Price-Cost Ratios in Higher Education: Subsidy Structure and Policy Implications

Science.gov (United States)

Xie, Yan

2010-01-01

The diversity of US institutions of higher education is manifested in many ways. This study looks at that diversity from the economic perspective by studying the subsidy structure through the distribution of institutional price-cost ratio (PCR), defined as the sum of net tuition price divided by total supplier cost and equals to one minus…

Higher cost of implementing Xpert(®) MTB/RIF in Ugandan peripheral settings: implications for cost-effectiveness.

Science.gov (United States)

Hsiang, E; Little, K M; Haguma, P; Hanrahan, C F; Katamba, A; Cattamanchi, A; Davis, J L; Vassall, A; Dowdy, D

2016-09-01

Initial cost-effectiveness evaluations of Xpert(®) MTB/RIF for tuberculosis (TB) diagnosis have not fully accounted for the realities of implementation in peripheral settings. To evaluate costs and diagnostic outcomes of Xpert testing implemented at various health care levels in Uganda. We collected empirical cost data from five health centers utilizing Xpert for TB diagnosis, using an ingredients approach. We reviewed laboratory and patient records to assess outcomes at these sites and10 sites without Xpert. We also estimated incremental cost-effectiveness of Xpert testing; our primary outcome was the incremental cost of Xpert testing per newly detected TB case. The mean unit cost of an Xpert test was US$21 based on a mean monthly volume of 54 tests per site, although unit cost varied widely (US$16-58) and was primarily determined by testing volume. Total diagnostic costs were 2.4-fold higher in Xpert clinics than in non-Xpert clinics; however, Xpert only increased diagnoses by 12%. The diagnostic costs of Xpert averaged US$119 per newly detected TB case, but were as high as US$885 at the center with the lowest volume of tests. Xpert testing can detect TB cases at reasonable cost, but may double diagnostic budgets for relatively small gains, with cost-effectiveness deteriorating with lower testing volumes.

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

Science.gov (United States)

Kaganoff, Tessa

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

Bully University? The Cost of Workplace Bullying and Employee Disengagement in American Higher Education

Directory of Open Access Journals (Sweden)

Leah P. Hollis

2015-06-01

Full Text Available Workplace bullying has a detrimental effect on employees, yet few studies have examined its impact on personnel in American higher education administration. Therefore, two central research questions guided this study: (a What is the extent of workplace bullying in higher education administration? and (b What is the cost of workplace bullying specifically to higher education administration? Participants from 175 four-year colleges and universities were surveyed to reveal that 62% of higher education administrators had experienced or witnessed workplace bullying in the 18 months prior to the study. Race and gender were not parameters considered in the sample. A total of 401 (n = 401 higher education respondents completed the instrument from various departments on a campus: academic affairs, student affairs, athletics, development/advancement, admissions/financial aid, information technology, arts faculty, sciences faculty, and executives. Employment disengagement served as the theoretical lens to analyze the financial cost to higher education when employees mentally disengage from organizational missions and objectives. With this lens, the study examined staff hours lost through employee disengagement and the associated costs.

Positive Attitude toward Healthy Eating Predicts Higher Diet Quality at All Cost Levels of Supermarkets☆

Science.gov (United States)

Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J.; Drewnowski, Adam

2014-01-01

Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. PMID:23916974

Positive attitude toward healthy eating predicts higher diet quality at all cost levels of supermarkets.

Science.gov (United States)

Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J; Drewnowski, Adam

2014-02-01

Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Higher costs confirmed for US supercollider

CERN Multimedia

Vaughan, C

1990-01-01

American Secratary of Energy, James Watkins told Congress that the SSC will cost at least one to two billion dollars more than its estimated cost. He admitted that the final cost may be so high that the collider is not worth building (3 paragraphs).

Scheme of higher-density storage of spent nuclear fuel in Chernobyl NPP interim storage facility no. 1

International Nuclear Information System (INIS)

Britan, P.M.

2008-01-01

On 29. March 2000 the Cabinet of Ministers of Ukraine issued a decree prescribing that the last operating unit of Chernobyl NPP be shut down before its design lifetime expiry. In accordance with the Contract concluded on 14 June 1999 between the National Energy-generating Company 'Energoatom' and the Consortium of Framatome, Campenon Bernard-SGE and Bouygues, in order to store the spent ChNPP fuel a new interim dry storage facility (ISF-2) for spent ChNPP fuel would be built. Currently the spent nuclear fuel (spent fuel assemblies - SFAs) is stored in reactor cooling pools and in the reactors on Units 1, 2, 3, as well as in the wet Interim Storage Facility (ISF-1). Taking into account the expected delay with the commissioning of ISF-2, and in connection with the scheduled activities to build the New Safe Confinement (including the taking-down of the existing ventilation stack of ChNPP Units 3 and 4) and the expiry of the design operation life of Units 1 and 2, it is expedient to remove the nuclear fuel from Units 1, 2 and 3. This is essential to improve nuclear safety and ensure that the schedule of construction of the New Safe Confinement is met. The design capacity of ISF-1 (17 800 SFAs) is insufficient to store all SFAs (21 284) currently on ChNPP. A technically feasible option that has been applied on other RBMK plants is denser storage of spent nuclear fuel in the cooling ponds of the existing ISF-1. The purpose of the proposed modifications is to introduce changes to the ISF-1 design supported by necessary justifications required by the Ukrainian codes with the objective of enabling the storage of additional SFAs in the existing storage space (cooling pools). The need for the modification is caused by the requirement to remove nuclear fuel from the ChNPP units as soon as possible, before the work begins to decommission these units, as well as to create safe conditions for the construction of the New Safe Confinement over the existing Shelter Unit. (author)

Efficiency, Costs, Rankings and Heterogeneity: The Case of US Higher Education

Science.gov (United States)

Agasisti, Tommaso; Johnes, Geraint

2015-01-01

Among the major trends in the higher education (HE) sector, the development of rankings as a policy and managerial tool is of particular relevance. However, despite the diffusion of these instruments, it is still not clear how they relate with traditional performance measures, like unit costs and efficiency scores. In this paper, we estimate a…

Recent development in U.S. reporting

International Nuclear Information System (INIS)

Crossley, R.D.

1998-01-01

The issue of reporting requirements imposed on U.S. public enterprises, including the oil and gas industry, was discussed. The presentation focused on recent developments in reporting requirements in U.S. GAAP (derivatives, fair-value hedge-accounting, cash flow hedges-accounting, foreign currency hedges-accounting), pension and OPEB disclosures, segment disclosures, SEC initiatives such as earnings management, Y2K update, and SFAS 69. With respect to SFAS 69, U. S. regulations require specific disclosures with respect to movement in proved reserves, capitalized cost, and results of operations for oil and gas. Canadian disclosure laws do not have these provisions

Bully University? The Cost of Workplace Bullying and Employee Disengagement in American Higher Education

OpenAIRE

Leah P. Hollis

2015-01-01

Workplace bullying has a detrimental effect on employees, yet few studies have examined its impact on personnel in American higher education administration. Therefore, two central research questions guided this study: (a) What is the extent of workplace bullying in higher education administration? and (b) What is the cost of workplace bullying specifically to higher education administration? Participants from 175 four-...

How Much Is Too Much? Controlling Administrative Costs through Effective Oversight. A Guide for Higher Education Trustees

Science.gov (United States)

Alacbay, Armand; Barden, Danielle

2017-01-01

With recent research from the Institute for Higher Education Policy showing that college is unaffordable for as many as 70% of working- and middle-class students, concerns about college costs are mounting. The cost of operating an institution of higher education, with very few exceptions, is reflected in the price of attendance that students,…

Teaching the Interrelationships among Costs, Expense, and Liability of a Defined Benefit Pension Plan

Science.gov (United States)

Wilson, Arlette C.; Godwin, Norman H.

2008-01-01

The Financial Accounting Standards Board (FASB) recently issued Statement of Financial Accounting Standards No. 158 "Employers' Accounting for Defined Benefit Pension and Other Postretirement Plans" (SFAS #158). Their intent is to comprehensively reconsider the accounting for postretirement benefit plans in phases. The first phase was to provide…

Investment Evaluation of Higher Education through Cost-Benefit Analysis: Evidence from Adrar University-Algeria

Science.gov (United States)

Hocine, Benlaria; Sofiane, Mostéfaoui

2017-01-01

This study aims to measure the social and individual rates of return for investment in higher education at Adrar University. The approach adopted looks for investigating the costs and benefits of the human capital. The study found that the economic feasibility of investment in higher education exists at both the individual and social levels, where…

Appraising the Cost Efficiency of Higher Technological and Vocational Education Institutions in Taiwan Using the Metafrontier Cost-Function Model

Science.gov (United States)

Lu, Yung-Hsiang; Chen, Ku-Hsieh

2013-01-01

This paper aims at appraising the cost efficiency and technology of institutions of higher technological and vocational education. Differing from conventional literature, it considers the potential influence of inherent discrepancies in output quality and characteristics of school systems for institutes of technology (ITs) and universities of…

Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

Directory of Open Access Journals (Sweden)

Ibnteesam Pondor

2017-09-01

Full Text Available Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI. DDC in Malaysian Ringgit (RM was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49. The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001. There were also positive associations between DDC and M-HEI scores for fruits (p < 0.001 and vegetables (p = 0.017 for all respondents. Predictors of diet quality included carbohydrate (β = 0290; p < 0.001 and fat intakes (β = −0.242; p < 0.001 and energy adjusted DDC (β = 0.196; p < 0.001. Higher dietary cost is associated with healthy eating among Malaysian adults.

Cheaper fuel and higher health costs among the poor in rural Nepal

Energy Technology Data Exchange (ETDEWEB)

Pant, Krishna Prasad [Ministry of Agriculture and Cooperatives, Vidhya Lane, Devnagar, Kathmandu (Nepal)], email: kppant@yahoo.com

2012-03-15

Biomass fuels are used by the majority of resource poor households in low-income countries. Though biomass fuels, such as dung-briquette and firewood are apparently cheaper than the modern fuels indoor pollution from burning biomass fuels incurs high health costs. But, the health costs of these conventional fuels, mostly being indirect, are poorly understood. To address this gap, this study develops probit regression models using survey data generated through interviews from households using either dung-briquette or biogas as the primary source of fuel for cooking. The study investigates factors affecting the use of dung-briquette, assesses its impact on human health, and estimates the associated household health costs. Analysis suggests significant effects of dung-briquette on asthma and eye diseases. Despite of the perception of it being a cheap fuel, the annual health cost per household due to burning dung-briquette (US$ 16.94) is 61.3% higher than the annual cost of biogas (US$ 10.38), an alternative cleaner fuel for rural households. For reducing the use of dung-briquette and its indirect health costs, the study recommends three interventions: (1) educate women and aboriginal people, in particular, and make them aware of the benefits of switching to biogas; (2) facilitate tree planting in communal as well as private lands; and (3) create rural employment and income generation opportunities.

[Tumor markers p53, sFAS, FASL, CEA and CA 19-9 in evaluating the effectiveness of surgical and pharmaco nutritional treatment of patients with gastric cancer].

Science.gov (United States)

Bluvshteĭn, G A; Lysenko, V G; Zakharova, N B; Kitaev, I V

2012-01-01

The objective of this study is to develop a marker panel of abnormalities of immune regulatory systems and cell genome in patients with gastric cancer for assessment of efficacy of surgical treatment in combination with pharmaco-nutritional therapy in early postoperative period. Expression of p53, sFAS, FASL, CEA, and CA 19-9, nutritial status, as well as incidence of purulent-septic complications in early postoperative period were determined in 40 patients with gastric cancer (21 patients--the test group and 19 patients--the comparative group) prior to a curative surgical intervention, postoperative days 1 and 7, while the pharmaco-nutritional therapy (the test group) or partial parenteral nutrition (the comparative group) has been performed. The pharmaco-nutritional therapy significantly decreases in activity of tumor suppressing genome, lymphocyte apoptosis, expression of oncology-associated markers, incidence of purulent-septic complications, as well as exacerbation risk for hypotrophy in patients with gastric cancer in early postoperative period. To assess the efficacy of the surgical intervention performed in patients with gastric cancer, an expression of mutant p53 and markers of lymphocyte apoptosis (sFAS/FASL) is reasonable to be evaluated together with determination of oncomarkers (CEA and CA 19-9).

Soluble Fas might serve as a diagnostic tool for gastric adenocarcinoma

International Nuclear Information System (INIS)

Boroumand-Noughabi, Samaneh; Mashhadinejad, Mojtaba; Tavakkol-Afshari, Jalil; Sima, Hamid Reza; Ghaffarzadehgan, Kamran; Jafarzadeh, Mostafa; Raziee, Hamid Reza; Hosseinnezhad, Hanieh; Moaven, Omeed; Rajabi-Mashhadi, Mohammad Taghi; Azarian, Amir Abbas

2010-01-01

Fas (Apo-1/CD95) and its specific ligand (FasL) are key elements in apoptosis. They have been studied in different malignancies but there are few published studies about the soluble forms of these markers (i.e. sFas/sFasL) in gastric cancer. We have compared the serum levels of sFas/sFasL in gastric adenocarcinoma patients and cases with pre-neoplastic lesions as potential markers for early diagnosis, and investigated their relation with clinicopathological characteristics. Fifty-nine newly-diagnosed cases of gastric adenocarcinoma who had undergone gastrectomy, along with 62 endoscopically- and histologically-confirmed non-cancer individuals were enrolled in this study. sFas/sFasL serum levels were detected by Enzyme Linked Immunosurbent Assay. Mean serum sFas level was significantly higher in gastric cancer patients than in control group (305.97 ± 63.71 (pg/ml) vs. 92.98 ± 4.95 (pg/ml), P < 0.001); while the mean serum level of sFasL was lower in patients with gastric adenocarcinoma (0.138 ± 0.04 (pg/ml) vs. 0.150 ± 0.02 (pg/ml), P < 0.001). Mean serum levels of sFas/sFasL were significantly different in both intestinal/diffuse and cardiac/non-cardiac subtypes when compared to the control group (P < 0.001). There was an increase in the serum level of sFas from the first steps of pre-neoplastic lesions to gastric adenocarcinoma (P < 0.001). Patients who had no lymph node involvement (N 0 ) showed significantly higher serum levels of sFas compared to others (P = 0.044). Production of sFas may play a critical role in the carcinogenesis of intestinal-type gastric cancer. sFas serum level may serve as a non-invasive tool for early diagnosis of gastric cancer

Optimization of economic load dispatch of higher order general cost polynomials and its sensitivity using modified particle swarm optimization

International Nuclear Information System (INIS)

Saber, Ahmed Yousuf; Chakraborty, Shantanu; Abdur Razzak, S.M.; Senjyu, Tomonobu

2009-01-01

This paper presents a modified particle swarm optimization (MPSO) for constrained economic load dispatch (ELD) problem. Real cost functions are more complex than conventional second order cost functions when multi-fuel operations, valve-point effects, accurate curve fitting, etc., are considering in deregulated changing market. The proposed modified particle swarm optimization (PSO) consists of problem dependent variable number of promising values (in velocity vector), unit vector and error-iteration dependent step length. It reliably and accurately tracks a continuously changing solution of the complex cost function and no extra concentration/effort is needed for the complex higher order cost polynomials in ELD. Constraint management is incorporated in the modified PSO. The modified PSO has balance between local and global searching abilities, and an appropriate fitness function helps to converge it quickly. To avoid the method to be frozen, stagnated/idle particles are reset. Sensitivity of the higher order cost polynomials is also analyzed visually to realize the importance of the higher order cost polynomials for the optimization of ELD. Finally, benchmark data sets and methods are used to show the effectiveness of the proposed method. (author)

Apolipoprotein A2 -265 T>C polymorphism interacts with dietary fatty acids intake to modulate inflammation in type 2 diabetes mellitus patients.

Science.gov (United States)

Keramat, Laleh; Sadrzadeh-Yeganeh, Haleh; Sotoudeh, Gity; Zamani, Elham; Eshraghian, Mohammadreza; Mansoori, Anahita; Koohdani, Fariba

2017-05-01

Several investigations have been conducted regarding the interaction between Apolipoprotein A2 (APOA2) -265 T>C polymorphism and dietary intake of saturated fatty acids (SFAs) on obesity in healthy individuals or type 2 diabetes mellitus (T2 DM) patients. The aim of the present study is to examine the effect of this interaction on inflammatory markers in T2 DM patients. This is a comparative cross-sectional study on 180 T2 DM patients with known APOA2 genotype. Dietary intake was assessed by food-frequency questionnaire and serum levels of inflammatory markers (interleukin [IL]-18, pentraxin 3, and high-sensitivity C-reactive protein [hs-CRP]) were measured. The subjects were dichotomized into "high" and "low" categories, based on the median dietary intake of polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs), and SFAs. The data were analyzed by analysis of covariance multivariate interaction model. In CC genotype, higher median intake of ω-3 PUFAs and MUFAs was associated with decreased serum levels of IL-18 and hs-CRP (P = 0.014 and 0.008, respectively). In T-allele carriers, higher median intake of SFAs was associated with increased serum hs-CRP level (P fatty acids, such as ω-3 PUFAs and MUFAs, could reduce the inflammatory effects associated with the CC genotype. In addition, proinflammatory fatty acids, such as SFAs, could overcome the antiinflammatory effect of the T-allele. Further studies are needed to confirm these findings. Copyright © 2016 Elsevier Inc. All rights reserved.

Multi-Product Total Cost of Function for Higher Education: A Case of Bible Colleges.

Science.gov (United States)

Koshal, Rajindar K.; Koshal, Manjulika; Gupta, Ashok

2001-01-01

This study empirically estimates a multiproduct total cost function and output relationship for comprehensive U.S. universities. Statistical results for 184 Bible colleges suggest that there are both economies of scale and of scope in higher education. Additionally, product-specific economies of scope exist for all output levels and activities.…

The role of reducing intakes of saturated fat in the prevention of cardiovascular disease

DEFF Research Database (Denmark)

Astrup, Arne; Dyerberg, Jørn; Elwood, Peter

2011-01-01

Current dietary recommendations advise reducing the intake of saturated fatty acids (SFAs) to reduce coronary heart disease (CHD) risk, but recent findings question the role of SFAs. This expert panel reviewed the evidence and reached the following conclusions: the evidence from epidemiologic......, clinical, and mechanistic studies is consistent in finding that the risk of CHD is reduced when SFAs are replaced with polyunsaturated fatty acids (PUFAs). In populations who consume a Western diet, the replacement of 1% of energy from SFAs with PUFAs lowers LDL cholesterol and is likely to produce...... a reduction in CHD incidence of ≥2-3%. No clear benefit of substituting carbohydrates for SFAs has been shown, although there might be a benefit if the carbohydrate is unrefined and has a low glycemic index. Insufficient evidence exists to judge the effect on CHD risk of replacing SFAs with MUFAs. No clear...

Dietary medium-chain saturated fatty acids induce gene expression of energy metabolism-related pathways in adipose tissue of abdominally obese subjects

NARCIS (Netherlands)

Matualatupauw, J.C.; Bohl, Mette; Gregersen, Søren; Hermansen, K.; Afman, L.A.

2017-01-01

Background:Dietary medium-chain saturated fatty acids (MC-SFAs) have been shown to reduce total body fat. Previously, we showed that MC-SFAs prevent body fat accumulation, despite weight gain. Here, we aim to explore potential molecular mechanisms underlying the protective effect of MC-SFAs on body

Physicochemical properties of 2S Albumins and the corresponding protein isolate from Sunflower (Helianthus annuus)

NARCIS (Netherlands)

Gonzalez-Perez, S.; Vereijken, J.M.; Koningsveld, van G.A.; Gruppen, H.; Voragen, A.G.J.

2005-01-01

Sunflower albumins (SFAs) are a diverse group of proteins present in sunflower isolates, with a sedimentation coefficient of approximately 2S. This research presents a detailed study of the influence of pH on the structure and solubility of SFAs. The effect of temperature on the structure of SFAs

A administração do lucro contábil e os critérios para determinação da eficácia do hedge accounting: utilização da correlação simples dentro do arcabouço do sfas nº 133

Directory of Open Access Journals (Sweden)

Alexsandro Broedel Lopes

2003-04-01

Full Text Available O hedge accounting constitui inovação relevante introduzida pelo SFAS 133. Dentro desse critério, operações designadas como hedge deverão ter seus resultados diferidos para o momento no qual os itens sendo protegidos forem reconhecidos. Problema central nessa contabilização é a determinação do quê constitui uma operação de hedge. Os órgãos reguladores analisados neste trabalho apresentam critérios ad hoc para a determinação da eficácia das operações de hedge. Esses critérios não possuem propriedades estatísticas de previsão do comportamento dos ativos no futuro, condição necessária para o sucesso do hedge. Esse tipo de qualificação de hedge introduz enorme subjetividade no processo de reconhecimento contábil, fornecendo ampla margem para manipulação dos resultados. Este trabalho analisa e critica a opção adotada pelo FASB e outros órgãos reguladores e oferece sugestões.The hedge accounting mechanism is a recent innovation introduced by SFAS 133. According to this method, transactions designated as hedge should have their results deferred to a future period when the hedged items are recognised. hedge characterisation is a central problem in this subject. Regulatory bodies studied in this work use ad hoc criteria to determine hedge effectiveness. Those criteria are not statistically significant in terms of forecasting the asset's behaviour, a necessary condition for a successful hedge. This sort of hedge characterisation introduces more subjectivity into accounting recognition, allowing for manipulation. This work criticises the option adopted by FASB and other regulatory bodies.

Preparing for asset retirement.

Science.gov (United States)

Luecke, Randall W; Reinstein, Alan

2003-04-01

Statement of Financial Accounting Standards (SFAS) No. 143 requires organizations to recognize a liability for an asset retirement obligation when it is incurred--even if that occurs far in advance of the asset's planned retirement. For example, organizations must recognize future costs associated with medical equipment disposal that carries hazardous material legal obligations.

Enhanced saturated fatty acids accumulation in cultures of newly-isolated strains of Schizochytrium sp. and Thraustochytriidae sp. for large-scale biodiesel production.

Science.gov (United States)

Wang, Qiuzhen; Sen, Biswarup; Liu, Xianhua; He, Yaodong; Xie, Yunxuan; Wang, Guangyi

2018-08-01

Heterotrophic marine protists (Thraustochytrids) have received increasingly global attention as a renewable, sustainable and alternative source of biodiesel because of their high ability of saturated fatty acids (SFAs) accumulation. Yet, the influence of extrinsic factors (nutrients and environmental conditions) on thraustochytrid culture and optimal conditions for high SFAs production are poorly described. In the present study, two different thraustochytrid strains, Schizochytrium sp. PKU#Mn4 and Thraustochytriidae sp. PKU#Mn16 were studied for their growth and SFAs production profiles under various conditions (carbon, nitrogen, temperature, pH, KH 2 PO 4 , salinity, and agitation speed). Of the culture conditions, substrates (C and N) source and conc., temperature, and agitation speed significantly influenced the cell growth and SFAs production of both strains. Although both the strains were capable of growth and SFAs production in the broad range of culture conditions, their physiological responses to KH 2 PO 4 , pH, and salinity were dissimilar. Under their optimal batch culture conditions, peak SFAs productions of 3.3g/L and 2.2g/L with 62% and 49% SFAs contents (relative to total fatty acids) were achieved, respectively. The results of 5-L fed-batch fermentation under optimal conditions showed a nearly 4.5-fold increase in SFAs production (i.e., 7.5g/L) by both strains compared to unoptimized conditions. Of the two strains, the quality of biodiesel produced from the fatty acids of PKU#Mn4 met the biodiesel standard defined by ASTM6751. This study, to the knowledge of the authors, is the first comprehensive report of optimal fermentation conditions demonstrating enhanced SFAs production by strains belonging to two different thraustochytrid genera and provides the basis for large-scale biodiesel production. Copyright © 2018. Published by Elsevier B.V.

Public Concepts of the Values and Costs of Higher Education, 1963-1974. A Preliminary Analysis.

Science.gov (United States)

Minor, Michael J.; Murray, James R.

Statistical data are presented on interviews conducted through the Continuous National Survey (CNS) at the National Opinion Research Center in Chicago and based on results reprinted from "Public Concepts of the Values and Costs of Higher Education," by Angus Campbell and William C. Eckerman. The CNS results presented in this report are…

Higher threat avoidance costs reduce avoidance behaviour which in turn promotes fear extinction in humans.

Science.gov (United States)

Rattel, Julina A; Miedl, Stephan F; Blechert, Jens; Wilhelm, Frank H

2017-09-01

Theoretical models specifying the underlying mechanisms of the development and maintenance of anxiety and related disorders state that fear responses acquired through classical Pavlovian conditioning are maintained by repeated avoidance behaviour; thus, it is assumed that avoidance prevents fear extinction. The present study investigated behavioural avoidance decisions as a function of avoidance costs in a naturalistic fear conditioning paradigm. Ecologically valid avoidance costs - manipulated between participant groups - were represented via time-delays during a detour in a gamified computer task. After differential acquisitions of shock-expectancy to a predictive conditioned stimulus (CS+), participants underwent extinction where they could either take a risky shortcut, while anticipating shock signaled by the CS+, or choose a costly avoidance option (lengthy detour); thus, they were faced with an approach-avoidance conflict. Groups with higher avoidance costs (longer detours) showed lower proportions of avoiders. Avoiders gave heightened shock-expectancy ratings post-extinction, demonstrating 'protecting from extinction', i.e. failure to extinguish. Moreover, there was an indirect effect of avoidance costs on protection from extinction through avoidance behaviour. No moderating role of trait-anxiety was found. Theoretical implications of avoidance behaviour are discussed, considering the involvement of instrumental learning in the maintenance of fear responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lowering the Cost Barrier to Higher Education for Undocumented Students: A Promising University-Level Intervention

Science.gov (United States)

Thangasamy, Andrew; Horan, Deborah

2016-01-01

Undocumented students, many of Hispanic origin, face among the strictest cost barriers to higher education in the United States. Lack of legal status excludes them from most state and all federal financial aid programs. Furthermore, most states require them to pay out-of-state tuition rates at publicly supported institutions. In a new direction,…

Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

Science.gov (United States)

Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

2016-03-01

The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Suberin fatty acids isolated from outer birch bark improve moisture barrier properties of cellulose ether films intended for tablet coatings.

Science.gov (United States)

Heinämäki, Jyrki; Halenius, Anna; Paavo, Maaja; Alakurtti, Sami; Pitkänen, Pauliina; Pirttimaa, Minni; Paaver, Urve; Kirsimäe, Kalle; Kogermann, Karin; Yliruusi, Jouko

2015-07-15

We showed that the addition of suberin fatty acids (SFAs) even at small concentrations significantly improves the water vapor barrier properties of hydroxypropyl methylcellulose (HPMC) films. SFAs were isolated from the outer birch bark using extractive hydrolysis. The effects of SFAs on the film formation of aqueous HPMC were investigated with free films plasticized with polyethylene glycol (PEG 400). Special attention was paid on the physical solid-state, moisture barrier and mechanical stress-strain properties of films intended for tablet film coatings. Topography and surface morphology, glass transition temperature (Tg), tensile strength, Young's modulus, and water vapor permeation (WVP) of films were studied. The addition of SFAs lowered the Tg of films suggesting partial enhancement in film plasticization. The WVP of films decreased with increasing SFAs concentration up to 15% (calculated as a % w/w from a polymer weight). The WVP value for a non-suberized reference film and suberized film plasticized with PEG 400 was 2.13×10(-6) and 0.69[×10(-6) g/(mm(2)×h)×mm/Pa], respectively. The addition of SFAs impaired the mechanical stress-strain properties of HPMC films by reducing the deformation capacity of film. In conclusion, the film properties and performance of aqueous HPMC can be modified by including SFAs in the films. Copyright © 2015 Elsevier B.V. All rights reserved.

Exploring perceptions and beliefs about the cost of fruit and vegetables and whether they are barriers to higher consumption.

Science.gov (United States)

Chapman, Kathryn; Goldsbury, David; Watson, Wendy; Havill, Michelle; Wellard, Lyndal; Hughes, Clare; Bauman, Adrian; Allman-Farinelli, Margaret

2017-06-01

Fruit and vegetable (F&V) consumption is below recommendations, and cost may be a barrier to meeting recommendations. Limited evidence exists on individual perceptions about the cost, actual spending and consumption of F&V. This study investigated perceptions and beliefs about cost of F&V and whether this is a barrier to higher consumption. An online survey of Australian adults (n = 2474) measured F&V consumption; expenditure on F&V and food; and perceived barriers to consumption. Multivariable logistic regression examined associations between participants' responses about cost of F&V and demographic factors, and with actual consumption and expenditure on F&V. Cost was identified as a barrier for 29% of people not meeting recommended fruit servings and for 14% of people not meeting recommendations for vegetables. Cost was a more common barrier for those on lower incomes (fruit aOR 1.89; 95% CI 1.20-2.98 and vegetables aOR 2.94; 95% CI 1.97-4.39) and less common for older participants (fruit aOR 0.33; 95% CI 0.17-0.62 and vegetables aOR 0.31; 95% CI 0.18-0.52). There was no association between the perceived barriers and actual F&V spending. Twenty percent of participants said F&V were not affordable; 39% said cost made it difficult to buy F&V, and for 23% the cost of F&V meant they bought less than desired. A minority reported F&V were not affordable where they shopped and that cost was a barrier to higher consumption. However, it is apparent that young adults and those on low incomes eat less than they would like because of cost. Strategies that remove financial impediments to consumption are indicated for these population sub-groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Optimization of methanol crystallization for highly efficient separation of palmitic acid from palm fatty acid mixture using response surface methodology

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A. A.W. Japir

2018-01-01

Full Text Available The objective of the current study was to develop parameters for the separation of palmitic acid (PA from a crude palm oil saturated fatty acid (SFAs mixture by using the methanol crystallization method. The conditions of methanol crystallization were optimized by the response surface methodology (RSM with the D-optimal design. The procedure of developing the solvent crystallization method was based on various different parameters. The fatty acid composition was carried out using a gas chromatography flame ionization detector (GC-FID as fatty acid methyl esters. The highest percentage of SFAs was more than 96% with the percentage yield of 87.5% under the optimal conditions of fatty acids-to-methanol ratio of 1: 20 (w/v, the crystallization temperature of -15 °C, and the crystallization time of 24 hours, respectively. The composition of separated SFAs in the solid fraction contains 96.7% of palmitic acid (C16:0 as a dominant component and 3.3% of stearic acid (C18:0. The results showed that utilizing methanol as a crystallization solvent is recommended because of its high efficiency, low cost, stability, availability, comparative ease of recovery and its ability to form needle-like crystals which have good filtering and washing characteristics.

Optimization of methanol crystallization for highly efficient separation of palmitic acid from palm fatty acid mixture using response surface methodology

International Nuclear Information System (INIS)

Japir, A.A.W.; Salimon, J.; Derawi, D.; Yahaya, B.H.; Jamil, M.S.M.; Yusop, M.R.

2017-01-01

The objective of the current study was to develop parameters for the separation of palmitic acid (PA) from a crude palm oil saturated fatty acid (SFAs) mixture by using the methanol crystallization method. The conditions of methanol crystallization were optimized by the response surface methodology (RSM) with the D-optimal design. The procedure of developing the solvent crystallization method was based on various different parameters. The fatty acid composition was carried out using a gas chromatography flame ionization detector (GC-FID) as fatty acid methyl esters. The highest percentage of SFAs was more than 96% with the percentage yield of 87.5% under the optimal conditions of fatty acids-to-methanol ratio of 1: 20 (w/v), the crystallization temperature of -15 °C, and the crystallization time of 24 hours, respectively. The composition of separated SFAs in the solid fraction contains 96.7% of palmitic acid (C16:0) as a dominant component and 3.3% of stearic acid (C18:0). The results showed that utilizing methanol as a crystallization solvent is recommended because of its high efficiency, low cost, stability, availability, comparative ease of recovery and its ability to form needle-like crystals which have good filtering and washing characteristics. [es

Circulating soluble Fas levels and risk of ovarian cancer

International Nuclear Information System (INIS)

Akhmedkhanov, Arslan; Lenner, Per; Muti, Paola; Rinaldi, Sabina; Kaaks, Rudolf; Berrino, Franco; Hallmans, Göran; Toniolo, Paolo; Lundin, Eva; Guller, Seth; Lukanova, Annekatrin; Micheli, Andrea; Ma, Yuehong; Afanasyeva, Yelena; Zeleniuch-Jacquotte, Anne; Krogh, Vittorio

2003-01-01

Dysregulation of apoptosis, specifically overexpression of soluble Fas (sFas), has been proposed to play a role in the development of ovarian cancer. The main objective of the present study was to evaluate serum sFas as a potential biomarker of ovarian cancer risk. The association between serum sFas levels and the risk of ovarian cancer was examined in a case-control study nested within three prospective cohorts in New York (USA), Umeå (Sweden), and Milan (Italy). Case subjects were 138 women with primary invasive epithelial ovarian cancer diagnosed between 2 months and 13.2 years after the initial blood donation. Control subjects were 263 women who were free of cancer, and matched the case on cohort, menopausal status, age, and enrollment date. Serum sFas levels were determined using a quantitative sandwich enzyme immunoassay. Serum sFas levels were similar in women subsequently diagnosed with ovarian cancer (median, 6.5 ng/mL; range, 4.4 – 10.2) and in controls (median, 6.8 ng/mL; range, 4.5 – 10.1). Statistically significant trends of increasing serum sFas with age were observed among cases (r = 0.39, p < 0.0001) and controls (r = 0.42, p < 0.0001). Compared to women in the lowest third, women in the highest third of serum sFas were not at increased risk of ovarian cancer after adjustment for potential confounders (odd ratio (OR), 0.87; 95% confidence interval (CI), 0.42 – 1.82). The results suggest that serum sFas may not be a suitable marker for identification of women at increased risk of ovarian cancer

Optimization of methanol crystallization for highly efficient separation of palmitic acid from palm fatty acid mixture using response surface methodology; Optimización de la cristalización con metanol para una separación altamente eficiente del ácido palmítico en mezclas de ácidos grasos de palma usando metodología de superficie de respuesta

Energy Technology Data Exchange (ETDEWEB)

Japir, A.A.W.; Salimon, J.; Derawi, D.; Yahaya, B.H.; Jamil, M.S.M.; Yusop, M.R.

2017-07-01

The objective of the current study was to develop parameters for the separation of palmitic acid (PA) from a crude palm oil saturated fatty acid (SFAs) mixture by using the methanol crystallization method. The conditions of methanol crystallization were optimized by the response surface methodology (RSM) with the D-optimal design. The procedure of developing the solvent crystallization method was based on various different parameters. The fatty acid composition was carried out using a gas chromatography flame ionization detector (GC-FID) as fatty acid methyl esters. The highest percentage of SFAs was more than 96% with the percentage yield of 87.5% under the optimal conditions of fatty acids-to-methanol ratio of 1: 20 (w/v), the crystallization temperature of -15 °C, and the crystallization time of 24 hours, respectively. The composition of separated SFAs in the solid fraction contains 96.7% of palmitic acid (C16:0) as a dominant component and 3.3% of stearic acid (C18:0). The results showed that utilizing methanol as a crystallization solvent is recommended because of its high efficiency, low cost, stability, availability, comparative ease of recovery and its ability to form needle-like crystals which have good filtering and washing characteristics. [Spanish] El objetivo del presente estudio fue desarrollar parámetros para la separación de ácido palmítico (PA) en mezclas de ácidos grasos saturados (SFAs) de aceites de palma crudo mediante el método de cristalización con metanol. Las condiciones de cristalización con metanol se optimizaron utilizando la metodología de superficie de respuesta (RSM) con el diseño D-Optimal. El procedimiento de desarrollo del método de cristalización con disolvente se basó en diversos parámetros diferentes. La composición de ácidos grasos se llevó a cabo por cromatografía de gases (GC-FID) como ésteres metílicos de ácidos grasos usando un detector de ionización de llama. El porcentaje más alto de SFAs fue mayor

Manipulative therapy in addition to usual medical care accelerates recovery of shoulder complaints at higher costs: economic outcomes of a randomized trial

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Bergman Gert JD

2010-09-01

Full Text Available Abstract Background Shoulder complaints are common in primary care and have unfavourable long term prognosis. Our objective was to evaluate the clinical effectiveness of manipulative therapy of the cervicothoracic spine and the adjacent ribs in addition to usual medical care (UMC by the general practitioner in the treatment of shoulder complaints. Methods This economic evaluation was conducted alongside a randomized trial in primary care. Included were 150 patients with shoulder complaints and a dysfunction of the cervicothoracic spine and adjacent ribs. Patients were treated with UMC (NSAID's, corticosteroid injection or referral to physical therapy and were allocated at random (yes/no to manipulative therapy (manipulation and mobilization. Patient perceived recovery, severity of main complaint, shoulder pain, disability and general health were outcome measures. Data about direct and indirect costs were collected by means of a cost diary. Results Manipulative therapy as add-on to UMC accelerated recovery on all outcome measures included. At 26 weeks after randomization, both groups reported similar recovery rates (41% vs. 38%, but the difference between groups in improvement of severity of the main complaint, shoulder pain and disability sustained. Compared to the UMC group the total costs were higher in the manipulative group (€1167 vs. €555. This is explained mainly by the costs of the manipulative therapy itself and the higher costs due sick leave from work. The cost effectiveness ratio showed that additional manipulative treatment is more costly but also more effective than UMC alone. The cost-effectiveness acceptability curve shows that a 50%-probability of recovery with AMT within 6 months after initiation of treatment is achieved at €2876. Conclusion Manipulative therapy in addition to UMC accelerates recovery and is more effective than UMC alone on the long term, but is associated with higher costs. International Standard

Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults.

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Pondor, Ibnteesam; Gan, Wan Ying; Appannah, Geeta

2017-09-16

Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49). The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001). There were also positive associations between DDC and M-HEI scores for fruits ( p diet quality included carbohydrate (β = 0290; p healthy eating among Malaysian adults.

Endoscopic third ventriculostomy has no higher costs than ventriculoperitoneal shunt

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Benicio Oton de Lima

2014-07-01

Full Text Available Objective: To evaluate the cost of endoscopic third ventriculostomy (ETV compared to ventriculoperitoneal shunt (VPS in the treatment of hydrocephalus in children. Method: We studied 103 children with hydrocephalus, 52 of which were treated with ETV and 51 with VPS in a prospective cohort. Treatment costs were compared within the first year after surgery, including subsequent surgery or hospitalization. Results: Twenty (38.4% of the 52 children treated with VPS needed another procedure due to shunt failure, compared to 11 (21.5% of 51 children in the ETV group. The average costs per patient in the group treated with ETV was USD$ 2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group. Conclusions: In this series there was no significant difference in costs between the ETV and VPS groups.

Reproductive performance and gestational effort in relation to dietary fatty acids in guinea pigs.

Science.gov (United States)

Nemeth, Matthias; Millesi, Eva; Siutz, Carina; Wagner, Karl-Heinz; Quint, Ruth; Wallner, Bernard

2017-01-01

Dietary saturated (SFAs) and polyunsaturated (PUFAs) fatty acids can highly affect reproductive functions by providing additional energy, modulating the biochemical properties of tissues, and hormone secretions. In precocial mammals such as domestic guinea pigs the offspring is born highly developed. Gestation might be the most critical reproductive period in this species and dietary fatty acids may profoundly influence the gestational effort. We therefore determined the hormonal status at conception, the reproductive success, and body mass changes during gestation in guinea pigs maintained on diets high in PUFAs or SFAs, or a control diet. The diets significantly affected the females' plasma fatty acid status at conception, while cortisol and estrogen levels did not differ among groups. SFA females exhibited a significantly lower body mass and litter size, while the individual birth mass of pups did not differ among groups and a general higher pup mortality rate in larger litters was diminished by PUFAs and SFAs. The gestational effort, determined by a mother's body mass gain during gestation, increased with total litter mass, whereas this increase was lowest in SFA and highest in PUFA individuals. The mother's body mass after parturition did not differ among groups and was positively affected by the total litter mass in PUFA females. While SFAs reduce the litter size, but also the gestational effort as a consequence, PUFA supplementation may contribute to an adjustment of energy accumulations to the total litter mass, which may both favor a mother's body condition at parturition and perhaps increase the offspring survival at birth.

The Cost-Accounting Mechanism in Higher Educational Institutions.

Science.gov (United States)

Lukoshkin, A. P.; Min'ko, E. V.

1990-01-01

Examines the need to increase expenditures per student at Soviet technical institutes. Proposes seeking financial assistance from enterprises employing technical specialists. Outlines an experimental program in cost accounting. Suggests stipend and wage allotments and explains some of the contractual obligations involved. (CH)

Detection and identification of extra virgin olive oil adulteration by GC-MS combined with chemometrics.

Science.gov (United States)

Yang, Yang; Ferro, Miguel Duarte; Cavaco, Isabel; Liang, Yizeng

2013-04-17

In this study, an analytical method for the detection and identification of extra virgin olive oil adulteration with four types of oils (corn, peanut, rapeseed, and sunflower oils) was proposed. The variables under evaluation included 22 fatty acids and 6 other significant parameters (the ratio of linoleic/linolenic acid, oleic/linoleic acid, total saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs), MUFAs/PUFAs). Univariate analyses followed by multivariate analyses were applied to the adulteration investigation. As a result, the univariate analyses demonstrated that higher contents of eicosanoic acid, docosanoic acid, tetracosanoic acid, and SFAs were the peculiarities of peanut adulteration and higher levels of linolenic acid, 11-eicosenoic acid, erucic acid, and nervonic acid the characteristics of rapeseed adulteration. Then, PLS-LDA made the detection of adulteration effective with a 1% detection limit and 90% prediction ability; a Monte Carlo tree identified the type of adulteration with 85% prediction ability.

Measuring the Cost of Quality in Higher Education: A Faculty Perspective

Science.gov (United States)

Ruhupatty, LeRoy; Maguad, Ben A.

2015-01-01

Most critical activities in colleges and universities are driven by financial considerations. It is thus important that revenues are found to support these activities or ways identified to streamline costs. One way to cut cost is to improve the efficiency of schools to address the issue of poor quality. In this paper, the cost of poor quality in…

The influence of acclimation temperature on the lipid composition of the larval lamprey, Petromyzon marinus, depends on tissue and lipid class.

Science.gov (United States)

Kao, Yung-Hsi; Sheridan, Mark A; Holmes, John A; Youson, John H

2010-11-01

This study was designed to examine the effect of thermal acclimation on the lipid composition of fat depot organs the liver and kidneys of larval sea lamprey, Petromyzon marinus. We found that 21 °C-acclimated larvae possessed lower total lipid amounts in the liver (39% lower) and kidneys (30% lower) than 13 °C-acclimated larvae. Relatively lower lipid contents in the liver and kidneys of 21 °C-acclimated lamprey primarily resulted from a reduction in stored lipid reserve, triacylglycerol, but not the structural lipid, phospholipid. Compared to 21 °C-acclimated larvae, 13 °C-acclimated larvae were found to possess fewer saturated fatty acids (SFAs) and more unsaturated fatty acids (USFAs) in renal triacylglycerol and phospholipid classes, while there were no significant differences in the SFAs and USFAs of hepatic triacylglycerol, phospholipid, cholesteryl ester, fatty acid, and monoacylglycerol classes. Fewer SFAs, found in the kidney triacylglycerol of 13 °C-acclimated lamprey, were due to lower 12:0 and 14:0 fatty acids, but those in the renal phospholipid class were characterized by fewer 14:0, 15:0, and 16:0 fatty acids. More USFAs in renal triacylglycerol, as indicated by a higher unsaturation index, primarily resulted from higher polyunsaturated fatty acids (18:2ω6, 18:3ω3, and 18:4ω3); whereas, in the renal phospholipid class, this was a result of higher monoenes (18:1, 20:1, and 22:1ω9) and ω3 polyunsaturated fatty acids (18:4ω3). These data suggest that the influence of thermal acclimation on the lipid composition of lamprey fat depot organs depends on tissue and lipid class.

Effects of meals rich in either monounsaturated or saturated fat on lipid concentrations and on insulin secretion and action in subjects with high fasting triglyceride concentrations.

Science.gov (United States)

Lopez, Sergio; Bermudez, Beatriz; Ortega, Almudena; Varela, Lourdes M; Pacheco, Yolanda M; Villar, Jose; Abia, Rocio; Muriana, Francisco J G

2011-03-01

The nature of dietary fats and fasting concentrations of triglycerides affect postprandial hypertriglyceridemia and glucose homeostasis. The objectives were to examine the effects of meals enriched in monounsaturated fatty acids (MUFAs) or saturated fatty acids (SFAs) on postprandial lipid, glucose, and insulin concentrations and to examine the extent of β cell function and insulin sensitivity in subjects with high fasting triglyceride concentrations. Fourteen men with fasting hypertriglyceridemia and normal glucose tolerance were given meals (≈10 kcal/kg body weight) containing MUFAs, SFAs, or no fat. Blood samples were collected at baseline and hourly over 8 h for analysis. The high-fat meals significantly increased postprandial concentrations of triglycerides, nonesterified fatty acids, and insulin and postprandial indexes of β cell function. However, postprandial indexes of insulin sensitivity decreased significantly. These effects were significantly attenuated with MUFAs relative to SFAs. MUFAs postprandially buffered β cell hyperactivity and insulin intolerance relative to SFAs in subjects with high fasting triglyceride concentrations. These data suggest that, in contrast with SFAs, MUFA-based strategies may provide cardiovascular benefits to persons at risk by limiting lipid and insulin excursions and may contribute to optimal glycemic control after meal challenges.

Different in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study

NARCIS (Netherlands)

Forouhi, N.G.; Koulman, A.; Sharp, S.J.; Groenendijk-van Woudenbergh, G.J.; Feskens, E.J.M.

2014-01-01

Background Conflicting evidence exists regarding the association between saturated fatty acids (SFAs) and type 2 diabetes. In this longitudinal case-cohort study, we aimed to investigate the prospective associations between objectively measured individual plasma phospholipid SFAs and incident type 2

Can a Costly Intervention Be Cost-effective?

Science.gov (United States)

Foster, E. Michael; Jones, Damon

2009-01-01

Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

Do Medicare Advantage Plans Minimize Costs? Investigating the Relationship Between Benchmarks, Costs, and Rebates.

Science.gov (United States)

Zuckerman, Stephen; Skopec, Laura; Guterman, Stuart

2017-12-01

Medicare Advantage (MA), the program that allows people to receive their Medicare benefits through private health plans, uses a benchmark-and-bidding system to induce plans to provide benefits at lower costs. However, prior research suggests medical costs, profits, and other plan costs are not as low under this system as they might otherwise be. To examine how well the current system encourages MA plans to bid their lowest cost by examining the relationship between costs and bonuses (rebates) and the benchmarks Medicare uses in determining plan payments. Regression analysis using 2015 data for HMO and local PPO plans. Costs and rebates are higher for MA plans in areas with higher benchmarks, and plan costs vary less than benchmarks do. A one-dollar increase in benchmarks is associated with 32-cent-higher plan costs and a 52-cent-higher rebate, even when controlling for market and plan factors that can affect costs. This suggests the current benchmark-and-bidding system allows plans to bid higher than local input prices and other market conditions would seem to warrant. To incentivize MA plans to maximize efficiency and minimize costs, Medicare could change the way benchmarks are set or used.

The ABCs of Activity-Based Costing: A Cost Containment and Reallocation Tool.

Science.gov (United States)

Turk, Frederick J.

1992-01-01

This article describes activity-based costing (ABC) and how this tool may help management understand the costs of major activities and identify possible alternatives. Also discussed are the traditional costing systems used by higher education and ways of applying ABC to higher education. (GLR)

The Cost of Chaos in the Curriculum. Perspectives on Higher Education

Science.gov (United States)

Capaldi Phillips, Elizabeth D.; Poliakoff, Michael B.

2015-01-01

ACTA's report "The Cost of Chaos in the Curriculum" reveals that the vast array of course choices given to college students is a cause of exploding costs and poor academic outcomes. And a bloated undergraduate curriculum is particularly detrimental to the success of students from lower socioeconomic backgrounds. The report documents how…

Simulation of differential die-away instrument’s response to asymmetrically burned spent nuclear fuel

International Nuclear Information System (INIS)

Martinik, Tomas; Henzl, Vladimir; Grape, Sophie; Svärd, Staffan Jacobsson; Jansson, Peter; Swinhoe, Martyn T.; Tobin, Stephen J.

2015-01-01

Previous simulation studies of Differential Die‐Away (DDA) instrument’s response to active interrogation of spent nuclear fuel from a pressurized water reactor (PWR) yielded promising results in terms of its capability to accurately measure or estimate basic spent fuel assembly (SFA) characteristics, such as multiplication, initial enrichment (IE) and burn-up (BU) as well as the total plutonium content. These studies were however performed only for a subset of idealized SFAs with a symmetric BU with respect to its longitudinal axis. Therefore, to complement the previous results, additional simulations have been performed of the DDA instrument’s response to interrogation of asymmetrically burned spent nuclear fuel in order to determine whether detailed assay of SFAs from all 4 sides will be necessary in real life applications or whether a cost and time saving single sided assay could be used to achieve results of similar quality as previously reported in case of symmetrically burned SFAs. The results of this study suggest that DDA instrument response depends on the position of the individual neutron detectors and in fact can be split in two modes. The first mode, measured by the back detectors, is not significantly sensitive to the spatial distribution of fissile isotopes and neutron absorbers, but rather reflects the total amount of both contributors as in the cases of symmetrically burned SFAs. In contrary, the second mode, measured by the front detectors, yields certain sensitivity to the orientation of the asymmetrically burned SFA inside the assaying instrument. This study thus provides evidence that the DDA instrument can potentially be utilized as necessary in both ways, i.e. a quick determination of the average SFA characteristics in a single assay, as well as a more detailed characterization involving several DDA observables through assay of the SFA from all of its four sides that can possibly map the burn-up distribution and/or identify diversion or

Simulation of differential die-away instrument’s response to asymmetrically burned spent nuclear fuel

Energy Technology Data Exchange (ETDEWEB)

Martinik, Tomas, E-mail: tomas.martinik@physics.uu.se [Department of Physics and Astronomy, Uppsala University, Box 516 Sweden, SE-75120 Uppsala (Sweden); Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545 (United States); Henzl, Vladimir [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545 (United States); Grape, Sophie; Svärd, Staffan Jacobsson; Jansson, Peter [Department of Physics and Astronomy, Uppsala University, Box 516 Sweden, SE-75120 Uppsala (Sweden); Swinhoe, Martyn T. [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545 (United States); Tobin, Stephen J. [Department of Physics and Astronomy, Uppsala University, Box 516 Sweden, SE-75120 Uppsala (Sweden); Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545 (United States); Swedish Nuclear Fuel and Waste Management Company, Blekholmstorget 30, Box 250, SE-101 24 Stockholm (Sweden)

2015-07-11

Previous simulation studies of Differential Die‐Away (DDA) instrument’s response to active interrogation of spent nuclear fuel from a pressurized water reactor (PWR) yielded promising results in terms of its capability to accurately measure or estimate basic spent fuel assembly (SFA) characteristics, such as multiplication, initial enrichment (IE) and burn-up (BU) as well as the total plutonium content. These studies were however performed only for a subset of idealized SFAs with a symmetric BU with respect to its longitudinal axis. Therefore, to complement the previous results, additional simulations have been performed of the DDA instrument’s response to interrogation of asymmetrically burned spent nuclear fuel in order to determine whether detailed assay of SFAs from all 4 sides will be necessary in real life applications or whether a cost and time saving single sided assay could be used to achieve results of similar quality as previously reported in case of symmetrically burned SFAs. The results of this study suggest that DDA instrument response depends on the position of the individual neutron detectors and in fact can be split in two modes. The first mode, measured by the back detectors, is not significantly sensitive to the spatial distribution of fissile isotopes and neutron absorbers, but rather reflects the total amount of both contributors as in the cases of symmetrically burned SFAs. In contrary, the second mode, measured by the front detectors, yields certain sensitivity to the orientation of the asymmetrically burned SFA inside the assaying instrument. This study thus provides evidence that the DDA instrument can potentially be utilized as necessary in both ways, i.e. a quick determination of the average SFA characteristics in a single assay, as well as a more detailed characterization involving several DDA observables through assay of the SFA from all of its four sides that can possibly map the burn-up distribution and/or identify diversion or

Comparing goodwill before and after the changes in us gaap in 2001

NARCIS (Netherlands)

Lycklama à Nijeholt, M.P.; Grift, Y.K.; Blommaert, J.M.J.

2012-01-01

This study examines whether the introduction of SFAS 141 “Business Combinations” (2001) and SFAS 142 “Goodwill and other Intangible Assets” (2001) has led to more precise information about accounting goodwill in the financial statements of acquirers. Acquisitions in the period 1997-2005 between US

Microglia Dictate the Impact of Saturated Fat Consumption on Hypothalamic Inflammation and Neuronal Function

Directory of Open Access Journals (Sweden)

Martin Valdearcos

2014-12-01

Full Text Available Diets rich in saturated fat produce inflammation, gliosis, and neuronal stress in the mediobasal hypothalamus (MBH. Here, we show that microglia mediate this process and its functional impact. Although microglia and astrocytes accumulate in the MBH of mice fed a diet rich in saturated fatty acids (SFAs, only the microglia undergo inflammatory activation, along with a buildup of hypothalamic SFAs. Enteric gavage specifically with SFAs reproduces microglial activation and neuronal stress in the MBH, and SFA treatment activates murine microglia, but not astrocytes, in culture. Moreover, depleting microglia abrogates SFA-induced inflammation in hypothalamic slices. Remarkably, depleting microglia from the MBH of mice abolishes inflammation and neuronal stress induced by excess SFA consumption, and in this context, microglial depletion enhances leptin signaling and reduces food intake. We thus show that microglia sense SFAs and orchestrate an inflammatory process in the MBH that alters neuronal function when SFA consumption is high.

On Account--table Combined Method for Education Cost Calculation of Higher Vocational Colleges%高职院校教育成本帐表结合法的探析

Institute of Scientific and Technical Information of China (English)

韩征

2012-01-01

随着高职院校各项教育费用支出的增加，教育成本逐渐受到人们的关注．为了科学核算高职院校教育成本，分析了高职院校现行核算方法不能客观反映教育成本的原因，明确了教育成本核算的基本会计假设和原则．以高职院校经费预算项目核算为基础，结合高职院校财务现状和办学特点，提出了帐表结合法核算高职院校教育成本．该方法采用项目帐和费用分配表相结合的模式，可科学核算高职院校教育成本．%With the increase of various education expenses of higher vocational colleges, educa-tion cost is gradually getting noticed by people. In order to calculate education cost of higher vo-cational colleges scientifically, this paper puts forward that current calculation method can not re-flect the education cost of higher vocational colleges objectively and clarifies basic accounting pos-tulate as well as principles of education cost calculation. Based on calculation of fund budget i-tems of higher vocational colleges, this paper puts forward account table combined method to calculate education cost of higher vocational colleges according to their financial situation and school-running characteristics. This method adopts the model combining item account with cost allocation table, which can calculate education cost of higher vocational colleges scientifically.

National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis with Policy Implications

OpenAIRE

Harris, Catherine R.; Osterberg, E. Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W.; McAninch, Jack W.; McCulloch, Charles E.; Breyer, Benjamin N.

2016-01-01

To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality.We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear ...

Formation and Stability of Foams Made with Sunflower (Helianthus annuus) Proteins

NARCIS (Netherlands)

Gonzalez-Perez, S.; Vereijken, J.M.; Koningsveld, van G.A.; Gruppen, H.; Voragen, A.G.J.

2005-01-01

Foam properties of a sunflower isolate (SI), as well as those of helianthinin and sunflower albumins (SFAs), were studied at various pH values and ionic strengths and after heat treatment. Less foam could be formed from helianthinin than from SFAs, but foam prepared with helianthinin was more stable

Saturated Fats from Butter but Not from Cheese Increase HDL-Mediated Cholesterol Efflux Capacity from J774 Macrophages in Men and Women with Abdominal Obesity.

Science.gov (United States)

Brassard, Didier; Arsenault, Benoît J; Boyer, Marjorie; Bernic, Daniela; Tessier-Grenier, Maude; Talbot, Denis; Tremblay, Angelo; Levy, Emile; Asztalos, Bela; Jones, Peter J H; Couture, Patrick; Lamarche, Benoît

2018-04-01

Recent evidence suggests that the association between dietary saturated fatty acids (SFAs) and coronary artery disease risk varies according to food sources. How SFAs from butter and cheese influence HDL-mediated cholesterol efflux capacity (CEC), a key process in reverse cholesterol transport, is currently unknown. In a predefined secondary analysis of a previously published trial, we have examined how diets rich in SFAs from either cheese or butter influence HDL-mediated CEC, compared with diets rich in either monounsaturated fatty acids (MUFAs) or polyunsaturated fatty acids (PUFAs). In a randomized crossover controlled consumption trial, 46 men and women with abdominal obesity consumed 5 isocaloric diets, each for 4 wk. Two diets were rich in SFAs either from cheese (CHEESE) or butter (BUTTER) [12.4-12.6% of energy (%E) as SFAs, 32%E as fat, 52%E as carbohydrates]. In 2 other diets, SFAs (5.8%E) were replaced with either MUFAs from refined olive oil (MUFA) or PUFAs from corn oil (PUFA). Finally, a lower fat and carbohydrate diet was used as a control (5.8%E as SFAs, 25.0%E as fat, 59%E as carbohydrates; CHO). Post-diet HDL-mediated CEC was determined ex vivo using radiolabelled J774 macrophages incubated with apolipoprotein B-depleted serum from the participants. Mean (±SD) age was 41.4 ± 14.2 y, and waist circumference was 107.6 ± 11.5 cm in men and 94.3 ± 12.4 cm in women. BUTTER and MUFA increased HDL-mediated CEC compared with CHEESE (+4.3%, P = 0.026 and +4.7%, P = 0.031, respectively). Exploring the significant diet × sex interaction (P = 0.044) revealed that the increase in HDL-mediated CEC after BUTTER compared with CHEESE was significant among men (+6.0%, P = 0.047) but not women (+2.9%, P = 0.19), whereas the increase after MUFA compared with CHEESE was significant among women (+9.1%, P = 0.008) but not men (-0.6%, P = 0.99). These results provide evidence of a food matrix effect modulating the impact of dairy SFAs on HDL

Fat intake in children with autism spectrum disorder in the Mediterranean region (Valencia, Spain).

Science.gov (United States)

Marí-Bauset, Salvador; Llopis-González, Agustín; Zazpe, Itziar; Marí-Sanchis, Amelia; Suárez-Varela, María Morales

2016-11-01

Children with autism spectrum disorder (ASD) have been found to have alterations in dietary fat intake and fat quality. The fat intakes of the foods consumed by children with and without ASD were compared, and the deficiency and excess of these nutrients were examined. In a matched case-control study, 3-day food diaries were completed by 105 children with ASD and 495 typically developing (TD) 6- to 9-year-old children in Valencia (Spain). We used the probabilistic approach and estimated average requirement cut-point to evaluate the risk of inadequate nutrients intakes. These were compared between groups and with Spanish recommendations using linear and logistic regression, respectively. Groups did not differ significantly in age, total dietary intake, Healthy Eating Index, or food variety score. Children with ASD had lower saturated fatty acids (SFAs) and ω-3 polyunsaturated fatty acids (PUFAs) intakes, but their total PUFAs and (PUFAs + monounsaturated fatty acids (MUFAs)/SFAs, PUFAs/SFAs intakes and ω-6/ω-3 ratios were higher than TD children. The total fat and cholesterol intakes of both groups were slightly above Spanish recommendations. Both groups had low ω-6 intakes, very low ω-3 intakes, and high ω-6/ω-3 ratios. Further research is required to clarify associations between ASD symptomatology, fat-eating patterns and health status.

Review and Analysis of Alternatives for the Valorisation of Agro-Industrial Olive Oil By-Products

Directory of Open Access Journals (Sweden)

Julio Berbel

2018-01-01

Full Text Available By-products and waste from olive production (agriculture and the olive oil industry (mills and refineries are an important environmental issue in Mediterranean areas. Industrial waste and by-products contain highly valuable components that can also be phytotoxic. This article reviews recent research on the valorisation of olive by-products under the bioeconomy strategy. The alternatives are classified according to the ‘bioeconomy value pyramid’, which prioritises higher value uses over the current energy and compost valorisation. Special attention is paid to the use of these by-products for animal feed that can be improved by reducing the content of saturated fatty acids (SFAs and increase the polyunsaturated fatty acids amount considered beneficial in response to their use; this makes the food healthier for humans while simultaneously reducing feeding costs and the environmental impact of livestock.

Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

Directory of Open Access Journals (Sweden)

Menzies Dick

2008-06-01

Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

Evaluasi Konseptual Atas PSAK No. 26 Serta Dampaknya Terhadap Sektor Properti

OpenAIRE

Wirjolukito, Aruna

2004-01-01

Implementation of capitalization treatment of borrowing costs is often questioned related to the effective of accounting information presentation. So far, PSAK Indonesia had already adapted these issues taken from SFAS. About two half years later, PSAK No. 26 had been revised at mid term of January 1997, by adding some important stressing about qualifying assets. One thing to be considered in accounting treatment implementation is the false impact in the process of decision making, e.g. in [1...

Sex-specific effects of dietary fatty acids on saliva cortisol and social behavior in guinea pigs under different social environmental conditions.

Science.gov (United States)

Nemeth, Matthias; Millesi, Eva; Puehringer-Sturmayr, Verena; Kaplan, Arthur; Wagner, Karl-Heinz; Quint, Ruth; Wallner, Bernard

2016-01-01

Unbalanced dietary intakes of saturated (SFAs) and polyunsaturated (PUFAs) fatty acids can profoundly influence the hypothalamic-pituitary-adrenal (HPA)-axis and glucocorticoid secretions in relation to behavioral performances. The beneficial effects of higher dietary PUFA intakes and PUFA:SFA ratios may also affect social interactions and social-living per se, where adequate physiological and behavioral responses are essential to cope with unstable social environmental conditions. Effects of diets high in PUFAs or SFAs and a control diet were investigated in male and female guinea pigs after 60 days of supplementation. Plasma fatty acid patterns served as an indicator of the general fatty acid status. HPA-axis activities, determined by measuring saliva cortisol concentrations, social behaviors, and hierarchy ranks were analyzed during group housing of established single-sexed groups and during challenging social confrontations with unfamiliar individuals of the other groups. The plasma PUFA:SFA ratio was highest in PUFA supplemented animals, with female levels significantly exceeding males, and lowest in SFA animals. SFA males and females showed increased saliva cortisol levels and decreased aggressiveness during group housing, while sociopositive behaviors were lowest in PUFA males. Males generally showed higher cortisol increases in response to the challenging social confrontations with unfamiliar individuals than females. While increasing cortisol concentrations were detected in control and PUFA animals, no such effect was found in SFA animals. During social confrontations, PUFA males showed higher levels of agonistic and sociopositive behaviors and also gained higher dominance ranks among males, which was not detected for females. While SFAs seemingly impaired cortisol responses and social behaviors, PUFAs enabled adequate behavioral responses in male individuals under stressful new social environmental conditions. This sex-specific effect was possibly

Dietary fatty acids on aortic root calcification in mice with metabolic syndrome.

Science.gov (United States)

Naranjo, Maria C; Bermudez, Beatriz; Garcia, Indara; Lopez, Sergio; Abia, Rocio; Muriana, Francisco J G; Montserrat-de la Paz, Sergio

2017-04-19

Metabolic syndrome (MetS) is associated with obesity, dyslipidemia, type 2 diabetes, and chronic low-grade inflammation. The aim of this study was to determine the role of high-fat low-cholesterol diets (HFLCDs) rich in SFAs (HFLCD-SFAs), MUFAs (HFLCD-MUFAs) or MUFAs plus omega-3 long-chain PUFAs (HFLCD-PUFAs) on vascular calcification by the modulation of the RANKL/RANK/OPG system in the aortic roots of Lep ob/ob LDLR -/- mice. Animals fed with HFLCD-SFAs had increased weight and a greater atheroma plaque size, calcification, and RANKL/CATHK expression in the aortic root than mice on MUFA-enriched diets, with an increasing OPG expression in the aortic roots of the latter. Our study demonstrates that compared to dietary SFAs, MUFAs from olive oil protect against atherosclerosis by interfering with vascular calcification via the RANKL/RANK/OPG system in the setting of MetS. These findings open opportunities for developing novel nutritional strategies with olive oil as the most important dietary source of MUFAs (notably oleic acid) to prevent cardiovascular complications in MetS.

Niacin and olive oil promote skewing to the M2 phenotype in bone marrow-derived macrophages of mice with metabolic syndrome.

Science.gov (United States)

Montserrat-de la Paz, Sergio; Naranjo, Maria C; Lopez, Sergio; Abia, Rocio; Muriana, Francisco J G; Bermudez, Beatriz

2016-05-18

Metabolic syndrome (MetS) is associated with obesity, dyslipemia, type 2 diabetes and chronic low-grade inflammation. The aim of this study was to determine the role of high-fat low-cholesterol diets (HFLCDs) rich in SFAs (HFLCD-SFAs), MUFAs (HFLCD-MUFAs) or MUFAs plus omega-3 long-chain PUFAs (HFLCD-PUFAs) on polarisation and inflammatory potential in bone marrow-derived macrophages (BMDMs) from niacin (NA)-treated Lep(ob/ob)LDLR(-/-) mice. Animals fed with HFLCD-SFAs had increased weight and serum triglycerides, and their BMDMs accumulated triglycerides over the animals fed with HFLCD-MUFAs or -PUFAs. Furthermore, BMDMs from animals fed with HFLCD-SFAs were polarised towards the M1 phenotype with functional competence to produce pro-inflammatory cytokines, whereas BMDMs from animals fed with HFLCD-MUFAs or -PUFAs were skewed to the anti-inflammatory M2 phenotype. These findings open opportunities for developing novel nutritional strategies with olive oil as the most important dietary source of MUFAs (notably oleic acid) to prevent development and progression of metabolic complications in the NA-treated MetS.

Photonic Integrated Circuits for Cost-Effective, High Port Density, and Higher Capacity Optical Communications Systems

Science.gov (United States)

Chiappa, Pierangelo

Bandwidth-hungry services, such as higher speed Internet, voice over IP (VoIP), and IPTV, allow people to exchange and store huge amounts of data among worldwide locations. In the age of global communications, domestic users, companies, and organizations around the world generate new contents making bandwidth needs grow exponentially, along with the need for new services. These bandwidth and connectivity demands represent a concern for operators who require innovative technologies to be ready for scaling. To respond efficiently to these demands, Alcatel-Lucent is fast moving toward photonic integration circuits technologies as the key to address best performances at the lowest "bit per second" cost. This article describes Alcatel-Lucent's contribution in strategic directions or achievements, as well as possible new developments.

Relations Between Serum Essential Fatty Acids, Cytokines (IL-6 & IL ...

African Journals Online (AJOL)

The aim of this study was to investigate the relations between free radical generation, interleukins (IL-6 & IL-8), apoptotic marker soluble Fas (sFas), and the level of ... IL-6, IL-8 and sFas whereas serum fatty acid revealed that Linoleicacid (LA) and alpha linolenic acid (ALA) were significantly decreased in the studied cases .

Reflections on Costing, Pricing and Income Measurement at UK Higher Education Institutions

Science.gov (United States)

Oduoza, Chike F.

2009-01-01

In these days of radical contraction of funding and expansion in student numbers, universities are under pressure to prioritise their resources, as well as to achieve effective costing and pricing to support judgement and decision making for funding and any external work undertaken. This study reviews costing, pricing and income measurement in…

Postprandial triglyceride-rich lipoproteins promote lipid accumulation and apolipoprotein B-48 receptor transcriptional activity in human circulating and murine bone marrow neutrophils in a fatty acid-dependent manner.

Science.gov (United States)

Ortega-Gómez, Almudena; Varela, Lourdes M; López, Sergio; Montserrat de la Paz, Sergio; Sánchez, Rosario; Muriana, Francisco J G; Bermúdez, Beatriz; Abia, Rocío

2017-09-01

Postprandial triglyceride-rich lipoproteins (TRLs) promote atherosclerosis. Recent research points the bone marrow (BM) as a primary site in atherosclerosis. We elucidated how the acute administration of monounsaturated fatty acids (MUFAs) MUFAs, omega-3 polyunsaturated fatty acids (PUFAs) PUFAs and saturated fatty acids (SFAs) affects human circulating and murine BM neutrophil lipid accumulation and functionality. Postprandial hypertriglyceridemia was induced in healthy subjects and Apoe -/- mice by the acute administration of dietary fats enriched in MUFAs, PUFAs, or SFAs. Postprandial hypertriglyceridemia increased apolipoprotein-B48 receptor (ApoB48R) transcriptional activity that was linearly correlated with intracellular triglycerides (TGs) TGs accumulation in human circulating and murine BM neutrophils. MUFA and omega-3 PUFAs attenuated ApoB48R gene expression and intracellular TG accumulation compared to SFAs. TRLs induced apoB48R-dependent TG accumulation in human neutrophils ex vivo. Murine BM neutrophils showed a decrease in surface L-selectin and an increase in TNF-α and IL-1β mRNA expressions only after SFAs administration. TRLs enriched in SFAs induced BM neutrophil degranulation ex vivo suggesting cell priming/activation. Postprandial TRLs disrupts the normal biology and function of circulating and BM neutrophils. MUFA- and omega-3 PUFA-rich dietary fats such as virgin olive oil or fish oil has the potential to prevent excessive neutrophil lipid accumulation and activation by targeting the fatty acid composition of TRLs. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

Higher energy: is it necessary, is it worth the cost for radiation oncology?

Science.gov (United States)

Das, I J; Kase, K R

1992-01-01

The physical characteristics of the interactions of megavoltage photons and electrons with matter provide distinct advantages, relative to low-energy (orthovoltage) x rays, that lead to better radiation dose distributions in patients. Use of these high-energy radiations has resulted in better patient care, which has been reflected in improved radiation treatment outcome in recent years. But, as the desire for higher energy radiation beams increases, it becomes important to determine whether the physical characteristics that make megavoltage beams beneficial continue to provide a net advantage. It is demonstrated that, in fact, there is an energy range from 4 to 15 MV for photons and 4 to 20 MeV for electrons that is optimally suited for the treatment of cancer in humans. Radiation beams that exceed these maximum energies were found to add no advantage. This is because the costs (price of unit, installation, maintenance, shielding for neutron and photons) are not justified by either improved physical characteristics of the radiation (penetration, skin sparing, dose distribution) or treatment outcome. In fact, for photon beams some physical characteristics result in less desirable dose distributions, less accurate dosimetry, and increased safety problems as the energy increases for example, increasingly diffuse beam edges, loss of electron equilibrium, uncertainty in dose perturbations at interfaces, increased neutron contamination, and potential for higher personnel dose. The special features that make electron beams useful at lower energies, for example, skin sparing and small penetration, are lost at high energies. These physical factors are analyzed together with the economic factors related to radiation therapy patient care using megavoltage beams.

Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.

Science.gov (United States)

Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin

2015-08-28

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing

Cost benefit analysis vs. referenda

OpenAIRE

Martin J. Osborne; Matthew A. Turner

2007-01-01

We consider a planner who chooses between two possible public policies and ask whether a referendum or a cost benefit analysis leads to higher welfare. We find that a referendum leads to higher welfare than a cost benefit analyses in "common value" environments. Cost benefit analysis is better in "private value" environments.

Correlated changes of serum sFas/sFasL and TRAb concentrations in patients with Graves' disease after treatment with lesser dosage of 131i combined with traditional Chinese medicine

International Nuclear Information System (INIS)

Zhang Jinshan; Deng Yongmei; Li Min; Huang Guimin; Feng Chonglian

2005-01-01

Objective: To investigate the rule of changes of serum sFas/sFasL and TRAb concentrations in patients with Graves' disease after treatment with lesser dosage of 131 I combined with traditional chinese medicine. Methods: Thirty-one patients with Graves' disease were treated with a lesser dosage (85.1-207.2 MBq, mean--about 2/3 of conventional dose) of 131 I combined with traditional chinese medicine. Serum sFas, sFasL (with ELISA), TRAb (with RRA) and other thyroid-related hormones (TT 3 , TT 4 , FT 3 , FT 4 , TSH, TGA, TMA with RIA) concentrations were determined before and after the treatment. Seventeen controls participated in this experiment. Results: 1) Serum sFas contents in the patients before treatment (179.8 ± 64.2 pg/ml) were significantly higher than those in patients clinically cured (104.2 ± 23.5 pg/ml) and controls (110.6 ± 18.1 pg/ml) (both P 131 I and traditional chinese medicine was satisfactory. The treatment was immediately effective in 100% of the patients (31/31) with a permanent cure rate of 74.2% (23/31) (one dose only) and late hypothyroidism rate of 9.7% (3/31). Conclusion: Reversal of the dominant expression of sFas after the combined treatment indirectly showed the role of apoptosis in the cure of Graves' disease. TRAb was a practical laboratory diagnostic criterion for Graves' disease. (authors)

Correlation Between Dietary Fat Intake and Atherogenic Indices in Normal, Overweight and Obese Adults with or Without Type 2 Diabetes

Directory of Open Access Journals (Sweden)

Diaf Mustapha

2015-12-01

Full Text Available Background and aims: We investigated the association of dietary intake, particularly fat and its constituent fatty acids, with atherogenic indices in adult patients with overweight, obesity and/or type 2 diabetes (T2D. Material and Methods: Two hundred eighty-five outpatients were selected in two cities located in the Northwestern region of Algeria. Anthropometric measurements for body weight, height, body mass index (BMI and waist circumference were performed. Relationships between dietary intakes, estimated by a 3- days food record, and fasting blood atherogenic indices - total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL-c and apolipoprotein (apo B-to-apo A1 ratio, were analysed. Results: Study group included 58.59% overweight/obese T2D patients, 24.91% normal weight T2D patients and 16.49 % overweight/obese patients without diabetes. Higher dietary consumption (p= 0.003 of total fat, saturated fatty acids (SFAs and polyunsaturated fatty acids (PUFAs, was recorded in the group of overweight/obese T2D patients. Significant positive correlations were observed between apo B/apo A1 and total fat (p= 0.035, total SFAs (p= 0.042 and palmitic acid (p= 0.042 in the group of overweight/obese T2D patients and with ω6 fatty acid (p= 0.030 in the group of overweight/obese patients without diabetes. In the two groups of T2D patients, whether normal weight, overweight/obese, numerous positive correlations with TC/HDL-c were disclosed for PUFAs, ω6 and fatty acids ratios, namely, ω6/ω3, monounsaturated fatty acids (MUFA/SFAs and (MUFAs+PUFAs/SFAs. Conclusion: Most adults, whom are either affected by an excess weight or T2D or both together, are prone to cardiovascular risk. Dietary intakes, particularly in fat and its constituent fatty acids, have an important effect on blood lipid atherogenic indices (TC/HDL-c and apo B/apo A1 ratios.

Individual serum saturated fatty acids and markers of chronic subclinical inflammation: the Insulin Resistance Atherosclerosis Study.

Science.gov (United States)

Santaren, Ingrid D; Watkins, Steven M; Liese, Angela D; Wagenknecht, Lynne E; Rewers, Marian J; Haffner, Steven M; Lorenzo, Carlos; Festa, Andreas; Bazinet, Richard P; Hanley, Anthony J

2017-11-01

Recent evidence has documented distinct effects of individual saturated FAs (SFAs) on cardiometabolic outcomes, with potential protective effects from odd- and very long-chain SFAs (VLSFAs). Cross-sectional and prospective associations of individual serum SFAs (12:0, 14:0, 15:0, 16:0, 18:0, 20:0, 22:0, and total SFA) with proinflammatory biomarkers and adiponectin were investigated in 555 adults from the IRAS. Principal component analysis (PCA) of proinflammatory markers yielded three clusters: principal component (PC) 1: fibrinogen, white cell count, C-reactive protein; PC 2: plasminogen activator inhibitor-1 (PAI-1), TNF-α, IL-18; PC 3: IL-6 and IL-8. Cross-sectional analyses on proinflammatory PCs and adiponectin, and prospective analyses on 5 year PAI-1 and fibrinogen concentrations were conducted with multiple regression. Total SFA and 16:0 were positively associated with PC 1 and PC 2, and negatively associated with adiponectin. The 14:0 was positively associated with PC 1 and negatively associated with adiponectin. In contrast, 15:0, 20:0, and 22:0 were negatively associated with PC 2, and 20:0 and 22:0 were positively associated with adiponectin. The 18:0 was negatively associated with PC 3. Prospectively, 15:0, 18:0, 20:0, and 22:0 were negatively associated with 5 year PAI-1 concentrations. The results demonstrate that individual SFAs have distinct roles in subclinical inflammation, highlighting the unique metabolic impacts of individual SFAs. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

Cost and cost-effectiveness of conventional and liquid-based ...

African Journals Online (AJOL)

Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

Meeting UK dietary recommendations is associated with higher estimated consumer food costs: an analysis using the National Diet and Nutrition Survey and consumer expenditure data, 2008-2012.

Science.gov (United States)

Jones, Nicholas Rv; Tong, Tammy Yn; Monsivais, Pablo

2018-04-01

To test whether diets achieving recommendations from the UK's Scientific Advisory Committee on Nutrition (SACN) were associated with higher monetary costs in a nationally representative sample of UK adults. A cross-sectional study linking 4 d diet diaries in the National Diet and Nutrition Survey (NDNS) to contemporaneous food price data from a market research firm. The monetary cost of diets was assessed in relation to whether or not they met eight food- and nutrient-based recommendations from SACN. Regression models adjusted for potential confounding factors. The primary outcome measure was individual dietary cost per day and per 2000 kcal (8368 kJ). UK. Adults (n 2045) sampled between 2008 and 2012 in the NDNS. On an isoenergetic basis, diets that met the recommendations for fruit and vegetables, oily fish, non-milk extrinsic sugars, fat, saturated fat and salt were estimated to be between 3 and 17 % more expensive. Diets meeting the recommendation for red and processed meats were 4 % less expensive, while meeting the recommendation for fibre was cost-neutral. Meeting multiple targets was also associated with higher costs; on average, diets meeting six or more SACN recommendations were estimated to be 29 % more costly than isoenergetic diets that met no recommendations. Food costs may be a population-level barrier limiting the adoption of dietary recommendations in the UK. Future research should focus on identifying systems- and individual-level strategies to enable consumers achieve dietary recommendations without increasing food costs. Such strategies may improve the uptake of healthy eating in the population.

Can Online Learning Bend the Higher Education Cost Curve?

OpenAIRE

David J. Deming; Claudia Goldin; Lawrence F. Katz; Noam Yuchtman

2015-01-01

We examine whether online learning technologies have led to lower prices in higher education. Using data from the Integrated Postsecondary Education Data System, we show that online education is concentrated in large for-profit chains and less-selective public institutions. We find that colleges with a higher share of online students charge lower tuition prices. We present evidence of declining real and relative prices for full-time undergraduate online education from 2006 to 2013. Although t...

Controlling Health Care Costs

Science.gov (United States)

Dessoff, Alan

2009-01-01

This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

Replacement power costs due to nuclear-plant outages: a higher standard of care

International Nuclear Information System (INIS)

Gransee, M.F.

1982-01-01

This article examines recent state public utility commission cases that deal with the high costs of replacement power that utilities must purchase after a nuclear power plant outage. Although most commissions have approved such expenses, it may be that there is a trend toward splitting the costs of such expenses between ratepayer and stockholder. Commissions are demanding a management prudence test to determine the cause of the outage and whether it meets the reasonable man standard before allowing these costs to be passed along to ratepayers. Unless the standard is applied with flexibility, however, utility companies could invoke the defenses covering traditional common law negligence

Does obesity along with major depression or anxiety lead to higher use of health care and costs? : A 6-year follow-up study

NARCIS (Netherlands)

Nigatu, Yeshambel T.; Bultmann, Ute; Schoevers, Robert A.; Penninx, Brenda W. J. H.; Reijneveld, Sijmen A.

2017-01-01

Background: Evidence lacks on whether obesity along with major depression (MD)/anxiety leads to higher health care use (HCU) and health care-related costs (HCC) compared with either condition alone. The objective of the study was to examine the longitudinal associations of obesity, MD/anxiety, and

Intravenous thrombolysis of large vessel occlusions is associated with higher hospital costs than small vessel strokes: a rationale for developing stroke severity-based financial models.

Science.gov (United States)

Rai, Ansaar T; Evans, Kim; Riggs, Jack E; Hobbs, Gerald R

2016-04-01

Owing to their severity, large vessel occlusion (LVO) strokes may be associated with higher costs that are not reflected in current coding systems. This study aimed to determine whether intravenous thrombolysis costs are related to the presence or absence of LVO. Patients who had undergone intravenous thrombolysis over a 9-year period were divided into LVO and no LVO (nLVO) groups based on admission CT angiography. The primary outcome was hospital cost per admission. Secondary outcomes included admission duration, 90-day clinical outcome, and discharge destination. 119 patients (53%) had LVO and 104 (47%) had nLVO. Total mean±SD cost per LVO patient was $18,815±14,262 compared with $15,174±11,769 per nLVO patient (p=0.04). Hospital payments per admission were $17,338±13,947 and $15,594±16,437 for LVO and nLVO patients, respectively (p=0.4). A good outcome was seen in 33 LVO patients (27.7%) and in 69 nLVO patients (66.4%) (OR 0.2, 95% CI 0.1 to 0.3, pregression analysis after controlling for comorbidities showed the presence of LVO to be an independent predictor of higher total hospital costs. The presence or absence of LVO is associated with significant differences in hospital costs, outcomes, admission duration, and home discharge. These differences can be important when developing systems of care models for acute ischemic stroke. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Internationalization of Higher Education: Potential Benefits and Costs

Science.gov (United States)

Jibeen, Tahira; Khan, Masha Asad

2015-01-01

Internationalization of higher education is the top stage of international relations among universities and it is no longer regarded as a goal in itself, but as a means to improve the quality of education. The knowledge translation and acquisition, mobilization of talent in support of global research and enchantment of the curriculum with…

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

Directory of Open Access Journals (Sweden)

David Nicol

2003-12-01

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

Marketing Policy and Its Cost in a College of Higher Education.

Science.gov (United States)

Riley, Eric

1984-01-01

Discusses the development of advertising and publicity strategies and policy for student recruitment purposes at a college of education in the United Kingdom between 1972 and 1982. Covers changes in staff attitudes, selection of media, organization of administration, and cost factors. (PGD)

The weighted average cost of capital over the lifecycle of the firm: Is the overinvestment problem of mature firms intensified by a higher WACC?

Directory of Open Access Journals (Sweden)

Carlos S. Garcia

2016-08-01

Full Text Available Firm lifecycle theory predicts that the Weighted Average Cost of Capital (WACC will tend to fall over the lifecycle of the firm (Mueller, 2003, p. 80-81. However, given that previous research finds that corporate governance deteriorates as firms get older (Mueller and Yun, 1998; Saravia, 2014 there is good reason to suspect that the opposite could be the case, that is, that the WACC is higher for older firms. Since our literature review indicates that no direct tests to clarify this question have been carried out up till now, this paper aims to fill the gap by testing this prediction empirically. Our findings support the proposition that the WACC of younger firms is higher than that of mature firms. Thus, we find that the mature firm overinvestment problem is not intensified by a higher cost of capital, on the contrary, our results suggest that mature firms manage to invest in negative net present value projects even though they have access to cheaper capital. This finding sheds new light on the magnitude of the corporate governance problems found in mature firms.

The Real University Cost in a ''Free'' Higher Education Country

Science.gov (United States)

Psacharopoulos, G.; Papakonstantinou, G.

2005-01-01

Using a sample of over 3000 first year university entrants in Greece, we investigate the time and expense incurred in preparation for the highly competitive higher education entry examinations, as well as what students spend privately while attending university. It is shown that in a constitutionally ''free for all'' higher education country,…

Financial Resource Allocation in Higher Education

Science.gov (United States)

Ušpuriene, Ana; Sakalauskas, Leonidas; Dumskis, Valerijonas

2017-01-01

The paper considers a problem of financial resource allocation in a higher education institution. The basic financial management instruments and the multi-stage cost minimization model created are described involving financial instruments to constraints. Both societal and institutional factors that determine the costs of educating students are…

The disarmament cost

International Nuclear Information System (INIS)

Cattaneo, M.

1996-01-01

War is costly. But peace cost is even higher. The destruction of weapons (mines, nuclear weapons, chemical weapons) is much more expensive than their manufacturing. The soldiers demobilization cost is enormous, for instance in Angola, Mozambique, Nicaragua, Zimbabwe the demobilization of 270000 soldiers cost 2.5 10 9 francs. The measures intended to reduce the war risk are also expensive. That is why the arsenal of ex USSR is still intact. Today no international agency is entirely dedicated to peace building. The question is how would cost such an agency? (O.L.). 5 refs., 2 figs

34 CFR 74.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... Procedures or uniform cost accounting standards that comply with cost principles acceptable to ED. (b) The... OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial... principles for determining allowable costs. Allowability of costs are determined in accordance with the cost...

Higher fees paid to US physicians drive higher spending for physician services compared to other countries.

Science.gov (United States)

Laugesen, Miriam J; Glied, Sherry A

2011-09-01

Higher health care prices in the United States are a key reason that the nation's health spending is so much higher than that of other countries. Our study compared physicians' fees paid by public and private payers for primary care office visits and hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States. We also compared physicians' incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries' national spending on physician services. Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians' counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics.

28 CFR 70.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... AND AGREEMENTS (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.27 Allowable costs. (a... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

29 CFR 95.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... Governments.” The allowability of costs incurred by non-profit organizations is determined in accordance with... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

24 CFR 84.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... to the entity incurring the costs. Thus, allowability of costs incurred by State, local or federally..., “Cost Principles for State and Local Governments.” The allowability of costs incurred by non-profit...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

Costs of hospital malnutrition.

Science.gov (United States)

Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

2017-10-01

Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

High Concentration of Serum Soluble Fas in Patients with Head and Neck Carcinoma: A Comparative Study Before and After Surgical Removal of Tumor

OpenAIRE

Seyed Basir Hashemi; Mohammad Javad Fattahi; Mansooreh Jaberipour; Mojtaba Habibagahi; Mahmood Shariati

2010-01-01

Background:Alternative splicing of the Fas transcript can produce a naturalsecreted isoform of this molecule. Some cancer cells can also produce soluble Fas (sFas)which may have suppressive effects on the immune system's anti-tumor response.Elevated concentrations of sFas have been detected in the sera of patients with differentmalignancies. Materials and Methods:The concentrations of sFas in sera of patients with headand neck carcinoma (HNC, n=98) and healthy individuals (n=30) were measured...

Can value-based insurance impose societal costs?

Science.gov (United States)

Koenig, Lane; Dall, Timothy M; Ruiz, David; Saavoss, Josh; Tongue, John

2014-09-01

Among policy alternatives considered to reduce health care costs and improve outcomes, value-based insurance design (VBID) has emerged as a promising option. Most applications of VBID, however, have not used higher cost sharing to discourage specific services. In April 2011, the state of Oregon introduced a policy for public employees that required additional cost sharing for high-cost procedures such as total knee arthroplasty (TKA). Our objectives were to estimate the societal impact of higher co-pays for TKA using Oregon as a case study and building on recent work demonstrating the effects of knee osteoarthritis and surgical treatment on employment and disability outcomes. We used a Markov model to estimate the societal impact in terms of quality of life, direct costs, and indirect costs of higher co-pays for TKA using Oregon as a case study. We found that TKA for a working population can generate societal benefits that offset the direct medical costs of the procedure. Delay in receiving surgical care, because of higher co-payment or other reasons, reduced the societal savings from TKA. We conclude that payers moving toward value-based cost sharing should consider consequences beyond direct medical expenses. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

45 CFR 2543.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.27 Allowable costs. For each kind... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

20 CFR 435.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 435.27 Allowable costs. For each kind... Organizations.” (c) Allowability of costs incurred by institutions of higher education is determined in...

Matrix metalloproteinases and soluble Fas/FasL system as novel regulators of apoptosis in children and young adults on chronic dialysis.

Science.gov (United States)

Musiał, Kinga; Zwolińska, Danuta

2011-07-01

The system of membrane receptor Fas and its ligand FasL compose one of the main pathways triggering apoptosis. However, the role of their soluble forms has not been clarified yet. Although sFasL can be converted from the membrane-bound form by matrix metalloproteinases (MMPs), there are no data on relations between sFas/sFasL, MMPs and their tissue inhibitors (TIMPs) in patients on chronic dialysis--neither children nor adults. The aim of our study was to evaluate serum concentrations of sFas, sFasL, and their potential regulators (MMP-2, MMP-7, MMP-9, TIMP-1, TIMP-2), in children and young adults chronically dialyzed. Twenty-two children on automated peritoneal dialysis (APD), 19 patients on hemodialysis (HD) and 30 controls were examined. Serum concentrations of sFas, sFasL, MMPs and TIMPs were assessed by ELISA. Median values of sFas, sFasL, sFas/sFasL ratio, MMP-2, MMP-7, MMP-9, TIMP-1 and TIMP-2 were significantly elevated in all dialyzed patients vs. controls, the highest values being observed in subjects on HD. A single HD session caused the decrease in values of all parameters to the levels below those seen in children on APD. Regression analysis revealed that MMP-7 and TIMP-1 were the best predictors of sFas and sFasL concentrations. Children and young adults on chronic dialysis are prone to sFas/sFasL system dysfunction, more pronounced in patients on hemodialysis. The correlations between sFas/sFasL and examined enzymes suggest that MMPs and TIMPs take part in the regulation of cell death in the pediatric population on chronic dialysis, triggering both anti- (sFas) and pro-apoptotic (sFasL) mechanisms.

7 CFR 550.25 - Allowable costs.

Science.gov (United States)

2010-01-01

... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... at 2 CFR part 225. The allowability of costs incurred by non-profit organizations is determined in... at 2 CFR part 230. The allowability of costs incurred by institutions of higher education is...

Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

OpenAIRE

Ibnteesam Pondor; Wan Ying Gan; Geeta Appannah

2017-01-01

Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and nationa...

15 CFR 14.27 - Allowable costs.

Science.gov (United States)

2010-01-01

... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.27 Allowable costs. For each kind of... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

49 CFR 19.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

36 CFR 1210.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

7 CFR 3019.27 - Allowable costs.

Science.gov (United States)

2010-01-01

... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

Shared Leadership Transforms Higher Education IT

Science.gov (United States)

Duin, Ann Hill; Cawley, Steve; Gulachek, Bernard; O'Sullivan, Douglas M.; Wollner, Diane

2011-01-01

Globalization, immersive research and learning environments, unlimited access to information and analytics, and fiscal realities continue to impact higher education--and higher education IT. Although IT organizations face immense pressure to meet significantly greater expectations at significantly less cost, with such pressure comes the…

Differential effects of saturated fatty acids on the risk of metabolic syndrome: a matched case-control and meta-analysis study.

Science.gov (United States)

Yang, Wei-Sin; Chen, Pei-Chun; Hsu, Hsiu-Ching; Su, Ta-Chen; Lin, Hung-Ju; Chen, Ming-Fong; Lee, Yuan-Teh; Chien, Kuo-Liong

2018-06-01

We investigated the association between plasma saturated fatty acids (SFAs) and the risk of metabolic syndrome among ethnic Chinese adults in Taiwan who attended a health check-up center. A case-control study based on 1000 cases of metabolic syndrome and 1:1 matched control participants (mean age, 54.9 ± 10.7 y; 36% females) were recruited. Metabolic syndrome was defined according to the criteria of the International Diabetes Federation. Gas chromatography was used to measure the distribution of fatty acids in plasma (% of total fatty acids). Even-chain SFAs, including 14:0, 16:0, and 18:0, were associated with metabolic syndrome; the adjusted odds ratio [OR] and 95% confidence interval [CI] per standard deviation [SD] difference was 3.32, [1.98-5.59]; however, very-long-chain SFAs, including 20:0, 21:0, 22:0, 23:0, and 24:0, were inversely associated with metabolic syndrome. The adjusted OR [95% CI] per SD difference was 0.67 [0.58-0.78]. The area under the receiver operative characteristic curve increased from 0.814 in the basic model to 0.815 (p = 0.54, compared with the basic model), 0.818 (p metabolic syndrome, implying that SFAs are not homogenous for the effects. Copyright © 2018 Elsevier Inc. All rights reserved.

Measuring Direct Teaching Costs: Does an Undergraduate Business Degree Cost More to Produce than a Nonbusiness Degree?

Science.gov (United States)

Barth, Michael M.; Karagiannidis, Iordanis

2016-01-01

Many universities have implemented tuition differentials for certain undergraduate degree programs, citing higher degree costs or higher demand. However, most college accounting systems are unsuited for measuring cost differentials by degree program. This research outlines a method that can convert commonly available financial data to a more…

Costs comparison of electric energy in Brazil

International Nuclear Information System (INIS)

Goncalves, D.; Menegassi, J.

1981-01-01

A cost comparison study of various sources of electric energy generation was performed using uniform analysis criteria. The results indicate higher costs for coal, followed by nuclear and hidro. It was verified that presently, large hidro-power plants can only be located far from the load centers, with increasing costs of hidro-power energy in Brazil. These costs become higher than the nuclear plant if the hidro plant is located at distances exceeding 1000 Km. (Author) [pt

Effects of housing system on the costs of commercial egg production.

Science.gov (United States)

Matthews, W A; Sumner, D A

2015-03-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

Directory of Open Access Journals (Sweden)

Julia K Ostermann

Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

Science.gov (United States)

Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

2015-01-01

Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; phomeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

Is Higher Education Economically Unsustainable? An Exploration of Factors That Undermine Sustainability Assessments of Higher Education

Science.gov (United States)

Maragakis, Antonios; van den Dobbelsteen, Andy; Maragakis, Alexandros

2016-01-01

As students continue to review the sustainability of higher education institutions, there is a growing need to understand the economic returns of degrees as a function of a sustainable institution. This paper reviews a range of international research to summarize the economic drivers of higher education attainment. Although the cost inputs to…

Strategies for compensating for higher costs of geothermal electricity with environmental benefits

International Nuclear Information System (INIS)

Murphy, H.; Niitsuma, Hiroaki

1999-01-01

After very high growth in the 1980s, geothermal electricity production has slowed in the mid- and late-1990s. While Japanese, Indonesian and Philippine geothermal growth has remained high as a consequence of supportive government policies, geothermal electricity production has been flat or reduced in much of Europe and North America. Low prices for coal and natural gas, combined with deregulation, means that in much of the world electricity from new fuel-burning electricity plants can be provided at half the cost of new geothermal electricity. Cost-cutting must be pursued, but is unlikely to close the price gap by itself. Geothermal production is widely perceived as being environmentally clean, but this is not unambiguously true, and requires reinjection to be fully realized. Strategies for monetizing the environmental advantages of geothermal, including the carbon tax, are discussed. (author)

Technology and the Broken Higher Education Cost Model: Insights from the Delta Cost Project

Science.gov (United States)

Kirshstein, Rita; Wellman, Jane

2012-01-01

Although U.S. higher education has faced numerous crises and dilemmas in its history, the situation in which colleges and universities find themselves at the moment is indeed different. Shrinking public subsidies coupled with historic rises in tuitions come at the same time that colleges and universities have been tasked to dramatically increase…

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...

Quality of Higher Education

DEFF Research Database (Denmark)

Zou, Yihuan

is about constructing a more inclusive understanding of quality in higher education through combining the macro, meso and micro levels, i.e. from the perspectives of national policy, higher education institutions as organizations in society, individual teaching staff and students. It covers both......Quality in higher education was not invented in recent decades – universities have always possessed mechanisms for assuring the quality of their work. The rising concern over quality is closely related to the changes in higher education and its social context. Among others, the most conspicuous...... changes are the massive expansion, diversification and increased cost in higher education, and new mechanisms of accountability initiated by the state. With these changes the traditional internally enacted academic quality-keeping has been given an important external dimension – quality assurance, which...

The cost of electrocoagulation

Energy Technology Data Exchange (ETDEWEB)

Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L.

1993-01-01

Electrocoagulation could be an attractive and suitable method for separating solids from waste water. The electrocoagulation of kaolinite and bentonite suspensions was studied in a pilot electrocoagulation unit to assess the cost and efficiency of the process. Factors affecting cost such as the formation of passivation layers on electrode plates and the recirculation and concentration of sodium chloride were examined. Colorimetry was used to analyze aluminum content in the suspension. The results were used to calculate the cost due to consumption of electrode material (aluminium) during the process. Total cost was assumed to comprise the energy cost and the cost of electrode material. Comparison was based on the settling properties of the treated product: turbidity, settling rate, and cake height. In most cases, aluminium efficiency averaged around 200% and material cost accounted for 80% of total cost. Although higher concentrations of sodium chloride could only slightly increase aluminium efficiency and electrode efficiency, the higher concentrations resulted in much greater total cost, due to the greater current generated by the increased suspension conductivity, which in turn dissolved a larger amount of aluminium. The recirculation loop increased the flow rate by 3-10 times, enhancing the mass transport between the electrodes and resulting in lower cost and better settling properties. Over the course of two months the electrodes coatings became thicker while efficiency decreased. The electrode efficiency was found to be as high as 94% for virgin electrodes and as low as 10% after two months. 8 refs., 25 figs., 9 tabs.

Lowering Business Education Cost with a Custom Professor-Written Online Text

Science.gov (United States)

Baker-Eveleth, Lori Jo; Miller, Jon Robert; Tucker, Laura

2011-01-01

Inflation-adjusted tuition and fees in education have risen for decades. College textbook costs have risen as well. The authors discuss reasons for higher textbook costs. The development and use of encyclopedic introductory textbooks creates higher monetary cost for students and higher nonmonetary cost for students and teachers, from increased…

Effects of housing system on the costs of commercial egg production1

Science.gov (United States)

Matthews, W. A.; Sumner, D. A.

2014-01-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. PMID:25480736

Females with a mutation in a nuclear-encoded mitochondrial protein pay a higher cost of survival than do males in Drosophila.

Science.gov (United States)

Melvin, Richard G; Ballard, J William O

2011-07-01

Males and females age at different rates in a variety of species, but the mechanisms underlying the difference is not understood. In this study, we investigated sex-specific costs of a naturally occurring mildly deleterious deletion (DTrp85, DVal86) in cytochrome c oxidase subunit 7A (cox7A) in Drosophila simulans. We observed that females and males homozygous for the mutation had 30% and 26% reduced Cox activity, respectively, compared with wild type. Furthermore, 4-day-old females had 34%-42% greater physical activity than males. Greater physical activity in mutant females was correlated with a 19% lower 50% survival compared with wild-type females. Mutant and wild-type males had equal survival. These data suggest that females paid a higher cost of the mutation than did males. The data demonstrate linking population genetics and structural modeling to experimental manipulations that lead to functional predictions of mitochondrial bioenergetics and organism aging.

National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis With Policy Implications.

Science.gov (United States)

Harris, Catherine R; Osterberg, E Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W; McAninch, Jack W; McCulloch, Charles E; Breyer, Benjamin N

2016-08-01

To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality. We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear regression with sensitivity analysis was used to determine variables associated with increased costs. Extreme cost was defined as the top 20th percentile of expenditure, analyzed with logistic regression, and expressed as odds ratios (OR). A total of 2298 urethroplasties were recorded in NIS over the study period. The median (interquartile range) calculated cost was $7321 ($5677-$10,000). Patients with multiple comorbid conditions were associated with extreme costs [OR 1.56, 95% confidence interval (CI) 1.19-2.04, P = .02] compared with patients with no comorbid disease. Inpatient complications raised the odds of extreme costs (OR 3.2, CI 2.14-4.75, P costs (OR 1.78, 95% CI 1.2-2.64, P = .005). Variations in patient age, race, hospital region, bed size, teaching status, payor type, and volume of urethroplasty cases were not associated with extremes of cost. Cost variation for perioperative inpatient urethroplasty procedures is dependent on preoperative patient comorbidities, postoperative complications, and surgical complexity related to graft usage. Procedural cost and cost variation are critical for understanding which aspects of care have the greatest impact on cost. Copyright © 2016 Elsevier Inc. All rights reserved.

Attrition Cost Model Instruction Manual

Science.gov (United States)

Yanagiura, Takeshi

2012-01-01

This instruction manual explains in detail how to use the Attrition Cost Model program, which estimates the cost of student attrition for a state's higher education system. Programmed with SAS, this model allows users to instantly calculate the cost of attrition and the cumulative attrition rate that is based on the most recent retention and…

Net Shape Spin Formed Cryogenic Aluminum Lithium Cryogenic Tank Domes for Lower Cost Higher Performance Launch Vehicles

Science.gov (United States)

Curreri, Peter A.; Hoffman, Eric; Domack, Marcia; Brewster, Jeb; Russell, Carolyn

2013-01-01

With the goal of lower cost (simplified manufacturing and lower part count) and higher performance (higher strength to weight alloys) the NASA Technical Maturation Program in 2006 funded a proposal to investigate spin forming of space launch vehicle cryogenic tank domes. The project funding continued under the NASA Exploration Technology Development Program through completion in FY12. The first phase of the project involved spin forming of eight, 1 meter diameter "path finder" domes. Half of these were processed using a concave spin form process (MT Aerospace, Augsburg Germany) and the other half using a convex process (Spincraft, Boston MA). The convex process has been used to produce the Ares Common Bulkhead and the concave process has been used to produce dome caps for the Space Shuttle light weight external tank and domes for the NASDA H2. Aluminum Lithium material was chosen because of its higher strength to weight ratio than the Aluminum 2219 baseline. Aluminum lithium, in order to obtain the desired temper (T8), requires a cold stretch after the solution heat treatment and quench. This requirement favors the concave spin form process which was selected for scale up. This paper describes the results of processing four, 5.5 meter diameter (upper stage scale) net shaped spin formed Aluminum Lithium domes. In order to allow scalability beyond the limits of foundry and rolling mills (about 12 foot width) the circular blank contained one friction stir weld (heavy lifter scales require a flat blank containing two welds). Mechanical properties data (tensile, fracture toughness, stress corrosion, and simulated service testing) for the parent metal and weld will also be discussed.

Who Should Pay for Higher Education?

Science.gov (United States)

Bou-Habib, Paul

2010-01-01

Policies that shift the costs of higher education from the taxpayer to the university student or graduate are increasingly popular, yet they have not been subjected to a thorough normative analysis. This paper provides a critical survey of the standard arguments that have been used in the public debate on higher education funding. These arguments…

Cost-based droop scheme with lower generation costs for microgrids

DEFF Research Database (Denmark)

Nutkani, Inam Ullah; Loh, Poh Chiang; Blaabjerg, Frede

2014-01-01

-based droop scheme, whose objective is to reduce a generation cost function realised with various DG operating characteristics taken into consideration. Where desired, proportional power sharing based on the DG kVA ratings can also be included, whose disadvantage is a slightly higher generation cost, which...... on the DG kilovolts ampere (kVA) ratings. Other factors like generation costs, efficiencies and emission penalties at different load demands have not been considered. This omission might not be appropriate if different types of DGs are present in the microgrids. As an alternative, this study proposes a cost...... is still lower than that produced by the traditional droop schemes. The proposed droop scheme therefore retains all advantages of the traditional droop schemes, whereas at the same time, keeps its generation cost low. These findings have been validated in experiments....

Acute effects of dietary fatty acids on osteclastogenesis via RANKL/RANK/OPG system.

Science.gov (United States)

Naranjo, M Carmen; Garcia, Indara; Bermudez, Beatriz; Lopez, Sergio; Cardelo, Magdalena P; Abia, Rocio; Muriana, Francisco J G; Montserrat-de la Paz, Sergio

2016-11-01

Postprandial state is directly linked with chronic diseases. We hypothesized that dietary fats may have acute effects on health status by modulating osteoclast differentiation and activation in a fatty acid-dependent manner. In healthy subjects, a fat-enriched meal increased plasma levels of the RANKL (receptor activator of nuclear factor κB ligand)/OPG (osteoprotegerin) ratio (SFAs > MUFAs = PUFAs) in the postprandial state. Postprandial TRL-SFAs enhanced tartrate-resistant acid phosphatase (TRAP) activity and the expression of osteoclast marker genes (TRAP, OSCAR, RANK, and CATHK) while downregulated the expression of OPG gene in human monocyte-derived osteoclasts. These effects were not observed with monounsaturated fatty acid (MUFA)-enriched postprandial triglyceride-rich lipoproteins (TRLs). Moreover, postprandial TRL-SFAs increased the release of osteoclastogenic cytokines (TNF-α, IL-1β, and IL-6) meanwhile TRL-MUFAs and TRL-PUFAs increased the release of anti-osteoclastogenic cytokines (IL-4 and IL-10) in the medium of human monocyte-derived osteoclasts. For the first time, we show that postprandial TRLs are metabolic entities with osteoclastogenic activity and that this property is related to the type of dietary fatty acid in the meal. The osteoclastogenic potency was as follows: SFAs > MUFAs = PUFAs. These exciting findings open opportunities for developing nutritional strategies with olive oil as the principal dietary source of MUFAs, notably oleic acid, to prevent development and progression of osteoclast-related diseases. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Postprandial triglyceride-rich lipoproteins promote invasion of human coronary artery smooth muscle cells in a fatty-acid manner through PI3k-Rac1-JNK signaling.

Science.gov (United States)

Varela, Lourdes M; Bermúdez, Beatriz; Ortega-Gómez, Almudena; López, Sergio; Sánchez, Rosario; Villar, Jose; Anguille, Christelle; Muriana, Francisco J G; Roux, Pierre; Abia, Rocío

2014-06-01

The aim was to investigate the effect of postprandial triglyceride-rich lipoproteins (TRLs) with different fatty acid compositions on human coronary artery smooth muscle cell (hCASMC) invasion and to identify the molecular pathways involved. TRLs were isolated from the plasma of healthy volunteers after the ingestion of single meals enriched in MUFAs, saturated fatty acids (SFAs), or PUFAs. hCASMC invasion was analyzed using transwell chambers with Matrigel. TRLs-SFAs provoked the highest invasion, followed by TRLs-MUFAs and TRLs-PUFAs. Inhibition studies with Orlistat showed that invasion was dependent on the fatty acid composition of the TRLs. Fatty acids incorporated into the cell membranes strongly associated with cell invasion. Pull-down assays showed that TRLs-SFAs were able to increase Rac1 activity via inhibition of RhoA-dependent signaling. Chemical inhibition and siRNA studies showed that Rac1, PI3k, JNK, and MMP2 regulates TRL-SFA-induced hCASMC invasion. We demonstrate for the first time that TRLs induce hCASMCs invasion in a fatty acid dependent manner. This effect in TRLs-SFAs is mediated by the PI3k-Rac1-JNK, RhoA, and Rac1-MMP2 pathways. The ingestion of MUFA, compared to other dietary fatty acids such as SFA, could be considered as a nutritional strategy to reduce the atherosclerotic plaque formation. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The cost of tuberculosis in Denmark

DEFF Research Database (Denmark)

Fløe, Andreas; Hilberg, Ole; Wejse, Christian

Hypothesis: Tuberculosis (TB) patients carry higher direct health-related and indirect costs than the general population. Objective: To calculate the economic burden of TB in Denmark, including the health-related costs of treatment and the indirect costs for society in a national retrospective case...

The Future Train Wreck: Paying for Medical Costs for Higher Education's Retirees

Science.gov (United States)

Biggs, John H.

2006-01-01

Trustees and administrators today confront one of two problems with post-retirement medical care. First, if institutions provide no support for their retirees' medical care, they implicitly offer a powerful incentive for senior faculty to stay on. The compensation and opportunity costs of this effect are obviously very high. But, second, if they…

Activity-based costing methodology as tool for costing in hematopathology laboratory.

Science.gov (United States)

Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

2010-01-01

Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

Batteries: Lower cost than gasoline?

International Nuclear Information System (INIS)

Werber, Mathew; Fischer, Michael; Schwartz, Peter V.

2009-01-01

We compare the lifecycle costs of an electric car to a similar gasoline-powered vehicle under different scenarios of required driving range and cost of gasoline. An electric car is cost competitive for a significant portion of the scenarios: for cars of lower range and for higher gasoline prices. Electric cars with ∼150 km range are a technologically viable, cost competitive, high performance, high efficiency alternative that can presently suit the vast majority of consumers' needs.

Instructional Cost Analysis: History and Present Inadequacies.

Science.gov (United States)

Humphrey, David A.

The cost analysis of instruction is conducted according to principles of teaching and learning that have often become historically dated. Using today's costing systems prevents determination of whether cost effectiveness actually exists. The patterns of instruction in higher education and the systems employed for instructional cost analysis are…

Cost of illness and determinants of costs among patients with gout.

Science.gov (United States)

Spaetgens, Bart; Wijnands, José M A; van Durme, Caroline; van der Linden, Sjef; Boonen, Annelies

2015-02-01

To estimate costs of illness in a cross-sectional cohort of patients with gout attending an outpatient rheumatology clinic, and to evaluate which factors contribute to higher costs. Altogether, 126 patients with gout were clinically assessed. They completed a series of questionnaires. Health resource use was collected using a self-report questionnaire that was cross-checked with the electronic patient file. Productivity loss was assessed by the Work Productivity and Activity Impairment Questionnaire, addressing absenteeism and presenteeism. Resource use and productivity loss were valued by real costs, and annual costs per patient were calculated. Factors contributing to incurring costs above the median were explored using logistic univariable and multivariable regression analysis. Mean (median) annual direct costs of gout were €5647 (€1148) per patient. Total costs increased to €6914 (€1279) or €10,894 (€1840) per patient per year when adding cost for absenteeism or both absenteeism and presenteeism, respectively. Factors independently associated with high direct and high indirect costs were a positive history of cardiovascular disease, functional limitations, and female sex. In addition, pain, gout concerns, and unmet gout treatment needs were associated with high direct costs. The direct and indirect costs-of-illness of gout are primarily associated with cardiovascular disease, functional limitations, and female sex.

Nuclear thermal propulsion engine cost trade studies

International Nuclear Information System (INIS)

Paschall, R.K.

1993-01-01

The NASA transportation strategy for the Mars Exploration architecture includes the use of nuclear thermal propulsion as the primary propulsion system for Mars transits. It is anticipated that the outgrowth of the NERVA/ROVER programs will be a nuclear thermal propulsion (NTP) system capable of providing the propulsion for missions to Mars. The specific impulse (Isp) for such a system is expected to be in the 870 s range. Trade studies were conducted to investigate whether or not it may be cost effective to invest in a higher performance (Isp>870 s) engine for nuclear thermal propulsion for missions to Mars. The basic cost trades revolved around the amount of mass that must be transported to low-earth orbit prior to each Mars flight and the cost to launch that mass. The mass required depended on the assumptions made for Mars missions scenarios including piloted/cargo flights, number of Mars missions, and transit time to Mars. Cost parameters included launch cost, program schedule for development and operations, and net discount rate. The results were very dependent on the assumptions that were made. Under some assumptions, higher performance engines showed cost savings in the billions of dollars; under other assumptions, the additional cost to develop higher performance engines was not justified

Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach.

Science.gov (United States)

Hanly, Paul; Timmons, Aileen; Walsh, Paul M; Sharp, Linda

2012-05-01

Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods--the traditional human capital approach (HCA) and the emerging friction cost approach (FCA)--to estimate breast and prostate cancer productivity costs in Ireland in 2008. Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality. For breast cancer, productivity costs per person using the HCA were € 193,425 and those per person using the FCA were € 8,103; for prostate cancer, the comparable estimates were € 109,154 and € 8,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period. The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Postprandial dietary fatty acids exert divergent inflammatory responses in retinal-pigmented epithelium cells.

Science.gov (United States)

Montserrat-de la Paz, Sergio; Naranjo, M Carmen; Bermudez, Beatriz; Lopez, Sergio; Moreda, Wenceslao; Abia, Rocio; Muriana, Francisco J G

2016-03-01

Postprandial triglyceride-rich lipoproteins (TRLs) lead to a complex series of events that are potentially oxidative and inflammatory. The main goal of this study was to characterize the influence of postprandial TRLs with different fatty acid compositions (mainly SFAs, MUFAs or MUFAs plus omega-3 PUFAs) on oxidative and inflammatory markers in RPE cells, which play a pivotal role in age-related macular degeneration (AMD). Compared to TRL-SFAs, TRL-MUFAs and TRL-MUFAs plus omega-3 PUFAs decreased the production of ROS and nitrite, and the gene expression and secretion of IL-1β, IL-6, TNF-α, IFNγ and VEGF. For the first time we show that postprandial TRLs are metabolic entities able to induce RPE oxidative stress and inflammation in a fatty acid-dependent manner, TRL-SFAs ⋙ TRL-MUFAs = TRL-MUFAs plus omega-3 PUFAs. These exciting findings open new opportunities for developing novel nutritional strategies with olive oil as the principal dietary source of oleic acid to prevent the development and progression of AMD.

Regulation of the Docosapentaenoic Acid/Docosahexaenoic Acid Ratio (DPA/DHA Ratio) in Schizochytrium limacinum B4D1.

Science.gov (United States)

Zhang, Ke; Li, Huidong; Chen, Wuxi; Zhao, Minli; Cui, Haiyang; Min, Qingsong; Wang, Haijun; Chen, Shulin; Li, Demao

2017-05-01

Docosapentaenoic acid/docosahexaenoic acid ratio (DPA/DHA ratio) in Schizochytrium was relatively stable. But ideally the ratio of DPA/DHA will vary according to the desired end use. This study reports several ways of modulating the DPA/DHA ratio. Incubation times changed the DPA/DHA ratio, and changes in this ratio were associated with the variations in the saturated fatty acid (SFAs) content. Propionic acid sharply increased the SFAs content in lipids, dramatically decreased the even-chain SFAs content, and reduced the DPA/DHA ratio. Pentanoic acid (C5:0) and heptanoic acid (C7:0) had similar effects as propionic acid, whereas butyric acid (C4:0), hexanoic acid (C6:0), and octanoic acid (C8:0) did not change the fatty acid profile and the DPA/DHA ratio. Transcription analyses show that β-oxidation might be responsible for this phenomenon. Iodoacetamide upregulated polyunsaturated fatty acid (PUFA) synthase genes, reduced the DHA content, and improved the DPA content, causing the DPA/DHA ratio to increase. These results present new insights into the regulation of the DPA/DHA ratio.

IFRS and US GAAP convergence in the area of business combination

Directory of Open Access Journals (Sweden)

Hana Bohušová

2008-01-01

Full Text Available The IASB project "Business Combinations" started in 2001. The increase of financial statements quality and international harmonization of business combinations recording were main objectives of this project. The project was divided into two phases. IFRS 3 (2004 Business Combinations" which replaced former IAS 22 was the result of the first phase. Partial harmonization of recording and financial reporting of business combination in Europe and in the USA was the main objective of IFRS 3 (2004. IFRS 3 (2004 is based on SFAS 141 (2001. SFAS 141 (2001 was developed in 2001 and replaced APB (Accounting Principles Board Opinion No. 16 Business Combinations and SFAS 38. There is the pooling interest method forbidden and only the purchase method is allowed for all kinds of business combinations. Based on the comparison of both methodical approaches to business combinations are demonstrated reasons for refusing of pooling interest method. The second phase is aimed at purchase method application and new methodical approaches to business combination recording and it is the objective of the conclusion of this paper.

Activity-based costing methodology as tool for costing in hematopathology laboratory

Directory of Open Access Journals (Sweden)

Gujral Sumeet

2010-01-01

Full Text Available Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL Settings and Design: Activity-based costing (ABC method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs, payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC, bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

The Rapid Transit System That Achieves Higher Performance with Lower Life-Cycle Costs

Science.gov (United States)

Sone, Satoru; Takagi, Ryo

In the age of traction system made of inverter and ac traction motors, distributed traction system with pure electric brake of regenerative mode has been recognised very advantageous. This paper proposes a new system as the lowest life-cycle cost system for high performance rapid transit, a new architecture and optimum parameters of power feeding system, and a new running method of trains. In Japan, these components of this proposal, i.e. pure electric brake and various countermeasures of reducing loss of regeneration have been already popular but not as yet the new running method for better utilisation of the equipment and for lower life-cycle cost. One example of what are proposed in this paper will be made as Tsukuba Express, which is under construction as the most modern commuter railway in Greater Tokyo area.

Overview of Commercial Building Partnerships in Higher Education

Energy Technology Data Exchange (ETDEWEB)

Schatz, Glenn [Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States)

2013-03-01

Higher education uses less energy per square foot than most commercial building sectors. However, higher education campuses house energy-intensive laboratories and data centers that may spend more than this average; laboratories, in particular, are disproportionately represented in the higher education sector. The Commercial Building Partnership (CBP), a public/private, cost-shared program sponsored by the U.S. Department of Energy (DOE), paired selected commercial building owners and operators with representatives of DOE, its national laboratories, and private-sector technical experts. These teams explored energy-saving measures across building systems–including some considered too costly or technologically challenging–and used advanced energy modeling to achieve peak whole-building performance. Modeling results were then included in new construction or retrofit designs to achieve significant energy reductions.

Economic costs of social phobia: a population-based study.

Science.gov (United States)

Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P

2009-06-01

Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

Higher-order techniques in computational electromagnetics

CERN Document Server

Graglia, Roberto D

2016-01-01

Higher-Order Techniques in Computational Electromagnetics explains 'high-order' techniques that can significantly improve the accuracy, computational cost, and reliability of computational techniques for high-frequency electromagnetics, such as antennas, microwave devices and radar scattering applications.

Integrating Social Media Technologies in Higher Education: Costs-Benefits Analysis

Science.gov (United States)

Okoro, Ephraim

2012-01-01

Social networking and electronic channels of communication are effective tools in the process of teaching and learning and have increasingly improved the quality of students' learning outcomes in higher education in recent years. The process encourages students' active engagement, collaboration, and participation in class activities and group…

Stop Misusing Higher Education-Specific Price Indices

Science.gov (United States)

Gillen, Andrew; Robe, Jonathan

2011-01-01

In order to compare the price of things over time, it is necessary to use a price index to adjust for inflation. The Higher Education Price Index (HEPI) and the Higher Education Cost Adjustment (HECA) were designed to more accurately account for the spending patterns of colleges and universities. However, there are some methodological problems…

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.

Costs and Performance of English Mental Health Providers.

Science.gov (United States)

Moran, Valerie; Jacobs, Rowena

2017-06-01

Despite limited resources in mental health care, there is little research exploring variations in cost performance across mental health care providers. In England, a prospective payment system for mental health care based on patient needs has been introduced with the potential to incentivise providers to control costs. The units of payment under the new system are 21 care clusters. Patients are allocated to a cluster by clinicians, and each cluster has a maximum review period. The aim of this research is to explain variations in cluster costs between mental health providers using observable patient demographic, need, social and treatment variables. We also investigate if provider-level variables explain differences in costs. The residual variation in cluster costs is compared across providers to provide insights into which providers may gain or lose under the new financial regime. The main data source is the Mental Health Minimum Data Set (MHMDS) for England for the years 2011/12 and 2012/13. Our unit of observation is the period of time spent in a care cluster and costs associated with the cluster review period are calculated from NHS Reference Cost data. Costs are modelled using multi-level log-linear and generalised linear models. The residual variation in costs at the provider level is quantified using Empirical Bayes estimates and comparative standard errors used to rank and compare providers. There are wide variations in costs across providers. We find that variables associated with higher costs include older age, black ethnicity, admission under the Mental Health Act, and higher need as reflected in the care clusters. Provider type, size, occupancy and the proportion of formal admissions at the provider-level are also found to be significantly associated with costs. After controlling for patient- and provider-level variables, significant residual variation in costs remains at the provider level. The results suggest that some providers may have to increase

Strategies for monitoring of priority pollutant emission barriers

DEFF Research Database (Denmark)

Pettersson, Maria; De Keyser, Webbey; Birch, Heidi

2010-01-01

The objective of Task 7.5 was to develop tools for model-based planning of sampling campaigns in the design of monitoring strategies for priority pollutant emission barriers. Using integrated urban wastewater system (IUWS) models, measurement campaigns can be designed to improve the calibration...... to be implemented in the IUWS model, as well as the sampling and measuring devices that will be used. The simulation results are presented as a Substance Flow Analysis (SFA). These SFAs can be compared with empirical SFAs and can also be used to set up measurement campaigns aiming at gathering information...

Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review.

Science.gov (United States)

Konnopka, Alexander; Leichsenring, Falk; Leibing, Eric; König, Hans-Helmut

2009-04-01

To review cost-of-illness studies (COI) and cost-effectiveness analyses (CEA) conducted for anxiety disorders. Based on a database search in Pubmed, PsychINFO and NHS EED, studies were classified according to various criteria. Cost data were inflated and converted to 2005 US-$ purchasing power parities (PPP). We finally identified 20 COI and 11 CEA of which most concentrated on panic disorder (PD) and generalized anxiety disorder (GAD). Differing inclusion of cost categories limited comparability of COI. PD and GAD tended to show higher direct costs per case, but lower direct cost per inhabitant than social and specific phobias. Different measures of effectiveness severely limited comparability of CEA. Overall CEA analysed 26 therapeutic or interventional strategies mostly compared to standard treatment, 8 of them resulting in lower better effectiveness and costs than the comparator. Anxiety disorders cause considerable costs. More research on phobias, more standardised inclusion of cost categories in COI and a wider use of comparable effectiveness measures (like QALYs) in CEA is needed.

Cost Study Manual 1965-66.

Science.gov (United States)

Illinois State Board of Higher Education, Springfield.

Procedures are presented for use in reporting costs for institutions of higher education in Illinois. Following the definition of various accounting functions, the scope of the cost and statistical report is delimited, and specifications are presented for the collection of data on students, courses, academic faculty records, and academic faculty…

Political Economy of Cost-Sharing in Higher Education: The Case of Jordan

Science.gov (United States)

Kanaan, Taher H.; Al-Salamat, Mamdouh N.; Hanania, May D.

2011-01-01

This article analyzes patterns of expenditure on higher education in Jordan, explores the current system's adequacy, efficiency, and equity, and identifies its strengths and weaknesses in light of current constraints and future challenges. Among the constraints are the relatively low public expenditure on higher education, leaving households to…

Societal costs of multiple sclerosis in Ireland.

Science.gov (United States)

Carney, Peter; O'Boyle, Derek; Larkin, Aidan; McGuigan, Christopher; O'Rourke, Killian

2018-05-01

This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. A questionnaire was developed to capture the demographics, disease characteristics, healthcare use, informal care, employment, and wellbeing. Referencing international studies, standardized survey instruments were included (e.g. CSRI, MFIS-5, EQ-5D) or adapted (EDSS) for inclusion in an online survey platform. Recruitment was directed at people with MS via the MS Society mailing list and social media platforms, as well as in traditional media. The economic costing was primarily conducted using a 'bottom-up' methodology, and national estimates were achieved using 'prevalence-based' extrapolation. A total of 594 people completed the survey in full. The sample had geographic, disease, and demographic characteristics indicating good representativeness. At an individual level, average societal cost was estimated at €47,683; the average annual costs for those with mild, moderate, and severe MS were calculated as €34,942, €57,857, and €100,554, respectively. For a total Irish MS population of 9,000, the total societal costs of MS amounted to €429m. Direct costs accounted for just 30% of the total societal costs, indirect costs amounted to 50% of the total, and intangible or QoL costs represented 20%. The societal cost associated with a relapse in the sample is estimated as €2,438. The findings highlight that up to 70% of the total costs associated with MS are not routinely counted. These "hidden" costs are higher in Ireland than the rest of Europe, due in part to significantly lower levels of workforce participation, a higher likelihood of permanent workforce withdrawal, and higher levels of informal care needs. The relationship between disease progression and costs emphasize the societal importance of managing and slowing the progression of the illness.

Terminal patients in Belgian nursing homes: a cost analysis.

Science.gov (United States)

Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Vanden Berghe, Paul; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

2013-06-01

Policy makers and health care payers are concerned about the costs of treating terminal patients. This study was done to measure the costs of treating terminal patients during the final month of life in a sample of Belgian nursing homes from the health care payer perspective. Also, this study compares the costs of palliative care with those of usual care. This multicenter, retrospective cohort study enrolled terminal patients from a representative sample of nursing homes. Health care costs included fixed nursing home costs, medical fees, pharmacy charges, other charges, and eventual hospitalization costs. Data sources consisted of accountancy and invoice data. The analysis calculated costs per patient during the final month of life at 2007/2008 prices. Nineteen nursing homes participated in the study, generating a total of 181 patients. Total mean nursing home costs amounted to 3,243 € per patient during the final month of life. Total mean nursing home costs per patient of 3,822 € for patients receiving usual care were higher than costs of 2,456 € for patients receiving palliative care (p = 0.068). Higher costs of usual care were driven by higher hospitalization costs (p < 0.001). This study suggests that palliative care models in nursing homes need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients.

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.

Effect of mild hypothermia combined with VitC and EPO therapy on target organ damage in children with neonatal asphyxia

Directory of Open Access Journals (Sweden)

Shu-Yun Wang

2017-10-01

Full Text Available Objective: To study the effect of mild hypothermia combined with vitamin C (VitC and erythropoietin (EPO therapy on target organ damage in children with neonatal asphyxia. Methods: Children with neonatal asphyxia who were treated in Taihe County People’s Hospital between April 2014 and February 2017 were selected and randomly divided into two groups, mild hypothermia group received mild hypothermia combined VitC and EPO therapy, and control group received VitC and EPO therapy. Serum levels of of target organ damage markers, oxidative stress indexes and apoptosis indexes were measured before treatment as well as 3 d and 7 d after treatment. Results: 3 d and 7 d after treatment, serum NSE, H-FABP, cTnI, CysC, MDA, Caspase-3, PDCD5, sFas and sFasL levels of both groups of children were significantly lower than those before treatment while TAS, SOD, GSH and Bcl-2 levels were significantly higher than those before treatment, and serum NSE, H-FABP, cTnI, CysC, MDA, Caspase-3, PDCD5, sFas and sFasL levels of mild hypothermia group were significantly lower than those of control group while TAS, SOD, GSH and Bcl-2 levels were significantly higher than those of control group. Conclusion: Mild hypothermia combined with VitC and EPO therapy can reduce the target organ damage of children with neonatal asphyxia by inhibiting oxidative stress and apoptosis.

The nitrogen abatement cost in wetlands

International Nuclear Information System (INIS)

Bystroem, Olof

1998-01-01

The costs of abating agricultural nitrogen pollution in wetlands are estimated. By linking costs for construction of wetlands to the denitrification capacity of wetlands, an abatement cost function can be formed. A construction-cost function and a denitrification function for wetlands is estimated empirically. This paper establishes a link between abatement costs and the nitrogen load on wetlands. Since abatement costs fluctuate with nitrogen load, ignoring this link results in incorrect estimates of abatement costs. The results demonstrate that wetlands have the capacity to provide low cost abatement of nitrogen compounds in runoff. For the Kattegatt region in Sweden, marginal abatement costs for wetlands are shown to be lower than costs of land use changing measures, such as extended land under fallow or cultivation of fuel woods, but higher than the marginal costs of reducing nitrogen fertilizer

Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

Science.gov (United States)

Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

2011-02-01

To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

Electricity generation costs by source, and costs and benefits by substitutions of generation source

International Nuclear Information System (INIS)

Akimoto, Keigo; Oda, Junichiro; Sano, Fuminori

2015-01-01

After Fukushima-daiichi nuclear power accident, the Japanese government assessed the electricity generation costs by source in 2011. However, the conditions have been changing, and this study newly assessed the generation costs by source using new data. The generation costs for coal, oil, gas, nuclear, PV and wind power for 2013 and 2030 were estimated. According to the analysis, coal power is the cheapest when climate change damage costs are not considered, and nuclear power is the cheapest when the climate damage costs are considered. However, under the competitive electricity market in which power companies tend to invest in power plants with short-term payback investment preference, power companies will recognize higher costs of nuclear power particularly under highly uncertain nuclear regulation policies and energy policies. The policies to reduce the uncertainties are very important. (author)

Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs

Directory of Open Access Journals (Sweden)

C. Raineri

2015-08-01

Full Text Available Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i costs composition, and ii cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses.

An overview of American higher education.

Science.gov (United States)

Baum, Sandy; Kurose, Charles; McPherson, Michael

2013-01-01

This overview of postsecondary education in the United States reviews the dramatic changes over the past fifty years in the students who go to college, the institutions that produce higher education, and the ways it is financed. The article, by Sandy Baum, Charles Kurose, and Michael McPherson, creates the context for the articles that follow on timely issues facing the higher education community and policy makers. The authors begin by observing that even the meaning of college has changed. The term that once referred primarily to a four-year period of academic study now applies to virtually any postsecondary study--academic or occupational, public or private, two-year or four-year-- that can result in a certificate or degree. They survey the factors underlying the expansion of postsecondary school enrollments; the substantial increases in female, minority, disadvantaged, and older students; the development of public community colleges; and the rise of for-profit colleges. They discuss the changing ways in which federal and state governments help students and schools defray the costs of higher education as well as more recent budget tensions that are now reducing state support to public colleges. And they review the forces that have contributed to the costs of producing higher education and thus rising tuitions. The authors also cite evidence on broad measures of college persistence and outcomes, including low completion rates at community and for-profit colleges, the increasing need for remedial education for poorly prepared high school students, and a growing gap between the earnings of those with a bachelor's degree and those with less education. They disagree with critics who say that investments in higher education, particularly for students at the margin, no longer pay off. A sustained investment in effective education at all levels is vital to the nation's future, they argue. But they caution that the American public no longer seems willing to pay more for

Cleaning Management in Higher Education: Value for Money Study.

Science.gov (United States)

Scottish Higher Education Funding Council, Edinburgh.

This report identifies key management issues for senior managers and heads of cleaning departments in developing and reviewing cleaning services to support improvement and enhance cost effectiveness. The cleaning costs incurred by higher education institutions (HEIs) represent 2.7 percent of the total spent nationally on cleaning services for both…

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.

Determining the economic cost of ICU treatment: a prospective "micro-costing" study.

LENUS (Irish Health Repository)

McLaughlin, Anne Marie

2012-02-01

OBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical\\/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at 2,164 per day, compared with 3,496 euro per day for ICU non-survivors (P = 0.08). The requirements for continuous haemodiafiltration, blood products and anti-fungal agents were associated with higher daily and overall ICU costs (P = 0.002). Each point increase in SAPS3 was associated with a 305 euro (95% CI 31 euro-579 euro) increase in total ICU cost (P = 0.029). However, SAPS3 accounted for a small proportion of the variance in this model (R (2) = 0.08), limiting its usefulness as a stand-alone predictor of cost in clinical practice. A model including haemodiafiltration, blood products and anti-fungal agents explained 54% of the variance in total ICU cost. CONCLUSION: This bottom-up costing study highlighted the considerable individual variation in costs between ICU patients and identified the major factors contributing to cost. As the requirement for expensive interventions was the main driver for ICU cost, "severity of illness" scores may not be useful as stand-alone predictors of cost in the ICU.

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

Effects of immediate-release niacin and dietary fatty acids on acute insulin and lipid status in individuals with metabolic syndrome.

Science.gov (United States)

Montserrat-de la Paz, Sergio; Lopez, Sergio; Bermudez, Beatriz; Guerrero, Juan M; Abia, Rocio; Muriana, Francisco Jg

2018-04-01

The nature of dietary fats profoundly affects postprandial hypertriglyceridemia and glucose homeostasis. Niacin is a potent lipid-lowering agent. However, limited data exist on postprandial triglycerides and glycemic control following co-administration of high-fat meals with a single dose of niacin in subjects with metabolic syndrome (MetS). The aim of the study was to explore whether a fat challenge containing predominantly saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) or MUFAs plus omega-3 long-chain polyunsaturated (LCPUFAs) fatty acids together with a single dose of immediate-release niacin have a relevant role in postprandial insulin and lipid status in subjects with MetS. In a randomized crossover within-subject design, 16 men with MetS were given a single dose of immediate-release niacin (2 g) and ∼15 cal kg -1 body weight meals containing either SFAs, MUFAs, MUFAs plus omega-3 LCPUFAs or no fat. At baseline and hourly over 6 h, plasma glucose, insulin, C-peptide, triglycerides, free fatty acids (FFAs), total cholesterol, and both high- and low-density lipoprotein cholesterol were assessed. Co-administered with niacin, high-fat meals significantly increased the postprandial concentrations of glucose, insulin, C-peptide, triglycerides, FFAs and postprandial indices of β-cell function. However, postprandial indices of insulin sensitivity were significantly decreased. These effects were significantly attenuated with MUFAs or MUFAs plus omega-3 LCPUFAs when compared with SFAs. In the setting of niacin co-administration and compared to dietary SFAs, MUFAs limit the postprandial insulin, triglyceride and FFA excursions, and improve postprandial glucose homeostasis in MetS. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The Opportunity Cost of Capital

Directory of Open Access Journals (Sweden)

Ayman Chit PhD

2015-04-01

Full Text Available The opportunity cost of the capital invested in pharmaceutical research and development (R&D to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D.

The Opportunity Cost of Capital

Science.gov (United States)

Chit, Ayman; Chit, Ahmad; Papadimitropoulos, Manny; Krahn, Murray; Parker, Jayson; Grootendorst, Paul

2015-01-01

The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D. PMID:25933615

Implicit environmental costs in hydroelectric development

International Nuclear Information System (INIS)

Carlsen, A.J.; Wenstoep, F.; Strand, J.

1992-01-01

The ranking of hydropower projects under the Norwegian Master Plan for Water Resources is used to derive implicit government preferences for a number of environmental attributes described by ordinal scores for each project. Higher negative scores are generally associated with greater implicit willingness to pay to avoid the environmental damage tied to the attribute, caused by hydropower development. The total (ordinary economic and implicit environmental) cost for each project are derived, and the environmental costs per capacity unit are found to be on the same order as the economic costs, lower for projects ranked for early exploitation, and higher for projects to be saved permanently. An implicit long-run marginal cost curve for Norwegian hydropower development is derived, which is generally upward sloping, but not uniformly so. This can be due to the model specification problems or ranking inconsistencies, both of which are likely to be present. 11 refs., 7 figs., 1 tab

Factor 10 Visions project: Higher Education Sector Towards Sustainable Higher Education: Environmental impacts of campus-based and distance higher education systems

OpenAIRE

Roy, Robin; Potter, Stephen; Yarrow, Karen; Smith, Mark

2005-01-01

This report gives the findings of a major UK study of the environmental impacts of four different methods of providing higher education (HE) courses: Conventional campus-based full-time courses; Conventional campus-based part-time courses; Print-based distance taught courses; Part electronically-delivered distance taught courses.\\ud This is an environmental assessment of these different HE systems and does not assess their educational effectiveness or socio-economic costs and benefits.\\ud KEY...

Counting the Cost, Reconciling the Benefits: Understanding Employer Investment in Higher Apprenticeships in Accounting

Science.gov (United States)

Gambin, Lynn; Hogarth, Terence

2016-01-01

Lack of progression to higher education amongst those who complete an Advanced Apprenticeship in England and the country's need for higher level skills led to the introduction of Higher Apprenticeships in 2009. Whilst Higher Apprenticeships would be expected to facilitate learner progression, the volume of these has remained low. In this paper,…

Open Educational Practices in Higher Education: Institutional Adoption and Challenges

Science.gov (United States)

Murphy, Angela

2013-01-01

Open educational resources and open education practices have the potential to lower costs and increase participation in higher education. One hundred and ten individuals from higher education institutions around the world participated in a survey aimed at identifying the extent to which higher education institutions are currently implementing open…

Preterm birth-associated cost of early intervention services: an analysis by gestational age.

Science.gov (United States)

Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

2007-04-01

Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

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.

Preliminary cost estimating for the nuclear industry

International Nuclear Information System (INIS)

Klumpar, I.V.; Soltz, K.M.

1985-01-01

The nuclear industry has higher costs for personnel, equipment, construction, and engineering than conventional industry, which means that cost estimation procedures may need adjustment. The authors account for the special technical and labor requirements of the nuclear industry in making adjustments to equipment and installation cost estimations. Using illustrative examples, they show that conventional methods of preliminary cost estimation are flexible enough for application to emerging industries if their cost structure is similar to that of the process industries. If not, modifications can provide enough engineering and cost data for a statistical analysis. 9 references, 14 figures, 4 tables

Experience that much work produces many reinforcers makes the sunk cost fallacy in pigeons: A preliminary test

Directory of Open Access Journals (Sweden)

Shun eFujimaki

2016-03-01

Full Text Available The sunk cost fallacy is one of the irrational choice behaviors robustly observed in humans. This fallacy can be defined as a preference for a higher-cost alternative to a lower-cost one after previous investment in a higher-cost alternative. The present study examined this irrational choice by exposing pigeons to several types of trials with differently illuminated colors. We prepared three types of nonchoice trials for experiencing different outcomes after presenting same or different colors as alternatives and three types of choice trials for testing whether pigeons demonstrated irrational choice. In nonchoice trials, animals experienced either of the following: (1 no reinforcement after the presentation of an unrelated colored stimulus to the alternatives used in the choice situation, (2 no reinforcement after investment in the lower-cost alternative, or (3 reinforcement or no reinforcement after investment in the higher-cost alternative. In choice trials, animals were required to choose in the following three situations: (A higher-cost vs. lower-cost alternatives, (B higher-cost vs. lower-cost ones after some investment in the higher-cost alternative, and (C higher-cost vs. lower-cost alternatives after the presentation of an unrelated colored stimulus. From the definition of the sunk cost fallacy, we assumed that animals would exhibit this fallacy if they

Cost Estimating Handbook for Environmental Restoration

International Nuclear Information System (INIS)

1993-01-01

Environmental restoration (ER) projects have presented the DOE and cost estimators with a number of properties that are not comparable to the normal estimating climate within DOE. These properties include: An entirely new set of specialized expressions and terminology. A higher than normal exposure to cost and schedule risk, as compared to most other DOE projects, due to changing regulations, public involvement, resource shortages, and scope of work. A higher than normal percentage of indirect costs to the total estimated cost due primarily to record keeping, special training, liability, and indemnification. More than one estimate for a project, particularly in the assessment phase, in order to provide input into the evaluation of alternatives for the cleanup action. While some aspects of existing guidance for cost estimators will be applicable to environmental restoration projects, some components of the present guidelines will have to be modified to reflect the unique elements of these projects. The purpose of this Handbook is to assist cost estimators in the preparation of environmental restoration estimates for Environmental Restoration and Waste Management (EM) projects undertaken by DOE. The DOE has, in recent years, seen a significant increase in the number, size, and frequency of environmental restoration projects that must be costed by the various DOE offices. The coming years will show the EM program to be the largest non-weapons program undertaken by DOE. These projects create new and unique estimating requirements since historical cost and estimating precedents are meager at best. It is anticipated that this Handbook will enhance the quality of cost data within DOE in several ways by providing: The basis for accurate, consistent, and traceable baselines. Sound methodologies, guidelines, and estimating formats. Sources of cost data/databases and estimating tools and techniques available at DOE cost professionals

Counting the costs of accreditation in acute care: an activity-based costing approach.

Science.gov (United States)

Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2015-09-08

To assess the costs of hospital accreditation in Australia. Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Acute care hospitals accredited by the Australian Council for Health Care Standards. Six acute public hospitals across four States. Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The economic cost of pathways to care in first episode psychosis.

LENUS (Irish Health Repository)

Heslin, Margaret

2011-01-01

Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.

Analysis of Unit Costs in a University. The Fribourg Example. Program on Institutional Management in Higher Education.

Science.gov (United States)

Pasquier, Jacques; Sachse, Matthias

Costing principles are applied to a university by estimating unit costs and their component factors for the university's different inputs, activities, and outputs. The information system used is designed for Fribourg University but could be applicable to other Swiss universities and could serve Switzerland's universities policy. In general, it…

Effect of almond on technological, nutritional, textural and sensory characteristics of goat meat nuggets.

Science.gov (United States)

Rajkumar, V; Das, Arun K; Verma, Arun K

2014-11-01

An attempt was made through the present study to develop meat based functional food by incorporating almond nut at two different 2.5 and 5 % (Formulation 1 and 2) levels and observe its impact on the different quality attributes against control goat meat nuggets. Almond improved (P Product with 2.5 % almond had higher (P products, whereas expressible water was lower. Emulsion and products pH values increased with the addition of almond. Emulsion and products with almond had higher (P products did not differ significantly. Percent SFAs decreased (P products. Almond incorporation can be a very good approach to enhance nutritional profile of the meat products without affecting acceptability.

Agency costs and income taxation

Directory of Open Access Journals (Sweden)

Ulrich Schmidt

2012-03-01

Full Text Available This paper analyzes agency costs and the moral hazard problem in the presence of income taxation. As basic framework, income taxes are integrated in the hidden action model of agency theory. In the case of symmetric information no agency costs occur, i.e. optimal risk-sharing can be achieved, if and only if the tax is proportional. It is well-known that asymmetric information causes a welfare loss, termed agency costs, even if no taxes are imposed. Introducing a proportional income tax now increases (decreases these agency costs if the agent exhibits decreasing (increasing absolute risk aversion. Additionally, we show that non-proportional taxes cause higher (lower agency costs than a proportional tax if the agent’s marginal tax rate exceeds (is smaller than the marginal tax rate of the principal.

What can we learn from international comparisons of costs by DRG?

Science.gov (United States)

Pirson, M; Schenker, L; Martins, D; Dung, Duong; Chalé, J J; Leclercq, P

2013-02-01

The objective of this study was to compare costs data by diagnosis related group (DRG) between Belgium and Switzerland. Our hypotheses were that differences between countries can probably be explained by methodological differences in cost calculations, by differences in medical practices and by differences in cost structures within the two countries. Classifications of DRG used in the two countries differ (AP-DRGs version 1.7 in Switzerland and APR-DRGs version 15.0 in Belgium). The first step of this study was to transform Belgian summaries into Swiss AP-DRGs. Belgian and Swiss data were calculated with a clinical costing methodology (full costing). Belgian and Swiss costs were converted into US$ PPP (purchasing power parity) in order to neutralize differences in purchasing power between countries. The results of this study showed higher costs in Switzerland despite standardization of cost data according to PPP. The difference is not explained by the case-mix index because this was similar for inliers between the two countries. The length of stay (LOS) was also quite similar for inliers between the two countries. The case-mix index was, however, higher for high outliers in Belgium, as reflected in a higher LOS for these patients. Higher costs in Switzerland are thus probably explained mainly by the higher number of agency staff by service in this country or because of differences in medical practices. It is possible to make international comparisons but only if there is standardization of the case-mix between countries and only if comparable accountancy methodologies are used. Harmonization of DRGs groups, nomenclature and accountancy is thus required.

45 CFR 74.27 - Allowable costs.

Science.gov (United States)

2010-10-01

... FOR AWARDS AND SUBAWARDS TO INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NONPROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.27... Organizations” and paragraph (b) of this section. The allowability of costs incurred by institutions of higher...

22 CFR 145.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 145...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

38 CFR 49.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 49.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

40 CFR 30.27 - Allowable costs.

Science.gov (United States)

2010-07-01

... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 30.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

Smoking Cessation Is Associated With Lower Indirect Costs.

Science.gov (United States)

Baker, Christine L; Bruno, Marianna; Emir, Birol; Li, Vicky W; Goren, Amir

2018-06-01

This study quantified differences in indirect costs due to decreased work productivity between current and former smokers. Former smokers were further categorized by number of years since quitting to assess corresponding differences. Data on employed individuals were obtained from the 2013 US National Health and Wellness Survey (NHWS; N = 75,000). Indirect costs were calculated for current smokers and former smokers from weekly wages based on age and sex. The annual total indirect costs for current smokers were $1327.53, $1560.18, and $1839.87 higher than for those who quit 0 to 4 years, 5 to 10 years, and more than or equal to 11 years prior, respectively. There were no significant differences in mean total indirect costs between the former smoker groups. Current smokers showed significantly higher total annual indirect costs compared with former smokers, independently of the number of years since quitting smoking.

International differences in wage and nonwage labor costs

OpenAIRE

Riveros, Luis A.

1989-01-01

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

Changing Public Perceptions of Higher Ed

Science.gov (United States)

Harney, John O.

2018-01-01

The benefits of going to college and the importance of higher education institutions were once held to be a creed as American as apple pie. But recurring state budget challenges have constrained investment. Consistently rising tuitions--fueled by increasing college costs--have alarmed many. Politics and free-speech controversies have raised…

Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education

Science.gov (United States)

Ullman, Ellen

2013-01-01

Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families.

Science.gov (United States)

Burke, Rachel M; Rebolledo, Paulina A; Embrey, Sally R; Wagner, Laura Danielle; Cowden, Carter L; Kelly, Fiona M; Smith, Emily R; Iñiguez, Volga; Leon, Juan S

2013-08-02

Worldwide, acute gastroenteritis represents an enormous public health threat to children under five years of age, causing one billion episodes and 1.9 to 3.2 million deaths per year. In Bolivia, which has one of the lower GDPs in South America, an estimated 15% of under-five deaths are caused by diarrhea. Bolivian caregiver expenses related to diarrhea are believed to be minimal, as citizens benefit from universal health insurance for children under five. The goals of this report were to describe total incurred costs and cost burden associated with caregivers seeking treatment for pediatric gastroenteritis, and to quantify relationships among costs, cost burden, treatment setting, and perceptions of costs. From 2007 to 2009, researchers interviewed caregivers (n=1,107) of pediatric patients (costs (e.g. medication, consult fees) and indirect costs (e.g. lost wages). Patient populations were similar across cities in terms of gender, duration of illness, and age, but familial income varied significantly (pcosts to families were significantly higher for inpatients as compared to outpatients of urban (pcosts made up a large proportion of total costs. Forty-five percent of patients' families paid ≥1% of their annual household income for this single diarrheal episode. The perception that cost was affecting family finances was more frequent among those with higher actual cost burden. This study demonstrated that indirect costs due to acute pediatric diarrhea were a large component of total incurred familial costs. Additionally, familial costs associated with a single diarrheal episode affected the actual and perceived financial situation of a large number of caregivers. These data serve as a baseline for societal diarrheal costs before and immediately following the implementation of the rotavirus vaccine and highlight the serious economic importance of a diarrheal episode to Bolivian caregivers.

Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.

Science.gov (United States)

Alexandrescu, Doru Traian

2009-11-15

The rapidly increasing incidence of melanoma occurs at the same time as an increase in general healthcare costs, particularly the expenses associated with cancer care. Previous cost estimates in melanoma have not utilized a dynamic model considering the evolution of the disease and have not integrated the multiple costs associated with different aspects of medical interventions and patient-related factors. Futhermore, previous calculations have not been updated to reflect the modern tendencies in healthcare costs. We designed a comprehensive model of expenses in melanoma that considers the dynamic costs generated by the natural progression of the disease, which produces costs associated with treatment, surveillance, loss of income, and terminal care. The complete range of initial clinical (TNM) stages of the disease and initial tumor stages were analyzed in this model and the total healthcare costs for the five years following melanoma presentation at each particular stage were calculated. We have observed dramatic incremental total costs associated with progressively higher initial stages of the disease, ranging from a total of $4,648.48 for in situ tumors to $159,808.17 for Stage IV melanoma. By stage, early lesions associate 30-55 percent of their costs for the treatment of the primary tumor, due to a low rate of recurrence (local, regional, or distant), which limits the need for additional interventions. For in situ melanoma, T1a, and T1b, surveillance is an important contributor to the medical costs, accounting for more than 25 percent of the total cost over 5 years. In contrast, late lesions incur a much larger proportion of their associated costs (up to 80-85%) from the diagnosis and treatment of metastatic disease because of the increased propensity of those lesions to disseminate. This cost increases with increasing tumor stage (from $2,442.17 for T1a to $6,678.00 for T4b). The most expensive items in the medical care of patients with melanoma consist of

Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

DEFF Research Database (Denmark)

Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

2012-01-01

at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...

Development of a low-cost biogas filtration system to achieve higher-power efficient AC generator

Science.gov (United States)

Mojica, Edison E.; Ardaniel, Ar-Ar S.; Leguid, Jeanlou G.; Loyola, Andrea T.

2018-02-01

The paper focuses on the development of a low-cost biogas filtration system for alternating current generator to achieve higher efficiency in terms of power production. A raw biogas energy comprises of 57% combustible element and 43% non-combustible elements containing carbon dioxide (36%), water vapor (5%), hydrogen sulfide (0.5%), nitrogen (1%), oxygen (0 - 2%), and ammonia (0 - 1%). The filtration system composes of six stages: stage 1 is the water scrubber filter intended to remove the carbon dioxide and traces of hydrogen sulfide; stage 2 is the silica gel filter intended to reduce the water vapor; stage 3 is the iron sponge filter intended to remove the remaining hydrogen sulfide; stage 4 is the sodium hydroxide solution filter intended to remove the elemental sulfur formed during the interaction of the hydrogen sulfide and the iron sponge and for further removal of carbon dioxide; stage 5 is the silica gel filter intended to further eliminate the water vapor gained in stage 4; and, stage 6 is the activated carbon filter intended to remove the carbon dioxide. The filtration system was able to lower the non-combustible elements by 72% and thus, increasing the combustible element by 54.38%. The unfiltered biogas is capable of generating 16.3 kW while the filtered biogas is capable of generating 18.6 kW. The increased in methane concentration resulted to 14.11% increase in the power output. The outcome resulted to better engine performance in the generation of electricity.

Cost Economies in the Provision of Higher Education for International Students: Australian Evidence

Science.gov (United States)

Zhang, Liang-Cheng; Worthington, Andrew C.; Hu, Mingyan

2017-01-01

In the past few decades, the additional revenues available via higher education exports (through both relatively higher prices and increased enrolments) have attracted the attention of providers in many developed countries, not least in Anglophone countries like the USA, the UK, Canada and Australia. However, while the revenue case is strong, the…

Cost per remission and cost per response with infliximab, adalimumab, and golimumab for the treatment of moderately-to-severely active ulcerative colitis.

Science.gov (United States)

Toor, Kabirraaj; Druyts, Eric; Jansen, Jeroen P; Thorlund, Kristian

2015-06-01

To determine the short-term costs per sustained remission and sustained response of three tumor necrosis factor inhibitors (infliximab, adalimumab, and golimumab) in comparison to conventional therapy for the treatment of moderately-to-severely active ulcerative colitis. A probabilistic Markov model was developed. This included an 8-week induction period, and 22 subsequent 2-week cycles (up to 1 year). The model included three disease states: remission, response, and relapse. Costs were from a Canadian public payer perspective. Estimates for the additional cost per 1 year of sustained remission and sustained response were obtained. Golimumab 100 mg provided the lowest cost per additional remission ($935) and cost per additional response ($701) compared with conventional therapy. Golimumab 50 mg yielded slightly higher costs than golimumab 100 mg. Infliximab was associated with the largest additional number of estimated remissions and responses, but also higher cost at $1975 per remission and $1311 per response. Adalimumab was associated with the largest cost per remission ($7430) and cost per response ($2361). The cost per additional remission and cost per additional response associated with infliximab vs golimumab 100 mg was $14,659 and $4753, respectively. The results suggest that the additional cost of 1 full year of remission and response are lowest with golimumab 100 mg, followed by golimumab 50 mg. Although infliximab has the highest efficacy, it did not exhibit the lowest cost per additional remission or response. Adalimumab produced the highest cost per additional remission and response.

The unit cost factors and calculation methods for decommissioning - Cost estimation of nuclear research facilities

International Nuclear Information System (INIS)

Kwan-Seong Jeong; Dong-Gyu Lee; Chong-Hun Jung; Kune-Woo Lee

2007-01-01

Available in abstract form only. Full text of publication follows: The uncertainties of decommissioning costs increase high due to several conditions. Decommissioning cost estimation depends on the complexity of nuclear installations, its site-specific physical and radiological inventories. Therefore, the decommissioning costs of nuclear research facilities must be estimated in accordance with the detailed sub-tasks and resources by the tasks of decommissioning activities. By selecting the classified activities and resources, costs are calculated by the items and then the total costs of all decommissioning activities are reshuffled to match with its usage and objectives. And the decommissioning cost of nuclear research facilities is calculated by applying a unit cost factor method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning costs of nuclear research facilities are composed of labor cost, equipment and materials cost. Of these three categorical costs, the calculation of labor costs are very important because decommissioning activities mainly depend on labor force. Labor costs in decommissioning activities are calculated on the basis of working time consumed in decommissioning objects and works. The working times are figured out of unit cost factors and work difficulty factors. Finally, labor costs are figured out by using these factors as parameters of calculation. The accuracy of decommissioning cost estimation results is much higher compared to the real decommissioning works. (authors)

Health insurance, cost expectations, and adverse job turnover.

Science.gov (United States)

Ellis, Randall P; Albert Ma, Ching-To

2011-01-01

Because less healthy employees value health insurance more than the healthy ones, when health insurance is newly offered job turnover rates for healthier employees decline less than turnover rates for the less healthy. We call this adverse job turnover, and it implies that a firm's expected health costs will increase when health insurance is first offered. Health insurance premiums may fail to adjust sufficiently fast because state regulations restrict annual premium changes, or insurers are reluctant to change premiums rapidly. Even with premiums set at the long run expected costs, some firms may be charged premiums higher than their current expected costs and choose not to offer insurance. High administrative costs at small firms exacerbate this dynamic selection problem. Using 1998-1999 MEDSTAT MarketScan and 1997 Employer Health Insurance Survey data, we find that expected employee health expenditures at firms that offer insurance have lower within-firm and higher between-firm variance than at firms that do not. Turnover rates are systematically higher in industries in which firms are less likely to offer insurance. Simulations of the offer decision capturing between-firm health-cost heterogeneity and expected turnover rates match the observed pattern across firm sizes well. 2010 John Wiley & Sons, Ltd.

Developing a Cost Model and Methodology to Estimate Capital Costs for Thermal Energy Storage

Energy Technology Data Exchange (ETDEWEB)

Glatzmaier, G.

2011-12-01

This report provides an update on the previous cost model for thermal energy storage (TES) systems. The update allows NREL to estimate the costs of such systems that are compatible with the higher operating temperatures associated with advanced power cycles. The goal of the Department of Energy (DOE) Solar Energy Technology Program is to develop solar technologies that can make a significant contribution to the United States domestic energy supply. The recent DOE SunShot Initiative sets a very aggressive cost goal to reach a Levelized Cost of Energy (LCOE) of 6 cents/kWh by 2020 with no incentives or credits for all solar-to-electricity technologies.1 As this goal is reached, the share of utility power generation that is provided by renewable energy sources is expected to increase dramatically. Because Concentrating Solar Power (CSP) is currently the only renewable technology that is capable of integrating cost-effective energy storage, it is positioned to play a key role in providing renewable, dispatchable power to utilities as the share of power generation from renewable sources increases. Because of this role, future CSP plants will likely have as much as 15 hours of Thermal Energy Storage (TES) included in their design and operation. As such, the cost and performance of the TES system is critical to meeting the SunShot goal for solar technologies. The cost of electricity from a CSP plant depends strongly on its overall efficiency, which is a product of two components - the collection and conversion efficiencies. The collection efficiency determines the portion of incident solar energy that is captured as high-temperature thermal energy. The conversion efficiency determines the portion of thermal energy that is converted to electricity. The operating temperature at which the overall efficiency reaches its maximum depends on many factors, including material properties of the CSP plant components. Increasing the operating temperature of the power generation

The operating cost of electrocoagulation

Energy Technology Data Exchange (ETDEWEB)

Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L. (Canadian Centre for Mineral and Energy Technology, Devon, AB (Canada))

1994-12-01

The electrocoagulation of kaolinite and bentonite suspensions was studied in a pilot-scale electrocoagulation system to assess the operating cost and efficiency of the process. Factors affecting the operating cost such as formation of passivation layers on electrode plates, flow velocity, and concentration of NaCl in the suspension were examined. The operating costs investigated were the power cost of the electrocoagulation cell and the material cost due to the consumption of the aluminum electrode. Comparison was based on the settling properties of the treated product: turbidity, settling rate, and cake height. Higher NaCl concentration resulted in greater amounts of Al dissolved chemically and electrochemically into the suspension and thus a better clarity of the supernatant of the treated product. Increased flow velocity could reduce significantly the operating cost while improving both clarity of the supernatant and compactness of the sludge volume. The passivation layers developed quickly with time during the electrocoagulation process and more energy became wasted on the layers. 10 refs., 12 figs.

Globalization and the Emergence of For-Profit Higher Education

Science.gov (United States)

Morey, Ann I.

2004-01-01

Globalization and the revolution in technological communications are major forces of change in higher education. This environment, when coupled with the needs of adult learners and the rising costs of tuition at traditional colleges and universities, has stimulated the emergence of for-profit, degree-granting higher education in the United States.…

Cost estimates for nuclear power in the UK

International Nuclear Information System (INIS)

Harris, Grant; Heptonstall, Phil; Gross, Robert; Handley, David

2013-01-01

Current UK Government support for nuclear power has in part been informed by cost estimates that suggest that electricity from new nuclear power stations will be competitive with alternative low carbon generation options. The evidence and analysis presented in this paper suggests that the capital cost estimates for nuclear power that are being used to inform these projections rely on costs escalating over the pre-construction and construction phase of the new build programme at a level significantly below those that have been experienced by past US and European programmes. This paper applies observed construction time and cost escalation rates to the published estimates of capital costs for new nuclear plant in the UK and calculates the potential impact on levelised cost per unit of electricity produced. The results suggest that levelised cost may turn out to be significantly higher than expected which in turn has important implications for policy, both in general terms of the potential costs to consumers and more specifically for negotiations around the level of policy support and contractual arrangements offered to individual projects through the proposed contract for difference strike price. -- Highlights: •Nuclear power projects costs can rise substantially during the construction period. •Pre-construction and construction time can be much longer than anticipated. •Adjusting estimates for observed experience increases levelised costs significantly. •Higher costs suggest that more policy support than envisaged may be required

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

The squeezing properties in the Jaynes-Cummings model with arbitrary intensity-dependent coupling

International Nuclear Information System (INIS)

Rhui-Hua, X.; Dun-Huan, L.; Gong-Ou, X.

1996-01-01

It is studied the squeezing properties of the atom and the radiation field in arbitrary intensity-dependent-coupling Jaynes-Cummings model when it is restricted to the following initial condition: the atom in its coherent state and the field in the vacuum state. The influence of virtual-photon processes on the atomic squeezing predicted by the Jaynes-Cummings model (JCM) has been examined. The relationship between the field and atomic squeezing in the resonant multi-photon JCM has been discussed. The symmetry between the field and atomic squeezing (SFAS) has been exposed in the resonant vacuum one-photon JCM, and the influence of non-resonant interaction and virtual-photon processes on the SFAS has also been discussed

Effect of a dual-purpose cask payload increment of spent fuel assemblies from VVER 1000 Bushehr Nuclear Power Plant on basket criticality

International Nuclear Information System (INIS)

Rezaeian, M.; Kamali, J.

2017-01-01

Dual-purpose casks can be utilized for dry interim storage and transportation of the highly radioactive spent fuel assemblies (SFAs) of Bushehr Nuclear Power Plant (NPP). Criticality safety analysis was carried out using the MCNP code for the cask containing 12, 18, or 19 SFAs. The basket materials of borated stainless steel and Boral (Al-B_4C) were investigated, and the minimum required receptacle pitch of the basket was determined. - Highlights: • Criticality safety analysis for a dual purpose cask was carried out. • The basket material of borated stainless steel and Boral were investigated. • Minimum receptacle pitch was determined for 12, 18, or 19 VVER 1000 spent fuel assemblies.

7 CFR 3015.195 - Subgrants and cost-type contracts.

Science.gov (United States)

2010-01-01

...-21 would apply to the costs incurred by the institution of higher education even though OMB Circular A-87 would apply to the costs incurred by the State. ... 7 Agriculture 15 2010-01-01 2010-01-01 false Subgrants and cost-type contracts. 3015.195 Section...

British Asian Women and the Costs of Higher Education in England

Science.gov (United States)

Bhopal, Kalwant

2016-01-01

This article will examine Asian women's experiences of financial support in higher education. The article is based on 30 in-depth interviews with Asian women who were studying at a "new" (post-1992) university in the South East of England. Women identified themselves as Muslim, Hindu and Sikh. The findings reveal that women's religious…

22 CFR 518.27 - Allowable costs.

Science.gov (United States)

2010-04-01

... INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 518.27 Allowable costs. For each kind of recipient, there is a set of... by institutions of higher education is determined in accordance with the provisions of OMB Circular A...

Cost comparison of open and robotic partial nephrectomy using a short postoperative pathway.

Science.gov (United States)

Mano, Roy; Schulman, Ariel; Hakimi, A Ari; Sternberg, Itay A; Bernstein, Melanie; Bochner, Bernard H; Coleman, Jonathan A; Russo, Paul

2015-03-01

To compare immediate perioperative direct costs of open partial nephrectomy (OPN) and robotic partial nephrectomy (RPN), managed under a common care pathway. Retrospective review of detailed institutional cost data for patients treated with OPN and RPN during 2011 was conducted. Cost and clinical data of OPN and RPN were compared for all patients and for patients stratified by length of stay (LOS), American Society of Anesthesiologists (ASA), and RENAL nephrometry scores. The study cohort included 190 OPN and 63 RPN cases. OPN was associated with higher ASA scores (P days (2-3 days) for OPN compared with 1 day (1-2 days) for RPN (P cost of OPN was lower than that of RPN with a difference of $3091 (P costs were higher in OPN, surgical costs were higher in RPN ($854 and $3695 difference in median costs, respectively; P cost of OPN for patients with an above-average LOS remained lower than that of RPN ($2680 difference in median costs; P = .001). RPN costs remained significantly higher when stratifying patients by their ASA and RENAL nephrometry scores. Despite the shorter hospital LOS associated with RPN, the immediate perioperative cost of OPN was lower than that of RPN for patients managed under a common care pathway, mainly due to high robotic purchase and maintenance costs. In light of the current health care debate, such financial disincentives may compromise the sustainability of advances in medical technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Costs of day hospital and community residential chemical dependency treatment.

Science.gov (United States)

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use.

Science.gov (United States)

Costa, Camille K; Dagher, Jehane H; Lamoureux, Julie; de Guise, Elaine; Feyz, Mitra

2015-01-01

The goal of this study is to determine if a difference in societal costs exists from traumatic brain injuries (TBI) in patients who wear helmets compared to non-wearers. This is a retrospective cost-of-injury study of 128 patients admitted to the Montreal General Hospital (MGH) following a TBI that occurred while cycling between 2007-2011. Information was collected from Quebec Trauma Registry. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated societal costs. The median costs of hospitalization were significantly higher (p = 0.037) in the no helmet group ($7246.67 vs. $4328.17). No differences in costs were found for inpatient rehabilitation (p = 0.525), outpatient rehabilitation (p = 0.192), loss of productivity (p = 0.108) or death (p = 1.000). Overall, the differences in total societal costs between the helmet and no helmet group were not significantly different (p = 0.065). However, the median total costs for patients with isolated TBI in the non-helmet group ($22, 232.82) was significantly higher (p = 0.045) compared to the helmet group ($13, 920.15). Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.

Dietary fatty acids and lipoproteins on progression of age-related macular degeneration

International Nuclear Information System (INIS)

Montserrat-de la Paz, S.; Naranjo, M.C.; Bermúdez, B.; López, S.; Abia, R.; Muriana, F.J.G.

2017-01-01

Age-related macular degeneration (AMD) is a medical condition of central loss vision and blindness. Numerous studies have revealed that changes on certain dietary fatty acids (FAs) could have useful for AMD management. This review summarizes the effects of dietary omega-3 long-chain PUFAs, MUFAs, and SFAs, and lipoproteins on AMD. Findings are consistent with the beneficial role of dietary omega-3 long-chain PUFAs, while the effects of dietary MUFAs and SFAs appeared to be ambiguous with respect to the possible protection from MUFAs and to the possible adverse impact from SFAs on AMD. Some of the pathological mechanisms associated with lipoproteins on AMD share those observed previously in cardiovascular diseases. It was also noticed that the effects of FAs in the diet and lipoprotein on AMD could be modulated by genetic variants. From a population health perspective, the findings of this review are in favour of omega-3 long-chain FAs recommendations in a preventive and therapeutic regimen to attain lower AMD occurrence and progression rates. Additional long-term and short-term nutrigenomic studies are required to clearly establish the role and the relevance of interaction of dietary FAs, lipoproteins, and genes in the genesis and progression of AMD. [es

Dietary fatty acids and lipoproteins on progression of age-related macular degeneration

Directory of Open Access Journals (Sweden)

S. Montserrat-de la Paz

2017-06-01

Full Text Available Age-related macular degeneration (AMD is a medical condition of central loss vision and blindness. Numerous studies have revealed that changes on certain dietary fatty acids (FAs could have useful for AMD management. This review summarizes the effects of dietary omega-3 long-chain PUFAs, MUFAs, and SFAs, and lipoproteins on AMD. Findings are consistent with the beneficial role of dietary omega-3 long-chain PUFAs, while the effects of dietary MUFAs and SFAs appeared to be ambiguous with respect to the possible protection from MUFAs and to the possible adverse impact from SFAs on AMD. Some of the pathological mechanisms associated with lipoproteins on AMD share those observed previously in cardiovascular diseases. It was also noticed that the effects of FAs in the diet and lipoprotein on AMD could be modulated by genetic variants. From a population health perspective, the findings of this review are in favour of omega-3 long-chain FAs recommendations in a preventive and therapeutic regimen to attain lower AMD occurrence and progression rates. Additional long-term and short-term nutrigenomic studies are required to clearly establish the role and the relevance of interaction of dietary FAs, lipoproteins, and genes in the genesis and progression of AMD.

Consideration of higher seismic loads at existing plants

Energy Technology Data Exchange (ETDEWEB)

Liebig, J.; Pellissetti, M.

2015-07-01

Because of advancement of methods in probabilistic seismic hazard analysis, plenty of existing plants face higher seismic loads as an obligation from the national authorities. In case of such obligations safety related structures and equipment have to be reevaluated or requalified for the increased seismic loads. The paper provides solutions for different kinds of structures and equipment inside the plant, avoiding cost intensive hardware exchange. Due to higher seismic loads different kinds of structures and equipment inside a plant have to be reevaluated. For civil structures, primary components, mechanical components, distribution lines and electrical and I&C equipment different innovative concepts will be applied to keep structures and equipment qualified for the higher seismic loads. Detailed analysis, including the modeling of non-linear phenomena, or minor structural upgrades are cost competitive, compared to cost intensive hardware exchanges. Several case studies regarding the re-evaluation and requalification of structures and equipment due to higher seismic loads are presented. It is shown how the creation of coupled finite element models and the consistent propagation of acceleration time histories through the soil, building and primary circuit lead to a significant load reduction Electrical and I&C equipment is reinforced by smart upgrades which increase the natural equipment frequencies. Therefore for all devices inside the cabinets the local acceleration will not increase and the seismic qualification will be maintained. The case studies cover both classical deterministic and probabilistic re-evaluations (fragility analysis). Furthermore, the substantial benefits of non-linear limit load evaluation, such as push-over analysis of buildings and limit load analysis of fuel assemblies, are demonstrated. (Author)

The availability and cost of healthier food alternatives.

Science.gov (United States)

Jetter, Karen M; Cassady, Diana L

2006-01-01

Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products. Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005. In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year. The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

Digital vs conventional radiography: cost and revenue analysis

International Nuclear Information System (INIS)

Dalla Palma, L.; Cuttin, R.; Rimondini, A.; Grisi, G.

1999-01-01

The objective of this study was to analyse and compare the operating and investment costs of two radiographic systems, a conventional and a digital one, and to evaluate the cost/revenue ratio of the two systems. The radiological activity over 1 year for chest and skeletal exams was evaluated: 13,401 chest and 7,124 skeletal exams were considered. The following parameters of variable costs were evaluated: the difference between variable proportional costs of the two technologies, the effective variable cost of any size film, including the chemicals, and for different sizes of digital film, variable costs of chest plus skeletal exams performed with the two techniques. Afterwards the economical effect was considered taking into account depreciation during a time of utilization ranging between 8 and 4 years. In the second part of the analysis the total cost and the revenues of the two technologies were determined. The comparison between the digital and conventional systems has shown the following aspects: 1. Digital radiography system has a much higher investment cost in comparison with the conventional one. 2. Operating costs of digital equipment are higher or lower depending on the film size used. Evaluating chest X-ray we reach a breakeven point after 1 year and 10,000 exams only if displayed over 8 x 10-in. film and after 30,000 if displayed over a 11 x 14-in. film. 3. The total cost (variable cost, technology cost, labour cost) of digital technology is lower than that of the conventional system by 20 % on average using 8 x 10-in. film size. 4. Digital technology also allows lesser film waste and lesser film per exam (orig.)

Fair Access to Higher Education: Global Perspectives

Science.gov (United States)

Mountford-Zimdars, Anna, Ed.; Sabbagh, Daniel, Ed.; Post, David, Ed.

2015-01-01

What does "fairness" mean internationally in terms of access to higher education? Increased competition for places in elite universities has prompted a worldwide discussion regarding the fairness of student admission policies. Despite budget cuts from governments--and increasing costs for students--competition is fierce at the most…

Shadow Cost of Public Funds and Privatization Policies

OpenAIRE

Sato, Susumu; Matsumura, Toshihiro

2017-01-01

We investigate the optimal privatization policy in mixed oligopolies with shadow cost of public funds (excess burden of taxation). The government is concerned with both the total social surplus and the revenue obtained by the privatization of a public firm. We find that the relationship between the shadow cost of public funds and the optimal privatization policy is non-monotone. When the cost is moderate, then higher the cost is, the lower is the optimal degree of privatization. ...

Emissions trading and transaction costs : analyzing the flaws in the discussion

NARCIS (Netherlands)

Woerdman, E.

Although emissions trading lowers the costs of climate change mitigation, transaction costs (e.g. to find a trading partner) may reduce its cost-effectiveness. Some economists claim that transaction costs for Joint Implementation (JI) and Clean Development Mechanism (CDM) projects will be higher

Transaction costs and community-based natural resource management in Nepal.

Science.gov (United States)

Adhikari, Bhim; Lovett, Jon C

2006-01-01

Transaction costs in community-based resource management are incurred by households attempting to enforce property right rules over common resources similar to those inherent in private property rights. Despite their importance, transaction costs of community-based management of common pool resources (CPRs) are often not incorporated into the economic analysis of participatory resource management. This paper examines the transaction costs incurred by forest users in community forestry (CF) based on a survey of 309 households belonging to eight different forest user groups (FUGs) in the mid hills of Nepal. The analysis reveals that the average 'poor' household incurred Nepalese rupees (NRS) 1265 in transaction costs annually, while wealthier 'rich' households incurred an average of NRS 2312 per year. Although richer households bear higher proportions of such costs, transaction costs for CF management as a percentage of resource appropriation costs are higher for poorer households (26%) than those of middle-wealth (24%) or rich households (14%). There are also village differences in the level of transaction costs. The results show that transaction costs are a major component of resource management costs and vary according to socio-economic status of resource users and characteristics of the community.

How does Cash and Counseling affect costs?

Science.gov (United States)

Dale, Stacy B; Brown, Randall S

2007-02-01

To test the effect of a consumer-directed model (Cash and Counseling) of Medicaid personal care services (PCS) or home- and community-based waiver services (HCBS) on the cost of Medicaid services. Medicaid claims data were collected for all enrollees in the Cash and Counseling demonstration. Demonstration enrollees included those eligible for PCS (in Arkansas), those assessed to receive such services (in New Jersey), and recipients of Medicaid HCBS (in Florida). Enrollment occurred from December 1998 through April 2001. The follow-up period covered up to 24 months after enrollment. Demonstration volunteers were randomly assigned to have the option to participate in Cash and Counseling (the treatment group), or to receive Medicaid services as usual from an agency (the control group). Ordinary least squares regressions were used to estimate the effect of the program on costs for Medicaid PCS/waiver services and other Medicaid services, while controlling for consumers' preenrollment characteristics and preenrollment Medicaid spending. Models were estimated separately for nonelderly and elderly adults in each state and for children in Florida. Each state supplied claims data for demonstration enrollees. Largely because the program increased consumers' ability to get the authorized amount of paid care, expenditures for personal care/waiver services were higher for the treatment group than for the control group in each state and age group, except among the elderly in Florida. Higher costs for personal care/waiver services were partially offset by savings in other Medicaid services, particularly those related to long-term care. During year 1, total Medicaid costs were generally higher for the treatment group than for the control group, with treatment-control cost differences ranging from 1 percent (and statistically insignificant) for the elderly in Florida to 17 percent for the elderly in Arkansas. In year 2, these cost differences were generally greater than in year 1

Damage cost of the Dan River coal ash spill

International Nuclear Information System (INIS)

Dennis Lemly, A.

2015-01-01

The recent coal ash spill on the Dan River in North Carolina, USA has caused several negative effects on the environment and the public. In this analysis, I report a monetized value for these effects after the first 6 months following the spill. The combined cost of ecological damage, recreational impacts, effects on human health and consumptive use, and esthetic value losses totals $295,485,000. Because the environmental impact and associated economic costs of riverine coal ash spills can be long-term, on the order of years or even decades, this 6-month assessment should be viewed as a short-term preview. The total cumulative damage cost from the Dan River coal ash spill could go much higher. - Highlights: • Six-month post-spill damage cost exceeded $295,000,000. • Components of cost include ecological, recreational, human health, property, and aesthetic values. • Attempts by the electric utility to “clean” the river left over 95% of coal ash behind. • Long-term impacts will likely drive the total damage cost much higher. - Damage costs of the Dan River coal ash spill are extensive and growing. The 6-month cost of that spill is valued at $295,485,000, and the long-term total cost is likely to rise substantially

Costs and outcomes associated with IVF using recombinant FSH.

Science.gov (United States)

Ledger, W; Wiebinga, C; Anderson, P; Irwin, D; Holman, A; Lloyd, A

2009-09-01

Cost and outcome estimates based on clinical trial data may not reflect usual clinical practice, yet they are often used to inform service provision and budget decisions. To expand understanding of assisted reproduction treatment in clinical practice, an economic evaluation of IVF/intracytoplasmic sperm injection (ICSI) data from a single assisted conception unit (ACU) in England was performed. A total of 1418 IVF/ICSI cycles undertaken there between October 2001 and January 2006 in 1001 women were analysed. The overall live birth rate was 22% (95% CI: 19.7-24.2), with the 30- to 34-year age group achieving the highest rate (28%). The average recombinant FSH (rFSH) dose/cycle prescribed was 1855 IU. Average cost of rFSH/cycle was 646 pound(SD: 219 pound), and average total cost/cycle was 2932 pound (SD: 422 pound). Economic data based on clinical trials informing current UK guidance assumes higher doses of rFSH dose/cycle (1750-2625 IU), higher average cost of drugs/cycle (1179 pound), and higher average total cost/cycle (3266 pound). While the outcomes in this study matched UK averages, total cost/cycle was lower than those cited in UK guidelines. Utilizing the protocols and (lower) rFSH dosages reported in this study may enable other ACU to provide a greater number of IVF/ICSI cycles to patients within given budgets.

Excess costs from functional somatic syndromes in Germany - An analysis using entropy balancing.

Science.gov (United States)

Grupp, Helen; Kaufmann, Claudia; König, Hans-Helmut; Bleibler, Florian; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schäfert, Rainer; Konnopka, Alexander

2017-06-01

The aim of this study was to calculate disorder-specific excess costs in patients with functional somatic syndromes (FSS). We compared 6-month direct and indirect costs in a patient group with FSS (n=273) to a control group of the general adult population in Germany without FSS (n=2914). Data on the patient group were collected between 2007 and 2009 in a randomized controlled trial (speciAL). Data on the control group were obtained from a telephone survey, representative for the general German population, conducted in 2014. Covariate balance between the patient group and the control group was achieved using entropy balancing. Excess costs were calculated by estimating generalized linear models and two-part models for direct costs and indirect costs. Further, we estimated excess costs according to the level of somatic symptom severity (SSS). FSS patients differed significantly from the control group regarding 6-month costs of outpatient physicians (+€280) and other outpatient providers (+€74). According to SSS, significantly higher outpatient physician costs were found for mild (+€151), moderate (+€306) and severe (+€376) SSS. We also found significantly higher costs of other outpatient providers in patients with mild, moderate and severe SSS. Regarding costs of rehabilitation and hospital treatments, FSS patients did not differ significantly from the control group for any level of SSS. Indirect costs were significantly higher in patients with severe SSS (+€760). FSS were of major importance in the outpatient sector. Further, we found significantly higher indirect costs in patients with severe SSS. Copyright © 2017 Elsevier Inc. All rights reserved.

Improving building performance using smart building concept: Benefit cost ratio comparison

Science.gov (United States)

Berawi, Mohammed Ali; Miraj, Perdana; Sayuti, Mustika Sari; Berawi, Abdur Rohim Boy

2017-11-01

Smart building concept is an implementation of technology developed in the construction industry throughout the world. However, the implementation of this concept is still below expectations due to various obstacles such as higher initial cost than a conventional concept and existing regulation siding with the lowest cost in the tender process. This research aims to develop intelligent building concept using value engineering approach to obtain added value regarding quality, efficiency, and innovation. The research combined quantitative and qualitative approach using questionnaire survey and value engineering method to achieve the research objectives. The research output will show additional functions regarding technology innovation that may increase the value of a building. This study shows that smart building concept requires higher initial cost, but produces lower operational and maintenance costs. Furthermore, it also confirms that benefit-cost ratio on the smart building was much higher than a conventional building, that is 1.99 to 0.88.

The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

Science.gov (United States)

Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

2013-10-01

To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

Smoking, depression, and hospital costs of respiratory cancers: Examining race and sex variation

Directory of Open Access Journals (Sweden)

Baqar A. Husaini

2017-05-01

Full Text Available Objective: To investigate the effect of smoking and depression on hospital costs for lung cancer (LC. Methods: We extracted data on depression, smoking history, demographics, and hospital charges for patients with respiratory cancers (ICD-9 codes 161–163, 165 from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6665 was mostly white (86% and male (57%. Age-adjusted rates were developed in accordance with Centers for Disease Control and Prevention methods, and hospital costs were compared for patients with LC with versus without depression and a smoking history. Results: Three findings (P<0.001 emerged: (1 the LC rate was higher among blacks than among whites, and higher among men than among women; (2 while 66% of LC patients smoked (more men than women without racial variation, 24% had depression (more females and whites were depressed; (3 the LC hospital cost was 54% higher than the non-LC hospital cost, and this cost doubled for patients with LC with depression and smoking versus those without such characteristics. Conclusion: While LC is more prevalent among blacks and men, depression is higher among female and white patients. Since depression with higher costs existed among LC patients, our findings point to (1 the possibility of cost savings by diagnosing and treating depression among LC patients, and (2 implementation of proven smoking cessation programs to reduce LC morbidity and hospital costs.

Economic costs of electricity production in Poland

International Nuclear Information System (INIS)

Beeldman, M.; Solinski, J.

1994-02-01

This study presents a methodology for the calculation of the economic costs of the production of electricity. This methodology is applied to assess electricity production cost in Poland by type of power station for the years 1995 and 2000. In addition, an overview is presented of the methods used by the OECD countries, particularly in the Netherlands. The main conclusions of the study are: 1) the real economic costs to generate electricity in Poland are about two times higher compared with the traditional book-keeping data; 2) the investment costs will become the most important cost component in the near future; and 3) there are considerables differences in production cost per kWh for the different types of power plants in Poland. 4 appendices, 14 refs

Nuclear power investment and generating costs from a utility point of view

International Nuclear Information System (INIS)

Roth, B.F.

1975-01-01

Nuclear power stations presently in operation in the Federal Republic of Germany have electricity generating costs between 3.5 Pf/kWh and 4.5 Pf/kWh. The higher electricity generating costs are due mainly to the increased expenditure required for the protection of plants against airplane crashes, earthquakes and sabotage, and to the higher costs of the entire fuel cycle. (orig./RW) [de

Managing the higher risks of low-cost high-efficiency advanced power generation technologies

International Nuclear Information System (INIS)

Pearson, M.

1997-01-01

Independent power producers operate large coal-fired installations and gas turbine combined-cycle (GTCC) facilities. Combined cycle units are complex and their reliability and availability is greatly influenced by mechanical, instrumentation and control weaknesses. It was suggested that these weaknesses could be avoided by tighter specifications and more rigorous functional testing before acceptance by the owner. For the present, the difficulties of developing reliable, lower installed cost/kw, more efficient GTCC designs, pressure for lower NO x emissions with 'dry' combustors continue to be the most difficult challenges for all GT manufacturers

COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

Directory of Open Access Journals (Sweden)

Moisello Anna Maria

2012-07-01

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

Proprietary hospitals in cost containment.

Science.gov (United States)

Jones, D A

1985-08-23

Any effort to control the rise in health care costs must start with analyzing the causes, which are really quite simple. Most cost control efforts fail because they do not address the causes. The causes are large subsidies in several forms that send a false message that health care is free and should be used abundantly, and expansive reimbursement programs that reward inefficient providers with higher payments. This combination of demand stimulation and cost-plus reimbursement produced the world's most expensive health care delivery system and strident calls for reform. A long overdue change in public policy took effect October 1, 1983, when Medicare payments moved from cost-plus reimbursement to fixed, prospectively determined prices. Because it addressed one of the causes of medical inflation, this change has been effective in slowing the rise in Medicare expenditures. Sponsorship of a hospital is not a determinant of its cost-effectiveness. There are examples of efficient and inefficient hospitals in both the voluntary and the investor-owned or taxpaying hospitals. The determining factor is the will of management to keep costs under control.

Real world costs and cost-effectiveness of Rituximab for diffuse large B-cell lymphoma patients: a population-based analysis.

Science.gov (United States)

Khor, Sara; Beca, Jaclyn; Krahn, Murray; Hodgson, David; Lee, Linda; Crump, Michael; Bremner, Karen E; Luo, Jin; Mamdani, Muhammad; Bell, Chaim M; Sawka, Carol; Gavura, Scott; Sullivan, Terrence; Trudeau, Maureen; Peacock, Stuart; Hoch, Jeffrey S

2014-08-12

Current treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative to CHOP alone as first-line treatment of DLBCL, but it remains unclear what its real-world costs and cost-effectiveness are in routine clinical practice. We performed a population-based retrospective cohort study from 1997 to 2007, using linked administrative databases in Ontario, Canada, to evaluate the costs and cost-effectiveness of RCHOP compared to CHOP alone. A historical control cohort (n = 1,099) with DLBCL who received CHOP before rituximab approval was hard-matched on age and treatment intensity and then propensity-score matched on sex, comorbidity, and histology to 1,099 RCHOP patients. All costs and outcomes were adjusted for censoring using the inverse probability weighting method. The main outcome measure was incremental cost per life-year gained (LYG). Rituximab was associated with a life expectancy increase of 3.2 months over 5 years at an additional cost of $16,298, corresponding to an incremental cost-effectiveness ratio of $61,984 (95% CI $34,087-$135,890) per LYG. The probability of being cost-effective was 90% if the willingness-to-pay threshold was $100,000/LYG. The cost-effectiveness ratio was most favourable for patients less than 60 years old ($31,800/LYG) but increased to $80,600/LYG for patients 60-79 years old and $110,100/LYG for patients ≥ 80 years old. We found that post-market survival benefits of rituximab are similar to or lower than those reported in clinical trials, while the costs, incremental costs and cost-effectiveness ratios are higher than in published economic models and differ by age. Our results showed that the addition of rituximab to standard CHOP chemotherapy was associated with improvement in survival but at a higher cost, and was

Costs of electronuclear fuel production

International Nuclear Information System (INIS)

Flaim, T.; Loose, V.

1978-07-01

The Los Alamos Scientific Laboratory (LASL) proposes to study the electronuclear fuel producer (EFP) as a means of producing fissile fuel to generate electricity. The main advantage of the EFP is that it may reduce the risks of nuclear proliferation by breeding 233 U from thorium, thereby avoiding plutonium separation. A report on the costs of electronuclear fuel production based upon two designs considered by LASL is presented. The findings indicate that the EFP design variations considered are not likely to result in electricity generation costs as low as the uranium fuel cycle used in the US today. At current estimates of annual fuel output (500 kg 233 U per EFP), the costs of electricity generation using fuel produced by the EFP are more than three times higher than generating costs using the traditional fuel cycle. Sensitivity analysis indicates that electronuclear fuel production would become cost competitive with the traditional uranium fuel cycle when U 3 O 8 (yellowcake) prices approach $1000 per pound

[Cost effectiveness of workplace smoking policies].

Science.gov (United States)

Raaijmakers, Tamara; van den Borne, Inge

2003-01-01

This study reviews the motivations of companies to set out a policy for controlling smoking, the economic benefits for the company resulting from such a policy and the costs, broken down by European Union countries. The literature on the costs of implementing a policy related to smoking at the workplace is reviewed. The main objective of policies related to smoking at the workplace is that of safeguarding employees from environmental tobacco smoke. Other reasons are cutting costs, improving the company image, and reducing absenteeism, occupational accidents, internal quarrels and extra costs due to cigarette smoking, protection against environmental tobacco smoke does not entail any higher costs for companies, and economic advantages are visible. The benefits are by far greater than the costs involved, particularly on a long-range basis, and seem to be greater when smoking at the workplace is completely prohibited and no smoking areas are set.

Potential costs of breast augmentation mammaplasty.

Science.gov (United States)

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

2016-01-01

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

Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.

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Sevick, Laura K; Ghali, Sarah; Hill, Michael D; Danthurebandara, Vishva; Lorenzetti, Diane L; Noseworthy, Tom; Spackman, Eldon; Clement, Fiona

2017-09-01

Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients. Systematic review best practices were followed, and study quality was assessed. Four-hundred sixty-three articles were identified from electronic databases. After deduplication, abstract review, and full-text review, 17 studies were included. Seven of the studies were cost analyses, and 10 were cost-effectiveness studies. Generally, the cost analyses reported on the cost of the approach/procedure or the hospitalization costs associated with EVT. All of the cost-effectiveness studies reported a cost per quality-adjusted life year as the primary outcomes. Studies varied in regards to the costs considered, the perspective adopted, and the time horizon used. All the studies reported a cost per quality-adjusted life year of cost and cost-effectiveness of EVT. The cost analyses suggested that although EVT was associated with higher costs, it also resulted in improved patient outcomes. From the cost-effectiveness studies, EVT seems to be good value for money when a threshold of $50 000 per quality-adjusted life year gained is adopted. © 2017 American Heart Association, Inc.

Alterations in peripheral fatty acid composition in bipolar and unipolar depression.

Science.gov (United States)

Scola, Gustavo; Versace, Amelia; Metherel, Adam H; Monsalve-Castro, Luz A; Phillips, Mary L; Bazinet, Richard P; Andreazza, Ana C

2018-06-01

Lipid metabolism has been shown to play an important role in unipolar and bipolar depression. In this study, we aimed to evaluate levels of fatty acids in patients with unipolar (MDD) and bipolar depression (BDD) in comparison to patients with bipolar disorder in euthymia (BDE) and non-psychiatric controls. Levels of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) were assessed in serum of (87) patients with BD (31 euthymic, 22 depressive) or MDD (34) and (31) non-psychiatric controls through GC-FID. No significant difference in total levels of PUFAs (polyunsaturated fatty acids), SFAs (saturated fatty acids), MUFAs (monounsaturated fatty acids) and total fatty acids were found between groups. Our results demonstrated higher levels AA: EPA and AA: EPA+DHA in patients with BDD. Additionally, we observed that overall omega-6 present a positive correlation with illness duration in patients with BDD and AA: EPA ratio positively associated with illness duration in MDD group. Depression severity was positively associated with AA: EPA+DHA ratio in all participants. Together, our results support the relevance for the balance of omega-3 and omega-6 in BDD. Also, our results suggest a potential subset of stage-related lipid biomarkers that further studies are needed to help clarify the dynamics of lipid alteration in BD and MDD. Copyright © 2018 Elsevier B.V. All rights reserved.

Correlation of QRS complex after percutaneous coronary intervention with myocardial ischemia reperfusion injury and apoptosis molecule contents

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Ming-Min Jiang

2017-11-01

Full Text Available Objective: To study the correlation of QRS complex after percutaneous coronary intervention (PCI with myocardial ischemia reperfusion injury and apoptosis molecule contents. Methods: Patients with non-ST-segment elevation myocardial infarction who were treated in Nanchong Central Hospital between June 2014 and August 2016 were selected and divided into the PCI group who received emergency PCI surgery and the control group who accepted selective PCI or refused emergency PCI after the medical data were retrospectively analyzed. The fQRS as well as the contents of ischemia reperfusion injury indexes and apoptosis molecules was determined after 1 week of treatment. Results: The incidence of fQRS in PCI group was significantly lower than that in control group; serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group were greatly lower than those of control group; serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group of patients with fQRS complex (+ were greatly higher than those of patients with fQRS complex (-. Conclusion: The occurrence of fQRS after PCI is closely related to myocardial ischemia reperfusion injury and apoptosis.

Effect of alteplase thrombolysis sequenced by low molecular heparin calcium antithrombosis on the neurological function and serum cytokines in patients with cerebral infarction

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Yi-Ping Dan

2017-04-01

Full Text Available Objective: To study the effect of alteplase thrombolysis sequenced by low molecular heparin calcium antithrombosis on the neurological function and serum cytokines in patients with cerebral infarction. Methods: Patients with acute cerebral infarction who received alteplase thrombolysis in Zigong Fourth People's Hospital between June 2014 and October 2016 were retrospectively analyzed and divided into the intervention group who received low molecular heparin calcium treatment and the control group who did not receive low molecular heparin calcium treatment. The serum was collected before and after treatment to determine the contents of platelet activation factors, nerve injury molecules, soluble apoptotic molecules and growth factors. Results: Serum CD62p, CD63, PAF, GMP-140, NSE, S100B, GFAP, sFas, sFasL, sTRAIL, IGF-1, VEGF, BDNF and bFGF levels of both groups of patients after treatment were lower than those before treatment, serum CD62p, CD63, PAF, GMP-140, NSE, S100B, GFAP, sFas, sFasL and sTRAIL levels of intervention group after treatment were lower than those of control group while IGF-1, VEGF, BDNF and bFGF levels were higher than those of control group. Conclusion: Alteplase thrombolysis sequenced by low molecular heparin calcium antithrombosis for acute cerebral infarction can inhibit platelet activation and cell apoptosis, alleviate nerve injury and improve neurotrophy status.

Comparison of cost determination of both resource consumption accounting and time-driven activity-based costing systems in a healthcare setting.

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Özyapıcı, Hasan; Tanış, Veyis Naci

2017-05-01

Objective The aim of the present study was to explore the differences between resource consumption accounting (RCA) and time-driven activity-based costing (TDABC) systems in determining the costs of services of a healthcare setting. Methods A case study was conducted to calculate the unit costs of open and laparoscopic gall bladder surgeries using TDABC and RCA. Results The RCA system assigns a higher cost both to open and laparoscopic gall bladder surgeries than TDABC. The total cost of unused capacity under the TDABC system is also double that in RCA. Conclusion Unlike TDABC, RCA calculates lower costs for unused capacities but higher costs for products or services in a healthcare setting in which fixed costs make up a high proportion of total costs. What is known about the topic? TDABC is a revision of the activity-based costing (ABC) system. RCA is also a new costing system that includes both the theoretical advantages of ABC and the practical advantages of German costing. However, little is known about the differences arising from application of TDABC and RCA. What does this paper add? There is no study comparing both TDABC and RCA in a single case study based on a real-world healthcare setting. Thus, the present study fills this gap in the literature and it is unique in the sense that it is the first case study comparing TDABC and RCA for open and laparoscopic gall bladder surgeries in a healthcare setting. What are the implications for practitioners? This study provides several interesting results for managers and cost accounting researchers. Thus, it will contribute to the spread of RCA studies in healthcare settings. It will also help the implementers of TDABC to revise data concerning the cost of unused capacity. In addition, by separating costs into fixed and variable, the paper will help managers to create a blended (combined) system that can improve both short- and long-term decisions.

Internal Resources to Improve the Quality of Higher Education

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Tatyana V. Zak

2016-03-01

Full Text Available The article deals with the situation in the Russian higher education system. The factors affecting the improvement of the quality of higher education are analyzed. The emphasis is on mass universities. The main obstacles to improving the quality of education in these institutions are the Institute of collective reputation and the high costs of the struggle for improving the quality of education.The necessity of focusing on the actuation of the internal resources to improve the quality associated with the change in the educational process: giving students the right to choose the timing exams and training period at university. The implementation of the proposed measures will reduce the opportunity costs associated with quality improvement activities. The proposed change in the organization of the learning process opens the possibility to estimate the activity of universities in terms of medium-term implementation of educational programs. The use of this indicator will not only combine the two different targets of universities, but also to minimize the costs of opportunistic behavior of teachers and management.

Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

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Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

2016-11-01

To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

Activity-Based Costing in the After Press Services Industry

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Shevasuthisilp, Suntichai; Punsathitwong, Kosum

2009-10-01

This research was conducted to apply activity-based costing (ABC) in an after press service company in Chiang Mai province, Thailand. The company produces all of its products by one-stop service (such as coating, stitching, binding, die cutting, and gluing). All products are made to order, and have different sizes and patterns. A strategy of low price is used to compete in the marketplace. After cost analysis, the study found that the company has high overhead (36.5% of total cost). The company's problem is its use of traditional cost accounting, which has low accuracy in assigning overhead costs. If management uses this information when pricing customer orders, losses may occur because real production costs may be higher than the selling price. Therefore, the application of ABC in cost analysis can help executives receive accurate cost information; establish a sound pricing strategy; and improve the manufacturing process by determining work activities which have excessively high production costs. According to this research, 6 out of 56 items had a production cost higher than the selling price, leading to losses of 123,923 baht per year. Methods used to solve this problem were: reducing production costs; establishing suitable prices; and creating a sales promotion with lower prices for customers whose orders include processes involving unused capacity. These actions will increase overall sales of the company, and allow more efficient use of its machinery.

The Food Costs of Healthier School Lunches

OpenAIRE

Newman, Constance

2012-01-01

The U.S. Department of Agriculture proposed and adopted a new set of meal pattern requirements for the National School Lunch Program that will allow schools to claim 6 cents more in lunch reimbursement rates. This study analyzes the food costs of school menus in 2005 that met many of the proposed requirements. Overall, schools that served more, and more diverse, non-starchy vegetables had higher average food costs, and schools that served menus with lower calories had lower food costs. The fo...

THE PRICE OF HIGHER EDUCATION AND INDIVIDUAL DEMAND

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Filiz Golpek

2012-01-01

Full Text Available The rise in the living standards in most of the world, the rise in population and schooling rates have increased the demand for higher education. The attribution of semi public property becomes determinant to decide whom will provide the supply and the production in semi public properties is realized by means of a supply and demand mechanism. The supply of higher education is mostly secured in accordance with the public demand as well as the resources available.  In addition, the fact that higher education services have produced significant benefits has led to over demand. This situation relates to a simple economic rule that a commodity or service which costs almost nothing or little will increase until the mariginal benefit of its demand equals to 0 or almost 0. However, the educational supply and demand is difficult to identify in accordance to the supply and demand and balance of price as observed in the economic theory. The high profits that would be attracted in the future are significant factors influencing individual’s decisions for investment. The decision for investment depends on the possible return in the future, the cost of investment, and the current interest rates. Higher education with investment purposes is influenced by these three factors and higher education is demanded more and more by individuals on the expectation that they will gain high profits In theory, it is accepted that the basic factors identifying the demand for higher education are in harmony with empirical research results in several countries including Turkey.

Cost Per Pound From Orbit

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Merriam, M. L.

2002-01-01

Traditional studies of Reusable Launch Vehicle (RLV) designs have focused on designs that are completely reusable except for the fuel. This may not be realistic with current technology . An alternate approach is to look at partially reusable launch vehicles. This raises the question of which parts should be reused and which parts should be expendable. One approach is to consider the cost/pound of returning these parts from orbit. With the shuttle, this cost is about three times the cost/pound of launching payload into orbit. A subtle corollary is that RLVs are much less practical for higher orbits, such as the one on which the International Space Station resides, than they are for low earth orbits.

Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

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Koopmanschap Marc A

2003-02-01

Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis.

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Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

2016-01-01

The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Executive Compensation and the Cost of Debt

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Kabir, Rezaul; Liu, Hao; Veld-Merkoulova, Yulia V.

2013-01-01

This study examines how different components of executive compensation affect the cost of debt. We find that debt-like and equity-like pay components have differing effects: an increase in defined benefit pensions is associated with lower bond yield spread, while higher share holdings lead to higher

Activity-Based Costing Model for Assessing Economic Performance.

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DeHayes, Daniel W.; Lovrinic, Joseph G.

1994-01-01

An economic model for evaluating the cost performance of academic and administrative programs in higher education is described. Examples from its application at Indiana University-Purdue University Indianapolis are used to illustrate how the model has been used to control costs and reengineer processes. (Author/MSE)

Cost Comparison of Fundamentals of Laparoscopic Surgery Training Completed With Standard Fundamentals of Laparoscopic Surgery Equipment versus Low-Cost Equipment.

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Franklin, Brenton R; Placek, Sarah B; Wagner, Mercy D; Haviland, Sarah M; O'Donnell, Mary T; Ritter, E Matthew

Training for the Fundamentals of Laparoscopic Surgery (FLS) skills test can be expensive. Previous work demonstrated that training on an ergonomically different, low-cost platform does not affect FLS skills test outcomes. This study compares the average training cost with standard FLS equipment and medical-grade consumables versus training on a lower cost platform with non-medical-grade consumables. Subjects were prospectively randomized to either the standard FLS training platform (n = 19) with medical-grade consumables (S-FLS), or the low-cost platform (n = 20) with training-grade products (LC-FLS). Both groups trained to proficiency using previously established mastery learning standards on the 5 FLS tasks. The fixed and consumable cost differences were compared. Training occurred in a surgical simulation center. Laparoscopic novice medical student and resident physician health care professionals who had not completed the national FLS proficiency curriculum and who had performed less than 10 laparoscopic cases. The fixed cost of the platform was considerably higher in the S-FLS group (S-FLS, $3360; LC-FLS, $879), and the average consumable training cost was significantly higher for the S-FLS group (S-FLS, $1384.52; LC-FLS, $153.79; p group had a statistically discernable cost reduction for each consumable (Gauze $9.24 vs. $0.39, p = 0.002; EndoLoop $540.00 vs. $40.60, p group versus $1647.95 in the LC-FLS group. This study shows that the average cost to train a single trainee to proficiency using a lower fixed-cost platform and non-medical-grade equipment results in significant financial savings. A 5-resident program will save approximately $8500 annually. Residency programs should consider adopting this strategy to reduce the cost of FLS training. Published by Elsevier Inc.

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

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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

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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

(Super Variable Costing-Throughput Costing)

OpenAIRE

Çakıcı, Cemal

2006-01-01

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

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

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Paul Bacsich

2000-12-01

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

Costs of health care across primary care models in Ontario.

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Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

2017-08-01

The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

Resource Requirements and Costs of Developing and Delivering MOOCs

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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.

Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing.

Science.gov (United States)

Graff, Jennifer S; Shih, Chuck; Barker, Thomas; Dieguez, Gabriela; Larson, Cheryl; Sherman, Helen; Dubois, Robert W

2017-06-01

Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration. For example, patients with rheumatoid arthritis may be required to fail low-cost generic treatments before obtaining coverage for a higher-tier tumor necrosis factor alpha inhibitor for which they would have a larger financial burden. Little is known about stakeholders' views on the acceptability of greater patient cost sharing if the individual patient characteristics lead to the higher-cost treatments. To identify and discuss the trade-offs associated with variable cost sharing in pharmacy benefits. To discuss the trade-offs associated with variable cost sharing in pharmacy benefits, we convened an expert roundtable of patient, payer, and employer representatives (panelists). Panelists reviewed background white papers, including an ethics framework; actuarial analysis; legal review; and stakeholder perspectives representing health plan, employer, and patient views. Using case studies, panelists were asked to consider (a) when it would be more (or less) acceptable to require higher cost sharing; (b) the optimal distribution of financial burdens across patients, all plan members, and employers; and (c) the existing barriers and potential solutions to align OOP costs with medically appropriate treatments. Panelists felt it was least acceptable for patients to have greater OOP costs if the

Primary kidney disease and post-renal transplantation hospitalization costs.

Science.gov (United States)

Ghoddousi, K; Ramezani, M K; Assari, S; Lankarani, M M; Amini, M; Khedmat, H; Hollisaaz, M T

2007-05-01

This study sought to assess posttransplantation hospitalizations costs in diabetic and nondiabetic subjects to see whether diabetes mellitus (DM) as a primary cause of end-stage renal disease (ESRD) increased posttransplantation hospitalization costs. From 2000 to 2005, the hospitalization costs of 387 consecutive rehospitalizations of kidney recipients were retrospectively compared for two groups: patients with ESRD due to DM (n=71) and those with ESRD of non-DM etiologies (n=316). The hospitalization costs included the costs of hotel, medications, surgical procedures, paraclinical tests, imaging tests, health personnel time, special services (ie, patient transportation by ambulance), and miscellaneous costs. Societal perspective was used with costs expressed in PPP$ purchase power parity dollars (PPP$) estimated to be equal to 272 Iranian rials. Compared with the non-DM group, DM patients experienced significantly higher median costs both in total (1262 vs 870 PPP$, P=.001) and in cost components related to hotel (384 vs 215 PPP$, P=.001), health personnel time (235 vs 115 PPP$, P<.001), paraclinical tests (177 vs 149 PPP$, P=.012), and special services (100 vs 74 PPP$, P=.041). The mean of age was higher (P<.001), and the transplantation hospitalization time interval was also shorter in the DM group (median: 2.7 vs 12, P=.025). Considering DM as a leading cause of ESRD and its increasing prevalence in some countries, the association between hospitalization costs of posttransplant patients and DM may be of great economic importance to many transplantation centers.

External costs of nuclear: Greater or less than the alternatives?

International Nuclear Information System (INIS)

Rabl, Ari; Rabl, Veronika A.

2013-01-01

Since Fukushima many are calling for a shutdown of nuclear power plants. To see whether such a shutdown would reduce the risks for health and environment, the external costs of nuclear electricity are compared with alternatives that could replace it. The frequency of catastrophic nuclear accidents is based on the historical record, about one in 25 years for the plants built to date, an order of magnitude higher than the safety goals of the U.S. Nuclear Regulatory Commission. Impacts similar to Chernobyl and Fukushima are assumed to estimate the cost. A detailed comparison is presented with wind as alternative with the lowest external cost. The variability of wind necessitates augmentation by other sources, primarily fossil fuels, because storage at the required scale is in most regions too expensive. The external costs of natural gas combined cycle are taken as 0.6 €cent/kWh due to health effects of air pollution and 1.25 €cent/kWh due to greenhouse gases (at 25€/t CO 2 eq ) for the central estimate, but a wide range of different parameters is also considered, both for nuclear and for the alternatives. Although the central estimate of external costs of the wind-based alternative is higher than that of nuclear, the uncertainty ranges overlap. - Highlights: ► The external costs of nuclear electricity are compared with the alternatives. ► Frequency and cost of nuclear accidents based on Chernobyl and Fukushima. ► Detailed comparison with wind as alternative with the lowest external costs. ► High external cost of wind because of natural gas backup (storage too limited). ► External costs of wind higher than nuclear but uncertainty ranges overlap

Costs of Robotic-Assisted Versus Traditional Laparoscopy in Endometrial Cancer.

Science.gov (United States)

Vuorinen, Riikka-Liisa K; Mäenpää, Minna M; Nieminen, Kari; Tomás, Eija I; Luukkaala, Tiina H; Auvinen, Anssi; Mäenpää, Johanna U

2017-10-01

The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer. A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis. Main outcome measures were item costs and total costs related to the operation, including a 6-month postoperative follow-up. The total costs including late complications were 2160 &OV0556; higher in the robotic group (median for traditional 5823 &OV0556;, vs robot median 7983 &OV0556;, P costs for instruments and equipment as well as to more expensive operating room and postanesthesia care unit time. Traditional laparoscopy involved higher costs for operation personnel, general costs, medication used in the operation, and surgeon, although these costs were not substantial. There was no significant difference in in-patient stay, laboratory, radiology, blood products, or costs related to complications. According to this study, robotic-assisted laparoscopy is 37% more expensive than traditional laparoscopy in the treatment of endometrial cancer. The cost difference is mainly explained by amortization of the robot and its instrumentation.

When Industries Change: The Future of Higher Education.

Science.gov (United States)

Collis, David

2001-01-01

Factors altering the higher education industry include radical change in the type of students, necessity of lifetime education, and new technologies. These factors are increasing the entry of private-sector players. Strategic university responses may be strengthening of accreditation, cost-cutting and efficiency measures, horizontal…

Improving Measurement of Productivity in Higher Education

Science.gov (United States)

Massy, William F.; Sullivan, Teresa A.; Mackie, Christopher

2013-01-01

Higher education is a critical element of the American economy, because of both its benefits and its costs to individuals and taxpayers. Yet we know very little about the relationships between the things colleges and universities do and the resources they need to do them. Currently, shrinking public support and increasing tuition make it urgent…

Transaction-cost Expenditures and the Relative Performance of Mutual Funds

OpenAIRE

John M.R. Chalmers; Roger M. Edelen; Gregory B. Kadlec

1999-01-01

We directly estimate annual trading costs for a sample of equity mutual funds and find that these costs are large and exhibit substantial cross sectional variation. Trading costs average 0.78% of fund assets per year and have an inter-quartile range of 0.59%. Trading costs, like expense ratios, are negatively related to fund returns and we find no evidence that on average trading costs are recovered in higher gross fund returns. We find that our direct estimates of trading costs have more exp...

Labour cost of radiation dose

International Nuclear Information System (INIS)

Cook, A.; Lockett, L.E.

1978-01-01

In order to optimise capital expenditure on measures to protect workers against radiation it would be useful to have a means to measure radiation dose in money terms. Because labour has to be employed to perform radiation work there must be some relationship between the wages paid and the doses received. Where the next increment of radiation dose requires additional labour to be recruited the cost will at least equal the cost of the extra labour employed. This paper examines some of the factors which affect the variability of the labour cost of radiation dose and notes that for 'in-plant' exposures the current cost per rem appears to be significantly higher than values quoted in ICRP Publication 22. An example is given showing how this concept may be used to determine the capital it is worth spending on installed plant to prevent regular increments of radiation dose to workers. (author)

A Low Cost Ferritic Stainless Steel Microalloyed by Higher Nb for Automotive Exhaust System

Science.gov (United States)

Chen, Erhu; Wang, Xuelin; Shang, Chengjia

Automotive engine exhaust gas after combustion of fuel, and the gas will be liquefied in the rear of automotive exhaust system. A lot of corrosive anions existing in the condensate make corrosion of the exhaust system materials. Therefore, once pitting perforation, automotive exhaust system will fail directly. In 1980s, automotive exhaust manifold was made of Si-Mo ductile iron, mufflers and the tail pipe were made of carbon steel or aluminized steel. But with higher emission standards carried out, the improvement of engine performance and the higher exhaust temperature as well as the needs of the automotive light-weighting, we need the higher corrosion resistance of the material for automotive exhaust systems to meet the requirements.

Cost Recovery Through Depreciation.

Science.gov (United States)

Forrester, Robert T.; Wesolowski, Leonard V.

1983-01-01

The approach of adopting depreciation rather than use allowance in order to recover more accurately the cost of college buildings and equipment used on federal projects is considered. It is suggested that depreciation will offer most colleges and universities a higher annual recovery rate, and an opportunity for better facilities planning. For…

Value Added: The Costs and Benefits of College Preparatory Programs. American Higher Education Report Series

Science.gov (United States)

Swail, Watson Scott

2004-01-01

Rarely do stakeholders ask about the effectiveness of outreach programs or whether they are an efficient use of tax dollars and philanthropic funds. As government budgets continue to be constrained and philanthropic investment gets more competitive, there is a growing acknowledgment of the need to look at the cost/benefit of these programs and…

Understanding Health Care Costs in a Wisconsin Acute Leukemia Population

Directory of Open Access Journals (Sweden)

Patricia Steinert

2016-08-01

Full Text Available Purpose: We investigated factors driving health care costs of patients with a diagnosis of acute myeloid and acute lymphoblastic leukemia. Methods: Standard costs identified in insurance claims data obtained from the Wisconsin Health Information Organization were used in a sample of 837 acute leukemia patients from April 2009 to June 2011. The Andersen behavioral model of health care utilization guided selection of patient and community factors expected to influence health care costs. A generalized linear model fitting gamma-distributed data with log-link technique was used to analyze cost. Results: Type of treatment received and disease severity represented significant cost drivers, and patients receiving at least some of their treatment from academic medical centers experienced higher costs. Inpatient care and pharmacy costs of patients who received treatment from providers located in areas of higher poverty experienced lower costs, raising questions of potential treatment and medical practice disparities between provider locations. Directions of study findings were not consistent between different types of services received and underscore the complexity of investigating health care cost. Conclusions: While prevalence of acute leukemia in the United States is low compared to other diseases, its extreme high cost of treatment is not well understood and potentially influences treatment decisions. Acute leukemia health care costs may not follow expected patterns; further exploration of the relationship between cost and the treatment decision, and potential treatment disparities between providers in different socioeconomic locations, is needed.

A predation cost to bold fish in the wild

DEFF Research Database (Denmark)

Hulthén, Kaj; Chapman, Ben; Nilsson, Anders P.

2017-01-01

in the animal kingdom. Theory predicts that individual behavioural types differ in a cost-benefit trade-off where bolder individuals benefit from greater access to resources while paying higher predation-risk costs. However, explicitly linking predation events to individual behaviour under natural conditions...

The effects of exogenous fatty acids and niacin on human monocyte-macrophage plasticity.

Science.gov (United States)

Montserrat-de la Paz, Sergio; Rodriguez, Dolores; Cardelo, Magdalena P; Naranjo, Maria C; Bermudez, Beatriz; Abia, Rocio; Muriana, Francisco J G; Lopez, Sergio

2017-08-01

Macrophage plasticity allows adapting to different environments, having a dual activity in inflammatory-related diseases. Our hypothesis is that the type of dietary fatty acids into human postprandial triglyceride-rich lipoproteins (TRLs), alone or in combination with niacin (vitamin B3), could modulate the plasticity of monocytes-macrophages. We isolated TRLs at the postprandial peak from blood samples of healthy volunteers after the ingestion of a meal rich in saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) or MUFAs plus omega-3 long-chain polyunsaturated fatty acids (LCPUFAs). Autologous monocytes isolated at fasting were first induced to differentiate into naïve macrophages. We observed that postprandial TRL-MUFAs, particularly in combination with niacin, enhance competence to monocytes to differentiate and polarise into M2 macrophages. Postprandial TRL-SFAs made polarised macrophages prone to an M1 phenotype. In contrast to dietary SFAs, dietary MUFAs in the meals plus immediate-release niacin primed circulating monocytes for a reduced postprandial pro-inflammatory profile. Our study underlines a role of postprandial TRLs as a metabolic entity in regulating the plasticity of the monocyte-macrophage lineage and also brings an understanding of the mechanisms by which dietary fatty acids are environmental factors fostering the innate immune responsiveness in humans. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

Directory of Open Access Journals (Sweden)

Hong J. Kan

2013-01-01

Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

Strategic Thinking about How Costs and Goals Interact

Science.gov (United States)

Cavanaugh, John C.; Graves, William H.

2010-01-01

In the grand economic scheme, the intense public pressure to lower costs came late to higher education. No institution--public or private, non-profit or for-profit--has escaped the always difficult, sometimes protracted discussions of how to increase efficiency and lower costs. Although this intense pressure predates the recent great recession,…

The hidden costs of nuclear energy

International Nuclear Information System (INIS)

Sweet, C.

1978-01-01

A lynch pin of the pro-nuclear argument is that atomic energy provides cheap electricity. Many are sceptical of such claims, realising that a lot of figures have been omitted from the accounting - the cost of R and D, of dismantling the obsolete stations and of waste management - but having no access to all the figures, such scepticism has remained little more than a hunch. Using conventional economic accounting it is shown that nuclear power must be considerably more costly than has ever been admitted by any of the authorities. The CEGB claims that reprocessing amounts to no more than 8 per cent of the total costs of nuclear generated electricity. According to the present author the costs are 20 per cent - and that 20 per cent is of a much higher figure. (author)

Cost analysis of singleton versus twin pregnancies after in vitro fertilization.

Science.gov (United States)

Lukassen, H G Marieke; Schönbeck, Yvonne; Adang, Eddy M M; Braat, Didi D M; Zielhuis, Gerhard A; Kremer, Jan A M

2004-05-01

To determine the difference in costs between singleton and twin pregnancies after IVF treatment from pregnancy to 6 weeks after delivery from a health care perspective. Retrospective cost analysis. IVF department at the University Medical Center Nijmegen, The Netherlands. A representative sample of singleton and twin pregnancies after IVF treatment between 1995 and 2001 at the University Medical Center Nijmegen. IVF with or without intracytoplasmic sperm injection and with or without cryopreservation. Medical costs per singleton and twin pregnancy after IVF. In patients pregnant with twins, the incidence of hospital antenatal care, complicated vaginal deliveries, and cesarean sections was higher and was associated with more frequent and longer maternal and neonatal hospital admissions. Maternal and neonatal hospital admissions were the major cost drivers. The medical cost per twin pregnancy was found to be more than five times higher than per singleton pregnancy, 13,469 and 2,550, respectively. The medical cost per twin pregnancy was more than 10,000 higher than per singleton pregnancy. A reduction in the number of twin pregnancies by elective single ET will save substantial amounts of money. This money might be used for the additional IVF cycles that will probably be needed to achieve similar success rates between single ET and two-embryo transfer.

Real money: complications and hospital costs in trauma patients.

Science.gov (United States)

Hemmila, Mark R; Jakubus, Jill L; Maggio, Paul M; Wahl, Wendy L; Dimick, Justin B; Campbell, Darrell A; Taheri, Paul A

2008-08-01

Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, duration of stay, and payment associated with complications in trauma patients. Using NSQIP principles, patient data were collected for 512 adult patients admitted to the trauma service for > 24 hours at a Level 1 trauma center (2004-2005). Patients were placed in 1 of 3 groups: no complications (none), >or=1 minor complication (minor, eg, urinary tract infection), or >or=1 major complication (major, eg, pneumonia). Total hospital charges, costs, payment, and duration of stay associated with each complication group were determined from a cost-accounting database. Multiple regression was used to determine the costs of each type of complication after adjusting for differences in age, sex, new injury severity score, Glasgow coma scale score, maximum head abbreviated injury scale, and first emergency department systolic blood pressure. A total of 330 (64%) patients had no complications, 53 (10%) had >or= 1 minor complication, and 129 (25%) had >or= 1 major complication. Median hospital charges increased from $33,833 (none) to $81,936 (minor) and $150,885 (major). The mean contribution to margin per day was similar for the no complication and minor complication groups ($994 vs $1,115, P = .7). Despite higher costs, the patients in the major complication group generated a higher mean contribution to margin per day compared to the no complication group ($2,168, P costs when adjusted for confounding variables was $19,915 for the minor complication group (P costs associated with traumatic injury provides a window for assessing the potential cost reductions associated with improved quality care. To optimize system benefits, payers and providers should develop integrated

What Are the Alternatives to Student Loans in Higher Education Funding?

Science.gov (United States)

Stokes, Anthony; Wright, Sarah

2010-01-01

In a period of student loan scandals and U.S. financial market instability impacting on the cost and availability of student loans, this paper looks at alternative models of higher education funding. In this context, it also considers the level of financial support that the government should provide to higher education.

Long-term impact of war on healthcare costs: an eight-country study.

Directory of Open Access Journals (Sweden)

Ramon Sabes-Figuera

Full Text Available Exposure to war can negatively affect health and may impact on healthcare costs. Estimating these costs and identifying their predictors is important for appropriate service planning. We aimed to measure use of health services in an adult population who had experienced war in the former-Yugoslavia on average 8 years previously, and to identify characteristics associated with the use and costs of healthcare.War-affected community samples in Bosnia-Herzegovina, Croatia, Kosovo, FYR Macedonia, and Serbia were recruited through a random walk technique. Refugees in Germany, Italy and the UK were contacted through registers, organisations and networking. Current service use was measured for the previous three months and combined with unit costs for each country for the year 2006/7. A two-part approach was used, to identify predictors of service use with a multiple logistic regression model and predictors of cost with a generalised linear regression model.3,313 participants were interviewed in Balkan countries and 854 refugees in Western European countries. In the Balkan countries, traumatic events and mental health status were related to greater service use while in Western countries these associations were not found. Participants in Balkan countries with post traumatic stress disorder (PTSD had costs that were 63% higher (p = 0.005 than those without PTSD. Distress experienced during the most traumatic war event was associated with higher costs (p = 0.013. In Western European countries costs were 76% higher if non-PTSD anxiety disorders were present (0.027 and 63% higher for mood disorders (p = 0.006.War experiences and their effects on mental health are associated with increased health care costs even many years later, especially for those who stayed in the area of conflict. Focussing on the mental health impact of war is important for many reasons including those of an economic nature.

Regional differences in China's CO2 abatement cost

International Nuclear Information System (INIS)

He, Xiaoping

2015-01-01

Under a framework of output distance function with multiple outputs, the study discusses the carbon abatement cost at provincial and regional levels in China, using the shadow price analysis. The findings show that the abatement cost, reflecting the marginal opportunity cost of carbon reduction, varies greatly among the provinces. On average, the abatement cost of the eastern region was much higher than that of the mid-western region during the observed period. The findings provide evidence that the carbon prices in the current ETS pilots have been much lower than desired levels, implying inefficiency of the markets. The wide range of the abatement cost estimates supports that the equi-marginal principle does not hold for the regulations on carbon pollution at regional levels. The regional cost differences indicate the huge potential for China to minimize the total abatement cost with policy instruments that may motive the emissions moving from areas of low abatement cost to where the abatement cost is higher. For a few undeveloped provinces that are environmentally fragile and have high abatement cost, supplementary measures will be needed to reduce the negative impact of carbon cutbacks on the poor to the minimum. - Highlights: • The marginal abatement cost of CO 2 is defined by the shadow price measure. • A linear programming model based on distance function is established. • Marginal abatement costs at provincial level are empirical investigated. • The abatement cost varies across provinces and regions in China. • The findings provide evidence that the current ETS pilots are inefficient

Exploring Business Models for MOOCS in Higher Education

Science.gov (United States)

Burd, Elizabeth L.; Smith, Shamus P.; Reisman, Sorel

2015-01-01

Massive Open Online Courses (MOOCs) potentially challenge the traditional dominance of brick and mortar institutions as providers of quality higher education. The benefits for students include reduced education costs and global access to exclusive institution courses and instructors. However, the benefits for institutions are less clear as there…

Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs.

Science.gov (United States)

Brady, Brenna L; Tkacz, Joseph; Meyer, Roxanne; Bolge, Susan C; Ruetsch, Charles

2017-02-01

The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of the measures. Medical, pharmacy, and laboratory claims for RA patients (International Classification of Diseases, Ninth Revision, Clinical Modification 714.x) were extracted from the Optum Clinformatics Datamart database for 2011. Individuals were predominately female and in their mid-fifties. Measure achievement ranged from 55.9% to 80.8%. The mean cost of care for members meeting the measure was $18,644; members who did not meet the measures had a mean cost of $14,973. Primary cost drivers were pharmacy and office expenses, accounting for 42.4% and 26.3% of total costs, respectively. Regression analyses revealed statistically significant associations between biologic usage, which was more prevalent in groups attaining measures, and total expenditure across all measures (Ps < 0.001). Pharmacy costs were similar between both groups. Individuals meeting the measures had a higher proportion of costs accounted for by office visits; those not meeting the measures had a higher proportion of costs from inpatient and outpatient visits. These findings suggest that increased quality may lead to lower inpatient and outpatient hospital costs. Yet, the overall cost of RA care is likely to remain high because of intensive pharmacotherapy regimens.

Uncertainty in relative cost investigation

International Nuclear Information System (INIS)

Bunn, D.; Viahos, K.

1989-01-01

One of the consequences of the privatization of the Central Electricity Generating Board has been a weakening of the economic case for nuclear generation over coal. Nuclear has higher capital, but lower operating costs than coal and is therefore favoured in capital budgeting by discounting at lower rates of return. In the Sizewell case (in 1987), discounting at the public sector rate of 5 per cent favoured nuclear. However, the private sector will require higher rates of return, thus rendering nuclear less attractive. Hence the imposition by the government of a diversity constraint on the privatized industry to ensure that contracts are made for a minimum fraction of non-fossil (essentially nuclear) energy. An electricity capacity planning model was developed to estimate the costs of imposing various non-fossil energy constraints on the planning decision of a privatized electricity supply industry, as a function of various discount rates. Using a large-scale linear programming technique, the model optimizes over a 50 year horizon the schedule of installation, and mix of generating capacity, both with and without a minimum non-fossil constraint. The conclusion is that the opportunity cost of diversity may be a complex joint substation of more than one type of plant (eg coal and gas) depending on the discount rate. (author)

Sustaining Higher Education Using Wal-Mart's Best Supply Chain Management Practices

Science.gov (United States)

Comm, Clare L.; Mathaisel, Dennis F. X.

2008-01-01

Purpose: The costs in higher education are increasing and need to be controlled. This paper aims to demonstrate what lessons higher education could learn from Wal-Mart's reasons for its financial success with its focus on efficient and effective supply chain management (SCM) best practices. Design/methodology/approach: Wal-Mart's best practices in…

Controlling costs without compromising quality: paying hospitals for total knee replacement.

Science.gov (United States)

Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

2010-10-01

Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

ON A COURNOT DUOPOLY GAME WITH DIFFERENTIATED GOODS, HETEROGENEOUS EXPECTATIONS AND A COST FUNCTION INCLUDING EMISSION COSTS

Directory of Open Access Journals (Sweden)

Georges SARAFOPOULOS

2017-07-01

Full Text Available In this study we investigate the dynamics of a nonlinear Cournot- type duopoly game with differentiated goods, linear demand and a cost function that includes emission costs. The game is modeled with a system of two difference equations. Existence and stability of equilibria of this system are studied. We show that the model gives more complex chaotic and unpredictable trajectories as a consequence of change in the parameter of horizontal product differentiation and a higher (lower degree of product differentiation (weaker or fiercer competition destabilize (stabilize the economy. The chaotic features are justified numerically via computing Lyapunov numbers and sensitive dependence on initial conditions. Also, we show that in this case there are stable trajectories and a higher (lower degree of product differentiation does not tend to destabilize the economy.

Making College Worth It: A Review of the Returns to Higher Education

Science.gov (United States)

Oreopoulos, Philip; Petronijevic, Uros

2013-01-01

Despite a general rise in the return to college, likely due to technological change, the cost-benefit calculus facing prospective students can make the decision to invest in and attend college dauntingly complex. Philip Oreopoulos and Uros Petronijevic review research on the varying costs and benefits of higher education and explore in full the…

Estimating the cost-effectiveness of linezolid for the treatment of methicillin-resistant Staphylococcus aureus nosocomial pneumonia in Taiwan.

Science.gov (United States)

Lin, Po-Chang; Wang, Bruce C M; Kim, Richard; Magyar, Andrew; Lai, Chung-Chih; Yang, Ya-Wen; Huang, Yhu-Chering

2016-02-01

Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia (NP) is associated with higher resource utilization, increased hospital stays, and mortality. We present a health economics model to understand the impact of using linezolid as the first-line treatment of MRSA NP in Taiwan. We developed a cost-effectiveness model to estimate the costs and clinical outcomes of using linezolid 600 mg b.i.d. versus vancomycin 15 mg/kg b.i.d. as the first-line treatment of MRSA NP in Taiwan. The model is a decision-analytic analysis in which a MRSA-confirmed patient is simulated to utilize one of the treatments, using data from a clinical trial. Within each treatment arm, the patient can or cannot achieve clinical cure. Regardless of whether the clinical cure was achieved or not, the patient may or may not have experienced an adverse event. The per-protocol results for clinical cure were 57.6% and 46.6% for linezolid and vancomycin, respectively. The total cost of linezolid was $376 more per patient than that of vancomycin. Drug costs were higher for linezolid than for vancomycin ($1108 vs. $233), and hospitalization costs were lower ($4998 vs. $5496). With higher cost and higher cure rates for linezolid, the incremental cost per cure was $3421. This study projects linezolid to have higher drug costs, lower hospital costs, and higher overall costs compared with vancomycin. This is balanced against the higher clinical cure rate for linezolid. Depending on the willingness to pay for clinical cure, linezolid could be cost effective as the first-line treatment of NP in Taiwan. Copyright © 2015. Published by Elsevier B.V.

Cost-benefit of ventilation and averted radon in dwellings

International Nuclear Information System (INIS)

Katona, T.; Kanyar, B.

2003-01-01

To assess an economically optimal ventilation rate we have introduced a cost-benefit analysis taking into account the cost of heating and benefit of averted dose due to ventilation. The cost of heating due to the elevated ventilation for mitigation of radon content in dwellings can be compensated by the monetary benefit of the averted dose, in case of higher (annually 3-10 mSv) exposure. During the heating season the economically optimal ventilation takes 0.1-0.5 h -1 , meanwhile the radon concentration in the indoor air decreases to 200-800 Bq/m 3 , depending on the exhalation of radon, number of persons living in the dwellings and other local parameters. Our results from the optimal planning correspond to the radon concentrations recommended by the international organizations as action levels. In general, the periodic ventilation in daytime provides a higher averted dose than the constant one in case of the same heating cost. (authors)

Cost and affordability of healthy food in rural South Australia.

Science.gov (United States)

Ward, P R; Coveney, J; Verity, F; Carter, P; Schilling, M

2012-01-01

As in many other countries, Australian consumers have recently had to accommodate increases in costs of basic food, and during the financial year 2007-2008 overall food prices rose by nearly 4%. Food costs are mediating factors in food choice, especially for low-income groups, where food security is often tenuous. There are reports that rural populations may have higher levels of food insecurity, although the evidence is often contradictory. To assess cost and affordability of food in rural areas this study used the Healthy Food Basket (HFB) methodology, which has been applied in a number of settings. The HFBs were costed at supermarkets and stores in different locations with different degrees of rurality. Compared with metropolitan areas, healthy food is more expensive in rural areas; costs are even higher in more remote areas. The overall affordability of HFB in rural areas was not significantly different from metro areas. The main difference concerned low socio-economic status (SES) groups, where the proportion of household income spent on the HFB was three times that of higher SES groups. The unaffordability of healthy food, or 'food stress' in low SES groups is a concern, especially when this group carries the greatest burden of diet-related disease. Findings suggest that there is a need to consider both rurality and SES when developing policy responses to decrease the cost and increase the affordability of healthy foods in rural and remote areas.

The indirect costs of multiple sclerosis: systematic review and meta-analysis.

Science.gov (United States)

Stawowczyk, Ewa; Malinowski, Krzysztof Piotr; Kawalec, Paweł; Moćko, Paweł

2015-01-01

The aim of this systematic review is to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with multiple sclerosis. Searches were conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2014 prices US$ using the consumer price index and purchasing power parity (scenario 1) and expressed as proportion of specific gross domestic product in current local currency unit to adjust for country's development (scenario 2). Identified studies were then analyzed in order to assess their possible inclusion in the meta-analysis. The authors identified 63 records, of which 23 were eligible for meta-analysis. Overall indirect cost per patient calculated in scenario 1 was as high as US$20,167 with US$22,197 in Europe, US$17,382 in North America and US$153 in Asia. Overall indirect cost per patient calculated in scenario 2 was equal to US$16,939, with US$19,612 in Europe, US$11,592 in North America and US$899 in Asia. Overall indirect costs varied from US$3726 for patients with EDSS score less than 3 to US$19,264 for patients with Expanded Disability Status Scale score grater that 7. This review revealed the great economic burden of multiple sclerosis on society. The authors observed a great variety of the considered components of indirect costs and their definitions. Costs were higher for Europe than for other continents and were also higher for patients with a higher Expanded Disability Status Scale score.

EMBL pay settlement will cost millions

CERN Multimedia

Abott, A

1999-01-01

A labour dispute at EMBL, Heidelberg, was settled last week at a cost of at least DM4 million for the organisation's 16 member states. The lab has asked for clarification on whether the ruling from the IL0 refers simply to a salary adjustment from 1995 or also to a backdated implementation of higher salary scales. This second option would cost considerably more - 8 percent of the budget in back pay and DM3.5 million per annum (1/2 page).

Cath lab costs in patients undergoing percutaneous coronary angioplasty - detailed analysis of consecutive procedures.

Science.gov (United States)

Dziki, Beata; Miechowicz, Izabela; Iwachów, Piotr; Kuzemczak, Michał; Kałmucki, Piotr; Szyszka, Andrzej; Baszko, Artur; Siminiak, Tomasz

2017-01-01

Costs of percutaneous coronary interventions (PCI) have an important impact on health care expenditures. Despite the present stress upon the cost-effectiveness issues in medicine, few comprehensive data exist on costs and resource use in different clinical settings. To assess catheterisation laboratory costs related to use of drugs and single-use devices in patients undergoing PCI due to coronary artery disease. Retrospective analysis of 1500 consecutive PCIs (radial approach, n = 1103; femoral approach, n = 397) performed due to ST segment elevation myocardial infarction (STEMI; n = 345) and non ST-segment elevation myocardial infarction (NSTEMI; n = 426) as well as unstable angina (UA; n = 489) and stable angina (SA; n = 241) was undertaken. Comparative cost analysis was performed and shown in local currency units (PLN). The cath lab costs were higher in STEMI (4295.01 ± 2384.54PLN, p costs were positively correlated with X-ray dose, fluoroscopy, and total procedure times. Patients' age negatively correlated with cath lab costs in STEMI/NSTEMI patients. Cath lab costs were higher in STEMI patients compared to other groups. In STEMI/NSTEMI they were lower in older patients. In all analysed groups costs were related to the level of procedural difficulty. In female patients, the costs of PCI performed via radial approach were higher compared to femoral approach. Despite younger age, male patients underwent more expensive procedures.

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

Science.gov (United States)

Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

The cost of dysphagia in geriatric patients

Directory of Open Access Journals (Sweden)

Westmark S

2018-06-01

Full Text Available Signe Westmark,1 Dorte Melgaard,1,2 Line O Rethmeier,3 Lars Holger Ehlers3 1Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; 2Department of Physiotherapy and Occupational Therapy, North Denmark Regional Hospital, Hjørring, Denmark; 3Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark Objectives: To estimate the annual cost at the hospital and in the municipality (social care due to dysphagia in geriatric patients.Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization.Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality.Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department.Materials and methods: Volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for data collection. A Charlson Comorbidity Index score measured comorbidity, and functional status was measured by Barthel-100. To investigate the cost of dysphagia, patient-specific data on health care consumption at the hospital and in the municipality (nursing, home care, and training were collected from medical registers and records 1 year before hospitalization including the hospitalization for screening for dysphagia. Multiple linear regression analyses were conducted to determine the relationship between dysphagia and hospital and municipality costs, respectively, adjusting for age, gender, and comorbidity.Results: Patients with dysphagia were significantly costlier than patients without dysphagia in both hospital (p=0.013 and municipality costs (p=0.028 compared to patients without dysphagia. Adjusted annual hospital costs in patients with dysphagia were 27,347 DKK (3,677 EUR, 4,282 USD higher than patients without dysphagia at the hospital, and annual health care costs in the

Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011.

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de Oliveira, Michele Lessa; Santos, Leonor Maria Pacheco; da Silva, Everton Nunes

2015-01-01

Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Public hospitals and outpatient care. A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

Information and the Cost of Capital: An Ex Ante Perspective

DEFF Research Database (Denmark)

Christensen, Peter Ove; de la Rosa, Leonidas Enrique; Feltham, Gerald A.

2010-01-01

Recent articles have demonstrated that increased public disclosure can decrease firms' cost of capital. The focus has been on the impact of information on the cost of capital subsequent to the release of the information (the ex post cost of capital). We show that the reduction in the ex post cost...... investors may actually benefit from a higher ex post cost of capital....... of capital is offset by an equal increase in the cost of capital for the period leading up to the release of the information (the preposterior cost of capital). Thus, within the class of models framing the recent discussion, there is no impact on the ex ante cost of capital covering the full time span...

Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom.

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Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

2015-07-01

The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. In this cross-sectional study of adults aged 39-79 y from the European Prospective Investigation into Cancer and Nutrition-Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom-based supermarket comparison website. Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed.

How much does it cost? The LIFE Project - Costing Models for Digital Curation and Preservation

Directory of Open Access Journals (Sweden)

Richard Davies

2007-11-01

Full Text Available Digital preservation is concerned with the long-term safekeeping of electronic resources. How can we be confident of their permanence, if we do not know the cost of preservation? The LIFE (Lifecycle Information for E-Literature Project has made a major step forward in understanding the long-term costs in this complex area. The LIFE Project has developed a methodology to model the digital lifecycle and to calculate the costs of preserving digital information for the next 5, 10 or 100 years. National and higher education (HE libraries can now apply this process and plan effectively for the preservation of their digital collections. Based on previous work undertaken on the lifecycles of paper-based materials, the LIFE Project created a lifecycle model and applied it to real-life digital collections across a diverse subject range. Three case studies examined the everyday operations, processes and costs involved in their respective activities. The results were then used to calculate the direct costs for each element of the digital lifecycle. The Project has made major advances in costing preservation activities, as well as making detailed costs of real digital preservation activities available. The second phase of LIFE (LIFE2, which recently started, aims to refine the lifecycle methodology and to add a greater range and breadth to the project with additional exemplar case studies.

The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community

Science.gov (United States)

Vriezen, Rachael; Edge, Victoria L.; Ford, James; Wood, Michele; Harper, Sherilee

2018-01-01

Background Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities’ unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs. Methods A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs. Results/Significance The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs. PMID:29768456

Societal costs of diabetes mellitus in Denmark

DEFF Research Database (Denmark)

Sortsø, C; Green, A; Jensen, Peter Bjødstrup

2016-01-01

AIM: To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark. METHODS: National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N...... = 318 729) were included in this study. Complication status was defined according to data from the Danish National Hospital Register. Diabetes-attributable costs were calculated as the difference between costs of patients with diabetes and the expected costs given the annual resource consumption...... of the diabetes-free population. RESULTS: Societal costs attributable to diabetes were estimated to be at least 4.27 billion EUR in 2011, corresponding to 14,349 EUR per patient-year. A twofold higher healthcare resource usage was found for patients with diabetes as compared with the diabetes-free population...

Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at standard surgical risk: results from the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

Science.gov (United States)

Vilain, Katherine R; Magnuson, Elizabeth A; Li, Haiyan; Clark, Wayne M; Begg, Richard J; Sam, Albert D; Sternbergh, W Charles; Weaver, Fred A; Gray, William A; Voeks, Jenifer H; Brott, Thomas G; Cohen, David J

2012-09-01

The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated similar rates of the primary composite end point between carotid artery stenting (CAS) and carotid endarterectomy (CEA), although the risk of stroke was higher with CAS, and the risk of myocardial infarction was higher with CEA. Given the large number of patients who are candidates for these procedures, an understanding of their relative cost and cost-effectiveness may have important implications for health care policy and treatment guidelines. We performed a formal economic evaluation alongside the CREST trial. Costs were estimated from all trial participants over the first year of follow-up using a combination of resource use data and hospital billing data. Patient-level health use scores were obtained using data from the SF-36. We then used a Markov disease-simulation model calibrated to the CREST results to project 10-year costs and quality-adjusted life expectancy for the 2 treatment groups. Although initial procedural costs were $1025/patient higher with CAS, postprocedure costs and physician costs were lower such that total costs for the index hospitalization were similar for the CAS and CEA groups ($15 055 versus $14 816; mean difference, $239/patient; 95% CI for difference, -$297 to $775). Neither follow-up costs after discharge nor total 1-year costs differed significantly. For the CREST population, model-based projections over a 10-year time horizon demonstrated that CAS would result in a mean incremental cost of $524/patient and a reduction in quality-adjusted life expectancy of 0.008 years compared with CEA. Probabilistic sensitivity analysis demonstrated that CEA was economically attractive at an incremental cost-effectiveness threshold of $50 000/quality-adjusted life-year gained in 54% of samples, whereas CAS was economically attractive in 46%. Despite slightly lower in-trial costs and lower rates of stroke with CEA compared with CAS, projected 10-year outcomes

Negotiated Settlements: Long-term Profits and Costs

Directory of Open Access Journals (Sweden)

G. Kent Fellows

2012-05-01

Full Text Available Over the last 20 years, utility regulators have relaxed their oversight of cost-ofservice regulation and this holds true for Alberta, where such regulation determines the fees associated with oil and gas pipeline usage. The traditional method has been for regulators to issue binding decisions on a firm’s cost of service after taking evidence at a formal hearing. Many regulators now prefer to encourage parties to settle a cost-of-service agreement through a negotiated settlement, which the regulator then approves. This process not only saves the cost of a hearing, it also permits firms and consumers to trade costs and benefits, settling on a final price more favourable to both. The author details how this arrangement can negatively impact future consumers by allowing the firm to defer the true burden of its depreciation expenses in return for inflated capital costs. Such a settlement lowers prices for the present but saddles future consumers with higher prices.

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.

Passenger vehicles that minimize the costs of ownership and environmental damages in the Indian market

International Nuclear Information System (INIS)

Gilmore, Elisabeth A.; Patwardhan, Anand

2016-01-01

Highlights: • Full costs (private and social) are evaluated for Indian passenger cars. • Diesel has low ownership costs, but higher climate and health damages. • Compressed natural gas cars have lower costs and damages than petrol cars. • Electric cars have higher damages due to electricity generation emissions. • CNG and less carbon intensive electricity minimizes Indian cars’ full cost. - Abstract: Rapid expansion of population and income growth in developing countries, such as India, is increasing the demand for many goods and services, including four-wheeled passenger cars. Passenger cars provide personal mobility; however, they also have negative implications for human wellbeing from increased air pollutants and greenhouse gases (GHG). Here, we evaluate the range of passenger vehicles available in the Indian market to identify options that minimize costs, human health effects and climate damages. Our approach is to compare alternative fuel/powertrain vehicles with similar conventional gasoline fueled vehicles and assess the differences in full (private and societal) costs for each pair. Private costs are the combination of capital costs and the discounted expected future fuel costs over the vehicle lifetime. The costs to human health from air quality are calculated using intake fractions to estimate exposure and literature values for the damage costs adjusted by benefits transfer methods. We use the Social Cost of Carbon to estimate climate damages. We find that, on average, the net present value (NPV) of the full costs of compressed natural gas (CNG) vehicles are lower than comparable gasoline vehicles, while, diesel vehicles have higher costs. Presently, electric vehicles have higher private costs (due to high capital costs) and societal costs (due to electricity generation emissions). Either a less carbon intensive electricity grid or an increase in the CNG fleet would minimize total costs, human health effects and GHG emissions from the

Perineal tap water burns in the elderly: at what cost?

Science.gov (United States)

Potter, Michael D E; Maitz, Peter K M; Kennedy, Peter J; Goltsman, David

2017-11-01

Burn injuries are expensive to treat. Burn injuries have been found to be difficult to treat in elderly patients than their younger counterparts. This is likely to result in higher financial burden on the healthcare system; however, no population-specific study has been conducted to ascertain the inpatient treatment costs of elderly patients with hot tap water burns. Six elderly patients (75-92 years) were admitted for tap water burns at Concord Hospital during 2010. All costs incurred during their hospitalization were followed prospectively, and were apportioned into 'direct' and 'indirect' costs. Direct costs encompassed directly measurable costs, such as consumables used on the ward or in theatres, and indirect costs included hospital overheads, such as bed and theatre costs. Three males and three females admitted with burns to the buttocks, legs or feet. Total burn surface area (TBSA) ranged from 9-21% (mean 12.8%). Length of stay ranged from 26-98 days (mean 46 days). One patient died, and four required surgical management or grafting. Total inpatient costs ranged from $69 782.33 to $254 652.70 per patient (mean $122 800.20, standard deviation $67 484.46). TBSA was directly correlated with length of stay (P < 0.01) and total cost (P < 0.01). Hot water burns among the elderly are associated with high treatment costs, which are proportional to the size of the burn. The cost of treating this cohort is higher than previously reported in a general Australian burn cohort. © 2016 Royal Australasian College of Surgeons.

Life cycle cost and risk estimation of environmental management options

International Nuclear Information System (INIS)

Shropshire, D.; Sherick, M.

1996-01-01

The evaluation process is demonstrated in this paper through comparative analysis of two alternative scenarios identified for the management of the alpha-contaminated fixed low-level waste currently stored at INEL. These two scenarios, the Base Case and the Delay Case, are realistic and based on actual data, but are not intended to exactly match actual plans currently being developed at INEL. Life cycle cost estimates were developed for both scenarios using the System Cost Model; resulting costs are presented and compared. Life cycle costs are shown as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Although there are some short-term cost savings for the Delay Case, cumulative life cycle costs eventually become much higher than costs for the Base Case over the same period of time, due mainly to the storage and repackaging necessary to accommodate the longer Delay Case schedule. Life cycle risk estimates were prepared using a new risk analysis method adapted to the System Cost Model architecture for automated, systematic cost/risk applications. Relative risk summaries are presented for both scenarios as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Relative risk of the Delay Case is shown to be higher than that of the Base Case. Finally, risk and cost results are combined to show how the collective information can be used to help identify opportunities for risk or cost reduction and highlight areas where risk reduction can be achieved most economically

[Cost at the first level of care].

Science.gov (United States)

Villarreal-Ríos, E; Montalvo-Almaguer, G; Salinas-Martínez, M; Guzmán-Padilla, J E; Tovar-Castillo, N H; Garza-Elizondo, M E

1996-01-01

To estimate the unit cost of 15 causes of demand for primary care per health clinic in an institutional (social security) health care system, and to determine the average cost at the state level. The cost of 80% of clinic visits was estimated in 35 of 40 clinics in the social security health care system in the state of Nuevo Leon, Mexico. The methodology for fixed costs consisted of: departmentalization, inputs, cost, weights and construction of matrices. Variable costs were estimated for standard patients by type of health care sought and with the consensus of experts; the sum of fixed and variable costs gave the unit cost. A computerized model was employed for data processing. A large variation in unit cost was observed between health clinics studied for all causes of demand, in both metropolitan and non-metropolitan areas. Prenatal care ($92.26) and diarrhea ($93.76) were the least expensive while diabetes ($240.42) and hypertension ($312.54) were the most expensive. Non-metropolitan costs were higher than metropolitan costs (p < 0.05); controlling for number of physician's offices showed that this was determined by medical units with only one physician's office. Knowledge of unit costs is a tool that, when used by medical administrators, allows adequate health care planning and efficient allocation of health resources.

Cost overruns and demand shortfalls - Deception or selection?

DEFF Research Database (Denmark)

Eliasson, Jonas; Fosgerau, Mogens

2013-01-01

whether to implement projects. Using a database of projects we present examples indicating that the selection bias may be substantial. The examples also indicate that benefit-cost ratios remain a useful selection criterion even when cost and benefits are highly uncertain, gainsaying the argument......A number of highly cited papers by Flyvbjerg and associates have shown that ex ante infrastructure appraisals tend to be overly optimistic. Ex post evaluations indicate a bias where investment costs are higher and benefits lower on average than predicted ex ante. These authors argue that the bias...... that such uncertainties render cost-benefit analyses useless. © 2013 Elsevier Ltd....

The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

Science.gov (United States)

Doran, Tim; Cookson, Richard

2016-01-01

Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course. Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs. Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy. Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies. PMID:27189975

Chronic Disease Cost not Transferable: Colombian Reality

Directory of Open Access Journals (Sweden)

Karina Gallardo Solarte

2016-01-01

Full Text Available Objective: The aim is to reflect on the social and economic costs of chronic non-communicable disease (NCD in Colombia to display a charging indicator of these pathologies. Material and methods: In a review of 50 studies, 27 were selected since these met the inclusion criteria, like chronical disease, studies conducted between 2002 and 2011 related to costs, chronic disease, and being Colombian. Results: This is a review study of chronic diseases vs. their costs, being here cardiovascular diseases part of the group of high cost and higher incidence diseases, thus repre­senting a great risk to the financial stability of healthcare companies. There are few studies that address the costs generated by the treatment of ncds patients that show the economic impact experienced by public and private institutions providing and promoting health services. Most of them forget the economic, family and social costs the affected population must suffer. Conclu­sions: ncds represent a burden to the health service system for their very high costs, untimely intervention and reduced significant benefit for this population and their families.

Monetary Diet Cost, Diet Quality, and Parental Socioeconomic Status in Spanish Youth.

Directory of Open Access Journals (Sweden)

Helmut Schröder

Full Text Available Using a food-based analysis, healthy dietary patterns in adults are more expensive than less healthy ones; studies are needed in youth. Therefore, the objective of the present study was to determine relationships between monetary daily diet cost, diet quality, and parental socioeconomic status.Data were obtained from a representative national sample of 3534 children and young people in Spain, aged 2 to 24 years. Dietary assessment was performed with a 24-hour recall. Mediterranean diet adherence was measured by the KIDMED questionnaire. Average food cost was calculated from official Spanish government data. Monetary daily diet cost was expressed as euros per day (€/d and euros per day standardized to a 1000kcal diet (€/1000kcal/d.Mean monetary daily diet cost was 3.16±1.57€/d (1.56±0.72€/1000kcal/d. Socioeconomic status was positively associated with monetary daily diet cost and diet quality measured by the KIDMED index (€/d and €/1000kcal/d, p<0.019. High Mediterranean diet adherence (KIDMED score 8-12 was 0.71 €/d (0.28€/1000kcal/d more expensive than low compliance (KIDMED score 0-3. Analysis for nonlinear association between the KIDMED index and monetary daily diet cost per1000kcal showed no further cost increases beyond a KIDMED score of 8 (linear p<0.001; nonlinear p = 0.010.Higher monetary daily diet cost is associated with healthy eating in Spanish youth. Higher socioeconomic status is a determinant for higher monetary daily diet cost and quality.

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

The role of TNF-α, Fas/Fas ligand system and NT-proBNP in the early detection of asymptomatic left ventricular dysfunction in cancer patients treated with anthracyclines

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Alexandros Kouloubinis

2015-03-01

Conclusion: SFas, sFas-L and NT-proBNP correlate with reductions in LVEF and could be used as sensitive biochemical indices for the detection of asymptomatic left ventricular dysfunction in cancer patients under cardiotoxic chemotherapy.

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

Directory of Open Access Journals (Sweden)

Daniel G Datiko

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

Proton therapy of cancer: Potential clinical advantages and cost-effectiveness

International Nuclear Information System (INIS)

Lundkvist, Jonas; Ekman, Mattias; Rehn Ericsson, Suzanne; Glimelius, Bengt; Akademiska sjukhuset, Uppsala

2005-01-01

Proton therapy may offer potential clinical advantages compared with conventional radiation therapy for many cancer patients. Due to the large investment costs for building a proton therapy facility, however, the treatment cost with proton radiation is higher than with conventional radiation. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to motivate the higher costs. We assessed the cost-effectiveness of proton therapy in the treatment of four different cancers: left-sided breast cancer, prostate cancer, head and neck cancer, and childhood medulloblastoma. A Markov cohort simulation model was created for each cancer type and used to simulate the life of patients treated with radiation. Cost and quality adjusted life years (QALYs) were used as primary outcome measures. The results indicated that proton therapy was cost-effective if appropriate risk groups were chosen. The average cost per QALY gained for the four types of cancer assessed was about Euro 10,130. If the value of a QALY was set to Euro 55,000, the total yearly net benefit of treating 925 cancer patients with the four types of cancer was about Euro 20.8 million. Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used

The impact of feedstock cost on technology selection and optimum size

International Nuclear Information System (INIS)

Cameron, Jay B.; Kumar, Amit; Flynn, Peter C.

2007-01-01

Development of biomass projects at optimum size and technology enhances the role that biomass can make in mitigating greenhouse gas. Optimum sized plants can be built when biomass resources are sufficient to meet feedstock demand; examples include wood and forest harvest residues from extensive forests, and grain straw and corn stover from large agricultural regions. The impact of feedstock cost on technology selection is evaluated by comparing the cost of power from the gasification and direct combustion of boreal forest wood chips. Optimum size is a function of plant cost and the distance variable cost (DVC, $ dry tonne -1 km -1 ) of the biomass fuel; distance fixed costs (DFC, $ dry tonne -1 ) such as acquisition, harvesting, loading and unloading do not impact optimum size. At low values of DVC and DFC, as occur with wood chips sourced from the boreal forest, direct combustion has a lower power cost than gasification. At higher values of DVC and DFC, gasification has a lower power cost than direct combustion. This crossover in most economic technology will always arise when a more efficient technology with a higher capital cost per unit of output is compared to a less efficient technology with a lower capital cost per unit of output. In such cases technology selection cannot be separated from an analysis of feedstock cost

Leading the Charge: Governors, Higher Education and Accountability

Science.gov (United States)

American Council of Trustees and Alumni, 2014

2014-01-01

With this new tool, ACTA [American Council of Trustees and Alumni] is working to expand its outreach to governors nationwide on behalf of higher education reform, focusing on key issues of quality, cost, and accountability. ACTA has worked with governors and education leaders from across the country, and that experience has proven that innovative…

A societal cost-of-illness study of hemodialysis in Lebanon.

Science.gov (United States)

Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Salameh, Pascale; Evers, Silvia M A A

2016-12-01

Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy trial. Costs were assessed with a prevalence-based, bottom-up approach, for the period of June-December 2011. The data of 114 patients recruited from six hospital-based units were collected through a questionnaire measuring healthcare costs, costs to patients and family, and costs in other sectors. Recall data were used for the base-case analysis. Sensitivity analyses employing various sources of resources use and costs were performed. Costs were uprated to 2015US$. Multiple linear regression was conducted to explore the predictors of societal costs. The mean 6-month societal costs were estimated at $9,258.39. The larger part was attributable to healthcare costs (91.7%), while costs to patient and family and costs in other sectors poorly contributed to the total costs (4.2% and 4.1%, respectively). In general, results were robust to sensitivity analyses. Using the maximum value for hospitalization resulted in the biggest difference (+15.5% of the base-case result). Female gender, being widowed/divorced, having hypertension comorbidity, and higher weekly time on dialysis were significantly associated with greater societal costs. Information regarding resource consumption and cost were not readily available. Rather, they were obtained from a variety of sources, with each having its own strengths and limitations. Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting

Price Reversal Pattern of ARV Drugs: A Transaction-Cost Approach Digression

Directory of Open Access Journals (Sweden)

Frank LORNE

2015-05-01

Full Text Available A price reversal pattern of ARV drugs was noted across lower and middle income countries in that the lower-income countries have higher prices relative to higher-income countries based on a 2008-2009 Summary Report by World Health Organization. The transaction costs affecting AVR drug pricing can be broadly classified into two kinds: One between the final users and the opinion/knowledge experts, and the other between the opinion/knowledge experts and the manufacturers. Economist’s version of price discrimination needs to be modified by including transaction costs. Transaction costs also point to institution creditability factors that will affect NGO procurement.

Frequency and Costs of Communication with Citizens in Local Government

DEFF Research Database (Denmark)

Andersen, Kim Normann; Medaglia, Rony; Zinner Henriksen, Helle

2011-01-01

This paper addresses the frequency and costs of local governmentcitizen communication in five channels (physical meetings, postal mails, phone calls, e-mail and online self service. Considered to be among the advanced countries with regards to supply of e-services, our analysis shows a surprisingly...... low use of transactions in the Danish local government. Also, our estimate is that email costs are higher than phone call costs and that there is substantial room for advancing our knowledge of the costs of e-services....

Cost Benefit Analysis of Khaddar Industry: a Study on Comilla District

Directory of Open Access Journals (Sweden)

Shamimul Islam

2015-01-01

Full Text Available The study tries to findout the Cost Benefit Analysis (CBA of Khaddar industry. Comilla district is considered as the study area. Sample is selected purposively based on the stablishment available within the district. The collected data is analysed by using Microsoft Office Excel 2007 to calculate different statistical values used in this paper. All the possible techniques of Cost Benefit analysis are employed. The findings suggest that, in both the cases i.e., in case of Hand Loom as well as in case of Power Loom the expected return is very high. The value of Net Present Value (NPV, Benefit Cost Ratio (BCR and Internal Rate of Return (IRR suggest that, there is a very higher profitability in this sector. The IRR of the projects is 183 and 157 for Hand Loom and Power Loom respectively which is exceptionally very high. The higher value may due to low establishment costs and low maintenance costs for hand loom alternatively high productivity and comparatively lower operating costs for power loom industries.

Bearing Procurement Analysis Method by Total Cost of Ownership Analysis and Reliability Prediction

Science.gov (United States)

Trusaji, Wildan; Akbar, Muhammad; Sukoyo; Irianto, Dradjad

2018-03-01

In making bearing procurement analysis, price and its reliability must be considered as decision criteria, since price determines the direct cost as acquisition cost and reliability of bearing determine the indirect cost such as maintenance cost. Despite the indirect cost is hard to identify and measured, it has high contribution to overall cost that will be incurred. So, the indirect cost of reliability must be considered when making bearing procurement analysis. This paper tries to explain bearing evaluation method with the total cost of ownership analysis to consider price and maintenance cost as decision criteria. Furthermore, since there is a lack of failure data when bearing evaluation phase is conducted, reliability prediction method is used to predict bearing reliability from its dynamic load rating parameter. With this method, bearing with a higher price but has higher reliability is preferable for long-term planning. But for short-term planning the cheaper one but has lower reliability is preferable. This contextuality can give rise to conflict between stakeholders. Thus, the planning horizon needs to be agreed by all stakeholder before making a procurement decision.

Understanding the costs and schedule of hydroelectric projects

International Nuclear Information System (INIS)

Merrow, E.W.; Schroeder, B.R.

1991-01-01

This paper is based on a study conducted for the World Bank which evaluated the feasibility of developing an empirically based ex ante project analysis system for hydroelectric projects. The system would be used to assess: the reasonableness of engineering-based cost and schedule estimates used for project appraisal and preliminary estimates used to select projects for appraisal; and the potential for cost growth and schedule slip. The system would help identify projects early in the project appraisal process that harbor significantly higher than normal risks of overrunning cost and schedule estimates

Activity-Based Management System Implementation in Higher Education Institution: Benefits and Challenges

Science.gov (United States)

Ismail, Noor Azizi

2010-01-01

Purpose: The purpose of this paper is to discuss how activity-based costing (ABC) technique can be applied in the context of higher education institutions. It also discusses the obstacles and challenges to the successful implementation of activity-based management (ABM) in the higher education environment. Design/methodology/approach: This paper…

Nuclear operating costs are rising exponentially - official

International Nuclear Information System (INIS)

Thomas, S.

1988-01-01

The Energy Information Agency of the United States Department of Energy has collected data on the operations of nuclear power plants in the United States. A statistical regression analysis was made of this data base. This shows that the escalation in annual, real non-fuel operating costs is such that the operating cost savings made by closing down an old nuclear plant would be sufficient to pay the capital and operating costs of replacing it with a brand new coal-fired plant. The main reason for the increasing operating and maintenance costs is the cost of replacement power i.e. the higher the economic penalty of plant breakdown the more the utility has to spend on maintenance. Another reason is time -not the age of the plant - but the year the data was collected. The economic case for nuclear power is seriously challenged. (U.K.)

The impact of healthcare costs in the last year of life and in all life years gained on the cost-effectiveness of cancer screening

DEFF Research Database (Denmark)

de Kok, I M C M; Polder, J J; Habbema, J D F

2009-01-01

life year. We calculated the change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the LastYL or in LYsG would be included. Costs in the LastYL were on average 33% higher for persons dying from cancer than from any cause. Including costs in LysG increased the CER by 4040 euro...... in women, and by 4100 euro in men. Of these, 660 euro in women, and 890 euro in men, were costs in the LastYL. Including unrelated healthcare costs in the LastYL or in LYsG will change the comparative cost-effectiveness of healthcare programmes. The CERs of cancer screening programmes will clearly increase......, with approximately 4000 euro. However, because of the favourable CER's, including unrelated healthcare costs will in general have limited policy implications....

The cost of engineered disposal facilities

International Nuclear Information System (INIS)

Mallory, C.W.; Razor, J.E.; Mills, D.

1987-01-01

An improved disposal trench was designed, constructed and placed into operation at the Maxey Flats Disposal Site during the period April 1985 through July 1986. With the improved trench design, the waste packages are placed in clusters and the surrounding space is filled with gravel and grouted with a sand/cement mixture to form walls and cells that surround the waste package. The walls provide structural support for a poly-ethylene reinforced soil beam which in turn supports a multi-layer protective cap. About 2,700 drums of waste (20,250 CF) were placed into the trench. The total cost of the improved trench was $193,500 and the unit cost was $9.56 per cubic foot not including the placement of the waste. The engineered features of the trench (i.e., sidewall infiltration barrier, grout backfill and the soil beam) cost $82,600 for a unit cost of $4.08 per cubic foot of waste. This is compared to the cost of concrete cannisters used for radioactive waste disposal. On a production basis the cannisters are estimated to cost about $1,260. Depending upon the type waste, the cost of the cannisters will range from $2 to $12 per cubic foot of waste. The slightly higher cost of the concrete cannisters is offset by certain performance advantages

Issues in Moroccan Higher Education

Directory of Open Access Journals (Sweden)

Mohammed Lazrak

2017-06-01

Full Text Available Historically, education has always been the springboard for socio-economic development of nations. Undoubtedly, education proved to be the catalyst of change and the front wagon that drives with it all the other wagons pertaining to other dynamic sectors. In effect, the role of education can be seen to provide pupils with the curriculum and hidden curriculum skills alike; teaching skills that will prepare them physically, mentally and socially for the world of work in later life. In Morocco, the country spends over 26% of its Gross Domestic Product (GDP on education. Unfortunately, though this number is important, Moroccan education (primary, secondary and higher education alike still suffers from the mismatch between the state expenditures on education and the general product in reality. In this article, an attempt is made to touch on some relevant issues pertaining to higher education with special reference to Morocco. First, it provides some tentative definitions, mission and functions of university and higher education. Second, it gives a historical sketch of the major reforms that took place in Morocco as well as the major changes pertaining to these reforms respectively. Third, it provides a general overview of the history of higher education in Morocco, it also tackles an issue related to governance in higher education which is cost sharing. Fourth, it delves into the history of English Language Teaching (ELT, lists some characteristics of the English Departments in Morocco. Fifth, it discusses the issue of private vs. public higher education. Last, but not least, it tackles the issue of Brain Drain.

Costs of treating patients with schizophrenia who have illness-related crisis events

Directory of Open Access Journals (Sweden)

Peng Xiaomei

2008-08-01

Full Text Available Abstract Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18, psychiatric hospitalization in the past 6 months (n = 240, arrest in the past 6 months (n = 56, violent behaviors in the past 4 weeks (n = 62, and diagnosis of a co-occurring substance use disorder (n = 413. Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024, followed by persons with psychiatric hospitalization in

Fuel ethanol from cane molasses in Thailand: Environmental and cost performance

International Nuclear Information System (INIS)

Nguyen, Thu Lan T.; Gheewala, Shabbir H.

2008-01-01

In the context of the world's energy crisis and environmental concerns, crop-based ethanol has emerged as an energy alternative, the use of which can help reduce oil imports as well as emissions of CO 2 and other air pollutants. However, a clear disadvantage of ethanol is its high cost over gasoline under the current pricing scheme that does not include externalities. The intent of this study is to perform a life cycle analysis comparing environmental and cost performance of molasses-based E10 with those of CG. The results show that although E10 provides reduction in fossil energy use, petroleum use, CO 2 and NO x emissions, its total social costs are higher than those of gasoline due to higher direct production costs and external costs for other air emissions, e.g. CH 4 , N 2 O, CO, SO 2 , VOC and PM 10 . An analysis of projection scenarios shows that technological innovations towards cleaner production help maximize ethanol's benefits whilst minimizing its limitations

Total life-cycle cost analysis of conventional and alternative fueled vehicles

International Nuclear Information System (INIS)

Cardullo, M.W.

1993-01-01

Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

The role of capital costs in decarbonizing the electricity sector

Science.gov (United States)

Hirth, Lion; Steckel, Jan Christoph

2016-11-01

Low-carbon electricity generation, i.e. renewable energy, nuclear power and carbon capture and storage, is more capital intensive than electricity generation through carbon emitting fossil fuel power stations. High capital costs, expressed as high weighted average cost of capital (WACC), thus tend to encourage the use of fossil fuels. To achieve the same degree of decarbonization, countries with high capital costs therefore need to impose a higher price on carbon emissions than countries with low capital costs. This is particularly relevant for developing and emerging economies, where capital costs tend to be higher than in rich countries. In this paper we quantitatively evaluate how high capital costs impact the transformation of the energy system under climate policy, applying a numerical techno-economic model of the power system. We find that high capital costs can significantly reduce the effectiveness of carbon prices: if carbon emissions are priced at USD 50 per ton and the WACC is 3%, the cost-optimal electricity mix comprises 40% renewable energy. At the same carbon price and a WACC of 15%, the cost-optimal mix comprises almost no renewable energy. At 15% WACC, there is no significant emission mitigation with carbon pricing up to USD 50 per ton, but at 3% WACC and the same carbon price, emissions are reduced by almost half. These results have implications for climate policy; carbon pricing might need to be combined with policies to reduce capital costs of low-carbon options in order to decarbonize power systems.

Comparison of clinical outcome and costs with CC + gonadotropins and gnrha + gonadotropins during Ivf/ICSI cycles.

Science.gov (United States)

Kovacs, Peter; Matyas, Szabolcs; Bernard, l Artur; Kaali, Steven G

2004-06-01

To compare clinical outcome and costs of CC + gonadotropins with GnRHa + gonadotropins during IVF/ICSI cycles. Clinical outcome and expenses of 382 CC + gonadotropin and 964 GnRHa + gonadotropin cycles were compared. Medication costs were calculated on the basis of the mean number of ampoules and the proportion of various gonadotropins. Costs per clinical pregnancy were calculated on the basis of expenses and clinical pregnancy rates. Women in the CC + gonadotropin group were younger, and had fewer follicles, oocytes, embryos, and embryos transferred. Clinical pregnancy rates were higher in the GnRHa group (35.9 % vs 26.2%, p costs per cycle were higher in the GnRHa group (US dollars 357 vs 248). Expenses per pregnancy however were lower in the GnRHa group (USdollars 4197 vs 5335 with IVF; USdollars 5590 vs 7244 with ICSI). When different age subgroups with similar baseline characteristics and stimulation parameters were compared, pregnancy rates were significantly higher in the GnRHa groups. Medication cost per cycle was higher in the GnRHa subgroups, and the expense per pregnancy was lower with GnRHa protocol. Cost per cycle is higher with GnRHa + gonadotropin. However, because of the better performance of the GnRHa + gonadotropin stimulation, the cumulative costs are reduced by the time a clinical pregnancy is achieved.

Direct and indirect costs of surgically treated pelvic fractures.

Science.gov (United States)

Aprato, Alessandro; Joeris, Alexander; Tosto, Ferdinando; Kalampoki, Vasiliki; Stucchi, Alessandro; Massè, Alessandro

2016-03-01

Pelvic fractures requiring surgical fixation are rare injuries but present a great societal impact in terms of disability, as well as economic resources. In the literature, there is no description of these costs. Main aim of this study is to describe the direct and indirect costs of these fractures. Secondary aims were to test if the type of fracture (pelvic ring injury or acetabular fracture) influences these costs (hospitalization, consultation, medication, physiotherapy sessions, job absenteeism). We performed a retrospective study on patients with surgically treated acetabular fractures or pelvic ring injuries. Medical records were reviewed in terms of demographic data, follow-up, diagnosis (according to Letournel and Tile classifications for acetabular and pelvic fractures, respectively) and type of surgical treatment. Patients were interviewed about hospitalization length, consultations after discharge, medications, physiotherapy sessions and absenteeism. The study comprised 203 patients, with a mean age of 49.1 ± 15.6 years, who had undergone surgery for an acetabular fracture or pelvic ring injury. The median treatment costs were 29.425 Euros per patient. Sixty percent of the total costs were attributed to health-related work absence. Median costs (in Euros) were 2.767 for hospitalization from trauma to definitive surgery, 4.530 for surgery, 3.018 for hospitalization in the surgical unit, 1.693 for hospitalization in the rehabilitation unit, 1.920 for physiotherapy after discharge and 402 for consultations after discharge. Total costs for treating pelvic ring injuries were higher than for acetabular fractures, mainly due to the significant higher costs of pelvic injuries regarding hospitalization from trauma to definitive surgery (p fractures are associated with both high direct costs and substantial productivity loss.

Cost analysis of paroxetine versus imipramine in major depression.

Science.gov (United States)

Bentkover, J D; Feighner, J P

1995-09-01

A simulation decision analytical model was used to compare the annual direct medical costs of treating patients with major depression using the selective serotonin reuptake inhibitor (SSRI) paroxetine or the tricyclic antidepressant (TCA) imipramine. Medical treatment patterns were determined from focus groups of general and family practitioners and psychiatrists in Boston, Dallas and Chicago, US. Direct medical costs included the wholesale drug acquisition costs (based on a 6-month course of drug therapy), psychiatrist and/or general practitioner visits, hospital outpatient visits, hospitalisation and electroconvulsive therapy. Acute phase treatment failure rates were derived from an intention-to-treat analysis of a previously published trial of paroxetine, imipramine and placebo in patients with major depression. Maintenance phase relapse rates were obtained from a 12-month trial of paroxetine, supplemented from the medical literature. The relapse rates for the final 6 months of the year were obtained from medical literature and expert opinion. Direct medical costs were estimated from a health insurance claims database. The estimated total direct medical cost per patient was slightly lower using paroxetine ($US2348) than generic imipramine ($US2448) as first-line therapy. This result was sensitive to short term dropout rates but robust to changes in other major parameters, including hospitalisation costs and relapse rates. The financial benefit of paroxetine, despite its 15-fold higher acquisition cost compared with imipramine, is attributable to a higher rate of completion of the initial course of therapy and consequent reduced hospitalisation rates.

Costs and cost-effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist : results of a randomized, controlled trial and a review of international costs

NARCIS (Netherlands)

Schuttelaar, M L A; Vermeulen, K M; Coenraads, P J

BACKGROUND: In a randomized, controlled trial (RCT) on childhood eczema we reported that substituting nurse practitioners (NPs) for dermatologists resulted in similar outcomes of eczema severity and in the quality of life, and higher patient satisfaction. OBJECTIVES: To determine costs and

An analysis of the estimated capital cost of a fusion reactor

International Nuclear Information System (INIS)

Hollis, A.A.

1981-06-01

The cost of building a fusion reactor similar to the Culham Conceptual Tokamak reactor Mark IIB is assessed and compared with other published capital costs of fusion and fission reactors. It is concluded that capital-investment and structure-renewal costs for a typical fusion reactor as presently conceived are likely to be higher than for thermal-fission reactors. (author)

An analysis of the estimated capital cost of a fusion reactor

International Nuclear Information System (INIS)

Hollis, A.A.; Evans, L.S.

1981-01-01

The cost of building a fusion reactor similar to the Culham Conceptual Tokamak reactor Mark IIB is assessed and compared with other published capital costs of fusion and fission reactors. It is concluded that capital-investment and structure-renewal costs for a typical fusion reactor as presently conceived are likely to be higher than for thermal-fission reactors. (author)

Workforce Investments: State Strategies to Preserve Higher-Cost Career Education Programs in Community and Technical Colleges

Science.gov (United States)

Shulock, Nancy; Lewis, Jodi; Tan, Connie

2013-01-01

In today's highly-skilled economy, rewarding career pathways are available to those who acquire technical skills by enrolling in certificate and associate degree programs in a community or technical college. Such programs are often more costly to offer than liberal arts and sciences programs that prepare students to transfer to four-year…

12 CFR 219.3 - Cost reimbursement.

Science.gov (United States)

2010-01-01

... that the financial institution use programming or other higher level technical services of a computer... (private sector) set out in the Employment Cost Trends section of the National Compensation Survey (http... PROVIDING FINANCIAL RECORDS; RECORDKEEPING REQUIREMENTS FOR CERTAIN FINANCIAL RECORDS (REGULATION S...

Physician awareness of drug cost: a systematic review.

Science.gov (United States)

Allan, G Michael; Lexchin, Joel; Wiebe, Natasha

2007-09-01

Pharmaceutical costs are the fastest-growing health-care expense in most developed countries. Higher drug costs have been shown to negatively impact patient outcomes. Studies suggest that doctors have a poor understanding of pharmaceutical costs, but the data are variable and there is no consistent pattern in awareness. We designed this systematic review to investigate doctors' knowledge of the relative and absolute costs of medications and to determine the factors that influence awareness. Our search strategy included The Cochrane Library, EconoLit, EMBASE, and MEDLINE as well as reference lists and contact with authors who had published two or more articles on the topic or who had published within 10 y of the commencement of our review. Studies were included if: either doctors, trainees (interns or residents), or medical students were surveyed; there were more than ten survey respondents; cost of pharmaceuticals was estimated; results were expressed quantitatively; there was a clear description of how authors defined "accurate estimates"; and there was a description of how the true cost was determined. Two authors reviewed each article for eligibility and extracted data independently. Cost accuracy outcomes were summarized, but data were not combined in meta-analysis because of extensive heterogeneity. Qualitative data related to physicians and drug costs were also extracted. The final analysis included 24 articles. Cost accuracy was low; 31% of estimates were within 20% or 25% of the true cost, and fewer than 50% were accurate by any definition of cost accuracy. Methodological weaknesses were common, and studies of low methodological quality showed better cost awareness. The most important factor influencing the pattern and accuracy of estimation was the true cost of therapy. High-cost drugs were estimated more accurately than inexpensive ones (74% versus 31%, Chi-square p price of expensive drugs and overestimate the price of inexpensive ones, demonstrate a

Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

Science.gov (United States)

Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

2014-12-11

Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

Estimation of marginal costs at existing waste treatment facilities

DEFF Research Database (Denmark)

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

2016-01-01

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

Cost estimates for flat plate and concentrator collector arrays

Science.gov (United States)

Shimada, K.

1982-01-01

The current module and installation costs for the U.S. National Photovoltaic Program's grid-connected systems are significantly higher than required for economic viability of this alternative. Attention is accordingly given to the prospects for installed module cost reductions in flat plate, linear focus Fresnel concentrator, and point focus Fresnel concentrator candidate systems. Cost projections indicate that all three systems would meet near-term and midterm goals, provided that module costs of $2.80/W(p) and $0.70/W(p), respectively, are met. The point focus Fresnel system emerges as the most viable for the near term.

A Comparison of Response Rate, Response Time, and Costs of Mail and Electronic Surveys.

Science.gov (United States)

Shannon, David M.; Bradshaw, Carol C.

2002-01-01

Compared response rates, response time, and costs of mail and electronic surveys using a sample of 377 college faculty members. Mail surveys yielded a higher response rate and a lower rate of undeliverable surveys, but response time was longer and costs were higher than for electronic surveys. (SLD)

The Decision-Making Process for Families Investing in Higher Education: A Family Systems Perspective

Science.gov (United States)

McHugh, Erin M.

2017-01-01

When families consider investing in their children's education they must weigh the perceived costs against the potential benefits, which becomes increasingly difficult as the cost of higher education continues to rise. Using a family systems approach, this phenomenological study explored the central research question, "How do families…

Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition.

Science.gov (United States)

Morales, Eva; Cots, Francesc; Sala, Maria; Comas, Mercè; Belvis, Francesc; Riu, Marta; Salvadó, Margarita; Grau, Santiago; Horcajada, Juan P; Montero, Maria Milagro; Castells, Xavier

2012-05-23

We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

The cost of multiple sclerosis drugs in the US and the pharmaceutical industry

Science.gov (United States)

Bourdette, Dennis N.; Ahmed, Sharia M.; Whitham, Ruth H.

2015-01-01

Objective: To examine the pricing trajectories in the United States of disease-modifying therapies (DMT) for multiple sclerosis (MS) over the last 20 years and assess the influences on rising prices. Methods: We estimated the trend in annual drug costs for 9 DMTs using published drug pricing data from 1993 to 2013. We compared changes in DMT costs to general and prescription drug inflation during the same period. We also compared the cost trajectories for first-generation MS DMTs interferon (IFN)–β-1b, IFN-β-1a IM, and glatiramer acetate with contemporaneously approved biologic tumor necrosis factor (TNF) inhibitors. Results: First-generation DMTs, originally costing $8,000 to $11,000, now cost about $60,000 per year. Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation. Newer DMTs commonly entered the market with a cost 25%–60% higher than existing DMTs. Significant increases in the cost trajectory of the first-generation DMTs occurred following the Food and Drug Administration approvals of IFN-β-1a SC (2002) and natalizumab (reintroduced 2006) and remained high following introduction of fingolimod (2010). Similar changes did not occur with TNF inhibitor biologics during these time intervals. DMT costs in the United States currently are 2 to 3 times higher than in other comparable countries. Conclusions: MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class. There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs. PMID:25911108

Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies

DEFF Research Database (Denmark)

Jakobsen, Marianne Uhre; O'Reilly, Eilis J; Heitmann, Berit Lilienthal

2009-01-01

BACKGROUND: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. OBJECTIVE: ...

Direct health care costs associated with obesity in Chinese population in 2011.

Science.gov (United States)

Shi, Jingcheng; Wang, Yao; Cheng, Wenwei; Shao, Hui; Shi, Lizheng

2017-03-01

Overweight and obesity are established major risk factors for type 2 diabetes, and major public health concerns in China. This study aims to assess the economic burden associated with overweight and obesity in the Chinese population ages 45 and older. The Chinese Health and Retirement Longitudinal Study (CHARLS) in 2011 included 13,323 respondents of ages 45 and older living in 450 rural and urban communities across China. Demographic information, height, weight, direct health care costs for outpatient visits, hospitalization, and medications for self-care were extracted from the CHARLS database. Health Care costs were calculated in 2011 Chinese currency. The body mass index (BMI) was used to categorize underweight, normal weight, overweight, and obese populations. Descriptive analyses and a two-part regression model were performed to investigate the association of BMI with health care costs. To account for non-normality of the cost data, we applied a non-parametric bootstrap approach using the percentile method to estimate the 95% confidence intervals (95% CIs). Overweight and obese groups had significantly higher total direct health care costs (RMB 2246.4, RMB 2050.7, respectively) as compared with the normal-weight group (RMB 1886.0). When controlling for demographic characteristics, overweight and obese adults were 15.0% and 35.9% more likely to incur total health care costs, and obese individuals had 14.2% higher total health care costs compared with the normal-weight group. Compared with the normal-weight counterparts, the annual total direct health care costs were significantly higher among obese adults in China. Copyright © 2016 Elsevier Inc. All rights reserved.

Reward Pays the Cost of Noise Reduction in Motor and Cognitive Control.

Science.gov (United States)

Manohar, Sanjay G; Chong, Trevor T-J; Apps, Matthew A J; Batla, Amit; Stamelou, Maria; Jarman, Paul R; Bhatia, Kailash P; Husain, Masud

2015-06-29

Speed-accuracy trade-off is an intensively studied law governing almost all behavioral tasks across species. Here we show that motivation by reward breaks this law, by simultaneously invigorating movement and improving response precision. We devised a model to explain this paradoxical effect of reward by considering a new factor: the cost of control. Exerting control to improve response precision might itself come at a cost--a cost to attenuate a proportion of intrinsic neural noise. Applying a noise-reduction cost to optimal motor control predicted that reward can increase both velocity and accuracy. Similarly, application to decision-making predicted that reward reduces reaction times and errors in cognitive control. We used a novel saccadic distraction task to quantify the speed and accuracy of both movements and decisions under varying reward. Both faster speeds and smaller errors were observed with higher incentives, with the results best fitted by a model including a precision cost. Recent theories consider dopamine to be a key neuromodulator in mediating motivational effects of reward. We therefore examined how Parkinson's disease (PD), a condition associated with dopamine depletion, alters the effects of reward. Individuals with PD showed reduced reward sensitivity in their speed and accuracy, consistent in our model with higher noise-control costs. Including a cost of control over noise explains how reward may allow apparent performance limits to be surpassed. On this view, the pattern of reduced reward sensitivity in PD patients can specifically be accounted for by a higher cost for controlling noise. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hospital staffing and hospital costs.

Science.gov (United States)

Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Accounting for enforcement costs in the spatial allocation of marine zones.

Science.gov (United States)

Davis, Katrina; Kragt, Marit; Gelcich, Stefan; Schilizzi, Steven; Pannell, David

2015-02-01

Marine fish stocks are in many cases extracted above sustainable levels, but they may be protected through restricted-use zoning systems. The effectiveness of these systems typically depends on support from coastal fishing communities. High management costs including those of enforcement may, however, deter fishers from supporting marine management. We incorporated enforcement costs into a spatial optimization model that identified how conservation targets can be met while maximizing fishers' revenue. Our model identified the optimal allocation of the study area among different zones: no-take, territorial user rights for fisheries (TURFs), or open access. The analysis demonstrated that enforcing no-take and TURF zones incurs a cost, but results in higher species abundance by preventing poaching and overfishing. We analyzed how different enforcement scenarios affected fishers' revenue. Fisher revenue was approximately 50% higher when territorial user rights were enforced than when they were not. The model preferentially allocated area to the enforced-TURF zone over other zones, demonstrating that the financial benefits of enforcement (derived from higher species abundance) exceeded the costs. These findings were robust to increases in enforcement costs but sensitive to changes in species' market price. We also found that revenue under the existing zoning regime in the study area was 13-30% lower than under an optimal solution. Our results highlight the importance of accounting for both the benefits and costs of enforcement in marine conservation, particularly when incurred by fishers. © 2014 Society for Conservation Biology.

Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom12

Science.gov (United States)

Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

2015-01-01

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. Design: In this cross-sectional study of adults aged 39–79 y from the European Prospective Investigation into Cancer and Nutrition–Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom–based supermarket comparison website. Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed. PMID:25926505

Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder.

Science.gov (United States)

Hirjak, Dusan; Hochlehnert, Achim; Thomann, Philipp Arthur; Kubera, Katharina Maria; Schnell, Knut

2016-01-01

Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category. The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0) and 71 patients with SAD (F25). We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping. SAD patients had a longer duration of stay than patients with SZ (p = .02). Mean total costs were significantly higher for SAD patients (p = .023). Further, we found a significant difference in mean personnel costs (p = .02) between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12) but a marginal difference of mean infrastructure costs (p = .05) between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD. We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.

Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder.

Directory of Open Access Journals (Sweden)

Dusan Hirjak

Full Text Available Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ or schizoaffective disorder (SAD, a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category.The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0 and 71 patients with SAD (F25. We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping.SAD patients had a longer duration of stay than patients with SZ (p = .02. Mean total costs were significantly higher for SAD patients (p = .023. Further, we found a significant difference in mean personnel costs (p = .02 between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12 but a marginal difference of mean infrastructure costs (p = .05 between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD.We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.

Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh.

Science.gov (United States)

Carracedo, D; López-Fando, L; Sánchez, M D; Jiménez, M Á; Gómez, J M; Laso, I; Rodríguez, M Á; Burgos, F J

2017-03-01

The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5,985.7 €±1,550.8 € vs. 6,534.3 €±1,015.5 €), although it did not achieve statistical signification. In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women

DEFF Research Database (Denmark)

Thorning, Tanja Kongerslev; Raziani, Farinaz; Bendsen, Nathalie Tommerup

2015-01-01

BACKGROUND: Heart associations recommend limited intake of saturated fat. However, effects of saturated fat on low-density lipoprotein (LDL)-cholesterol concentrations and cardiovascular disease risk might depend on nutrients and specific saturated fatty acids (SFAs) in food. OBJECTIVE: We explored...... the effects of cheese and meat as sources of SFAs or isocaloric replacement with carbohydrates on blood lipids, lipoproteins, and fecal excretion of fat and bile acids. DESIGN: The study was a randomized, crossover, open-label intervention in 14 overweight postmenopausal women. Three full-diet periods of 2-wk...... duration were provided separated by 2-wk washout periods. The isocaloric diets were as follows: 1) a high-cheese (96-120-g) intervention [i.e., intervention containing cheese (CHEESE)], 2) a macronutrient-matched nondairy, high-meat control [i.e., nondairy control with a high content of high-fat processed...

Short-term exercise reduces markers of hepatocyte apoptosis in nonalcoholic fatty liver disease

DEFF Research Database (Denmark)

Fealy, Ciaran E; Haus, Jacob M; Solomon, Thomas

2012-01-01

and after the exercise intervention. The Matsuda index was used to assess insulin sensitivity. We observed significant decreases in CK18 fragments (558.4 ± 106.8 vs. 323.4 ± 72.5 U/l, P vs. 24.3 ± 4.8 U/l, P vs. 69...... changes in fat oxidation and circulating sFasL (rho = -0.65, P vs. 17.5 ± 2.1%, NS). We conclude that short-term exercise reduces a circulatory marker of hepatocyte apoptosis in obese individuals with NAFLD and propose that changes....... We therefore examined the effect of a short-term exercise program on markers of apoptosis-plasma cytokeratin 18 (CK18) fragments, alanine aminotransferase (ALT), aspartate aminotransferase (AST), soluble Fas (sFas), and sFas ligand (sFasL)-in 13 obese individuals with NAFLD [body mass index 35.2 ± 1...

The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

Science.gov (United States)

Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

2018-02-21

In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

Lean VOC-Air Mixtures Catalytic Treatment: Cost-Benefit Analysis of Competing Technologies

Directory of Open Access Journals (Sweden)

Gabriele Baldissone

2017-06-01

Full Text Available Various processing routes are available for the treatment of lean VOC-air mixtures, and a cost-benefit analysis is the tool we propose to identify the most suitable technology. Two systems have been compared in this paper, namely a “traditional” plant, with a catalytic fixed-bed reactor with a heat exchanger for heat recovery purposes, and a “non-traditional” plant, with a catalytic reverse-flow reactor, where regenerative heat recovery may be achieved thanks to the periodical reversal of the flow direction. To be useful for decisions-making, the cost-benefit analysis must be coupled to the reliability, or availability, analysis of the plant. Integrated Dynamic Decision Analysis is used for this purpose as it allows obtaining the full set of possible sequences of events that could result in plant unavailability, and, for each of them, the probability of occurrence is calculated. Benefits are thus expressed in terms of out-of-services times, that have to be minimized, while the costs are expressed in terms of extra-cost for maintenance activities and recovery actions. These variable costs must be considered together with the capital (fixed cost required for building the plant. Results evidenced the pros and cons of the two plants. The “traditional” plant ensures a higher continuity of services, but also higher operational costs. The reverse-flow reactor-based plant exhibits lower operational costs, but a higher number of protection levels are needed to obtain a similar level of out-of-service. The quantification of risks and benefits allows the stakeholders to deal with a complete picture of the behavior of the plants, fostering a more effective decision-making process. With reference to the case under study and the relevant operational conditions, the regenerative system was demonstrated to be more suitable to treat lean mixtures: in terms of time losses following potential failures the two technologies are comparable (Fixed bed

An equivalent marginal cost-pricing model for the district heating market

International Nuclear Information System (INIS)

Zhang, Junli; Ge, Bin; Xu, Hongsheng

2013-01-01

District heating pricing is a core element in reforming the heating market. Existing district heating pricing methods, such as the cost-plus pricing method and the conventional marginal-cost pricing method, cannot simultaneously provide both high efficiency and sufficient investment cost return. To solve this problem, the paper presents a new pricing model, namely Equivalent Marginal Cost Pricing (EMCP) model, which is based on the EVE pricing theory and the unique characteristics of heat products and district heating. The EMCP model uses exergy as the measurement of heating product value and places products from different district heating regions into the same competition platform. In the proposed model, the return on investment cost is closely related to the quoted cost, and within the limitations of the Heating Capacity Cost Reference and the maximum compensated shadow capacity cost, both lower and higher price speculations of heat producers are restricted. Simulation results show that the model can guide heat producers to bid according to their production costs and to provide reasonable returns on investment, which contributes to stimulate the role of price leverage and to promote the optimal allocation of heat resources. - Highlights: • Presents a new district heating pricing model. • Provides both high market efficiency and sufficient investment cost return. • Provides a competition mechanism for various products from different DH regions. • Both of lower and higher price speculations are restricted in the new model

Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

Science.gov (United States)

Puig-Junoy, Jaume

2012-11-01

In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.

Science.gov (United States)

Altawalbeh, Shoroq M; Saul, Melissa I; Seybert, Amy L; Thorpe, Joshua M; Kane-Gill, Sandra L

2018-04-01

To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. Financial transactions for all ICU patients during fiscal years (FY) 2009-2012 were retrieved from the hospital's data repository. ICU drug costs were evaluated for each FY. ICU departments' charges were also retrieved and calculated as percentages of total ICU charges. Albumin, prismasate (dialysate), voriconazole, factor VII and alteplase denoted the highest percentages of ICU drug costs. ICU drug costs contributed to an average of 31% (SD 1.0%) of the hospital's total drug costs. ICU drug costs per patient day increased by 5.8% yearly versus 7.8% yearly for non-ICU drugs. This rate was higher for ICU drugs costs at 12% a decade previous. Pharmacy charges contributed to 17.7% of the total ICU charges. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures. Copyright © 2017 Elsevier Inc. All rights reserved.

Benefit/cost comparisons for utility SMES applications

International Nuclear Information System (INIS)

De Steese, J.G.; Dagle, J.E.

1991-01-01

This paper summarizes eight cases studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES application in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios that those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in may utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems

Indirect costs of teaching in Canadian hospitals.

Science.gov (United States)

MacKenzie, T A; Willan, A R; Cox, M A; Green, A

1991-01-01

We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

Benefit/cost comparison for utility SMES applications

Science.gov (United States)

Desteese, J. G.; Dagle, J. E.

1991-08-01

This paper summarizes eight case studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES applications in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios than those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in many utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems.

Yükseköğretimin Finansmanı ve Türkiye İçin Yükseköğretim Finansman Modeli Önerisi(Financing Higher Education: Proposal For Higher Education Model In Turkey

Directory of Open Access Journals (Sweden)

Haşim AKÇA

2012-01-01

Full Text Available Higher education is a mixed commodity. Considering its attribute, it is a service benefiting its users directly and society indirectly. Therefore it is necessary that higher education be catered continuously. In this context, higher education institutions should prompt the dynamics of societal development and lead the society toward better future. One of fundamental task for universities is to provide positive externalities for the entire society. However, universities often face important financial difficulties to extent the externalities they provide. In recent years alternative resources also are employed in financing higher education. For instance it is universally accepted application that some of the costs of higher education are accrued to the direct beneficiaries or the students. In some countries however higher education is solely funded by public resources because higher education in these countries is considered as public good. However in the recent years, a widespread belief suggests that public resources are not fit for efficient use, therefore alternative means of higher education finance are being explored. One such means appears to be an income-contingent system or student borrowing system. This method eases the burden of public finance and allows for students to assume a partial cost of higher education.

“Fish, chicken, lean meat and eggs can be eaten daily”: a food ...

African Journals Online (AJOL)

2013-04-09

Apr 9, 2013 ... meat and eggs, constitute high-quantity and high-quality protein, as they contain essential ... Food (per 100 g, raw, edible portion). Fat. SFAs. MUFAs. PUFAs n-3 .... milk.27 The naturally present fibres, phytates, oxalates and.

Realistic costs of carbon capture

Energy Technology Data Exchange (ETDEWEB)

Al Juaied, Mohammed (Harvard Univ., Cambridge, MA (US). Belfer Center for Science and International Affiaris); Whitmore, Adam (Hydrogen Energy International Ltd., Weybridge (GB))

2009-07-01

There is a growing interest in carbon capture and storage (CCS) as a means of reducing carbon dioxide (CO2) emissions. However there are substantial uncertainties about the costs of CCS. Costs for pre-combustion capture with compression (i.e. excluding costs of transport and storage and any revenue from EOR associated with storage) are examined in this discussion paper for First-of-a-Kind (FOAK) plant and for more mature technologies, or Nth-of-a-Kind plant (NOAK). For FOAK plant using solid fuels the levelised cost of electricity on a 2008 basis is approximately 10 cents/kWh higher with capture than for conventional plants (with a range of 8-12 cents/kWh). Costs of abatement are found typically to be approximately US$150/tCO2 avoided (with a range of US$120-180/tCO2 avoided). For NOAK plants the additional cost of electricity with capture is approximately 2-5 cents/kWh, with costs of the range of US$35-70/tCO2 avoided. Costs of abatement with carbon capture for other fuels and technologies are also estimated for NOAK plants. The costs of abatement are calculated with reference to conventional SCPC plant for both emissions and costs of electricity. Estimates for both FOAK and NOAK are mainly based on cost data from 2008, which was at the end of a period of sustained escalation in the costs of power generation plant and other large capital projects. There are now indications of costs falling from these levels. This may reduce the costs of abatement and costs presented here may be 'peak of the market' estimates. If general cost levels return, for example, to those prevailing in 2005 to 2006 (by which time significant cost escalation had already occurred from previous levels), then costs of capture and compression for FOAK plants are expected to be US$110/tCO2 avoided (with a range of US$90-135/tCO2 avoided). For NOAK plants costs are expected to be US$25-50/tCO2. Based on these considerations a likely representative range of costs of abatement from CCS

The cost of nurse-sensitive adverse events.

Science.gov (United States)

Pappas, Sharon Holcombe

2008-05-01

The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.

Pros, cons of techniques used to calculate oil, gas finding costs

International Nuclear Information System (INIS)

Gaddis, D.; Brock, H.; Boynton, C.

1992-01-01

A major problem facing the U.S. petroleum industry is the higher average finding costs that now exist within the U.S. compared with the average finding costs outside the U.S. It has been argued that federal lands and offshore areas need to be open for drilling in order to reduce average finding costs in the U.S. This article analyzes the strengths and weaknesses of conventional techniques for determining finding costs. Our goal is a finding costs measure that is a reliable indicator of future profitability

All-Cause and Acute Pancreatitis Health Care Costs in Patients With Severe Hypertriglyceridemia.

Science.gov (United States)

Rashid, Nazia; Sharma, Puza P; Scott, Ronald D; Lin, Kathy J; Toth, Peter P

2017-01-01

The aim of this study was to assess health care utilization and costs related to acute pancreatitis (AP) in patients with severe hypertriglyceridemia (sHTG) levels. Patients with sHTG levels 1000 mg/dL or higher were identified from January 1, 2007, to June 30, 2013. The first identified incident triglyceride level was labeled as index date. All-cause, AP-related health care visits, and mean total all-cause costs in patients with and without AP were compared during 12 months postindex. A generalized linear model regression was used to compare costs while controlling for patient characteristics and comorbidities. Five thousand five hundred fifty sHTG patients were identified, and 5.4% of these patients developed AP during postindex. Patients with AP had significantly (P < 0.05) more all-cause outpatient visits, hospitalizations, longer length of stays during the hospital visits, and emergency department visits versus patients without AP. Mean (SD) unadjusted all-cause health care costs in the 12 months postindex were $25,343 ($33,139) for patients with AP compared with $15,195 ($24,040) for patients with no AP. The regression showed annual all-cause costs were 49.9% higher (P < 0.01) for patients with AP versus without AP. Patients who developed AP were associated with higher costs; managing patients with sHTG at risk of developing AP may help reduce unnecessary costs.

Additive versus multiplicative trade costs and the gains from trade

DEFF Research Database (Denmark)

Sørensen, Allan

This paper addresses welfare effects from trade liberalization in a heterogeneous-fi…rms trade model including the empirically important per-unit (i.e. additive) trade costs in addition to the conventional iceberg (i.e. multiplicative) and fi…xed trade costs. The novel contribution of the paper...... is the result that the welfare gain for a given increase in trade openness is higher for reductions in per-unit (additive) trade costs than for reductions in iceberg (multiplicative) trade costs. The ranking derives from differences in intra-industry reallocations and in particular from dissimilar impacts...

Enabling Process Improvement and Control in Higher Education Management

Science.gov (United States)

Bell, Gary; Warwick, Jon; Kennedy, Mike

2009-01-01

The emergence of "managerialism" in the governance and direction of UK higher education (HE) institutions has been led by government demands for greater accountability in the quality and cost of universities. There is emerging anecdotal evidence indicating that the estimation performance of HE spreadsheets and regression models are poor.…

Production cost of biomasses from eucalyptus and elefant grass for energy

Directory of Open Access Journals (Sweden)

Laurent Marie Roger Quéno

2011-09-01

Full Text Available This work established the unit energy cost generated from biomass of eucalyptus (Eucalyptus sp. and elephant grass (Pennisetum sp. and applied a sensitivity analysis to verify the influences of factors such as the silviculture of eucalyptus, production volume of each species, the cost of land and the interest rate. It was shown that the treatment of eucalyptus in very short rotation of 2 years with reform of stand every 6 years has a average cost of production higher than the traditional treatment of short rotation of 6 years with reform only at the age of 18. It was also observed that eucalyptus has a Production Cost on average of R$ 4,41 /Gj, lower than the elephant grass which is on average of R$ 5,44/Gj, which however has a higher annual capacity of dry matter production. The elephant grass has the possibility to compete with eucalyptus when a set of conditions is met: discount rate higher than or equal to 8%, High price of land, and elephant grass high volume production, greater than or equal to 35 tonnes of dry matter per hectare and year.

Cost of myopic patients with and without myopic choroidal neovascularisation.

Science.gov (United States)

Ruiz-Moreno, J M; Roura, M

2016-06-01

To study the costs associated with high myopia (HM) with choroidal neovascularisation (mCNV) or without mCNV. Observational, retrospective, cross-sectional, and multicentre study (HM and mCNV) conducted on adult patients. Annualised medical direct cost (MDC) from the perspective of the National Health System, the non-medical direct cost (nMDC) from the patient perspective, and productivity losses were calculated. A total of 137 mCNV and 48 HM patients were included (mean age [SD]: 55.1 [2.8] vs. 54.7 [13.8]; P=.2), with 80% women in both groups. The observation time (months) ranged from 17.9 (9.6) right eye (RE) and 20.0 (9.7), left eye (LE) in mCNV and 47.1 (21.5) RE/45.5 (20.7) LE in MM. A higher percentage of emergency room visits was observed in mCNV vs. HM patients (41.7 vs. 25%; P=.06) and retinal specialists (91.2 vs. 77.1%; P=.01). The MDC was higher in mCNV: € 1,985 (95% CI: 1772-2198) vs. € 356 (251-480) HM, P.4. The number of affected eyes, the follow-up time, and the mCNV were factors associated with direct costs. The impact on work productivity was higher in mCNV (quite/very concerned): 27.7 vs. 10.4% HM. The mCNV showed a significant association with activity impairment (OR: 3.47, 95% CI: 10.101-1.195). mCNV involves higher medical costs than HM. In addition, mCNV patients have a greater need of care and assistive devices, and greater impact of the disease in their work productivity. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

The Value of Negotiating Cost-Based Transfer Prices

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Anne Chwolka

2010-10-01

Full Text Available This paper analyzes the potential of one-step transfer prices based on either variable or full costs for coordinating decentralized production and quality-improving investment decisions. Transfer prices based on variable costs fail to induce investments on the upstream stage. In contrast, transfer prices based on full costs provide strong investment incentives for the upstream divisions. However, they fail to coordinate the investment decisions. We show that negotiations prevent such coordination failure. In particular, we find that the firm benefits from a higher degree of decentralization so that total profit increases in the number of parameters being subject to negotiations.

Risk factor and cost accounting analysis for dialysis patients in Taiwan.

Science.gov (United States)

Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

2010-05-01

According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

Capital Regulation, the Cost of Financial Intermediation and Bank Profitability: Evidence from Bangladesh

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Changjun Zheng

2017-04-01

Full Text Available In response to the recent global financial crisis, the regulatory authorities in many countries have imposed stringent capital requirements in the form of the BASEL III Accord to ensure financial stability. On the other hand, bankers have criticized new regulation on the ground that it would enhance the cost of funds for bank borrowers and deteriorate the bank profitability. In this study, we examine the impact of capital requirements on the cost of financial intermediation and bank profitability using a panel dataset of 32 Bangladeshi banks over the period from 2000 to 2015. By employing a dynamic panel generalized method of moments (GMM estimator, we find robust evidence that higher bank regulatory capital ratios reduce the cost of financial intermediation and increase bank profitability. The results hold when we use equity to total assets ratio as an alternative measure of bank capital. We also observe that switching from BASEL I to BASEL II has no measurable impact on the cost of financial intermediation and bank profitability in Bangladesh. In the empirical analysis, we further observe that higher bank management and cost efficiencies are associated with the lower cost of financial intermediation and higher bank profitability. These results have important implications for bank regulators, academicians, and bankers.

Environmental costs of fossil fuel energy production