous membrane was employed to lower the capital cost to less than $ 50 per kWh, which was the lowest value that has ever been reported. Combining the features of low cost, high energy density and high energy efficiency, the neutral zinc-iron FB is a promising candidate for stationary energy-storage applications. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

Energy Technology Data Exchange (ETDEWEB)

Schoenbauer, Ben [NorthernSTAR, St. Paul, MN (United States)

2017-03-01

High-performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiency water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

Energy Technology Data Exchange (ETDEWEB)

Schoenbauer, Ben [NorthernSTAR, St. Paul, MN (United States)

2017-03-28

High performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiency water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.

Delivering a MOOC for literature searching in health libraries: evaluation of a pilot project.

Science.gov (United States)

Young, Gil; McLaren, Lisa; Maden, Michelle

2017-12-01

In an era when library budgets are being reduced, Massive Online Open Courses (MOOC's) can offer practical and viable alternatives to the delivery of costly face-to-face training courses. In this study, guest writers Gil Young from Health Care Libraries Unit - North, Lisa McLaren from Brighton and Sussex Medical School and Liverpool University PhD student Michelle Maden describe the outcomes of a funded project they led to develop a MOOC to deliver literature search training for health librarians. Funded by Health Education England, the MOOC was developed by the Library and Information Health Network North West as a pilot project that ran for six weeks. In particular, the MOOC target audience is discussed, how content was developed for the MOOC, promotion and participation, cost-effectiveness, evaluation, the impact of the MOOC and recommendations for future development. H. S. © 2017 Health Libraries Group.

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation.

Science.gov (United States)

Rajaraman, Divya; Travasso, Sandra; Chatterjee, Achira; Bhat, Bhargav; Andrew, Gracy; Parab, Suraj; Patel, Vikram

2012-05-25

Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. The intervention was based on the WHO's Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students' anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

Directory of Open Access Journals (Sweden)

Rajaraman Divya

2012-05-01

Full Text Available Abstract Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility, the uptake of services (acceptability, and the number of students who received corrective health treatment (evidence of impact. Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility, evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the

Retinopathy of prematurity: the high cost of screening regional and remote infants.

Science.gov (United States)

Yu, Tzu-Ying; Donovan, Tim; Armfield, Nigel; Gole, Glen A

2018-01-25

Demand for retinopathy of prematurity (ROP) screening is increasing for infants born at rural and regional hospitals where the service is not generally available. The health system cost for screening regional/remote infants has not been reported. The objective of this study is to evaluate the cost of ROP screening at a large centralized tertiary neonatal service for infants from regional/rural hospitals. This is a retrospective study to establish the cost of transferring regional/rural infants to the Royal Brisbane and Women's Hospital for ROP screening over a 28-month period. A total of 131 infants were included in this study. Individual infant costs were calculated from analysis of clinical and administrative records. Economic cost of ROP screening for all transfers from regional/rural hospitals to Royal Brisbane and Women's Hospital. The average economic cost of ROP screening for this cohort was AUD$5110 per infant screened and the total cost was AUD$669 413. The average cost per infant screened was highest for infants from a regional centre with a population of 75 000 (AUD$14 856 per child), which was also geographically furthest from Brisbane. No infant in this cohort transferred from a regional nursery reached criteria for intervention for ROP by standard guidelines. Health system costs for ROP screening of remote infants at a centralized hospital are high. Alternative strategies using telemedicine can now be compared with centralized screening. © 2018 Royal Australian and New Zealand College of Ophthalmologists.

The hidden costs of installing xpert machines in a tuberculosis high ...

African Journals Online (AJOL)

The hidden costs of installing xpert machines in a tuberculosis high-burden country: experiences from Nigeria. Saddiq Tsimiri Abdurrahman, Nnamdi Emenyonu, Olusegun Joshua Obasanya, Lovett Lawson, Russell Dacombe, Muhammad Muhammad, Olanrewaju Oladimeji, Luis Eduardo Cuevas ...

High-efficiency and low-cost permanent magnet guideway consideration for high-Tc superconducting Maglev vehicle practical application

International Nuclear Information System (INIS)

Deng, Z; Wang, J; Zheng, J; Jing, H; Lu, Y; Ma, G; Liu, L; Liu, W; Zhang, Y; Wang, S

2008-01-01

In order to improve the cost performance of the present high-T c superconducting (HTS) Maglev vehicle system for practical application, the multi-pole permanent magnet guideway (PMG) concept was introduced. A well-known double-pole Halbach PMG was chosen as a representative of multi-pole PMGs to compare with traditional monopole PMGs from the point of view of levitation efficiency and cost. Experimental results show that YBCO bulks above the double-pole Halbach PMG can exhibit better load capability and guidance performance as well as dynamics stability at the applied working height between the bulk HTSC and the PMG due to a more reasonable magnetic field distribution at the working range of bulk HTSC. Furthermore, the double-pole PMG configuration can play a more important role in improving guidance performance due to the potential-well field configuration. By comparing with former 'century' PMGs, the double-pole Halbach PMG shows another remarkable advantage in reducing the cost of levitation. As another necessary issue, magnetic field homogeneity and the corresponding magnetic drag force of a double-pole Halbach PMG has been considered by experiment in spite of the above highlights. Synthetically, the multi-pole Halbach PMG design is concluded to be one important choice for future HTS Maglev vehicle applications because of its high efficiency and low cost.

A high volume cost efficient production macrostructuring process. [for silicon solar cell surface treatment

Science.gov (United States)

Chitre, S. R.

1978-01-01

The paper presents an experimentally developed surface macro-structuring process suitable for high volume production of silicon solar cells. The process lends itself easily to automation for high throughput to meet low-cost solar array goals. The tetrahedron structure observed is 0.5 - 12 micron high. The surface has minimal pitting with virtually no or very few undeveloped areas across the surface. This process has been developed for (100) oriented as cut silicon. Chemi-etched, hydrophobic and lapped surfaces were successfully texturized. A cost analysis as per Samics is presented.

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

Science.gov (United States)

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

2018-03-01

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

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

Science.gov (United States)

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

2015-08-29

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

The potential of the Code for Sustainable Homes to deliver genuine 'sustainable energy' in the UK social housing sector

International Nuclear Information System (INIS)

McManus, A.; Gaterell, M.R.; Coates, L.E.

2010-01-01

Environmental concern in light of anthropogenic climate change will impact the housing sector as one of the major energy-consuming and carbon dioxide producing sectors. For new housing, currently the most important policy to combat this issue is the Code for Sustainable Homes. The social housing sector is under obligation to comply with these standards, which entails a significant increase in the cost of housing delivery. The sector is also under pressure to increase much-needed housebuilding, without increased funding being available. The quandary facing the sector is how to achieve both aims. Therefore any policy, such as the Code, which impacts on the ability of the sector to deliver unit numbers must be truly effective at delivering its own main aim. This paper explores the current situation, with a preliminary analysis of how the Code may not be able to deliver its 'sustainable energy' goals due to the ways in which 'low and zero carbon technologies' are assessed and how they behave in real world situations. It demonstrates that further research and policy changes are needed to deliver sustainable energy for this sector and ensure the delivery of crucial new housing is not hampered whilst also failing to meet energy goals.

Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

Science.gov (United States)

Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

2017-03-01

Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

Towards the next generation 23% efficient n-type cells with low cost manufacturing

Energy Technology Data Exchange (ETDEWEB)

Yelundur, Vijay [Suniva Inc., Norcross, GA (United States)

2017-04-19

Suniva, Inc., in collaboration with the University Center for Excellence in Photovoltaics (UCEP) at the Georgia Institute of Technology (GIT) proposed this comprehensive three year program to enable the development of an advanced high performance product that will help the US regain its competitive edge in PV. This project was designed to overcome cost and efficiency barriers through advances in PV science, technology innovation, low-cost manufacturing and full production of ~22.5% efficient n-type Si cells in Norcross, GA. At the heart of the project is the desire to complement the technology being developed concurrently under the Solarmat and ARPAe initiatives to develop a differentiated product superior in both performance and cost effectiveness to the competing alternatives available on the market, and push towards achieving SunShot objectives while ensuring a sustainable business model based on US manufacturing. A significant reduction of the costs in modules produced today will need to combine reductions in wafer costs, cell processing costs as well as module fabrication costs while delivering a product that is not only more efficient under test conditions but also increases the energy yield in outdoor operations. This project will result in a differentiated high performance product and technology that is consistent with sustaining PV manufacturing in the US for a longer term and further highlights the need for continued support for developing the next generation concepts that can keep US manufacturing thriving to support the growing demand for PV in the US and consistent with the US government’s mandates for energy independence.

Analysis for the high-level waste disposal cost object

International Nuclear Information System (INIS)

Kim, S. K.; Lee, J. R.; Choi, J. W.; Han, P. S.

2003-01-01

The purpose of this study is to analyse the ratio of cost object in terms of the disposal cost estimation. According to the result, the ratio of operating cost is the most significant object in total cost. There are a lot of differences between the disposal costs and product costs in view of their constituents. While the product costs may be classified by the direct materials cost, direct manufacturing labor cost, and factory overhead the disposal cost factors should be constituted by the technical factors and the non-technical factors

Delivering Microwave Spectroscopy to the Masses: a Design of a Low-Cost Microwave Spectrometer Operating in the 18-26 GHZ Frequency Range

Science.gov (United States)

Steber, Amanda; Pate, Brooks

2014-06-01

Advances in chip-level microwave technology in the communications field have led to the possibilities of low cost alternatives for current Fourier transform microwave (FTMW) spectrometers. Many of the large, expensive microwave components in a traditional design can now be replaced by robust, mass market monolithic microwave integrated circuits (MMICs). "Spectrometer on a board" designs are now feasible that offer dramatic cost reduction for microwave spectroscopy. These chip-level components can be paired with miniature computers to produce compact instruments that are operable through USB. A FTMW spectrometer design using the key MMIC components that drive cost reduction will be presented. Two dual channel synthesizers (Valon Technology Model 5008), a digital pattern generator (Byte Paradigm Wav Gen Xpress), and a high-speed digitizer/arbitrary waveform generator combination unit (Tie Pie HS-5 530 XM) form the key components of the spectrometer for operation in the 18-26.5 GHz range. The design performance is illustrated using a spectrometer that is being incorporated into a museum display for astrochemistry. For this instrument a user interface, developed in Python, has been developed and will be shown.

Case mix-adjusted cost of colectomy at low-, middle-, and high-volume academic centers.

Science.gov (United States)

Chang, Alex L; Kim, Young; Ertel, Audrey E; Hoehn, Richard S; Wima, Koffi; Abbott, Daniel E; Shah, Shimul A

2017-05-01

Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied. Patient and procedure details were used to generate a case mix-adjusted predictive model of total direct costs. Observed to expected costs for each center were evaluated between centers based on overall procedure volume. Patient and procedure characteristics were significantly different between volume tertiles. Observed costs at high-volume centers were less than at middle- and low-volume centers. According to our predictive model, high-volume centers cared for a less expensive case mix than middle- and low-volume centers ($12,786 vs $13,236 and $14,497, P case mix at low-volume centers, which may lead to perceived poor performance at these centers. Copyright © 2016 Elsevier Inc. All rights reserved.

Planar junctionless phototransistor: A potential high-performance and low-cost device for optical-communications

Science.gov (United States)

Ferhati, H.; Djeffal, F.

2017-12-01

In this paper, a new junctionless optical controlled field effect transistor (JL-OCFET) and its comprehensive theoretical model is proposed to achieve high optical performance and low cost fabrication process. Exhaustive study of the device characteristics and comparison between the proposed junctionless design and the conventional inversion mode structure (IM-OCFET) for similar dimensions are performed. Our investigation reveals that the proposed design exhibits an outstanding capability to be an alternative to the IM-OCFET due to the high performance and the weak signal detection benefit offered by this design. Moreover, the developed analytical expressions are exploited to formulate the objective functions to optimize the device performance using Genetic Algorithms (GAs) approach. The optimized JL-OCFET not only demonstrates good performance in terms of derived drain current and responsivity, but also exhibits superior signal to noise ratio, low power consumption, high-sensitivity, high ION/IOFF ratio and high-detectivity as compared to the conventional IM-OCFET counterpart. These characteristics make the optimized JL-OCFET potentially suitable for developing low cost and ultrasensitive photodetectors for high-performance and low cost inter-chips data communication applications.

Nominal effective radiation doses delivered during clinical trials of boron neutron capture therapy

International Nuclear Information System (INIS)

Capala, J.; Diaz, A.Z.; Chanana, A.D.

1997-01-01

Boron neutron capture therapy (BNCT) is a binary system that, in theory, should selectively deliver lethal, high linear energy transfer (LET) radiation to tumor cells dispersed within normal tissues. It is based on the nuclear reaction 10-B(n, α)7-Li, which occurs when the stable nucleus of boron-10 captures a thermal neutron. Due to the relatively high cross-section of the 10-B nucleus for thermal neutron capture and short ranges of the products of this reaction, tumor cells in the volume exposed to thermal neutrons and containing sufficiently high concentration of 10-B would receive a much higher radiation dose than the normal cells contained within the exposed volume. Nevertheless, radiation dose deposited in normal tissue by gamma and fast neutron contamination of the neutron beam, as well as neutron capture in nitrogen, 14-N(n,p)14-C, hydrogen, 1-H(n,γ)2-H, and in boron present in blood and normal cells, limits the dose that can be delivered to tumor cells. It is, therefore, imperative for the success of the BNCT the dosed delivered to normal tissues be accurately determined in order to optimize the irradiation geometry and to limit the volume of normal tissue exposed to thermal neutrons. These are the major objectives of BNCT treatment planning

Delivering step change improvements to UK low level waste strategy - 16188

International Nuclear Information System (INIS)

Dean, Jason; Rossiter, David

2009-01-01

The UK Nuclear Industry continues to produce significant quantities of Low Level Waste (LLW) as decommissioning projects generating waste become more prevalent. Current infrastructure and projected increasing waste volumes will deliver a volumetric shortfall of storage capacity in the near future. Recently established as a standalone site licence company, the Low Level Waste Repository (LLWR) near Drigg, in West Cumbria (formerly operated and owned by British Nuclear Group) is tasked with managing the safe treatment and disposal of LLW in the UK, on behalf of the Nuclear Decommissioning Authority (NDA). The problem is complex involving many stakeholders with potentially different priorities. Previously, most nuclear waste generators operated independently with limited integration with other similar organisations. However, the current financial, programme and technical pressures require collaborative working to facilitate a step-change improvement in LLW management. Achieving this quickly is as much of a challenge as delivering robust cost effective technical solutions. NDA is working in partnership with LLWR to develop a LLW Strategy for the Nuclear Industry and has in parallel commissioned a number of studies by the National Nuclear Laboratory (NNL), looking at opportunities to share best practice. A National Strategy Group has been established to develop a working partnership between the Nuclear Decommissioning Authority, LLW Repository Ltd, Regulators, Stakeholders and LLW Consignors, promoting innovation, value for money, and robust implementation of the waste hierarchy (avoid-reduce-re-use-recycle). Additionally the LLWR supported by the NNL have undertaken a comprehensive strategic review of the UK's LLW management activities. Initial collaborative work has provided for the first time a detailed picture of the existing strategic baseline and identified significant national benefits from improving the way LLW is forecasted, characterised, segregated, and

Norwich Technologies' Advanced Low-Cost Receivers for Parabolic Troughs

Energy Technology Data Exchange (ETDEWEB)

Stettenheim, Joel [Norwich Technologies, White River Junction, VT (United States); McBride, Troy O. [Norwich Technologies, White River Junction, VT (United States); Brambles, Oliver J. [Norwich Technologies, White River Junction, VT (United States); Cashin, Emil A. [Norwich Technologies, White River Junction, VT (United States)

2013-12-31

This report summarizes the successful results of our SunShot project, Advanced Low-Cost Receivers for Parabolic Troughs. With a limited budget of $252K and in only 12 months, we have (1) developed validated optical and thermal models and completed rigorous optimization analysis to identify key performance characteristics as part of developing first-generation laboratory prototype designs, (2) built optical and thermal laboratory prototypes and test systems with associated innovative testing protocols, and (3) performed extensive statistically relevant testing. We have produced fully functioning optical and thermal prototypes and accurate, validated models shown to capture important underlying physical mechanisms. The test results from the first-generation prototype establish performance exceeding the FOA requirement of thermal efficiency >90% for a CSP receiver while delivering an exit fluid temperature of > 650 °C and a cost < $150/kWth. Our vacuum-free SunTrap receiver design provides improvements over conventional vacuum-tube collectors, allowing dramatic reductions in thermal losses at high operating temperature.

Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis

Directory of Open Access Journals (Sweden)

Ramponi F

2016-09-01

Full Text Available Francesco Ramponi,1,2 Claudio Ronco,1,3 Giacomo Mason,1 Enrico Rettore,4 Daniele Marcelli,5,6 Francesca Martino,1,3 Mauro Neri,1,7 Alejandro Martin-Malo,8 Bernard Canaud,5,9 Francesco Locatelli10 1International Renal Research Institute (IRRIV, San Bortolo Hospital, Vicenza, 2Department of Economics and Management, University of Padova, Padova, 3Department of Nephrology, San Bortolo Hospital, Vicenza, 4Department of Sociology and Social Research, University of Trento, FBK-IRVAPP & IZA, Trento, Italy; 5Europe, Middle East, Africa and Latin America Medical Board, Fresenius Medical Care,, Bad Homburg, Germany; 6Danube University, Krems, Austria; 7Department of Management and Engineering, University of Padova, Vicenza, Italy; 8Nephrology Unit, Reina Sofia University Hospital, Córdoba, Spain; 9School of Medicine, Montpellier University, Montpellier, France; 10Department of Nephrology, Manzoni Hospital, Lecco, Italy Background: Clinical studies suggest that hemodiafiltration (HDF may lead to better clinical outcomes than high-flux hemodialysis (HF-HD, but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD.Methods: The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1 estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2 simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3 application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different

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

Science.gov (United States)

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

2014-05-01

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

Cost of delivering secondary-level health care services through public sector district hospitals in India

Directory of Open Access Journals (Sweden)

Shankar Prinja

2017-01-01

Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Materials Delivered by Member States

International Nuclear Information System (INIS)

1962-01-01

The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

85 μm core rod fiber amplifier delivering 350 W/m

DEFF Research Database (Denmark)

Johansen, Mette Marie; Michieletto, Mattia; Kristensen, Torben

2016-01-01

An improved version of the distributed modal filtering (DMF) rod fiber is tested in a high power setup delivering 350 W/m of extracted signal average power limited by the available pump power. The rod fiber is thoroughly tested to record the transverse modal instability (TMI) behavior and also me...

Evaluation of publicly financed and privately delivered model of emergency referral services for maternal and child health care in India.

Directory of Open Access Journals (Sweden)

Shankar Prinja

Full Text Available BACKGROUND: Emergency referral services (ERS are being strengthened in India to improve access for institutional delivery. We evaluated a publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. METHODS: Data for almost 0.4 million calls received from April 2012 to March 2013 was analysed to assess the extent and pattern of utilization. Segmented linear regression was used to analyse month-wise data on number of institutional deliveries in public sector health facilities from 2008 to 2013. We inspected ambulances in 2 districts against the Basic Life Support (BLS standards. Timeliness of ERS was assessed for determining quality. Finally, we computed economic cost of implementing ERS from a health system perspective. RESULTS: On an average, an ambulance transported 3-4 patients per day. Poor and those farther away from the health facility had a higher likelihood of using the ambulance. Although the ERS had an abrupt positive effect on increasing the institutional deliveries in the unadjusted model, there was no effect on institutional delivery after adjustment for autocorrelation. Cost of operating the ambulance service was INR 1361 (USD 22.7 per patient transported or INR 21 (USD 0.35 per km travelled. CONCLUSION: Emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system.

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

Science.gov (United States)

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

2015-09-01

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

Cost-Effectiveness of Highly Active Antiretroviral Therapy in South Africa.

Directory of Open Access Journals (Sweden)

2005-12-01

Full Text Available BACKGROUND: Little information exists on the impact of highly active antiretroviral therapy (HAART on health-care provision in South Africa despite increasing scale-up of access to HAART and gradual reduction in HAART prices. METHODS AND FINDINGS: Use and cost of services for 265 HIV-infected adults without AIDS (World Health Organization [WHO] stage 1, 2, or 3 and 27 with AIDS (WHO stage 4 receiving HAART between 1995 and 2000 in Cape Town were compared with HIV-infected controls matched for baseline WHO stage, CD4 count, age, and socioeconomic status, who did not receive antiretroviral therapy (ART; No-ART group. Costs of service provision (January 2004 prices, US$1 = 7.6 Rand included local unit costs, and two scenarios for HAART prices for WHO recommended first-line regimens: scenario 1 used current South African public-sector ART drug prices of $730 per patient-year (PPY, whereas scenario 2 was based on the anticipated public-sector price for locally manufactured drug of $181 PPY. All analyses are presented in terms of patients without AIDS and patients with AIDS. For patients without AIDS, the mean number of inpatient days PPY was 1.08 (95% confidence interval [CI]: 0.97-1.19 for the HAART group versus 3.73 (95% CI: 3.55-3.97 for the No-ART group, and 8.71 (95% CI: 8.40-9.03 versus 4.35 (95% CI: 4.12-5.61, respectively, for mean number of outpatient visits PPY. Average service provision PPY was $950 for the No-ART group versus $1,342 and $793 PPY for the HAART group for scenario 1 and 2, respectively, whereas the incremental cost per life-year gained (LYG was $1,622 for scenario 1 and $675 for scenario 2. For patients with AIDS, mean inpatients days PPY was 2.04 (95% CI: 1.63-2.52 for the HAART versus 15.36 (95% CI: 13.97-16.85 for the No-ART group. Mean outpatient visits PPY was 7.62 (95% CI: 6.81-8.49 compared with 6.60 (95% CI: 5.69-7.62 respectively. Average service provision PPY was $3,520 for the No-ART group versus $1,513 and $964

Cost-effectiveness of highly active antiretroviral therapy in South Africa.

Directory of Open Access Journals (Sweden)

Motasim Badri

2006-01-01

Full Text Available Little information exists on the impact of highly active antiretroviral therapy (HAART on health-care provision in South Africa despite increasing scale-up of access to HAART and gradual reduction in HAART prices.Use and cost of services for 265 HIV-infected adults without AIDS (World Health Organization [WHO] stage 1, 2, or 3 and 27 with AIDS (WHO stage 4 receiving HAART between 1995 and 2000 in Cape Town were compared with HIV-infected controls matched for baseline WHO stage, CD4 count, age, and socioeconomic status, who did not receive antiretroviral therapy (ART; No-ART group. Costs of service provision (January 2004 prices, USD 1 = 7.6 Rand included local unit costs, and two scenarios for HAART prices for WHO recommended first-line regimens: scenario 1 used current South African public-sector ART drug prices of $730 per patient-year (PPY, whereas scenario 2 was based on the anticipated public-sector price for locally manufactured drug of $181 PPY. All analyses are presented in terms of patients without AIDS and patients with AIDS. For patients without AIDS, the mean number of inpatient days PPY was 1.08 (95% confidence interval [CI]: 0.97-1.19 for the HAART group versus 3.73 (95% CI: 3.55-3.97 for the No-ART group, and 8.71 (95% CI: 8.40-9.03 versus 4.35 (95% CI: 4.12-5.61, respectively, for mean number of outpatient visits PPY. Average service provision PPY was $950 for the No-ART group versus $1,342 and $793 PPY for the HAART group for scenario 1 and 2, respectively, whereas the incremental cost per life-year gained (LYG was $1,622 for scenario 1 and $675 for scenario 2. For patients with AIDS, mean inpatients days PPY was 2.04 (95% CI: 1.63-2.52 for the HAART versus 15.36 (95% CI: 13.97-16.85 for the No-ART group. Mean outpatient visits PPY was 7.62 (95% CI: 6.81-8.49 compared with 6.60 (95% CI: 5.69-7.62 respectively. Average service provision PPY was $3,520 for the No-ART group versus $1,513 and $964 for the HAART group for scenario 1

Using the Black Scholes method for estimating high cost illness insurance premiums in Colombia

Directory of Open Access Journals (Sweden)

Liliana Chicaíza

2009-04-01

Full Text Available This article applied the Black-Scholes option valuation formula to calculating high-cost illness reinsurance premiums in the Colombian health system. The coverage pattern used in reinsuring high-cost illnesses was replicated by means of a European call option contract. The option’s relevant variables and parameters were adapted to an insurance market context. The premium estimated by the BlackScholes method fell within the range of premiums estimated by the actuarial method.

High and rising health care costs.

Science.gov (United States)

Ginsburg, Paul B

2008-10-01

The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

Low Cost DIY Lenses kit For High School Teaching

Science.gov (United States)

Thepnurat, Meechai; Saphet, Parinya; Tong-on, Anusorn

2017-09-01

A set of lenses was fabricated from a low cost materials in a DIY (Do it yourself) process. The purpose was to demonstrate to teachers and students in high schools how to construct lenses by themselves with the local available materials. The lenses could be applied in teaching Physics, about the nature of a lens such as focal length and light rays passing through lenses in either direction, employing a set of simple laser pointers. This instrumental kit was made from a transparent 2 mm thick of acrylic Perspex. It was cut into rectangular pieces with dimensions of 2x15 cm2 and bent into curved shape by a hot air blower on a cylindrical wooden rod with curvature radii of about 3-4.5 cm. Then a pair of these Perspex were formed into a hollow thick lenses with a base supporting platform, so that any appropriate liquids could be filled in. The focal length of the lens was measured from laser beam drawing on a paper. The refractive index, n (n) of a filling liquid could be calculated from the measured focal length (f). The kit was low cost and DIY but was greatly applicable for optics teaching in high school laboratory.

Comparison of costs for solidification of high-level radioactive waste solutions: glass monoliths vs metal matrices

International Nuclear Information System (INIS)

Jardine, L.J.; Carlton, R.E.; Steindler, M.J.

1981-05-01

A comparative economic analysis was made of four solidification processes for liquid high-level radioactive waste. Two processes produced borosilicate glass monoliths and two others produced metal matrix composites of lead and borosilicate glass beads and lead and supercalcine pellets. Within the uncertainties of the cost (1979 dollars) estimates, the cost of the four processes was about the same, with the major cost component being the cost of the primary building structure. Equipment costs and operating and maintenance costs formed only a small portion of the building structure costs for all processes

42 CFR 412.84 - Payment for extraordinarily high-cost cases (cost outliers).

Science.gov (United States)

2010-10-01

... obtains accurate data with which to calculate either an operating or capital cost-to-charge ratio (or both... outlier payments will be based on operating and capital cost-to-charge ratios calculated based on a ratio... outliers). 412.84 Section 412.84 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study.

Science.gov (United States)

Lee, Kun Yun; Ong, Tiong Kiam; Low, Ee Vien; Liow, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng Bang; Ali, Rosli Mohd; Ismail, Omar; Ahmad, Wan Azman Wan; Said, Mas Ayu; Dahlui, Maznah

2017-05-28

Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for

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

Science.gov (United States)

Savitz, Lucy A; Savitz, Samuel T

2016-01-01

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

Nanosolar: Delivering Grid-Parity Solar Electricity

Energy Technology Data Exchange (ETDEWEB)

Sager, Brian [Nanosolar, Inc., San Jose, CA (United States)

2012-05-31

Nanosolar has developed proprietary technology based on Copper-Indium-Gallium-diSelenide (CIGS) absorber technology that allows the printing of this semiconductor material using a high-speed, high-throughput roll-to-roll manufacturing process. A central challenge in cost-effectively constructing a large-area CIGS-based solar cell or module is that the elements of the CIGS layer must be within a narrow stoichiometric ratio on nano-, meso-, and macroscopic length scale in all three dimensions in order for the resulting cell or module to be highly efficient. Achieving precise stoichiometric composition over relatively large substrate areas is however difficult using traditional vacuum-based deposition processes. For example, it is difficult to uniformly deposit compounds and/or alloys containing more than one element by sputtering or evaporation. Both techniques rely on deposition approaches that are limited to line-of-sight and limited-area sources, tending to result in poor surface coverage. Line-of-sight trajectories and limited-area sources can result in non-uniform three-dimensional distribution of the elements in all three dimensions and/or poor film-thickness uniformity over large areas. These non-uniformities can occur over the nano-, meso-, and/or macroscopic scales. Such non-uniformity also alters the local stoichiometric ratios of the absorber layer, decreasing the potential power conversion efficiency of the complete cell or module. Nanosolar has overcome these challenges by printing nanoparticulate CIGS precursor materials onto low-cost metal foil substrates, and performing a rapid thermal processing to convert the nanoparticulate coating into a CIGS absorber layer By locking in the appropriate stochiometry into the nanoparticulate precursor material, spatial uniformity is ensured in the coated layers, while printing at high speed and throughput minimizes solar cell cost.

Bottom-Up Cost Analysis of a High Concentration PV Module; NREL (National Renewable Energy Laboratory)

Energy Technology Data Exchange (ETDEWEB)

Horowitz, K.; Woodhouse, M.; Lee, H.; Smestad, G.

2015-04-13

We present a bottom-up model of III-V multi-junction cells, as well as a high concentration PV (HCPV) module. We calculate $0.65/Wp(DC) manufacturing costs for our model HCPV module design with today’s capabilities, and find that reducing cell costs and increasing module efficiency offer the promising pathways for future cost reductions. Cell costs could be significantly reduced via an increase in manufacturing scale, substrate reuse, and improved manufacturing yields. We also identify several other significant drivers of HCPV module costs, including the Fresnel lens primary optic, module housing, thermal management, and the receiver board. These costs could potentially be lowered by employing innovative module designs.

In search of low cost titanium: the fray farthing chen (FFC) cambridge process

CSIR Research Space (South Africa)

Oosthuizen, SJ

2011-03-01

Full Text Available delivering a sponge product, aimed at replacing Kroll sponge alone, does not have potential for large reduction in overall titanium cost. Significant cost savings can be achieved only by also reducing the large number of process steps required... to process the sponge to mill product, including sponge purification, comminution, electrode forming, vacuum arc re-melting, and hot and cold rolling. Presently, economy of scale in the production of titanium dictates that it is most cost...

Cost of Services Provided by the National Breast and Cervical Cancer Early Detection Program

Science.gov (United States)

Ekwueme, Donatus U.; Subramanian, Sujha; Trogdon, Justin G.; Miller, Jacqueline W.; Royalty, Janet E.; Li, Chunyu; Guy, Gery P.; Crouse, Wesley; Thompson, Hope; Gardner, James G.

2015-01-01

BACKGROUND The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP. METHODS We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program. RESULTS We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively. CONCLUSIONS These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program. PMID:25099904

Establishing a Cost Basis for Converting the High Flux Isotope Reactor from High Enriched to Low Enriched Uranium Fuel

International Nuclear Information System (INIS)

Primm, Trent; Guida, Tracey

2010-01-01

Under the auspices of the Global Threat Reduction Initiative Reduced Enrichment for Research and Test Reactors Program, the National Nuclear Security Administration/Department of Energy (NNSA/DOE) has, as a goal, to convert research reactors worldwide from weapons grade to non-weapons grade uranium. The High Flux Isotope Reactor (HFIR) at Oak Ridge National Lab (ORNL) is one of the candidates for conversion of fuel from high enriched uranium (HEU) to low enriched uranium (LEU). A well documented business model, including tasks, costs, and schedules was developed to plan the conversion of HFIR. Using Microsoft Project, a detailed outline of the conversion program was established and consists of LEU fuel design activities, a fresh fuel shipping cask, improvements to the HFIR reactor building, and spent fuel operations. Current-value costs total $76 million dollars, include over 100 subtasks, and will take over 10 years to complete. The model and schedule follows the path of the fuel from receipt from fuel fabricator to delivery to spent fuel storage and illustrates the duration, start, and completion dates of each subtask to be completed. Assumptions that form the basis of the cost estimate have significant impact on cost and schedule.

Norplant's high cost may prohibit use in Title 10 clinics.

Science.gov (United States)

1991-04-01

The article discusses the prohibitive cost of Norplant for the Title 10 low-income population served in public family planning clinics in the U.S. It is argued that it's unfair for U.S. users to pay $350 to Wyeth- Ayerst when another pharmaceutical company provides developing countries with Norplant at a cost of $14 - 23. Although the public sector and private foundations funded the development, it was explained that the company needs to recoup the investment in training and education. Medicaid and third party payers such as insurance companies will reimburse for the higher price, but if the public sector price is lowered, then the company would not make a profit and everyone would have argued for the reimbursement at the lower cost. It was suggested that a boycott of American Home Products, Wyeth-Ayerst's parent company, be made. Public family planning providers who are particularly low in funding reflect that their budget of $30,000 would only provide 85 users, and identified in this circumstance by drug abusers and multiple pregnancy women, and the need for teenagers remains unfulfilled. Another remarked that the client population served is 4700 with $54,000 in funding, which is already accounted for. The general trend of comments was that for low income women the cost is to high.

A high efficiency, high quality and low cost internal regulated bioanalytical laboratory to support drug development needs.

Science.gov (United States)

Song, Yan; Dhodda, Raj; Zhang, Jun; Sydor, Jens

2014-05-01

In the recent past, we have seen an increase in the outsourcing of bioanalysis in pharmaceutical companies in support of their drug development pipeline. This trend is largely driven by the effort to reduce internal cost, especially in support of late-stage pipeline assets where established bioanalytical assays are used to analyze a large volume of samples. This article will highlight our perspective of how bioanalytical laboratories within pharmaceutical companies can be developed into the best partner in the advancement of drug development pipelines with high-quality support at competitive cost.

Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults.

Science.gov (United States)

Raviotta, Jonathan M; Smith, Kenneth J; DePasse, Jay; Brown, Shawn T; Shim, Eunha; Nowalk, Mary Patricia; Wateska, Angela; France, Glenson S; Zimmerman, Richard K

2017-10-09

High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds. Markov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided. The least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values. Based on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

76 FR 60031 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

Science.gov (United States)

2011-09-28

... single-family matrix in FHFA's Public Use Database (PUDB) to include data fields for the high-cost single... Use Database Incorporating High-Cost Single-Family Securitized Loan Data Fields and Technical Data... amended, it is necessary to revise the single-family matrix of FHFA's Public Use Database (PUDB) by adding...

Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

Science.gov (United States)

French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

2016-09-01

With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

Integrated package approach in delivering interventions during immunisation campaigns in a complex environment in Papua New Guinea: a case study.

Science.gov (United States)

Vince, John David; Datta, Siddhartha Sankar; Toikilik, Steven; Lagani, William

2014-08-06

Papua New Guinea's difficult and varied topography, poor transport infrastructure, changing dynamics of population and economy in recent times and understaffed and poorly financed health service present major challenges for successful delivery of vaccination and other preventative health interventions to both the rural majority and urban populations, thereby posing risks for vaccine preventable disease outbreaks in the country. The country has struggled to meet the vaccination coverage targets required for the eradication of poliomyelitis and elimination of measles. Escalation of inter and intra country migration resulting from major industrial developments, particularly in extraction industries, has substantially increased the risk of infectious disease importation. This case study documents the evolution of immunisation programmes since the introduction of supplementary immunisation activities (SIAs). Single antigen SIAs have advantages and disadvantages. In situations in which the delivery of preventative health interventions is difficult, it is likely that the cost benefit is greater for multiple than for single intervention. The lessons learned from the conduct of single antigen SIAs can be effectively used for programmes delivering multiple SIA antigens, routine immunisations, and other health interventions. This paper describes a successful and cost effective multiple intervention programme in Papua New Guinea. The review of the last SIA in Papua New Guinea showed relatively high coverage of all the interventions and demonstrated the operational feasibility of delivering multiple interventions in resource constrained settings. Studies in other developing countries such as Lesotho and Ethiopia have also successfully integrated health interventions with SIA. In settings such as Papua New Guinea there is a strong case for integrating supplementary immunisation activity with routine immunisation and other health interventions through a comprehensive outreach

A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs.

Science.gov (United States)

Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter

2015-06-01

To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.

Very Low-Cost, Rugged, High-Vacuum System for Mass Spectrometers, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — NASA, the DoD, DHS, and commercial industry have a pressing need for miniaturized, rugged, low-cost, high vacuum systems. Recent advances in sensor technology at...

Development costs for a nuclear electric propulsion stage.

Science.gov (United States)

Mondt, J. F.; Prickett, W. Z.

1973-01-01

Development costs are presented for an unmanned nuclear electric propulsion (NEP) stage based upon a liquid metal cooled, in-core thermionic reactor. A total of 120 kWe are delivered to the thrust subsystem which employs mercury ion engines for electric propulsion. This study represents the most recent cost evaluation of the development of a reactor power system for a wide range of nuclear space power applications. These include geocentric, and outer planet and other deep space missions. The development program is described for the total NEP stage, based upon specific development programs for key NEP stage components and subsystems.

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

Directory of Open Access Journals (Sweden)

Emmanuel Chidiebere Eze

2018-01-01

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

Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH in ovulation induction: a prospective, randomized study with cost-minimization analysis

Directory of Open Access Journals (Sweden)

Grassi Giuseppina

2006-07-01

Full Text Available Abstract Background Both recombinant FSH (r-FSH and highly-purified, urinary FSH (HP-uFSH are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. Methods Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter, endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. Results The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. Conclusion Considering the significantly lower number of vials/patient and the slight (although non-significant increase in the delivery rate with r-FSH, the cost

Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis.

Science.gov (United States)

Revelli, Alberto; Poso, Francesca; Gennarelli, Gianluca; Moffa, Federica; Grassi, Giuseppina; Massobrio, Marco

2006-07-18

Both recombinant FSH (r-FSH) and highly-purified, urinary FSH (HP-uFSH) are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome) at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter), endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. Considering the significantly lower number of vials/patient and the slight (although non-significant) increase in the delivery rate with r-FSH, the cost-minimization analysis showed a 9.4% reduction in the overall therapy

Costs and cost-efficiency of a mobile cash transfer to prevent child undernutrition during the lean season in Burkina Faso: a mixed methods analysis from the MAM'Out randomized controlled trial.

Science.gov (United States)

Puett, Chloe; Salpéteur, Cécile; Houngbe, Freddy; Martínez, Karen; N'Diaye, Dieynaba S; Tonguet-Papucci, Audrey

2018-01-01

This study assessed the costs and cost-efficiency of a mobile cash transfer implemented in Tapoa Province, Burkina Faso in the MAM'Out randomized controlled trial from June 2013 to December 2014, using mixed methods and taking a societal perspective by including costs to implementing partners and beneficiary households. Data were collected via interviews with implementing staff from the humanitarian agency and the private partner delivering the mobile money, focus group discussions with beneficiaries, and review of accounting databases. Costs were analyzed by input category and activity-based cost centers. cost-efficiency was analyzed by cost-transfer ratios (CTR) and cost per beneficiary. Qualitative analysis was conducted to identify themes related to implementing electronic cash transfers, and barriers to efficient implementation. The CTR was 0.82 from a societal perspective, within the same range as other humanitarian transfer programs; however the intervention did not achieve the same degree of cost-efficiency as other mobile transfer programs specifically. Challenges in coordination between humanitarian and private partners resulted in long wait times for beneficiaries, particularly in the first year of implementation. Sensitivity analyses indicated a potential 6% reduction in CTR through reducing beneficiary wait time by one-half. Actors reported that coordination challenges improved during the project, therefore inefficiencies likely would be resolved, and cost-efficiency improved, as the program passed the pilot phase. Despite the time required to establish trusting relationships among actors, and to set up a network of cash points in remote areas, this analysis showed that mobile transfers hold promise as a cost-efficient method of delivering cash in this setting. Implementation by local government would likely reduce costs greatly compared to those found in this study context, and improve cost-efficiency especially by subsidizing expansion of mobile

Oral microflora in infants delivered vaginally and by caesarean section

DEFF Research Database (Denmark)

Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

2011-01-01

International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

Science.gov (United States)

Shishko, Robert; Jorgensen, Edward J.

1996-01-01

This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

Delivering an effective outpatient service in gynaecology. A randomised controlled trial analysing the cost of outpatient versus daycase hysteroscopy.

Science.gov (United States)

Marsh, Fiona; Kremer, Christian; Duffy, Sean

2004-03-01

To examine the cost implications of outpatient versus daycase hysteroscopy to the National Health Service, the patient and their employer. Randomised controlled trial. The gynaecology clinic of a large teaching hospital. Ninety-seven women with abnormal uterine bleeding requiring investigation. Women were randomly allocated to either outpatient or daycase hysteroscopy. They were asked to complete diaries recording expenses and time off work. The National Health Service costs were calculated for a standard outpatient and daycase hysteroscopy. Costs to the National Health Service, costs to the employer, loss of income, childcare costs and travel expenses. The outpatient group required significantly less time off work compared with the daycase group (0.8 days vs 3.3 days), P Service approximately pound 53.88 more per patient, than performing an outpatient hysteroscopy. Purchasing the hysteroscopes necessary to perform an outpatient hysteroscopy is a more expensive outlay than those required for daycase hysteroscopy. However, there are so many other savings that only 38 patients need to undergo outpatient hysteroscopy (even with a 4% failure rate) rather than daycase hysteroscopy in order to recoup the extra money required to set up an outpatient hysteroscopy service. Outpatient hysteroscopy offers many benefits over its traditional counterpart including faster recovery, less time away from work and home and cost savings to the woman and her employer and the National Health Service. Resources need to be made available to rapidly develop this service across the UK in order to better serve both patient and taxpayer.

Cost allocation in distribution planning

International Nuclear Information System (INIS)

Engevall, S.

1996-01-01

This thesis concerns cost allocation problems in distribution planning. The cost allocation problems we study are illustrated using the distribution planning situation at the Logistics department of Norsk Hydro Olje AB. The planning situation is modeled as a Traveling Salesman Problem and a Vehicle Routing Problem with an inhomogeneous fleet. The cost allocation problems are the problems of how to divide the transportation costs among the customers served in each problem. The cost allocation problems are formulated as cooperative games, in characteristic function form, where the customers are defined to be the players. The games contain five and 21 players respectively. Game theoretical solution concepts such as the core, the nucleolus, the Shapley value and the τ-value are discussed. From the empirical results we can, among other things, conclude that the core of the Traveling Salesman Game is large, and that the core of the Vehicle Routing Game is empty. In the accounting of Norsk Hydro the cost per m 3 can be found for each tour. We conclude that for a certain definition of the characteristic function, a cost allocation according to this principle will not be included in the core of the Traveling Salesman Game. The models and methods presented in this thesis can be applied to transportation problems similar to that of Norsk Hydro, independent of the type of products that are delivered. 96 refs, 11 figs, 26 tabs

Cost allocation in distribution planning

Energy Technology Data Exchange (ETDEWEB)

Engevall, S.

1996-12-31

This thesis concerns cost allocation problems in distribution planning. The cost allocation problems we study are illustrated using the distribution planning situation at the Logistics department of Norsk Hydro Olje AB. The planning situation is modeled as a Traveling Salesman Problem and a Vehicle Routing Problem with an inhomogeneous fleet. The cost allocation problems are the problems of how to divide the transportation costs among the customers served in each problem. The cost allocation problems are formulated as cooperative games, in characteristic function form, where the customers are defined to be the players. The games contain five and 21 players respectively. Game theoretical solution concepts such as the core, the nucleolus, the Shapley value and the {tau}-value are discussed. From the empirical results we can, among other things, conclude that the core of the Traveling Salesman Game is large, and that the core of the Vehicle Routing Game is empty. In the accounting of Norsk Hydro the cost per m{sup 3} can be found for each tour. We conclude that for a certain definition of the characteristic function, a cost allocation according to this principle will not be included in the core of the Traveling Salesman Game. The models and methods presented in this thesis can be applied to transportation problems similar to that of Norsk Hydro, independent of the type of products that are delivered. 96 refs, 11 figs, 26 tabs

Cost allocation in distribution planning

Energy Technology Data Exchange (ETDEWEB)

Engevall, S

1997-12-31

This thesis concerns cost allocation problems in distribution planning. The cost allocation problems we study are illustrated using the distribution planning situation at the Logistics department of Norsk Hydro Olje AB. The planning situation is modeled as a Traveling Salesman Problem and a Vehicle Routing Problem with an inhomogeneous fleet. The cost allocation problems are the problems of how to divide the transportation costs among the customers served in each problem. The cost allocation problems are formulated as cooperative games, in characteristic function form, where the customers are defined to be the players. The games contain five and 21 players respectively. Game theoretical solution concepts such as the core, the nucleolus, the Shapley value and the {tau}-value are discussed. From the empirical results we can, among other things, conclude that the core of the Traveling Salesman Game is large, and that the core of the Vehicle Routing Game is empty. In the accounting of Norsk Hydro the cost per m{sup 3} can be found for each tour. We conclude that for a certain definition of the characteristic function, a cost allocation according to this principle will not be included in the core of the Traveling Salesman Game. The models and methods presented in this thesis can be applied to transportation problems similar to that of Norsk Hydro, independent of the type of products that are delivered. 96 refs, 11 figs, 26 tabs

Cost-effective way to reduce stimulant-abuse among gay/bisexual men and transgender women: a randomized clinical trial with a cost comparison.

Science.gov (United States)

Zhang, S X; Shoptaw, S; Reback, C J; Yadav, K; Nyamathi, A M

2018-01-01

A randomized controlled study was conducted with 422 homeless, stimulant-using gay/bisexual (G/B) men and 29 transgender women (n = 451) to assess two community-based interventions to reduce substance abuse and improve health: (a) a nurse case-managed program combined with contingency management (NCM + CM) versus (b) standard education plus contingency management (SE + CM). Hypotheses tested included: a) completion of hepatitis A/B vaccination series; b) reduction in stimulant use; and c) reduction in number of sexual partners. A deconstructive cost analysis approach was utilized to capture direct costs associated with the delivery of both interventions. Based on an analysis of activity logs and staff interviews, specific activities and the time required to complete each were analyzed as follows: a) NCM + CM only; b) SE + CM only; c) time to administer/record vaccines; and d) time to receive and record CM visits. Cost comparison of the interventions included only staffing costs and direct cash expenditures. The study outcomes showed significant over time reductions in all measures of drug use and multiple sex partners, compared to baseline, although no significant between-group differences were detected. Cost analysis favored the simpler SE + CM intervention over the more labor-intensive NCM + CM approach. Because of the high levels of staffing required for the NCM relative to SE, costs associated with it were significantly higher. Findings suggest that while both intervention strategies were equally effective in achieving desired health outcomes, the brief SE + CM appeared less expensive to deliver. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

In search of low cost titanium: the Fray Farthing Chen (FFC) Cambridge process

CSIR Research Space (South Africa)

Oosthuizen, SJ

2010-10-01

Full Text Available delivering a sponge product, aimed at replacing Kroll sponge alone, does not have potential for large reduction in overall titanium cost. Significant cost savings can only be achieved by also reducing the large number of process steps required to process... the sponge to mill product, including sponge purification, comminution, electrode forming, Vacuum Arc Re-melting, Hot and cold rolling. Presently, economy of scale in the production of titanium dictates that it is most cost effective to cast the largest...

Museum genomics: low-cost and high-accuracy genetic data from historical specimens.

Science.gov (United States)

Rowe, Kevin C; Singhal, Sonal; Macmanes, Matthew D; Ayroles, Julien F; Morelli, Toni Lyn; Rubidge, Emily M; Bi, Ke; Moritz, Craig C

2011-11-01

Natural history collections are unparalleled repositories of geographical and temporal variation in faunal conditions. Molecular studies offer an opportunity to uncover much of this variation; however, genetic studies of historical museum specimens typically rely on extracting highly degraded and chemically modified DNA samples from skins, skulls or other dried samples. Despite this limitation, obtaining short fragments of DNA sequences using traditional PCR amplification of DNA has been the primary method for genetic study of historical specimens. Few laboratories have succeeded in obtaining genome-scale sequences from historical specimens and then only with considerable effort and cost. Here, we describe a low-cost approach using high-throughput next-generation sequencing to obtain reliable genome-scale sequence data from a traditionally preserved mammal skin and skull using a simple extraction protocol. We show that single-nucleotide polymorphisms (SNPs) from the genome sequences obtained independently from the skin and from the skull are highly repeatable compared to a reference genome. © 2011 Blackwell Publishing Ltd.

Testing the Feasibility of a Low-Cost Network Performance Measurement Infrastructure

Energy Technology Data Exchange (ETDEWEB)

Chevalier, Scott [Indiana Univ., Bloomington, IN (United States). International Networks; Schopf, Jennifer M. [Indiana Univ., Bloomington, IN (United States). International Networks; Miller, Kenneth [Pennsylvania State Univ., University Park, PA (United States). Telecommunications and Networking Services; Zurawski, Jason [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Sciences Network

2016-07-01

Todays science collaborations depend on reliable, high performance networks, but monitoring the end-to-end performance of a network can be costly and difficult. The most accurate approaches involve using measurement equipment in many locations, which can be both expensive and difficult to manage due to immobile or complicated assets. The perfSONAR framework facilitates network measurement making management of the tests more reasonable. Traditional deployments have used over-provisioned servers, which can be expensive to deploy and maintain. As scientific network uses proliferate, there is a desire to instrument more facets of a network to better understand trends. This work explores low cost alternatives to assist with network measurement. Benefits include the ability to deploy more resources quickly, and reduced capital and operating expenditures. Finally, we present candidate platforms and a testing scenario that evaluated the relative merits of four types of small form factor equipment to deliver accurate performance measurements.

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

Science.gov (United States)

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

2015-01-01

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

Changing physician incentives for cancer care to reward better patient outcomes instead of use of more costly drugs.

Science.gov (United States)

Newcomer, Lee N

2012-04-01

More-sophisticated chemotherapy regimens have improved the outlook for cancer patients since the 1970s, but the payment system for cancer chemotherapy has not changed during that time span. The "buy and bill" approach for reimbursement provides incentives for medical oncologists to use expensive medications when less costly alternatives that deliver similar results are available. Furthermore, the system does nothing to assess how much value society derives from high-price drugs. This paper reviews the historical context of "buy and bill" reimbursement and considers the use of clinical pathways and bundled payments, two alternative strategies that are being tried to reward physicians for improving outcomes and reducing the total cost of cancer care.

High relative humidity in-package of fresh-cut fruits and vegetables: advantage or disadvantage considering microbiological problems and antimicrobial delivering systems?

Science.gov (United States)

Ayala-Zavala, J F; Del-Toro-Sánchez, L; Alvarez-Parrilla, E; González-Aguilar, G A

2008-05-01

This hypothesis article states that the high relative humidity (RH) of packaged fresh-cut fruits or vegetables that is associated with spoilage can be used as an advantageous way to deliver antimicrobial compounds using cyclodextrins (CDs) as carriers. CDs can function as antimicrobial delivery systems as they can release antioxidant and antimicrobial compounds (guest molecules) as the humidity levels increase in the headspace. Hydrophobic antimicrobial guests can be complexed with CDs due to the amphiphatic nature of the host. Then, at high RH values, due to the water-CDs interaction, host-guest interactions are weakened; consequently, the antimicrobial molecule is released and should protect the product against the microbial growth. Potential antimicrobial compounds capable of forming complexes with CDs are discussed, as well as possible applications to preserve fresh-cut produce and future research in this area.

Cost-effectiveness of national health insurance programs in high-income countries: A systematic review.

Directory of Open Access Journals (Sweden)

Son Nghiem

Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions

A low-cost, high-magnification imaging system for particle sizing applications

International Nuclear Information System (INIS)

Tipnis, Tanmay J; Lawson, Nicholas J; Tatam, Ralph P

2014-01-01

A low-cost imaging system for high magnification and high resolution was developed as an alternative to long-working-distance microscope-based systems, primarily for particle sizing applications. The imaging optics, comprising an inverted fixed focus lens coupled to a microscope objective, were able to provide a working distance of approximately 50 mm. The system magnification could be changed by using an appropriate microscope objective. Particle sizing was achieved using shadow-based techniques with the backlight illumination provided by a pulsed light-emitting diode light source. The images were analysed using commercial sizing software which gave the particle sizes and their distribution. A range of particles, from 6 to 8 µm to over 100 µm, was successfully measured with a minimum spatial resolution of approximately 2.5 µm. This system allowed measurement of a wide range of particles at a lower cost and improved operator safety without disturbing the flow. (technical design note)

Formation of costs of high-rise objects of housing and civil purpose based on enlarged norms

Science.gov (United States)

Vorotyntseva, Anna; Ovsiannikov, Andrei; Bolgov, Vladimir

2018-03-01

When determining the cost of capital construction objects, for purposes of pre-design workings out and purposes of initial maximum initial price determination on tenders, construction price norms are used (CPNs). Modern CPNs are not designed to determine the value of high-rise buildings. It is necessary to adapt modern CPNs to get opportunity for the possibility to take into account special cost factors in determining the cost of high-rise buildings. The main ways can be: selection of new representative objects or application of additional correction factors.

[Evaluation of tidal volume delivered by ventilators during volume-controlled ventilation].

Science.gov (United States)

Zhou, Juan; Yan, Yong; Cao, Desen

2014-12-01

To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. The volume control ventilation model was chosen, and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance, air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume, the displaying values of tidal volume of E5, Servo i, Evital 4, and Evital XL ventilators with different lung types of patient, compliance of gas piping, leakage, gas types, etc. were evaluated. With the same setting tidal volume of a same ventilator, the tidal volume delivered to patients was different with different lung types of patient, compliance of gas piping, leakage, gas types, etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure, the tidal volume was lost in gas piping, and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage, the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient, the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping, leakage, and gas types should be controlled.

Delivering phonological and phonics training within whole-class teaching.

Science.gov (United States)

Shapiro, Laura R; Solity, Jonathan

2008-12-01

Early, intensive phonological awareness and phonics training is widely held to be beneficial for children with poor phonological awareness. However, most studies have delivered this training separately from children's normal whole-class reading lessons. We examined whether integrating this training into whole class, mixed-ability reading lessons could impact on children with poor phonological awareness, whilst also benefiting normally developing readers. Teachers delivered the training within a broad reading programme to whole classes of children from Reception to the end of Year 1 (N=251). A comparison group of children received standard teaching methods (N=213). Children's literacy was assessed at the beginning of Reception, and then at the end of each year until 1 year post-intervention. The strategy significantly impacted on reading performance for normally developing readers and those with poor phonological awareness, vastly reducing the incidence of reading difficulties from 20% in comparison schools to 5% in intervention schools. Phonological and phonics training is highly effective for children with poor phonological awareness, even when incorporated into whole-class teaching.

The COST model for calculation of forest operations costs

NARCIS (Netherlands)

Ackerman, P.; Belbo, H.; Eliasson, L.; Jong, de J.J.; Lazdins, A.; Lyons, J.

2014-01-01

Since the late nineteenth century when high-cost equipment was introduced into forestry there has been a need to calculate the cost of this equipment in more detail with respect to, for example, cost of ownership, cost per hour of production, and cost per production unit. Machine cost calculations

Can community care workers deliver a falls prevention exercise program? A feasibility study

Directory of Open Access Journals (Sweden)

Burton E

2018-03-01

were completed by the majority of community care workers (93.1%. Assessment staff found it difficult to find time to deliver the intervention. Support workers were able to complete the intervention within their current service delivery period, with the initial assessment taking a small amount of additional time. Support workers reported enjoying the additional responsibility afforded by delivering the falls prevention program and seeing changes in their clients. The majority of clients (82% reported enjoying the exercises, with 59% reporting that they felt it made a positive change in their health. Clients completed the exercises on average 4.8 (SD: 2.2 days per week. Conclusion: Community care workers who have completed appropriate training are able to deliver a falls prevention exercise program to their clients as part of their current services. Further research is required to determine whether the program reduces the rate of falls for community care clients and whether integration of a falls prevention program into an existing service is cost-effective. Keywords: strength, balance, pragmatic research, home and community care services, Regional Assessment Service (RAS, safety

A High-Efficient Low-Cost Converter for Capacitive Wireless Power Transfer Systems

Directory of Open Access Journals (Sweden)

Il-Oun Lee

2017-09-01

Full Text Available Growth of the Internet of Things (IoT spurs need for new ways of delivering power. Wireless power transfer (WPT has come into the spotlight from both academia and industry as a promising way to power the IoT devices. As one of the well-known WPT techniques, the capacitive power transfer (CPT has the merit of low electromagnetic radiation and amenability of combined power and data transfer over a capacitive interface. However, applying the CPT to the IoT devices is still challenging in reality. One of the major issues is due to the small capacitance of the capacitive interface, which results in low efficiency of the power transfer. To tackle this problem, we present a new step-up single-switch quasi-resonant (SSQR converter for the CPT system. To enhance the CPT efficiency, the proposed converter is designed to operate at low frequency and drive small current into the capacitive interfaces. In addition, by eliminating resistor-capacitor-diode (RCD snubber in the converter, we reduce the implementation cost of the CPT system. Based on intensive experimental work with a CPT system prototype that supports maximum 50 W (100 V/0.5 A power transfer, we demonstrate the functional correctness of the converter that achieves up to 93% efficiency.

FlexSAR, a high quality, flexible, cost effective, prototype SAR system

Science.gov (United States)

Jensen, Mark; Knight, Chad; Haslem, Brent

2016-05-01

The FlexSAR radar system was designed to be a high quality, low-cost, flexible research prototype instrument. Radar researchers and practitioners often desire the ability to prototype new or advanced configurations, yet the ability to enhance or upgrade existing radar systems can be cost prohibitive. FlexSAR answers the need for a flexible radar system that can be extended easily, with minimal cost and time expenditures. The design approach focuses on reducing the resources required for developing and validating new advanced radar modalities. Such an approach fosters innovation and provides risk reduction since actual radar data can be collected in the appropriate mode, processed, and analyzed early in the development process. This allows for an accurate, detailed understanding of the corresponding trade space. This paper is a follow-on to last years paper and discusses the advancements that have been made to the FlexSAR system. The overall system architecture is discussed and presented along with several examples illustrating the system utility.

A model for the inverse 1-median problem on trees under uncertain costs

Directory of Open Access Journals (Sweden)

Kien Trung Nguyen

2016-01-01

Full Text Available We consider the problem of justifying vertex weights of a tree under uncertain costs so that a prespecified vertex become optimal and the total cost should be optimal in the uncertainty scenario. We propose a model which delivers the information about the optimal cost which respect to each confidence level \\(\\alpha \\in [0,1]\\. To obtain this goal, we first define an uncertain variable with respect to the minimum cost in each confidence level. If all costs are independently linear distributed, we present the inverse distribution function of this uncertain variable in \\(O(n^{2}\\log n\\ time, where \\(n\\ is the number of vertices in the tree.

Low Cost Automated Manufacture of High Efficiency THINS ZTJ PV Blanket Technology (P-NASA12-007), Phase I

Data.gov (United States)

National Aeronautics and Space Administration — NASA needs lower cost solar arrays with high performance for a variety of missions. While high efficiency, space-qualified solar cells are in themselves costly, >...

Student peer teaching in paediatric simulation training is a feasible low-cost alternative for education.

Science.gov (United States)

Wagner, Michael; Mileder, Lukas P; Goeral, Katharina; Klebermass-Schrehof, Katrin; Cardona, Francesco S; Berger, Angelika; Schmölzer, Georg M; Olischar, Monika

2017-06-01

The World Health Organization recommends regular simulation training to prevent adverse healthcare events. We used specially trained medical students to provide paediatric simulation training to their peers and assessed feasibility, cost and confidence of students who attended the courses. Students at the Medical University of Vienna, Austria were eligible to participate. Students attended two high-fidelity simulation training sessions, delivered by peers, which were videorecorded for evaluation. The attendees then completed questionnaires before and after the training. Associated costs and potential benefits were analysed. From May 2013 to June 2015, 152 students attended the sessions and 57 (37.5%) completed both questionnaires. Satisfaction was high, with 95% stating their peer tutor was competent and 90% saying that peer tutors were well prepared. The attendees' confidence in treating critically ill children significantly improved after training (p peer tutor were six Euros per working hour, compared to 35 Euros for a physician. Using peer tutors for paediatric simulation training was a feasible and low-cost option that increased the number of medical students who could be trained and increased the self-confidence of the attendees. Satisfaction with the peer tutors was high. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Low-cost, High Flexibility I-V Curve Tracer for Photovoltaic Modules

DEFF Research Database (Denmark)

Ibirriaga, Julen Joseba Maestro; Pena, Xabier Miquelez de Mendiluce; Opritescu, Adrian

2010-01-01

This work presents the design, construction and test of an in-door low cost, high flexibility I-V curve tracer for photovoltaic modules. The tracer is connected to a Xenon lamp based flashing solar simulator. The designed tracer is able to deal with the very fast changing irradiation conditions...

What factors increase the risk of incurring high market impact costs?

NARCIS (Netherlands)

Bikker, Jacob A.; Spierdijk, Laura; van der Sluis, Pieter-Jelle

2010-01-01

This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world's second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker

High-concentration planar microtracking photovoltaic system exceeding 30% efficiency

Science.gov (United States)

Price, Jared S.; Grede, Alex J.; Wang, Baomin; Lipski, Michael V.; Fisher, Brent; Lee, Kyu-Tae; He, Junwen; Brulo, Gregory S.; Ma, Xiaokun; Burroughs, Scott; Rahn, Christopher D.; Nuzzo, Ralph G.; Rogers, John A.; Giebink, Noel C.

2017-08-01

Prospects for concentrating photovoltaic (CPV) power are growing as the market increasingly values high power conversion efficiency to leverage now-dominant balance of system and soft costs. This trend is particularly acute for rooftop photovoltaic power, where delivering the high efficiency of traditional CPV in the form factor of a standard rooftop photovoltaic panel could be transformative. Here, we demonstrate a fully automated planar microtracking CPV system 660× concentration ratio over a 140∘ full field of view. In outdoor testing over the course of two sunny days, the system operates automatically from sunrise to sunset, outperforming a 17%-efficient commercial silicon solar cell by generating >50% more energy per unit area per day in a direct head-to-head competition. These results support the technical feasibility of planar microtracking CPV to deliver a step change in the efficiency of rooftop solar panels at a commercially relevant concentration ratio.

To The Biorefinery: Delivered Forestland and Agricultural Resources

Energy Technology Data Exchange (ETDEWEB)

None

2016-06-01

It can be challenging and costly to transport biomass feedstock supplies from the roadside, or farmgate, to a biorefinery. Given the geographic dispersion and lowbulk density of cellulosic feedstocks, cost effective scaling of commercial biorefinery operations requires overcoming many challenges. The Biomass Research and Development Board’s Feedstock Logistics Interagency Working Group identified four primary barriers related to biorefinery commercialization: • Capacity and efficiency of harvest and collection equipment • High-moisture content leading to degradation of biomass • Variable biomass quality upon arrival at the biorefinery • Costly transportation options.1 Further, feedstock supply systems do not currently mitigate risks such as low crop yield, fire, or competition for resource use. Delivery and preprocessing improvements will allow for the development of a commercial-scale bioenergy industry that achieves national production and cost targets.

Partner-delivered reflexology: effects on cancer pain and anxiety.

Science.gov (United States)

Stephenson, Nancy L N; Swanson, Melvin; Dalton, Joann; Keefe, Frances J; Engelke, Martha

2007-01-01

To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. Four hospitals in the southeastern United States. 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. Pain and anxiety. Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in High-Risk Hospitalized Patients.

Science.gov (United States)

Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

2016-06-01

To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.

Inefficient national environmental regulation as a signal of high abatement costs

Energy Technology Data Exchange (ETDEWEB)

Steiner, U.

1997-12-31

This paper analyses the importance of informational asymmetries in international environmental regulation by use of a game theoretic approach of signaling games. More specific it analysis whether it is possible for a government to try to extract higher compensation in an international unidirectoral environmental problem. This may be possible when the national environmental regulation carries a signal of the cost of the regulated industry. In this case the government e.g. by means of inefficient environmental regulation on a national level may try to signal high abatement costs. In spite of the fact that many international environmental problems seem to be solvable by the use of financial payments there are only few examples that compensation payment arrangements have been implemented. As many countries and especially many polluting firms possess better information about abatement costs than the countries that receive the pollution, it is worthwhile to include asymmetric information. Consequently, this paper analyses whether the introduction of asymmetric information about abatement costs may bring forward incentives to misrepresent the true abatement cost in order to capture more compensation. If these incentives turn out to be present, it may explain some of the suspicion against using financial payment in order to induce other countries to join an agreement. The analysis shows that it may indeed be the case that the expected gain from cheating is so large that it gives incentives to use an inefficient national environmental policy. (au) 13 refs.

A preliminary benefit-cost study of a Sandia wind farm.

Energy Technology Data Exchange (ETDEWEB)

Ehlen, Mark Andrew; Griffin, Taylor; Loose, Verne W.

2011-03-01

In response to federal mandates and incentives for renewable energy, Sandia National Laboratories conducted a feasibility study of installing an on-site wind farm on Sandia National Laboratories and Kirtland Air Force Base property. This report describes this preliminary analysis of the costs and benefits of installing and operating a 15-turbine, 30-MW-capacity wind farm that delivers an estimated 16 percent of 2010 onsite demand. The report first describes market and non-market economic costs and benefits associated with operating a wind farm, and then uses a standard life-cycle costing and benefit-cost framework to estimate the costs and benefits of a wind farm. Based on these 'best-estimates' of costs and benefits and on factor, uncertainty and sensitivity analysis, the analysis results suggest that the benefits of a Sandia wind farm are greater than its costs. The analysis techniques used herein are applicable to the economic assessment of most if not all forms of renewable energy.

COST EFFECTIVE AND HIGH RESOLUTION SUBSURFACE CHARACTERIZATION USING HYDRAULIC TOMOGRAPHY

Science.gov (United States)

2017-08-01