WorldWideScience

Sample records for indirect cost recovery

  1. [Methodologies for estimating the indirect costs of traffic accidents].

    Science.gov (United States)

    Carozzi, Soledad; Elorza, María Eugenia; Moscoso, Nebel Silvana; Ripari, Nadia Vanina

    2017-01-01

    Traffic accidents generate multiple costs to society, including those associated with the loss of productivity. However, there is no consensus about the most appropriate methodology for estimating those costs. The aim of this study was to review methods for estimating indirect costs applied in crash cost studies. A thematic review of the literature was carried out between 1995 and 2012 in PubMed with the terms cost of illness, indirect cost, road traffic injuries, productivity loss. For the assessment of costs we used the the human capital method, on the basis of the wage-income lost during the time of treatment and recovery of patients and caregivers. In the case of premature death or total disability, the discount rate was applied to obtain the present value of lost future earnings. The computed years arose by subtracting to life expectancy at birth the average age of those affected who are not incorporated into the economically active life. The interest in minimizing the problem is reflected in the evolution of the implemented methodologies. We expect that this review is useful to estimate efficiently the real indirect costs of traffic accidents.

  2. STEM Faculty and Indirect Costs: What Administrators Need to Know

    Science.gov (United States)

    Gossman, Susan

    2016-01-01

    The focus of this single site, qualitative case study was on public research university STEM (science, technology, engineering and mathematics) faculty and their perspectives on, and behavior towards, indirect cost recovery. The explanatory scheme was derived from anthropological theory and incorporated organizational culture, resource dependency…

  3. Comparative Effects of Biomass Pre-Treatments for Direct and Indirect Transesterification to Enhance Microalgal Lipid Recovery

    International Nuclear Information System (INIS)

    Ghasemi Naghdi, Forough; Thomas-Hall, Skye R.; Durairatnam, Reuben; Pratt, Steven; Schenk, Peer M.

    2014-01-01

    Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME) recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however, FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane–ethanol (3:1). Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171%) under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min) in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

  4. Comparative effects of biomass pre-treatments for direct and indirect transesterification to enhance microalgal lipid recovery

    Directory of Open Access Journals (Sweden)

    Forough eGhasemi Naghdi

    2014-12-01

    Full Text Available Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane-ethanol (3:1. Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171% under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

  5. Comparative Effects of Biomass Pre-Treatments for Direct and Indirect Transesterification to Enhance Microalgal Lipid Recovery

    Energy Technology Data Exchange (ETDEWEB)

    Ghasemi Naghdi, Forough; Thomas-Hall, Skye R.; Durairatnam, Reuben [Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, QLD (Australia); Pratt, Steven [School of Chemical Engineering, The University of Queensland, Brisbane, QLD (Australia); Schenk, Peer M., E-mail: p.schenk@uq.edu.au [Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, QLD (Australia)

    2014-12-04

    Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME) recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however, FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane–ethanol (3:1). Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171%) under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min) in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

  6. Indirect Cost Reimbursement: An Industrial View.

    Science.gov (United States)

    Bolton, Robert

    1987-01-01

    The meaning of indirect costs in an industrial environment is discussed. Other factors considered are corporate policies; nature of work being supported; the uniqueness of the work; who is doing the negotiating for industry; and indirect rates. Suggestions are offered for approaches to indirect cost reimbursement. (Author/MLW)

  7. INDIRECT LABOR COSTS AND IMPLICATIONS FOR OVERHEAD ALLOCATION

    OpenAIRE

    Bea Chiang

    2013-01-01

    Cost accounting typically allocates indirect labor cost to cost object based on direct labor hours. The allocation process implicitly assumes that indirect labor costs vary proportionally with direct labor hours. The assumption of a linear relationship between indirect and direct labor is particularly suspicious at low production volume levels because there tends to be a fixed component in indirect labor. The linearity assumption is also challenged by recent increasing complexity of indirect ...

  8. 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.

  9. 10 CFR 602.15 - Indirect cost limitations.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Indirect cost limitations. 602.15 Section 602.15 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.15 Indirect cost limitations. Awards issued under this part for conferences and...

  10. 10 CFR 605.16 - Indirect cost limitations.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Indirect cost limitations. 605.16 Section 605.16 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM § 605.16 Indirect cost limitations. Awards issued under this part for conferences and scientific...

  11. Estimating direct and indirect costs of premenstrual syndrome.

    Science.gov (United States)

    Borenstein, Jeff; Chiou, Chiun-Fang; Dean, Bonnie; Wong, John; Wade, Sally

    2005-01-01

    To quantify the economic impact of premenstrual syndrome (PMS) on the employer. Data were collected from 374 women aged 18-45 with regular menses. Direct costs were quantified using administrative claims of these patients and the Medicare Fee Schedule. Indirect costs were quantified by both self-reported days of work missed and lost productivity at work. Regression analyses were used to develop a model to project PMS-related direct and indirect costs. A total of 29.6% (n = 111) of the participants were diagnosed with PMS. A PMS diagnosis was associated with an average annual increase of $59 in direct costs (P increase in direct medical costs and a large increase in indirect costs.

  12. The Indirect cost of illness in Africa

    Directory of Open Access Journals (Sweden)

    Joses Muthuri Kirigia

    2018-06-01

    Full Text Available Background: The current study estimated (a the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG compared to the costs under the status quo. Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP losses associated with the disability-adjusted-life-years (DALYs lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries. Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61% was attributable to maternal conditions, AIDS, tuberculosis (TB, malaria, neglected tropicald diseases (NTDs, non-communicable diseases and traffic injuries. Approximately half (47% of this cost could be avoided (or saved every year if the 3 (health targets of the SDG were fully met. Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories.

  13. The Indirect Costs of Financial Distress in Indonesia

    Directory of Open Access Journals (Sweden)

    Wijantini Wijantini

    2007-06-01

    Full Text Available This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported operating income, the estimated costs are overstated. The simple regressions analysis suggest that the indirect cost of financial distress significantly increases with size, leverage, number of creditors, and poor industry performance, but is not related to degree of bank loan reliance. The findings provide a weak support for the financial distress theory which suggests that conflicts of interest render the costs of financial distress.

  14. 77 FR 57074 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2012-09-17

    ... information on these rates and the DARRP policy can be found at the DARRP web site at: http://www.darrp.noaa.gov/library/12_b.html FOR FURTHER INFORMATION CONTACT: For further information, contact LaTonya... develop indirect cost rates for its component organizations and formulate policies on the recovery of...

  15. Indirect costs of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Filip Raciborski

    2015-12-01

    Full Text Available It is estimated that in Poland about 400,000 persons in general suffer from inflammatory joint diseases, including rheumatoid arthritis (RA. Epidemiological surveys documenting the frequency and disturbance of musculoskeletal disorders in the Polish population are few in number. Most of the estimations are based on epidemiological data from other countries (prevalence of 0.5–1%. According to the data of the National Health Fund in Poland 135,000–157,000 persons in total are treated because of rheumatoid arthritis per year [ICD10 (International Statistical Classification of Diseases and Related Health Problems: M05, M06]. In the case of this group of diseases indirect costs significantly outweigh the direct costs. Indirect costs increase together with activity level of the disease. The cost analysis of productivity loss of RA patients indicates that sickness absenteeism and informal care are the most burdensome. At the national level it amounts in total from 1.2 billion to 2.8 billion PLN per year, depending on the method of analysis. These costs could be significantly reduced through early diagnosis and introduction of effective treatment.

  16. The Indirect Costs of Financial Distress in Indonesia

    OpenAIRE

    Wijantini, Wijantini

    2007-01-01

    This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported opera...

  17. Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

    Science.gov (United States)

    Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

    2012-01-01

    The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. 48 CFR 31.203 - Indirect costs.

    Science.gov (United States)

    2010-10-01

    ... fiscal year used for financial reporting purposes in accordance with generally accepted accounting... contract or other work, indirect costs are those remaining to be allocated to intermediate or two or more... basis of the benefits accruing to intermediate and final cost objectives. When substantially the same...

  19. The indirect costs and benefits of greenhouse gas mitigation

    International Nuclear Information System (INIS)

    Markandya, A.

    1998-01-01

    The indirect costs of GHG projects are very important in the evaluation of such projects. In many cases they are more important than the direct costs. This paper has shown what such costs consist of and how they may be estimated. As countries prepare their mitigation strategies, it is very important that they develop tools for the assessment of these indirect costs and use these tools in the appropriate manner. Hopefully, this paper will point them in the right direction. (au) 11 refs

  20. 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

  1. 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

  2. The direct and indirect costs of Dravet Syndrome.

    Science.gov (United States)

    Whittington, Melanie D; Knupp, Kelly G; Vanderveen, Gina; Kim, Chong; Gammaitoni, Arnold; Campbell, Jonathan D

    2018-03-01

    The objective of this study was to estimate the annual direct and indirect costs associated with Dravet Syndrome (DS). A survey was electronically administered to the caregivers of patients with DS treated at Children's Hospital Colorado. Survey domains included healthcare utilization of the patient with DS and DS caregiver work productivity and activity impairment. Patient healthcare utilization was measured using modified questions from the National Health Interview Survey; caregiver work productivity and activity impairment were measured using modified questions from the Work Productivity and Activity Impairment questionnaire. Direct costs were calculated by multiplying the caregiver-reported healthcare utilization rates by the mean unit cost for each healthcare utilization category. Indirect costs included lost productivity, income loss, and lost leisure time. The indirect costs were a function of caregiver-reported hours spent caregiving and an hourly unit cost. The survey was emailed to 60 DS caregivers, of which 34 (57% response rate) responded. Direct costs on average were $27,276 (95% interval: $15,757, $41,904) per patient with DS. Hospitalizations ($11,565 a year) and in-home medical care visits ($9894 a year) were substantial cost drivers. Additionally, caregivers reported extensive time spent providing care to an individual with DS. This caregiver time resulted in average annual indirect costs of $81,582 (95% interval: $57,253, $110,151), resulting in an average total annual financial burden of $106,378 (95% interval: $78,894, $137,906). Dravet Syndrome results in substantial healthcare utilization, financial burden, and time commitment. Establishing evidence on the financial burden of DS is essential to understanding the overall impact of DS, identifying potential areas for support needs, and assessing the impact of novel treatments as they become available. Based on the study findings, in-home visits, hospitalizations, and lost productivity and

  3. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    Science.gov (United States)

    Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

    2014-01-01

    OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population. PMID:26039398

  4. Lifestyle factors, direct and indirect costs for a Brazilian airline company.

    Science.gov (United States)

    Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

    2014-12-01

    OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

  5. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    Directory of Open Access Journals (Sweden)

    Fabiana Maluf Rabacow

    2014-12-01

    Full Text Available OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking, was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

  6. Management of End-Stage Ankle Arthritis: Cost-Utility Analysis Using Direct and Indirect Costs.

    Science.gov (United States)

    Nwachukwu, Benedict U; McLawhorn, Alexander S; Simon, Matthew S; Hamid, Kamran S; Demetracopoulos, Constantine A; Deland, Jonathan T; Ellis, Scott J

    2015-07-15

    Total ankle replacement and ankle fusion are costly but clinically effective treatments for ankle arthritis. Prior cost-effectiveness analyses for the management of ankle arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for ankle arthritis with inclusion of direct and indirect costs in the analysis. Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). In the direct-cost analysis for the base case, total ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of ankle arthritis was preferred for patients younger than ninety-six years and total ankle replacement was increasingly more cost-effective in younger patients. Total ankle replacement, ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total ankle replacement, the failure rate of total ankle replacement, and the probability of arthritis after ankle fusion. Compared with nonoperative treatment for the management of end-stage ankle arthritis, total ankle

  7. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł

    2015-04-01

    The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

  8. Indirect reciprocity can overcome free-rider problems on costly moral assessment.

    Science.gov (United States)

    Sasaki, Tatsuya; Okada, Isamu; Nakai, Yutaka

    2016-07-01

    Indirect reciprocity is one of the major mechanisms of the evolution of cooperation. Because constant monitoring and accurate evaluation in moral assessments tend to be costly, indirect reciprocity can be exploited by cost evaders. A recent study crucially showed that a cooperative state achieved by indirect reciprocators is easily destabilized by cost evaders in the case with no supportive mechanism. Here, we present a simple and widely applicable solution that considers pre-assessment of cost evaders. In the pre-assessment, those who fail to pay for costly assessment systems are assigned a nasty image that leads to them being rejected by discriminators. We demonstrate that considering the pre-assessment can crucially stabilize reciprocal cooperation for a broad range of indirect reciprocity models. In particular for the most leading social norms, we analyse the conditions under which a prosocial state becomes locally stable. © 2016 The Authors.

  9. Indirect reciprocity provides a narrow margin of efficiency for costly punishment

    Science.gov (United States)

    Iwasa, Yoh; Nowak, Martin A.

    2008-01-01

    Indirect reciprocity1-5 is a key mechanism for the evolution of human cooperation. Our behavior toward other people depends not only on what they have done to us, but also on what they have done to others. Indirect reciprocity works via reputation5-17. The standard model of indirect reciprocity offers a binary choice: people can either cooperate or defect. Cooperation implies a cost for the donor and a benefit for the recipient. Defection has no cost and yields no benefit. Currently there is considerable interest in studying the effect of costly (or altruistic) punishment on human behavior18-25. Punishment implies a cost for the punished person. Costly punishment means that the punisher also pays a cost. It has been suggested that costly punishment between individuals can promote cooperation. Here we study the role of costly punishment in an explicit model of indirect reciprocity. We analyze all social norms, which depend on the action of the donor and the reputation of the recipient. We allow errors in assigning reputation and study gossip as a mechanism for establishing coherence. We characterize all strategies that allow the evolutionary stability of cooperation. Some of those strategies use costly punishment, while others do not. We find that punishment strategies typically reduce the average payoff of the population. Consequently, there is only a small parameter region where costly punishment leads to an efficient equilibrium. In most cases, the population does better by not using costly punishment. The efficient strategy for indirect reciprocity is to withhold help for defectors rather than punish them. PMID:19122640

  10. 48 CFR 52.216-15 - Predetermined Indirect Cost Rates.

    Science.gov (United States)

    2010-10-01

    .... (c) Allowability of costs and acceptability of cost allocation methods shall be determined in...) the period for which the rates apply, and (4) the specific items treated as direct costs or any changes in the items previously agreed to be direct costs. The indirect cost rate agreement shall not...

  11. 23 CFR 140.907 - Overhead and indirect construction costs.

    Science.gov (United States)

    2010-04-01

    ... accounting principles; (2) The costs included in the distribution are limited to costs actually incurred by...), part 31, Contract Cost Principles and Procedures, relating to contracts with commercial organizations... 23 Highways 1 2010-04-01 2010-04-01 false Overhead and indirect construction costs. 140.907...

  12. Estimating two indirect logging costs caused by accelerated erosion.

    Science.gov (United States)

    Glen O. Klock

    1976-01-01

    In forest areas where high soil erosion potential exists, a comparative yarding cost estimate, including the indirect costs determined by methods proposed here, shows that the total cost of using "advanced" logging methods may be less than that of "traditional" systems.

  13. 48 CFR 49.303-4 - Adjustment of indirect costs.

    Science.gov (United States)

    2010-10-01

    ... costs. 49.303-4 Section 49.303-4 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS Additional Principles for Cost-Reimbursement Contracts... compute indirect costs for other contracts performed during the applicable accounting period. [48 FR 42447...

  14. 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.

  15. How to Prepare an Indirect Cost Rate Proposal for a Non-profit Organization

    Science.gov (United States)

    The indirect cost rate proposal is the documentation prepared by a grantee organization, in accordance with applicable federal cost principles, to substantiate its claim for the reimbursement of indirect costs.

  16. 50 CFR 680.44 - Cost recovery.

    Science.gov (United States)

    2010-10-01

    ...) Publication—(i) General. During the first quarter of each crab fishing year, NMFS shall calculate the crab fee... Management Measures § 680.44 Cost recovery. (a) Cost recovery fees—(1) Responsibility. The person documented... holder's liability for noncompliance with this section. (2) Fee liability determination. (i) All CR...

  17. Utility loss and indirect costs after stroke in Sweden.

    Science.gov (United States)

    Lindgren, Peter; Glader, Eva-Lotta; Jönsson, Bengt

    2008-04-01

    Currently little data exist on the development of quality of life over time in patients suffering from stroke, in particular using instruments that can be adapted in economic studies. The purpose of the study was to assess the utility loss and indirect costs following a stroke in Sweden. A cross-sectional mail survey. In collaboration with the National Stroke registry (RIKS-STROKE), a questionnaire consisting of the EuroQol-5D and questions regarding the present working status and the status prior to the stroke was mailed to patients below 76 years of age at six participating centres. The questionnaire was mailed to 393 patients in total, divided into groups with 3, 6, 9 or 12 months having passed since the stroke. The EuroQol-5D scores were converted to utility scores using the UK social tariff. Indirect costs were valued according to the average salary+employer contributions. A total of 275 questionnaires (70%) were returned. Utility scores were similar over time: 0.65, 0.75, 0.63, and 0.67 at 3, 6, 9 and 12 months, respectively. Regression analyses revealed a tendency for lower utility scores among women, but no significant differences overall. Among patients in the working ages, a stroke caused 18.5 work weeks lost, corresponding to an indirect cost of 120,000 Swedish Kronor (SEK) (13,200euro, 95% confidence interval 82,541-160,050 SEK, 9080-17 605euro). Stroke causes a significant reduction in utility and causes high indirect costs. A substantial improvement was not noted over time, which is important to consider in economic models.

  18. Indirect Costs: Daily Bread, Cake, or Cracker.

    Science.gov (United States)

    Lucas, Robert A.

    1988-01-01

    The tradition of negotiating indirect costs in grants should be abandoned, and research administrators should instead offer different levels of service depending on what the sponsor wants to spend. Three levels of overhead rate are suggested (super, regular, and economy) and their corresponding levels of service are defined. (MSE)

  19. Indirect costs of inflammatory bowel diseases: Crohn's disease and ulcerative colitis. A systematic review.

    Science.gov (United States)

    Kawalec, Paweł

    2016-04-01

    Crohn's disease and ulcerative colitis are lifelong illnesses which have a significant impact on quality of life and personal burden through a reduction in the ability to work, sick leave and restrictions of leisure time. The aim of this study was to conduct a systematic review of the indirect costs of Crohn's disease and ulcerative colitis. The search was carried out in Medline, EMBASE, the Centre for Reviews and Dissemination, and reference lists of identified articles and reference lists of identified articles were also handsearched. All costs were adjusted to 2013 USD values by using the consumer price index and purchasing power parity. Identified studies were then analysed in order to assess their heterogeneity and possibility of inclusion in the meta-analysis. Eleven of the identified publications presented indirect costs of Crohn's disease or ulcerative colitis. The range of estimated yearly indirect costs per patient was large, from $1 159.09 for loss of earnings to $14 135.64 for lost productivity and sick leave for Crohn's disease. The values for ulcerative colitis ranged from $926.49 to $6 583.17. Because of the imprecise definition of methods of indirect cost calculations as well as heterogeneity of indirect cost components, a meta-analysis was not performed. The indirect costs of ulcerative colitis seem to be slightly lower than in the case of Crohn's disease. A small number of studies referring to indirect costs of Crohn's disease and ulcerative colitis were identified, which indicates the need to conduct further investigations on this problem.

  20. Direct and indirect economic costs among private-sector employees with osteoarthritis.

    Science.gov (United States)

    Berger, Ariel; Hartrick, Craig; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

    2011-11-01

    To estimate direct and indirect economic costs among private-sector employees with osteoarthritis (OA). Using a large US employer benefits database, we identified all employees with evidence of OA during calendar year 2007, and compared their costs of health care and work loss to age-and-sex-matched employees without evidence of OA in that year. Private-sector employees with OA (n = 2399) averaged 62.9 days of absenteeism versus 36.7 days among matched comparators (n = 2399) (P Private-sector employees with OA have higher direct and indirect costs than those without this condition.

  1. Issues connected with indirect cost quantification: a focus on the transportation system

    Science.gov (United States)

    Křivánková, Zuzana; Bíl, Michal; Kubeček, Jan; Vodák, Rostislav

    2017-04-01

    Transportation and communication networks in general are vital parts of modern society. The economy relies heavily on transportation system performance. A number of people commutes to work regularly. Stockpiles in many companies are being reduced as the just-in-time production process is able to supply resources via the transportation network on time. Natural hazards have the potential to disturb transportation systems. Earthquakes, flooding or landsliding are examples of high-energetic processes which are capable of causing direct losses (i.e. physical damage to the infrastructure). We have focused on quantification of the indirect cost of natural hazards which are not easy to estimate. Indirect losses can also emerge as a result of meteorological hazards with low energy which only seldom cause direct losses, e.g. glaze, snowfall. Whereas evidence of repair work and general direct costs usually exist or can be estimated, indirect costs are much more difficult to identify particularly when they are not covered by insurance agencies. Delimitations of alternative routes (detours) are the most frequent responses to blocked road links. Indirect costs can then be related to increased fuel consumption and additional operating costs. Detours usually result in prolonged travel times. Indirect costs quantification has to therefore cover the value of the time. The costs from the delay are a nonlinear function of travel time, however. The existence of an alternative transportation pattern may also result in an increased number of traffic crashes. This topic has not been studied in depth but an increase in traffic crashes has been reported when people suddenly changed their traffic modes, e.g. when air traffic was not possible. The lost user benefit from those trips that were cancelled or suppressed is also difficult to quantify. Several approaches, based on post-event questioner surveys, have been applied to communities and companies affected by transportation accessibility

  2. 78 FR 53425 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2013-08-29

    ... method continues to be the Direct Labor Cost Base for all three DARRP component organizations. The Direct... allocation method for the development of the FY 2012 indirect cost rates. The DARRP's Indirect Cost Rates and... accounting system and allocation practices; recommend the appropriate indirect cost allocation methodology...

  3. Productivity loss due to overweight and obesity: a systematic review of indirect costs.

    Science.gov (United States)

    Goettler, Andrea; Grosse, Anna; Sonntag, Diana

    2017-10-05

    The increasingly high levels of overweight and obesity among the workforce are accompanied by a hidden cost burden due to losses in productivity. This study reviews the extent of indirect cost of overweight and obesity. A systematic search was conducted in eight electronic databases (PubMed, Cochrane Library, Web of Science Core Collection, PsychInfo, Cinahl, EconLit and ClinicalTrial.gov). Additional studies were added from reference lists of original studies and reviews. Studies were eligible if they were published between January 2000 and June 2017 and included monetary estimates of indirect costs of overweight and obesity. The authors reviewed studies independently and assessed their quality. Of the 3626 search results, 50 studies met the inclusion criteria. A narrative synthesis of the reviewed studies revealed substantial costs due to lost productivity among workers with obesity. Especially absenteeism and presenteeism contribute to high indirect costs. However, the methodologies and results vary greatly, especially regarding the cost of overweight, which was even associated with lower indirect costs than normal weight in three studies. The evidence predominantly confirms substantial short-term and long-term indirect costs of overweight and obesity in the absence of effective customised prevention programmes and thus demonstrates the extent of the burden of obesity beyond the healthcare sector. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Development of subcontractor indirect cost and other direct cost at the DOE Fernald Site

    International Nuclear Information System (INIS)

    Cossman, R.L.

    1994-01-01

    The Fernald Environmental Restoration Management Corporation (FERMCO) took great strides in the development of cost estimates at Fernald. There have been many opportunities to improve on how the policies and procedures pertaining to cost estimates were to be implemented. As FERMCO took over the existing Fernald facility, the Project Controls Division began to format the estimating procedures and tools to do business at Fernald. The Estimating Department looked at the problems that pre-existed at the site. One of the key problems that FERMCO encountered was how to summarized the direct and indirect accounts of each subcontracted estimate. Direct costs were broken down by prime and sub-prime accounts. This presented a level of detail that had not been experienced at the site before; it also created many issues concerning accounts and definitions to be applied to ''all other accounts associated with a project.'' Existing subcontract indirect cost accounts were reviewed from existing historical estimates. It was found that some were very detailed and some were not. The Estimating Department was given the task of standardizing the accounts and percentages for each of the subcontractor indirect costs. Then, as the project progressed, the percentages could be revised with actual estimates, subcontract comparisons, or with level of effort (LOE) accounts, which would represent qualified people assigned a task for the completion of each project. The approach is to assign particular employees to perform a specific task within a project from start to finish, and then to reassign the individual(s) to a new project (if it was available) integrating the expertise available with the skills required by the other operable units

  5. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    NARCIS (Netherlands)

    F.M. Rabacow (Fabiana Maluf); O. Do Carmo Luiz (Olinda); A.M. Malik (Ana Maria); A. Burdorf (Alex)

    2014-01-01

    textabstractObjective: To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. Methods: In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave

  6. Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

    Science.gov (United States)

    Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

    2016-12-01

    Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic

  7. 77 FR 63804 - Federal Acquisition Regulation; Information Collection; Indirect Cost Rates

    Science.gov (United States)

    2012-10-17

    ... cost accounting information normally prepared by organizations under sound management and accounting...; Information Collection; Indirect Cost Rates AGENCY: Department of Defense (DOD), General Services... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and...

  8. Direct and indirect healthcare costs of rheumatoid arthritis patients in Turkey.

    Science.gov (United States)

    Hamuryudan, Vedat; Direskeneli, Haner; Ertenli, Ihsan; Inanc, Murat; Karaaslan, Yasar; Oksel, Fahrettin; Ozbek, Suleyman; Pay, Salih; Terzioglu, Ender; Balkan Tezer, Dilara; Hacibedel, Basak; Akkoc, Nurullah

    2016-01-01

    To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. The study included 689 RA patients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9.4±7.8 years. The mean scores of the Routine Assessment of Patient Index Data 3 and the Health Assessment Questionnaire-Disability Index (5.08±2.34 and 1.08±0.68, respectively) indicated moderate disease activity and severity for the whole group. One-third of the patients were on biologic agents and 12% had co-morbid conditions. The mean number of annual outpatient visits was 11.7±9.6 per patient. Of the patients, 15% required hospitalisation and 4% underwent surgery. The mean annual direct cost was € 4,954 (median, € 1,805), whereas the mean annual indirect cost was € 2,802 (median, € 608). Pharmacy costs accounted for the highest expenditure (mean, € 2,777; median, € 791), followed by the RA-related consultations and expenses (mean, € 1,600; median, € 696). RA has a substantial economic burden in Turkey, direct costs being higher than indirect costs. Although both direct and indirect costs are lower in Turkey than in Europe with respect to nominal Euro terms, they are higher from the perspectives of purchasing power parity and gross domestic product. Early diagnosis and treatment of RA may positively affect the national economy considering the positive correlation between health care utilisations and increased cost with disease severity.

  9. The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece.

    Science.gov (United States)

    Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Tzanakis, Nikos; Toumbis, Michalis; Vassilakopoulos, Theodoros

    2017-01-01

    COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs). In addition, absenteeism and caregiver's costs were recorded in order to quantify indirect COPD costs. The total costs of managing COPD per patient per year were estimated at €4,730, with direct (medical and nonmedical) and indirect costs accounting for 62.5% and 37.5%, respectively. COPD exacerbations were responsible for 32% of total costs (€1,512). Key exacerbation-related cost drivers were hospitalization (€830) and intensive care unit (ICU) admission costs (€454), jointly accounting for 85% of total exacerbation costs. Annual maintenance phase costs were estimated at €835, with pharmaceutical treatment accounting for 77% (€639.9). Patient time costs were estimated at €146 per year. The average number of sick days per year was estimated at 16.9, resulting in productivity losses of €968. Caregiver's costs were estimated at €806 per year. The management of COPD in Greece is associated with intensive resource use and significant economic burden. Exacerbations and productivity losses are the key cost drivers. Cost containment policies should focus on prioritizing treatments that increase patient compliance as these can lead to reduction of exacerbations, longer maintenance phases, and thus lower costs.

  10. [Direct and indirect costs of fractures due to osteoporosis in Austria].

    Science.gov (United States)

    Dimai, H-P; Redlich, K; Schneider, H; Siebert, U; Viernstein, H; Mahlich, J

    2012-10-01

    We examined the financial burden of osteoporosis in Austria. We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. While there exist similar studies for other countries, this is the first comprehensive study for Austria. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria. Our estimation of the total annual costs in the year 2008 imposed by osteoporosis in Austria is 707.4 million €. The largest fraction of this amount is incurred by acute hospital treatment. Another significant figure, accounting for 29% of total costs, is the opportunity cost of informal care. The financial burden of osteoporosis in Austria is substantial. Economic evaluations of preventive and therapeutic interventions for the specific context of Austria are needed to inform health policy decision makers. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

    Science.gov (United States)

    Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

    2012-06-13

    Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

  12. Stranded cost recovery in electricity market reforms in the US

    International Nuclear Information System (INIS)

    Woo, C.K.; Lloyd, D.; Karimov, R.; Tishler, A.

    2003-01-01

    An important element of an electricity market reform is stranded cost recovery. This paper explains the cause of stranded costs, describes four recovery mechanisms, evaluates these mechanisms using the criteria of recovery certainty, economic efficiency and equity, reviews the financial performance of 12 utilities in the US in connection to stranded cost recovery, and shows why the mechanism used in California has contributed to the reform failure in that state. (Author)

  13. Indirect costs and workplace productivity loss associated with non-Hodgkin lymphoma.

    Science.gov (United States)

    Yu, Justin S; Hansen, Ryan N; Valderrama, Adriana; Carlson, Josh J

    2016-11-01

    The objective of this study was to examine indirect costs and workplace productivity loss (defined as an aggregate measure of absenteeism, short-term disability, and long-term disability days) associated with non-Hodgkin lymphoma (NHL) from a societal perspective in a commercially insured working-age United States population. The MarketScan(®) Commercial Claims and Encounters and Health and Productivity Management Databases (2007-2013) were used in this study, with controls matched 3:1 to NHL patients. In comparison to controls, NHL patients incurred significantly more workplace productivity loss (31.99 days; 95% CI: 25.24 days, 38.73 days; p workplace productivity and higher associated indirect costs.

  14. 76 FR 65182 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2011-10-20

    ... determined that the most appropriate indirect allocation method continues to be the Direct Labor Cost Base... Cost Base is the most appropriate indirect allocation method for the development of the FY 2009 and FY... the Direct Labor Cost Base allocation methodology. The FY 2009 rates will be applied to all damage...

  15. 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…

  16. Study on the feasibility of implementing a cost-recovery program

    International Nuclear Information System (INIS)

    1988-02-01

    The AECB does not currently have an adequate legal basis for cost recovery. The use of amendments to the AEC (Atomic Energy Control) Act or Regulations to effect cost recovery would entail too high a risk of successful legal challenge and political complications which could adversely affect the AECB's operational effectiveness. In the time frame envisaged by Treasury Board Secretariat for the AECB to collect fees, it is not practical to amend the AEC Act to make it binding on the Crown, and specifically to authorize the AECB to recover its costs. The only practical approach to providing a sound legal basis for cost recovery is through amendment of the Financial Administration Act. Studies to date have provided a basis to establish options for cost recovery which may be practical, provided that a sound legal basis is established. Studies to date have not provided a basis to evaluate the impact of any of these options on the development, application, and use of atomic energy in Canada, or on the regulatory effectiveness of the AECB. While the principle of cost-recovery has been decided by the Treasury Board, public consultations are needed to evaluate impact and to arrive at a final decision on the extent of cost recovery. Such consultations are required by the government's Regulatory Process Action Plan. Cost recovery is likely to generate a strong negative reaction from the nuclear industry, some of which may affect the ability of the AECB to implement an effective regulatory program

  17. Indirect costs of diabetes and its impact on the public finance: the case of Poland.

    Science.gov (United States)

    Torój, Andrzej; Mela, Aneta

    2018-02-01

    Growing public and private expenditure on healthcare results i.a. from the spreading of chronic diseases. Diabetes belongs to the most frequent ones, beyond neoplasms and cardiological diseases, and hence generates a significant burden for the public finance in terms of the direct costs. However, the economy suffers also from the indirect cost of diabetes that manifests itself in the loss in Gross Domestic Product (GDP) and general government revenues. This paper aims to measure this indirect cost, both in terms of GDP drop (social perspective) and public revenue drop (public finance perspective), in the case of Poland in 2012-2014. We use a modified human capital approach and unique dataset provided by the Social Security institution in Poland and the Polish Central Statistical Office. Diabetes is a substantial and growing burden for the Polish economy. In the years 2012, 2013 and 2014 the indirect cost (output loss) amounted to 1.85 bn USD, 1.94 bn USD and 2.00 bn USD respectively. Estimated indirect cost of diabetes can be a useful input for health technology analyses of drugs or economic impact assessments of public health programmes.

  18. 77 FR 7237 - Railroad Cost Recovery Procedures-Productivity Adjustment

    Science.gov (United States)

    2012-02-10

    ... Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board. ACTION: Proposed railroad cost recovery procedures productivity adjustment. SUMMARY: In a decision served on... productivity for the 2006-2010 (5-year) averaging period. This represents a 0.6% decrease over the average for...

  19. 78 FR 10262 - Railroad Cost Recovery Procedures-Productivity Adjustment

    Science.gov (United States)

    2013-02-13

    ... Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board, DOT. ACTION: Proposed railroad cost recovery procedures productivity adjustment. SUMMARY: In a decision served on... productivity for the 2007-2011 (5-year) averaging period. This represents a 0.1% increase over the average for...

  20. 78 FR 25443 - Federal Acquisition Regulation; Submission for OMB Review; Indirect Cost Rates

    Science.gov (United States)

    2013-05-01

    ... supporting cost data are the cost accounting information normally prepared by organizations under sound management and accounting practices. The proposal and supporting data is used by the contracting official and...; Submission for OMB Review; Indirect Cost Rates AGENCY: Department of Defense (DOD), General Services...

  1. 75 FR 16575 - Railroad Cost Recovery Procedures-Productivity Adjustment

    Science.gov (United States)

    2010-04-01

    ...)] Railroad Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board. ACTION: Adoption of a railroad cost recovery procedures productivity adjustment. SUMMARY: By decision served on February 1, 2010, the Board proposed to adopt 1.010 (1.0% per year) as the 2008 productivity adjustment, as...

  2. 75 FR 5170 - Railroad Cost Recovery Procedures-Productivity Adjustment

    Science.gov (United States)

    2010-02-01

    ...)] Railroad Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board, DOT. ACTION: Proposed Railroad Cost Recovery Procedures Productivity Adjustment. SUMMARY: In a decision served... railroad productivity for the 2004-2008 (5-year) averaging period. This is a decline of 0.5 of a percentage...

  3. 40 CFR 35.928-4 - Moratorium on industrial cost recovery payments.

    Science.gov (United States)

    2010-07-01

    ... industrial users defined in paragraphs (a) and (b) of the definition in § 35.905 pay industrial cost recovery... industrial cost recovery charges incurred for accounting periods or portions of periods ending before January... defined in paragraphs (a) and (b) of the definition in § 35.905 to pay industrial cost recovery payments...

  4. [Prevalence and indirect costs of headache in a Brazilian Company].

    Science.gov (United States)

    Vincent, M; Rodrigues, A de J; De Oliveira, G V; De Souza, K F; Doi, L M; Rocha, M B; Saporta, M A; Orleans, R B; Kotecki, R; Estrela, V V; De Medeiros, V A; Borges, W I

    1998-12-01

    Employees from a Brazilian oil company research centre (n = 993) were interviewed on the occurrence of headache during a 30 days period. Headache prevalence was 49.8%, with a mean frequency of 4.3 +/- 7.0 attacks per month, lasting 12.2 +/- 21.4 hours each. According to the International Headache Society diagnostic criteria, migraine (5.5%), episodic tension-type headache (26.4%), chronic tension-type headache (1.7%) and headaches not fulfilling the criteria for such disorders (16.2%) were observed. Women suffered comparatively more headache and specifically migraine than men. The pain interfered with work productivity in 10% of the subjects, corresponding to 538.75 hours off. According to an indirect costs estimation for each headache, the company may loose up to US$125.98 per employee annually. Since among headaches migraine has the highest indirect cost, migraine prevention and treatment is particularly important at the working environment. Migraine frequency may be prevented to a large extent, resulting on positive effects in both the quality of life and productivity. The cost-benefit ratio clearly favours therapeutic and preventive programs against chronic headaches.

  5. 26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Qualified enhanced oil recovery costs. 1.43-4... TAXES Credits Against Tax § 1.43-4 Qualified enhanced oil recovery costs. (a) Qualifying costs—(1) In... “qualified enhanced oil recovery costs” if the amounts are paid or incurred with respect to an asset which is...

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

    Directory of Open Access Journals (Sweden)

    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

  7. Costs of endometriosis in Austria: a survey of direct and indirect costs.

    Science.gov (United States)

    Prast, Johanna; Oppelt, Peter; Shamiyeh, Andreas; Shebl, Omar; Brandes, Iris; Haas, Dietmar

    2013-09-01

    The literature includes a wealth of medical data on endometriosis, but the economic significance of the condition has so far been neglected. An analysis of hospital costs for endometriosis in Austria was, therefore, carried out for economic purposes. Seventy-three patients with endometriosis were included in the study. A bottom-up approach was used to collect data on the average hospital costs of an endometriosis patient over a time period of 1 year. In addition, a prevalence approach was used that allows subsequent estimation of the total costs of endometriosis for the health-care system in Austria for that period. Retrospective questionnaire survey was conducted. The average annual costs of one case of endometriosis are 7,712, with 5,605.55 attributable to direct costs and 2,106.34 to indirect costs. This indicates an overall economic burden of 328 million. In-patient care (45 %) and loss of productivity (27 %) were identified as the major cost factors. The patients themselves pay for 13 % of the costs (through out-of-pocket payments). This study impressively demonstrates the financial burden on the economy and on each individually affected patient caused by the disease of endometriosis. The massive consumption of resources represents a high level of usage of the medical services provided. The question arises as to whether more timely diagnosis, followed by better-targeted treatment, might have the potential to reduce these costs. The overall economic burden of endometriosis in Austria is currently comparable with that of Parkinson's disease.

  8. Resource-recovery facilities: Production and cost functions, and debt-financing issues

    International Nuclear Information System (INIS)

    Simonsen, W.S.

    1991-01-01

    Some of the fiscal questions relating to resource-recovery, or trash-burning, facilities are addressed. Production and cost functions for resource-recovery facilities are estimated using regression analysis. Whether or not there are returns to scale are addressed using the production and cost-function framework. Production functions are also estimated using data envelopment analysis (DEA), and results are compared to the regression results. DEA is a linear-program-based technique that can provide information about the production process. The data used to estimate the production and cost functions were collected from the Resource Recovery Yearbook. Once the decision is made to construct a resource-recovery facility, it needs to be financed. The high cost of these facilities usually prohibits financing construction out of regular operating revenues. Therefore, the issues a government faces when debt is used to finance a resource-recovery facility are analyzed. The most important public policy finding is that increasing economies of scale do not seem to be present for resource-recovery facilities

  9. Direct and indirect costs of tuberculosis among immigrant patients in the Netherlands.

    Science.gov (United States)

    Kik, Sandra V; Olthof, Sandra P J; de Vries, Jonie T N; Menzies, Dick; Kincler, Naomi; van Loenhout-Rooyakkers, Joke; Burdo, Conny; Verver, Suzanne

    2009-08-05

    In low tuberculosis (TB) incidence countries TB affects mostly immigrants in the productive age group. Little empirical information is available about direct and indirect TB-related costs that patients face in these high-income countries. We assessed the direct and indirect costs of immigrants with TB in the Netherlands. A cross-sectional survey at 14 municipal health services and 2 specialized TB hospitals was conducted. Interviews were administered to first or second generation immigrants, 18 years or older, with pulmonary or extrapulmonary TB, who were on treatment for 1-6 months. Out of pocket expenditures and time loss, related to TB, was assessed for different phases of the current TB illness. In total 60 patients were interviewed. Average direct costs spent by households with a TB patient amounted euro353. Most costs were spent when being hospitalized. Time loss (mean 81 days) was mainly due to hospitalization (19 days) and additional work days lost (60 days), and corresponded with a cost estimation of euro2603. Even in a country with a good health insurance system that covers medication and consultation costs, patients do have substantial extra expenditures. Furthermore, our patients lost on average 2.7 months of productive days. TB patients are economically vulnerable.

  10. Direct and indirect costs of tuberculosis among immigrant patients in the Netherlands

    Directory of Open Access Journals (Sweden)

    Kincler Naomi

    2009-08-01

    Full Text Available Abstract Background In low tuberculosis (TB incidence countries TB affects mostly immigrants in the productive age group. Little empirical information is available about direct and indirect TB-related costs that patients face in these high-income countries. We assessed the direct and indirect costs of immigrants with TB in the Netherlands. Methods A cross-sectional survey at 14 municipal health services and 2 specialized TB hospitals was conducted. Interviews were administered to first or second generation immigrants, 18 years or older, with pulmonary or extrapulmonary TB, who were on treatment for 1–6 months. Out of pocket expenditures and time loss, related to TB, was assessed for different phases of the current TB illness. Results In total 60 patients were interviewed. Average direct costs spent by households with a TB patient amounted €353. Most costs were spent when being hospitalized. Time loss (mean 81 days was mainly due to hospitalization (19 days and additional work days lost (60 days, and corresponded with a cost estimation of €2603. Conclusion Even in a country with a good health insurance system that covers medication and consultation costs, patients do have substantial extra expenditures. Furthermore, our patients lost on average 2.7 months of productive days. TB patients are economically vulnerable.

  11. 77 FR 8219 - Notice of Indirect Cost Rates for the Office of National Marine Sanctuaries for Fiscal Years 2008...

    Science.gov (United States)

    2012-02-14

    ... requirements. C&C also determined that the most appropriate indirect allocation method was the Direct Labor... most appropriate indirect allocation method for the development of the FY 2008 and 2009 indirect cost... October 1, 2008 and present, using the Direct Labor Cost base allocation methodology. For cases that have...

  12. Earthquake recovery of historic buildings: exploring cost and time needs.

    Science.gov (United States)

    Al-Nammari, Fatima M; Lindell, Michael K

    2009-07-01

    Disaster recovery of historic buildings has rarely been investigated even though the available literature indicates that they face special challenges. This study examines buildings' recovery time and cost to determine whether their functions (that is, their use) and their status (historic or non-historic) affect these outcomes. The study uses data from the city of San Francisco after the 1989 Loma Prieta earthquake to examine the recovery of historic buildings owned by public agencies and non-governmental organisations. The results show that recovery cost is affected by damage level, construction type and historic status, whereas recovery time is affected by the same variables and also by building function. The study points to the importance of pre-incident recovery planning, especially for building functions that have shown delayed recovery. Also, the study calls attention to the importance of further investigations into the challenges facing historic building recovery.

  13. Large and abundant flowers increase indirect costs of corollas: a study of coflowering sympatric Mediterranean species of contrasting flower size.

    Science.gov (United States)

    Teixido, Alberto L; Valladares, Fernando

    2013-09-01

    Large floral displays receive more pollinator visits but involve higher production and maintenance costs. This can result in indirect costs which may negatively affect functions like reproductive output. In this study, we explored the relationship between floral display and indirect costs in two pairs of coflowering sympatric Mediterranean Cistus of contrasting flower size. We hypothesized that: (1) corolla production entails direct costs in dry mass, N and P, (2) corollas entail significant indirect costs in terms of fruit set and seed production, (3) indirect costs increase with floral display, (4) indirect costs are greater in larger-flowered sympatric species, and (5) local climatic conditions influence indirect costs. We compared fruit set and seed production of petal-removed flowers and unmanipulated control flowers and evaluated the influence of mean flower number and mean flower size on relative fruit and seed gain of petal-removed and control flowers. Fruit set and seed production were significantly higher in petal-removed flowers in all the studied species. A positive relationship was found between relative fruit gain and mean individual flower size within species. In one pair of species, fruit gain was higher in the large-flowered species, as was the correlation between fruit gain and mean number of open flowers. In the other pair, the correlation between fruit gain and mean flower size was also higher in the large-flowered species. These results reveal that Mediterranean environments impose significant constraints on floral display, counteracting advantages of large flowers from the pollination point of view with increased indirect costs of such flowers.

  14. Universal access, cost recovery, and payment services

    OpenAIRE

    Sujit Chakravorti; Jeffery W. Gunther; Robert R. Moore

    2005-01-01

    We suggest a subtle, yet far- reaching, tension in the objectives specified by the Monetary Control Act of 1980 (MCA) for the Federal Reserve’s role in providing retail payment services, such as check processing. Specifically, we argue that the requirement of an overall cost-revenue match, coupled with the goal of ensuring equitable access on a universal basis, partially shifted the burden of cost recovery from high-cost to low-cost service points during the MCA’s early years, thereby allowin...

  15. Direct and indirect costs of Multiple Sclerosis in Baix Llobregat (Catalonia, Spain, according to disability

    Directory of Open Access Journals (Sweden)

    Gubieras Laura

    2006-11-01

    Full Text Available Abstract Background Multiple sclerosis (MS is an incurable chronic disease that predominantly affects young adults. It has a high socio-economic impact which increases as disability progresses. An assessment of the real costs of MS may contribute to our knowledge of the disease and to treat it more efficiently. Our objective is to assess the direct and indirect costs of MS from a societal perspective, in patients monitored in our MS Unit (Baix Llobregat, Catalonia and grouped according to their disability (EDSS. Methods We analysed data from 200 MS patients, who answered a questionnaire on resource consumption, employment and economical status. Mean age was 41.6 years, mean EDSS 2.7, 65.5% of patients were female, 79.5% had a relapsing-remitting course, and 67.5% of them were receiving immunomodulatory treatment (IT. Patients were grouped into five EDSS stages. Data from the questionnaires, hospital charts, Catalan Health Service tariffs, and figures from Catalan Institute of Statistics were used to calculate the direct and indirect costs. The cost-of-illness method, and the human capital approach for indirect costs, were applied. Sensitivity analyses were performed to strengthen results. Results The mean total annual cost of MS per patient results 24272 euros. This cost varied according to EDSS: 14327 euros (EDSS = 0, 18837 euros (EDSS = 1–3, 27870 euros (EDSS = 3.5–5.5, 41198 euros (EDSS = 6–7 and 52841 euros (EDSS>7.5. When the mean total annual costs was adjusted by the mean % of patients on IT in our Unit (31% the result was 19589 euros. The key-drivers for direct costs were IT in low EDSS stages, and caregiver costs in high stages. Indirect costs were assessed in terms of the loss of productivity when patients stop working. Direct costs accounted for around 60% of total costs in all EDSS groups. IT accounts from 78% to 11% of direct costs, and decreased as disability progressed. Conclusion The total mean social costs of MS in a

  16. Cost analysis and ecological benefits of environmental recovery methodologies in bauxite mining

    OpenAIRE

    Guimarães,João Carlos Costa; Barros,Dalmo Arantes de; Pereira,José Aldo Alves; Silva,Rossi Allan; Oliveira,Antonio Donizette de; Borges,Luís Antônio Coimbra

    2013-01-01

    This work analyzed and compared three methods of environmental recovery in bauxite mining commonly used in Poços de Caldas Plateau, MG, by means of recovery costs and ecological benefits. Earnings and costs data of environmental recovery activities were obtained for the areas that belonged to the Companhia Geral de Minas – CGM, on properties sited in the city of Poços de Caldas, MG. The amount of costs of these activities was used to compare the recovery methods by updating them monetarily to...

  17. Marginal cost and congestion in the Italian electricity market: An indirect estimation approach

    International Nuclear Information System (INIS)

    Bigerna, Simona; Andrea Bollino, Carlo; Polinori, Paolo

    2015-01-01

    In this paper we construct an indirect measure of the supply marginal cost function for the main generators from the observed bid data in the Italian electricity market in the period 2004–2007. We compute the residual demand function for each generator, taking explicitly into account the issue of transmission line congestion. This procedure allows recovering correct zonal Lerner index and the implied measure of the marginal cost function. We find evidence of a stable U-shaped marginal cost function for three main Italian generators, but a flat function for ENEL, the former national monopolist. The policy relevance of our approach lies in the possibility to offer some empirical knowledge of the marginal cost function of each generator to the regulator to design appropriate policy measures geared to the promotion of competitive market conditions. We propose a new market surveillance mechanism, which is based on the principle of sanctioning excessive deviations from the estimated measure of the marginal cost function presented in this work. -- Highlights: •We construct an indirect measure of the supply marginal cost function. •We compute the residual demand function taking into account transmission line congestion. •We find a general evidence of a stable U-shaped marginal cost function for Italian generators. •We find flat marginal cost function for the former national monopolist. •We use excessive deviations from estimated marginal cost function as a new market surveillance mechanism

  18. The Societal Benefits and Costs of School Dropout Recovery

    Directory of Open Access Journals (Sweden)

    James S. Catterall

    2011-01-01

    Full Text Available This article reports an analysis of the societal benefits and costs of recovering school dropouts. Successful recovery is defined by subsequent graduation from high school. The analysis is based on established estimates of the societal costs of dropping out including reduced government tax collections and higher social costs of welfare, healthcare, and crime. These potential costs are cast as benefits when a dropout is recovered. A large dropout recovery program provides the setting for the analysis. Rigorous attention is given to accurate estimation of the number of students who would not have graduated without the program in the year assessed and to the induced public costs of their continued education. Estimated benefits are weighed against the total annual public costs of the program, which operates in 65 school centers and commands an annual budget of about $70 million. The estimated benefit-cost ratio for this program is 3 to 1, a figure comparable to benefit-cost ratio estimates reported in studies of dropout prevention. The sensitivity of this conclusion to specific assumptions within the analysis is discussed.

  19. 40 CFR 35.928-3 - Implementation of the industrial cost recovery system.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Implementation of the industrial cost...-Clean Water Act § 35.928-3 Implementation of the industrial cost recovery system. (a) When a grantee's industrial cost recovery system is approved, implementation of the approved system shall become a condition...

  20. Indirect costs in chronic obstructive pulmonary disease: A review of the economic burden on employers and individuals in the United States

    Science.gov (United States)

    Patel, Jeetvan G; Nagar, Saurabh P; Dalal, Anand A

    2014-01-01

    Objective To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US. Methods Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Results Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987–2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%–18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27–63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3–19.4 days. Estimates of bed confinement range from 13–32 days per year. Estimated mean annual indirect costs were $893–$2,234/person (US dollars) with COPD ($1,521–$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%–61% of total costs, depending on the population studied. Conclusions COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD. PMID:24672234

  1. Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.

    LENUS (Irish Health Repository)

    Hannon, Niamh

    2014-10-30

    No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.

  2. Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference.

    Science.gov (United States)

    Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M

    2017-12-01

    The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.

  3. Recovery of Indirect Costs in the Pricing of Equitable Adjustments and Terminations for Convenience

    Science.gov (United States)

    1988-05-01

    HORNGREN , COST ACCOUNTING , A MANAGERIAL EMPHASIS, 21 (5th ed. 1982). 2 6FAR Part 31, Contract Cost Principles and Procedures. 2 7 L. ANDERSON...O WOIRECT COSTS /0 5. TYPE OF REPORT & PERIOD COVERED T$0, PEIK~ O ITPA3L-, AO s ~tjQr5 AfJI0 MS THESIS p O12T0MIPJTIOOZ P 0 o, CO V rJiC I rL)C .. S ... Accounting Standards (CAS) 13 C. The Cost Principles 14 D. Measurement of Cost 15 E. Accounting Systems 16 F. Allocation of Costs 17 1. Direct Costs

  4. Indirect health costs in ulcerative colitis and Crohn's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2015-04-01

    The aim of this systematic review was to collect all current data on indirect costs related to inflammatory bowel disease as well as assessing homogeneity and comparability, and conducting a meta-analysis. Costs were collected using databases from Medline, Embase and Centre for Reviews and Dissemination databases, then average annual cost per patient was calculated and expressed in 2013-rate USD using the consumer price index and purchasing power parity (scenario 1) and then adjusted to specific gross domestic product (scenario 2) to make them comparable. The studies were then included in quantitative synthesis using the meta-analysis and bootstrap methods. This systematic review was carried out and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 18 publications, overall annual indirect costs per patient as a result of the quantitative synthesis among all studies eligible for meta-analysis ranged from US$2425.01-US$9622.15 depending on the scenario and model used for analysis. The cost of presenteeism was assessed in only two studies. Considering heterogeneity among all identified studies random-effect model presented the most accurate results of meta-analysis equal to US$7189.27 and US$9622.15 per patient per year for scenario 1 and scenario 2, respectively. This systematic review revealed the existence of a relatively small number of studies that reported on the great economic burden of the disease upon society. A great variety of methodologies and cost components resulted in a very large discrepancy in indirect costs and made meta-analysis difficult to perform, so two scenarios were considered and meta-analysis conducted in subgroups to make data more comparable.

  5. AECB Cost Recovery Fees Regulations, amendment

    International Nuclear Information System (INIS)

    1992-01-01

    The amendments to the AECB Cost Recovery Fees Regulations have been made with a view to simplifying the registration procedure for obtaining such a certificate or approval under the above Transport Regulations. In effect there will no longer be a need for a separate fee system for registered users of certified package designs. (NEA)

  6. Indirect costs in chronic obstructive pulmonary disease: A review of the economic burden on employers and individuals in the United States

    Directory of Open Access Journals (Sweden)

    Patel JG

    2014-03-01

    Full Text Available Jeetvan G Patel,1,2 Saurabh P Nagar,2 Anand A Dalal2 1Pharmacy Administration and Public Health, University of Houston, Houston, TX, 2US Health Outcomes, GlaxoSmithKline, Durham, NC, USA Objective: To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD in the US. Methods: Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Results: Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987–2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%–18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27–63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3–19.4 days. Estimates of bed confinement range from 13–32 days per year. Estimated mean annual indirect costs were $893–$2,234/person (US dollars with COPD ($1,521–$3,348 in 2010 [US dollars] and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect costs, indirect costs accounted for 27%–61% of total costs, depending on the population studied. Conclusions: COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability

  7. Medical Care Cost Recovery National Database (MCCR NDB)

    Data.gov (United States)

    Department of Veterans Affairs — The Medical Care Cost Recovery National Database (MCCR NDB) provides a repository of summary Medical Care Collections Fund (MCCF) billing and collection information...

  8. AECB Cost Recovery Fees Regulations, amendment

    International Nuclear Information System (INIS)

    1991-01-01

    The amendment to the Regulations was published on 24 October 1991 (SOR/91-590,Canada Gazette Part II, Vol.125, No 23). It modifies the list of institutions exempted from paying cost recovery fees (licence fees) to the Atomic Energy Control Board. The exemptions now include educational and health care institutions as well as Departments. (NEA)

  9. 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.

  10. Converting a conventional wired-halogen illuminated indirect ophthalmoscope to a wireless-light emitting diode illuminated indirect ophthalmoscope in less than 1000/- rupees

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2015-01-01

    Full Text Available Aim: To report the "do it yourself" method of converting an existing wired-halogen indirect ophthalmoscope (IO to a wireless-light emitting diode (LED IO and report the preferences of the patients and the ophthalmologists. Subjects and Methods: In this prospective observational study, a conventional IO was converted to wireless-LED IO using easily available, affordable electrical components. Conventional and the converted IO were then used to perform photo-stress test and take the feedback of subjects and the ophthalmologists regarding its handling and illumination characteristics. Results: The cost of conversion to wireless-LED was 815/- rupees. Twenty-nine subjects, mean age 34.3 ΁ 10 years with normal eyes were recruited in the study. Between the two illumination systems, there was no statistical difference in the magnitude of the visual acuity loss and the time to recovery of acuity and the bleached vision on photo-stress test, although the visual recovery was clinically faster with LED illumination. The heat sensation was more with halogen illumination than the LED (P = 0.009. The ophthalmologists rated wireless-LED IO higher than wired-halogen IO on the handling, examination comfort, patient′s visual comfort and quality of the image. Twenty-two (81% ophthalmologists wanted to change over to wireless-LED IO. Conclusions: Converting to wireless-LED IO is easy, cost-effective and preferred over a wired-halogen indirect ophthalmoscope.

  11. Converting a conventional wired-halogen illuminated indirect ophthalmoscope to a wireless-light emitting diode illuminated indirect ophthalmoscope in less than 1000/- rupees.

    Science.gov (United States)

    Kothari, Mihir; Kothari, Kedar; Kadam, Sanjay; Mota, Poonam; Chipade, Snehal

    2015-01-01

    To report the "do it yourself" method of converting an existing wired-halogen indirect ophthalmoscope (IO) to a wireless-light emitting diode (LED) IO and report the preferences of the patients and the ophthalmologists. In this prospective observational study, a conventional IO was converted to wireless-LED IO using easily available, affordable electrical components. Conventional and the converted IO were then used to perform photo-stress test and take the feedback of subjects and the ophthalmologists regarding its handling and illumination characteristics. The cost of conversion to wireless-LED was 815/- rupees. Twenty-nine subjects, mean age 34.3 [formula in text] 10 years with normal eyes were recruited in the study. Between the two illumination systems, there was no statistical difference in the magnitude of the visual acuity loss and the time to recovery of acuity and the bleached vision on photo-stress test, although the visual recovery was clinically faster with LED illumination. The heat sensation was more with halogen illumination than the LED (P = 0.009). The ophthalmologists rated wireless-LED IO higher than wired-halogen IO on the handling, examination comfort, patient's visual comfort and quality of the image. Twenty-two (81%) ophthalmologists wanted to change over to wireless-LED IO. Converting to wireless-LED IO is easy, cost-effective and preferred over a wired-halogen indirect ophthalmoscope.

  12. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Alam Khurshid

    2010-06-01

    Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase

  13. Indirect cost of maternal deaths in the WHO African Region in 2010.

    Science.gov (United States)

    Kirigia, Joses Muthuri; Mwabu, Germano Mwige; Orem, Juliet Nabyonga; Muthuri, Rosenabi Deborah Karimi

    2014-08-31

    An estimated 147,741 maternal deaths occurred in 2010 in 45 of the 47 countries in the African Region of the World Health Organization (WHO). The objective of this study was to estimate the indirect cost of maternal deaths in the Region to provide data for use in advocacy for increased domestic and external investment in multisectoral policy interventions to curb maternal mortality. This study used the cost-of-illness method to estimate the indirect cost of maternal mortality, i.e. the loss in non-health gross domestic product (GDP) attributable to maternal deaths. Estimates on maternal mortality for 2010 from Trends in maternal mortality: 1990 to 2010 published by WHO, UNICEF, UNFPA and the World Bank were used in these calculations. Values for future non-health GDP lost were converted into their present values by applying a 3% discount rate. One-way sensitivity analysis at 5% and 10% discount rates assessed the impact on non-health GDP loss. Indirect cost analysis was undertaken for the countries, categorized under three income groups. Group 1 consisted of nine high and upper middle income countries, Group 2 of 12 lower middle income countries, and Group 3 of 26 low income countries. Estimates for Seychelles in Group 1 and South Sudan in Group 3 were not provided in the source used. The 147,741 maternal deaths that occurred in 45 countries in the African Region in 2010 resulted in a total non-health GDP loss of Int$ 4.5 billion (PPP). About 24.5% of the loss was in Group 1 countries, 44.9% in Group 2 countries and 30.6% in Group 3 countries. This translated into losses in non-health GDP of Int$ 139,219, Int$ 35,440 and Int$ 16,397 per maternal death, respectively, for the three groups. Using discount rates of 5% and 10% reduced the total non-health GDP loss by 19.1% and 47.7%, respectively. Maternal mortality is responsible for a noteworthy level of non-health GDP loss among the countries in the African Region. There is urgent need, therefore, to increase

  14. 76 FR 61089 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

    Science.gov (United States)

    2011-10-03

    ... method continues to be the Direct Labor Cost Base for all three DARRP component organizations. The Direct....gov . Cotton reaffirmed that the Direct Labor Cost Base is the most appropriate indirect allocation... Natural Resources (GCNR).... 83.93 49.49 These rates are based on the Direct Labor Cost Base allocation...

  15. 75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

    Science.gov (United States)

    2010-08-13

    ...] Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY: Federal Emergency Management Agency, DHS... (FEMA) is accepting comments on RP9525.7, Labor Costs--Emergency Work. This is an existing policy that is scheduled for review to ensure that Recovery Directorate policies are up to date, incorporate...

  16. U.S. Department of Education Indirect Cost Determination Guidance for State and Local Government Agencies.

    Science.gov (United States)

    Department of Education, Washington, DC. Office of the Chief Financial and Chief Information Officer.

    This guide provides new direction in financial management and oversight practices for accounting and charging administrative costs as they relate to programs administered by the U.S. Department of Education. The document is divided into six sections. Section 1, which presents general information, offers details on definitions; indirect-cost rates;…

  17. The indirect costs of cancer-related absenteeism in the workplace in Poland.

    Science.gov (United States)

    Macioch, Tomasz; Hermanowski, Tomasz

    2011-12-01

    The aim of this study was to evaluate cancer-related absenteeism costs in Poland. Data on sickness absences and disability were retrieved from the Department of Statistics of the Social Insurance Institution. The cost of lost productivity owing to premature death was estimated from data retrieved from the Polish National Cancer Registry. Absenteeism costs were estimated on the basis of the measure of gross value added per employee. The costs of lost productivity owing to sick leave, disability, and premature death were estimated to be 1.572 billion EUR, 0.504 billion EUR, and 0.535 billion EUR, respectively, in 2009. The indirect costs of lost productivity owing to cancer-related sick leave, disability, and premature death have a substantial effect on the Polish economy. In 2009, they accounted for more than 0.8% of GDP.

  18. Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study

    Directory of Open Access Journals (Sweden)

    Sánchez-Lastres Juan

    2011-09-01

    Full Text Available Abstract Background The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE in Spain. Methods A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE who attended primary care (n = 18 and emergency room/hospital settings (n = 10, covering the regions of Galicia and Asturias (North-west Spain. All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Results Among the 682 enrolled children, 207 (30.4% were rotavirus positive and 170 (25% had received at least one dose of rotavirus vaccine. The mean (standard deviation indirect cost caused by an episode of AGE was estimated at 135.17 (182.70 Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8 Euros vs. 111.6 (163.5 Euros (p Conclusions Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

  19. Direct and indirect costs for adverse drug events identified in medical records across care levels, and their distribution among payers.

    Science.gov (United States)

    Natanaelsson, Jennie; Hakkarainen, Katja M; Hägg, Staffan; Andersson Sundell, Karolina; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K; Gyllensten, Hanna

    2017-11-01

    Adverse drug events (ADEs) cause considerable costs in hospitals. However, little is known about costs caused by ADEs outside hospitals, effects on productivity, and how the costs are distributed among payers. To describe the direct and indirect costs caused by ADEs, and their distribution among payers. Furthermore, to describe the distribution of patient out-of-pocket costs and lost productivity caused by ADEs according to socio-economic characteristics. In a random sample of 5025 adults in a Swedish county, prevalence-based costs for ADEs were calculated. Two different methods were used: 1) based on resource use judged to be caused by ADEs, and 2) as costs attributable to ADEs by comparing costs among individuals with ADEs to costs among matched controls. Payers of costs caused by ADEs were identified in medical records among those with ADEs (n = 596), and costs caused to individual patients were described by socio-economic characteristics. Costs for resource use caused by ADEs were €505 per patient with ADEs (95% confidence interval €345-665), of which 38% were indirect costs. Compared to matched controls, the costs attributable to ADEs were €1631, of which €410 were indirect costs. The local health authorities paid 58% of the costs caused by ADEs. Women had higher productivity loss than men (€426 vs. €109, p = 0.018). Out-of-pocket costs displaced a larger proportion of the disposable income among low-income earners than higher income earners (0.7% vs. 0.2%-0.3%). We used two methods to identify costs for ADEs, both identifying indirect costs as an important component of the overall costs for ADEs. Although the largest payers of costs caused by ADEs were the local health authorities responsible for direct costs, employers and patients costs for lost productivity contributed substantially. Our results indicate inequalities in costs caused by ADEs, by sex and income. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. [Assessing the economic impact of cancer in Chile: a direct and indirect cost measurement based on 2009 registries].

    Science.gov (United States)

    Cid, Camilo; Herrera, Cristian; Rodríguez, Rodrigo; Bastías, Gabriel; Jiménez, Jorge

    2016-08-02

    This paper aims to determine the economic impact that cancer represents to Chile, exploring the share of costs for the most important cancers and the differences between the public and private sector. We used the cost of illness methodology, through the assessment of the direct and indirect costs associated with cancer treatment. Data was obtained from 2009 registries of the Chilean Ministry of Health and the Superintendence of Health. Indirect costs were calculated by days of job absenteeism and potential years of life lost. Over US$ 2.1 billion were spent on cancer in 2009, which represents almost 1% of Chile’s Gross Domestic Product. The direct per capita cost was US$ 47. Indirect costs were 1.92 times more than direct costs. The three types of cancer that embody the highest share of costs were gastric cancer (17.6%), breast cancer (7%) and prostate cancer (4.2%) in the public sector, and breast cancer (14%), lung cancer (7.5%) and prostate cancer (4.1%) in the private sector. On average men spent 30.33% more than women. There are few studies of this kind in Chile and the region. The country can be classified as having a cancer economic impact below the average of those in European Union countries. We expect that this information can be used to develop access policies and resource allocation decision making, and as a first step into further cancer-costing studies in Chile and the Latin American and Caribbean region.

  1. Secukinumab Significantly Reduces Psoriasis-Related Work Impairment and Indirect Costs Compared With Ustekinumab and Etanercept in the United Kingdom.

    Science.gov (United States)

    Warren, R B; Halliday, A; Graham, C N; Gilloteau, I; Miles, L; McBride, D

    2018-05-30

    Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different timepoints and with patient cohorts, including FIXTURE. In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI hours; PASI 50-74: 13.3%/4.45 hours; PASI 75-89: 6.4%/2.14 hours; PASI ≥90: 4.9%/1.65 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P=0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρreduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the UK. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Relationship between patient dependence and direct medical-, social-, indirect-, and informal-care costs in Spain

    Directory of Open Access Journals (Sweden)

    Darbà J

    2015-07-01

    Full Text Available Josep Darbà,1 Lisette Kaskens2 1Department of Economics, University of Barcelona, 2BCN Health Economics and Outcomes Research SL, Barcelona, Spain Objective: The objectives of this analysis were to examine how patients' dependence on others relates to costs of care and explore the incremental effects of patient dependence measured by the Dependence Scale on costs for patients with Alzheimer's disease (AD in Spain. Methods: The Co-Dependence in Alzheimer's Disease study is an 18 multicenter, cross-sectional, observational study among patients with AD according to the clinical dementia rating score and their caregivers in Spain. This study also gathered data on resource utilization for medical care, social care, caregiver productivity losses, and informal caregiver time reported in the Resource Utilization in Dementia Lite instrument and a complementary questionnaire. The data of 343 patients and their caregivers were collected through the completion of a clinical report form during one visit/assessment at an outpatient center or hospital, where all instruments were administered. The data collected (in addition to clinical measures also included sociodemographic data concerning the patients and their caregivers. Cost analysis was based on resource use for medical care, social care, caregiver productivity losses, and informal caregiver time reported in the Resource Utilization in Dementia Lite instrument and a complementary questionnaire. Resource unit costs were applied to value direct medical-, social-, and indirect-care costs. A replacement cost method was used to value informal care. Patient dependence on others was measured using the Dependence Scale, and the Cumulative Index Rating Scale was administered to the patient to assess multi-morbidity. Multivariate regression analysis was used to model the effects of dependence and other sociodemographic and clinical variables on cost of care. Results: The mean (standard deviation costs per patient

  3. Life-Cycle Costing of Food Waste Management in Denmark: Importance of Indirect Effects

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Tonini, Davide; Møller, Flemming

    2016-01-01

    assessment combined with life-cycle assessment, to evaluate food waste management. Both life-cycle costing assessments included direct and indirect effects. The latter are related to income effects, accounting for the marginal consumption induced when alternative scenarios lead to different household......Prevention has been suggested as the preferred food waste management solution compared to alternatives such as conversion to animal fodder or to energy. In this study we used societal life-cycle costing, as a welfare economic assessment, and environmental life-cycle costing, as a financial...... be included whenever alternative scenarios incur different financial costs. Furthermore, it highlights that food prevention measures should not only demote the purchase of unconsumed food but also promote a low-impact use of the savings generated....

  4. Cost analysis and ecological benefits of environmental recovery methodologies in bauxite mining

    Directory of Open Access Journals (Sweden)

    João Carlos Costa Guimarães

    2013-03-01

    Full Text Available This work analyzed and compared three methods of environmental recovery in bauxite mining commonly used in Poços de Caldas Plateau, MG, by means of recovery costs and ecological benefits. Earnings and costs data of environmental recovery activities were obtained for the areas that belonged to the Companhia Geral de Minas – CGM, on properties sited in the city of Poços de Caldas, MG. The amount of costs of these activities was used to compare the recovery methods by updating them monetarily to a reference date, in other words, the present moment. It is concluded that the difference between the present value of costs for simple restoration and rehabilitation activities are less than 1% and that between the complete restoration and rehabilitation is about 15.12%, suggesting that the choice of the methods to be used must be based on the ecological earnings proportional to each of them. The methodology of environmental restoration of the mining areas emphasizes the ecological variables in the process of establishment of the community, to the detriment of complex ecological aspects, which show difficulties in measuring the actual moment of the development of the ecosystem considered.

  5. The effect of short recovery period investment on least-cost generation system expansion

    International Nuclear Information System (INIS)

    Yiqun He; David, A.K.; Fernando, P.N.

    1995-01-01

    The effect of the short recovery period of private investment on least-cost generation system expansion is analysed, and a trade-off method for generation system expansion, which gives consideration to both the least-cost strategy and the short recovery period of private investment, is presented. First, the optimal mix of generation units under a standard recovery period for all units is established, and then the surcharge, due to the difference between the short recovery period and the standard recovery period, is calculated and shared between all units. The former is an optimization to make best use of natural resources, and the latter is a trade-off method to spread the surcharge throughout the system. (Author)

  6. A prospective cohort study to investigate cost-minimisation, of Traditional open, open fAst track recovery and laParoscopic fASt track multimodal management, for surgical patients with colon carcinomas (TAPAS study

    Directory of Open Access Journals (Sweden)

    van Duivendijk Peter

    2010-06-01

    Full Text Available Abstract Background The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS recovery program. The Tapas-study was conceived to determine which of the three treatment programs: open conventional surgery, open 'ERAS' surgery or laparoscopic 'ERAS' surgery for patients with colon carcinomas is most cost minimizing? Method/design The Tapas-study is a three-arm multicenter prospective cohort study. All patients with colon carcinoma, eligible for surgical treatment within the study period in four general teaching hospitals and one university hospital will be included. This design produces three cohorts: Conventional open surgery is the control exposure (cohort 1. Open surgery with ERAS recovery (cohort 2 and laparoscopic surgery with ERAS recovery (cohort 3 are the alternative exposures. Three separate time periods are used in order to prevent attrition bias. Primary outcome parameters are the two main cost factors: direct medical costs (real cost price calculation and the indirect non medical costs (friction method. Secondary outcome parameters are mortality, complications, surgical-oncological resection margins, hospital stay, readmission rates, time back to work/recovery, health status and quality of life. Based on an estimated difference in direct medical costs (highest cost factor of 38% between open and laparoscopic surgery (alfa = 0.01, beta = 0.05, a group size of 3×40 = 120 patients is calculated. Discussion The Tapas-study is three-arm multicenter cohort study that will provide a cost evaluation of three treatment programs for patients with colon carcinoma, which may serve as a guideline for choice of treatment and investment strategies in hospitals. Trial registration ISRCTN44649165.

  7. The indirect costs of psoriatic arthritis: systematic review and meta-analysis.

    Science.gov (United States)

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2015-02-01

    The aim of this systematic review is to collect all current data on the indirect costs (IC) related to psoriatic arthritis (PsA). The search was conducted using MEDLINE (via PubMed), Embase and Centre for Reviews and Dissemination databases. We considered original studies, systematic reviews, economic evaluations, conference abstracts and posters. All collected data were recalculated to average annual cost per patient, expressed using the consumer price index for 2013 and converted to US dollars using purchasing power parity. Eight of the identified publications presented IC of PsA. Average annual IC per patient calculated using the friction cost approach range from US$1693.83 to $12,318.45, while using the human capital approach they range from US$1750.68 to $50,270.52. Result of the meta-analysis was a basis for calculating cost of work disability equaled US$10,754.04 per patient per year in 2013 prices. This systematic review revealed a great economic burden of the disease to the society. A small number of studies on IC in PsA justify further investigations.

  8. Waste Processing Cost Recovery at Los Alamos National Laboratory-Analysis and Recommendations

    International Nuclear Information System (INIS)

    Booth, St. R.

    2009-01-01

    Los Alamos National Laboratory is implementing full cost recovery for waste processing in fiscal year 2009 (FY2009), after a transition year in FY2008. Waste processing cost recovery has been implemented in various forms across the nuclear weapons complex and in corporate America. The fundamental reasoning of sending accurate price signals to waste generators is economically sound, and leads to waste minimization and reduced waste expense over time. However, Los Alamos faces significant implementation challenges because of its status as a government-owned, contractor-operated national scientific institution with a diverse suite of experimental and environmental cleanup activities, and the fact that this represents a fundamental change in how waste processing is viewed by the institution. This paper describes the issues involved during the transition to cost recovery and the ultimate selection of the business model. Of the six alternative cost recovery models evaluated, the business model chosen to be implemented in FY2009 is Recharge Plus Generators Pay Distributed Direct. Under this model, all generators who produce waste must pay a distributed direct share associated with their specific waste type to use a waste processing capability. This cost share is calculated using the distributed direct method on the fixed cost only, i.e., the fixed cost share is based on each program's forecast proportion of the total Los Alamos volume forecast of each waste type. (Fixed activities are those required to establish the waste processing capability, i.e., to make the process ready, permitted, certified, and prepared to handle the first unit of waste. Therefore, the fixed cost ends at the point just before waste begins to be processed. The activities to actually process the waste are considered variable.) The volume of waste actually sent for processing is charged a unit cost based solely on the variable cost of disposing of that waste. The total cost recovered each year is the

  9. Assessment of indirect losses and costs of emergency for project planning of alpine hazard mitigation

    Science.gov (United States)

    Amenda, Lisa; Pfurtscheller, Clemens

    2013-04-01

    By virtue of augmented settling in hazardous areas and increased asset values, natural disasters such as floods, landslides and rockfalls cause high economic losses in Alpine lateral valleys. Especially in small municipalities, indirect losses, mainly stemming from a breakdown of transport networks, and costs of emergency can reach critical levels. A quantification of these losses is necessary to estimate the worthiness of mitigation measures, to determine the appropriate level of disaster assistance and to improve risk management strategies. There are comprehensive approaches available for assessing direct losses. However, indirect losses and costs of emergency are widely not assessed and the empirical basis for estimating these costs is weak. To address the resulting uncertainties of project appraisals, a standardized methodology has been developed dealing with issues of local economic effects and emergency efforts needed. In our approach, the cost-benefit-analysis for technical mitigation of the Austrian Torrent and Avalanche Control (TAC) will be optimized and extended using the 2005-debris flow as a design event, which struggled a small town in the upper Inn valley in southwest Tyrol (Austria). Thereby, 84 buildings were affected, 430 people were evacuated and due to this, the TAC implemented protection measures for 3.75 million Euros. Upgrading the method of the TAC and analyzing to what extent the cost-benefit-ratio is about to change, is one of the main objectives of this study. For estimating short-run indirect effects and costs of emergency on the local level, data was collected via questionnaires, field mapping, guided interviews, as well as intense literature research. According to this, up-to-date calculation methods were evolved and the cost-benefit-analysis of TAC was recalculated with these new-implemented results. The cost-benefit-ratio will be more precise and specific and hence, the decision, which mitigation alternative will be carried out

  10. A HALF-WAY RIGHT: FREE EDUCATION, INDIRECT COSTS, AND EDUCATIONAL POLICY

    Directory of Open Access Journals (Sweden)

    Mariano Fernández Enguita

    2014-12-01

    Full Text Available This paper examines those indirect costs of education associated to state funded schooling that come to be privately financed by families, specially those linked to mandatory or mandated provision schooling. Discussion is more detailed about textbooks, school meals and academic support activities. Then we study the consequences of this private spending for gratuity and its effects related to educational and social equality or inequality. Finally, we analyze the implications related to sectional interests at stake and educational policies.

  11. A half-way right: free education, indirect costs, and educational policy

    Directory of Open Access Journals (Sweden)

    Mariano Fernández Enguita

    2014-12-01

    Full Text Available This paper examines those indirect costs of education associated to state funded schooling that come to be privately financed by families, specially those linked to mandatory or mandated provision schooling. Discussion is more detailed about textbooks, school meals and academic support activities. Then we study the consequences of this private spending for gratuity and its effects related to educational and social equality or inequality. Finally, we analyze the implications related to sectional interests at stake and educational policies.

  12. Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil

    Science.gov (United States)

    Novaes, Hillegonda Maria Dutilh; Itria, Alexander; Silva, Gulnar Azevedo e; Sartori, Ana Marli Christovam; Rama, Cristina Helena; de Soárez, Patrícia Coelho

    2015-01-01

    OBJECTIVE: To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil. METHODS: This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD. RESULTS: From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%. CONCLUSION: Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management. PMID:26017797

  13. Design and analysis of heat recovery system in bioprocess plant

    International Nuclear Information System (INIS)

    Anastasovski, Aleksandar; Rašković, Predrag; Guzović, Zvonimir

    2015-01-01

    Highlights: • Heat integration of a bioprocess plant is studied. • Bioprocess plant produces yeast and ethyl-alcohol. • The design of a heat recovery system is performed by batch pinch analysis. • Direct and indirect heat integration approaches are used in process design. • The heat recovery system without a heat storage opportunity is more profitable. - Abstract: The paper deals with the heat integration of a bioprocess plant which produces yeast and ethyl-alcohol. The referent plant is considered to be a multiproduct batch plant which operates in a semi-continuous mode. The design of a heat recovery system is performed by batch pinch analysis and by the use of the Time slice model. The results obtained by direct and indirect heat integration approaches are presented in the form of cost-optimal heat exchanger networks and evaluated by different thermodynamic and economic indicators. They signify that the heat recovery system without a heat storage opportunity can be considered to be a more profitable solution for the energy efficiency increase in a plant

  14. Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

    Science.gov (United States)

    Kawalec, Paweł; Mossakowska, Małgorzata; Pilc, Andrzej

    2016-01-01

    Background and Aims Evidence on indirect cost of Crohn’s disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity). Methods A self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients’ characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient’s version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients’ productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients’ productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders. Results The responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (pabsenteeism, 41% (p = 0.030) for presenteeism, 76% (pproductivity loss at unpaid work, and 75% (p<0.001) for informal care. Conclusions Our study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland. PMID:27992531

  15. Cost Effective Recovery of Low-TDS Frac Flowback Water for Re-use

    Energy Technology Data Exchange (ETDEWEB)

    Claire Henderson; Harish Acharya; Hope Matis; Hareesh Kommepalli; Brian Moore; Hua Wang

    2011-03-31

    The project goal was to develop a cost-effective water recovery process to reduce the costs and envi-ronmental impact of shale gas production. This effort sought to develop both a flowback water pre-treatment process and a membrane-based partial demineralization process for the treatment of the low-Total Dissolved Solids (TDS) portion of the flowback water produced during hydrofracturing operations. The TDS cutoff for consideration in this project is < 35,000 {approx} 45,000 ppm, which is the typical limit for economic water recovery employing reverse osmosis (RO) type membrane desalination processes. The ultimate objective is the production of clean, reclaimed water suitable for re-use in hydrofracturing operations. The team successfully compiled data on flowback composition and other attributes across multiple shale plays, identified the likely applicability of membrane treatment processes in those shales, and expanded the proposed product portfolio to include four options suitable for various reuse or discharge applications. Pretreatment technologies were evaluated at the lab scale and down-selected based upon their efficacy in removing key contaminants. The chosen technologies were further validated by performing membrane fouling studies with treated flowback water to demonstrate the technical feasibility of flowback treatment with RO membranes. Process flow schemes were constructed for each of the four product options based on experimental performance data from actual flowback water treatment studies. For the products requiring membrane treatment, membrane system model-ing software was used to create designs for enhanced water recovery beyond the typical seawater desalination benchmark. System costs based upon vendor and internal cost information for all process flow schemes were generated and are below target and in line with customer expectations. Finally, to account for temporal and geographic variability in flowback characteristics as well as local

  16. The long-term power purchase: Recovery of capacity costs

    International Nuclear Information System (INIS)

    Cross, P.S.

    1990-01-01

    As electric utilities increase their reliance on the long-term power purchase as an alternative to utility-owned generation, the appropriate rate treatment of the costs established in the purchase agreement assumes growing importance. In the November 9, 1989, issue, the authors examined the recent trend among state regulators to treat the long-term purchase in a manner similar to the addition by a utility of a new plant, including a full-scale prudence review. This installment will review recent rulings on the related issue of rate recovery of long-term capacity costs through the fuel cost adjustment clause

  17. Effect of adalimumab on work productivity and indirect costs in moderate to severe Crohn’s disease: A meta-analysis

    Science.gov (United States)

    Binion, David G; Louis, Edouard; Oldenburg, Bas; Mulani, Parvez; Bensimon, Arielle G; Yang, Mei; Chao, Jingdong

    2011-01-01

    OBJECTIVE: To assess the effect of adalimumab on work productivity and indirect costs in patients with Crohn’s disease (CD) using a meta-analysis of clinical trials. METHODS: Study-level results were pooled from all clinical trials of adalimumab for moderate to severe CD in which work productivity outcomes were evaluated. Work Productivity and Activity Impairment Questionnaire outcomes (absenteeism, presenteeism and total work productivity impairment [TWPI]) were extracted from adalimumab trials. Meta-analyses were used to estimate pooled averages and 95% CIs of one-year accumulated reductions in work productivity impairment with adalimumab. Pooled averages were multiplied by the 2008 United States national average annual salary ($44,101) to estimate per-patient indirect cost savings during the year following adalimumab initiation. RESULTS: The four included trials (ACCESS, CARE, CHOICE and EXTEND) represented a total of 1202 employed adalimumab-treated patients at baseline. Each study followed patients for a minimum of 20 weeks. Pooled estimates (95% CIs) of one-year accumulated work productivity improvements were as follows: −9% (−10% to −7%) for absenteeism; −22% (−26% to −18%) for presenteeism; and −25% (−30% to −20%) for TWPI. Reductions in absenteeism and TWPI translated into per-patient indirect cost savings (95% CI) of $3,856 ($3,183 to $4,529) and $10,964 ($8,833 to $13,096), respectively. CONCLUSION: Adalimumab provided clinically meaningful improvements in work productivity among patients with moderate to severe CD, which may translate into substantial indirect cost savings from an employer’s perspective. PMID:21912760

  18. 18 CFR 284.265 - Cost recovery by interstate pipeline.

    Science.gov (United States)

    2010-04-01

    ... 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale, Transportation, and Exchange Transactions... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Cost recovery by interstate pipeline. 284.265 Section 284.265 Conservation of Power and Water Resources FEDERAL ENERGY...

  19. Tuberculosis patients in the Dominican Republic face severe direct and indirect costs and need social protection

    NARCIS (Netherlands)

    Mauch, V.M.C.; Melgen, R.; Marcelino, B.; Acosta, I.; Klinkenberg, E.; Suarez, P.

    2013-01-01

    OBJECTIVE: To examine direct and indirect costs incurred by new, retreatment, and multidrug-resistant (MDR) tuberculosis (TB) patients in the Dominican Republic before and during diagnosis, and during treatment, to generate an evidence base and formulate recommendations. METHODS: The "Tool to

  20. Healthcare resource use, direct and indirect costs of hypoglycemia in type 1 and type 2 diabetes, and nationwide projections. Results of the HYPOS-1 study.

    Science.gov (United States)

    Giorda, C B; Rossi, M C; Ozzello, O; Gentile, S; Aglialoro, A; Chiambretti, A; Baccetti, F; Gentile, F M; Romeo, F; Lucisano, G; Nicolucci, A

    2017-03-01

    To obtain an accurate picture of the total costs of hypoglycemia, including the indirect costs and comparing the differences between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). HYPOS-1 was a multicenter, retrospective cohort study which analyzed the data of 2229 consecutive patients seen at 18 diabetes clinics. Data on healthcare resource use and indirect costs by diabetes type were collected via a questionnaire. The domains of inpatient admission and hospital stay, work days lost, and third-party assistance were also explored. Resource utilization was reported as estimated incidence rates (IRs) of hypoglycemic episodes per 100 person-years and estimated costs as IRs per person-years. For every 100 patients with T1DM, 9 emergency room (ER) visits and 6 emergency medical service calls for hypoglycemia were required per year; for every 100 patients with T2DM, 3 ER visits and 1 inpatient admission were required, with over 3 nights spent in hospital. Hypoglycemia led to 58 work days per 100 person-years lost by the patient or a family member in T1DM versus 19 in T2DM. The costs in T1DM totaled €90.99 per person-year and €62.04 in T2DM. Direct and indirect costs making up the total differed by type of diabetes (60% indirect costs in T1DM versus 43% in T2DM). The total cost associated with hypoglycemia in Italy is estimated to be €107 million per year. Indirect costs meaningfully contribute to the total costs associated with hypoglycemia. As compared with T1DM, T2DM requires fewer ER visits and incurs lower indirect costs but more frequent hospital use. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  1. Cost Scaling of a Real-World Exhaust Waste Heat Recovery Thermoelectric Generator: A Deeper Dive

    Science.gov (United States)

    Hendricks, Terry J.; Yee, Shannon; LeBlanc, Saniya

    2015-01-01

    Cost is equally important to power density or efficiency for the adoption of waste heat recovery thermoelectric generators (TEG) in many transportation and industrial energy recovery applications. In many cases the system design that minimizes cost (e.g., the $/W value) can be very different than the design that maximizes the system's efficiency or power density, and it is important to understand the relationship between those designs to optimize TEG performance-cost compromises. Expanding on recent cost analysis work and using more detailed system modeling, an enhanced cost scaling analysis of a waste heat recovery thermoelectric generator with more detailed, coupled treatment of the heat exchangers has been performed. In this analysis, the effect of the heat lost to the environment and updated relationships between the hot-side and cold-side conductances that maximize power output are considered. This coupled thermal and thermoelectric treatment of the exhaust waste heat recovery thermoelectric generator yields modified cost scaling and design optimization equations, which are now strongly dependent on the heat leakage fraction, exhaust mass flow rate, and heat exchanger effectiveness. This work shows that heat exchanger costs most often dominate the overall TE system costs, that it is extremely difficult to escape this regime, and in order to achieve TE system costs of $1/W it is necessary to achieve heat exchanger costs of $1/(W/K). Minimum TE system costs per watt generally coincide with maximum power points, but Preferred TE Design Regimes are identified where there is little cost penalty for moving into regions of higher efficiency and slightly lower power outputs. These regimes are closely tied to previously-identified low cost design regimes. This work shows that the optimum fill factor Fopt minimizing system costs decreases as heat losses increase, and increases as exhaust mass flow rate and heat exchanger effectiveness increase. These findings have

  2. Claus sulphur recovery potential approaches 99% while minimizing cost

    Energy Technology Data Exchange (ETDEWEB)

    Berlie, E M

    1974-01-21

    In a summary of a paper presented to the fourth joint engineering conference of the American Institute of Chemical Engineers and the Canadian Society for Chemical Engineering, the Claus process is discussed in a modern setting. Some problems faced in the operation of sulfur recovery plants include (1) strict pollution control regulations; (2) design and operation of existing plants; (3) knowledge of process fundamentals; (4) performance testing; (5) specification of feed gas; (6) catalyst life; (7) instrumentation and process control; and (8) quality of feed gas. Some of the factors which must be considered in order to achieve the ultimate capability of the Claus process are listed. There is strong evidence to support the contention that plant operators are reluctant to accept new fundamental knowledge of the Claus sulfur recovery process and are not taking advantage of its inherent potential to achieve the emission standards required, to minimize cost of tail gas cleanup systems and to minimize operating costs.

  3. Cost recovery of NGO primary health care facilities: a case study in Bangladesh

    OpenAIRE

    Alam, Khurshid; Ahmed, Shakil

    2010-01-01

    Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...

  4. Indirect Transportation Cost in the border crossing process: The United States–Mexico trade

    Directory of Open Access Journals (Sweden)

    Carlos Obed Figueroa Ortiz

    2015-12-01

    Full Text Available Using a Social Accounting Matrix as database, a Computable General Equilibrium model is implemented in order to estimate the Indirect Transportations Costs (ITC present in the border crossing for the U.S.–Mexico bilateral trade. Here, an “iceberg–type” transportation function is assumed to determine the amount of loss that must be faced as a result of border crossing process through the ports of entry existing between the two countries. The study period covers annual data from 1995 to 2009 allowing the analysis of the trend of these costs considering the trade liberalisation that is experienced. Results show that the ITC have experienced a decrease of 12% during the period.Test

  5. Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States.

    Science.gov (United States)

    Bonafede, Machaon; Sapra, Sandhya; Shah, Neel; Tepper, Stewart; Cappell, Katherine; Desai, Pooja

    2018-05-01

    The goal of this analysis was to provide a contemporary estimate of the burden of migraine, incorporating both direct and indirect costs, by comparing the costs of migraine patients to a matched group of patients without migraine in a large, nationally representative sample of commercially insured patients in the United States. Previous studies have shown that the economic burden of migraine in the United States is substantial for payers, patients, and employers. Despite the availability of multiple acute and preventive pharmacological treatment options and a relatively stable migraine prevalence in the United States, there has been a documented increase in migraine-related healthcare resource and pharmacy use. Given the frequently disabling nature of migraine and its high prevalence, especially during peak productive years, and the lack of recent estimates of the burden of migraine, there is a need to update the existing literature with more current data. This retrospective, observational cohort study identified migraine patients in the Truven Health Market Scan Research Databases between January 2008 and June 2013. Adult patients had 12 months of continuous enrollment before (baseline period) and after (follow-up period) the day they received migraine diagnoses and/or medications (index) and no diagnosis of HIV or malignancy during the study period. The patients with migraine were matched 1:1 to a group of patients without migraine on demographic variables and index date. Direct healthcare utilization and costs and indirect (absenteeism, short-term disability, and long-term disability) costs were assessed during the 12-month follow-up period and differences between patients with vs without migraine were assessed. Two additional multivariable logistic regression analyses were conducted. First, an analysis was conducted comparing the odds of having a short-term disability claim between patients with and without migraine after controlling for patient demographic and

  6. Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

    Science.gov (United States)

    Bouzón-Alejandro, Marta; Redondo-Collazo, Lorenzo; Sánchez-Lastres, Juan Manuel; Martinón-Torres, Nazareth; Martinón-Sánchez, José María; Martinón-Torres, Federico

    2011-09-14

    The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

  7. Cost analysis of enhanced recovery after surgery in microvascular breast reconstruction.

    Science.gov (United States)

    Oh, Christine; Moriarty, James; Borah, Bijan J; Mara, Kristin C; Harmsen, William S; Saint-Cyr, Michel; Lemaine, Valerie

    2018-06-01

    Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. A standardized ERAS pathway was developed through multidisciplinary collaboration. It addressed all phases of surgical care for patients undergoing free-flap breast reconstruction utilizing an abdominal donor site. In this retrospective cohort study, clinical variables associated with hospitalization costs for patients who underwent free-flap breast reconstruction with the ERAS pathway were compared with those of historical controls, termed traditional recovery after surgery (TRAS). All patients included in the study underwent surgery between September 2010 and September 2014. Predicted costs of the study groups were compared using generalized linear modeling. A total of 200 patients were analyzed: 82 in the ERAS cohort and 118 in the TRAS cohort. Clinical variables that were identified to potentially affect costs were found to have a statistically significant difference between groups and included unilateral versus bilateral procedures (p = 0.04) and the need for postoperative blood transfusion (p = 0.03). The cost regression analysis on the two cohorts was adjusted for these significant variables. Adjusted mean costs of patients with ERAS were found to be $4,576 lesser than those of the TRAS control group ($38,688 versus $43,264). Implementation of the ERAS pathway was associated with significantly decreased costs when compared to historical controls. There has been a healthcare focus toward prudent resource allocation, which dictates the need for plastic surgeons to recognize economic evaluation of clinical practice. The ERAS pathway can increase healthcare accountability by improving

  8. Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol.

    Science.gov (United States)

    Murphy, Jacqueline; Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni; Leal, José

    2018-03-14

    Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures.We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation.Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be

  9. 42 CFR 412.105 - Special treatment: Hospitals that incur indirect costs for graduate medical education programs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Hospitals that incur indirect costs for graduate medical education programs. 412.105 Section 412.105 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective...

  10. The logic of indirect speech

    Science.gov (United States)

    Pinker, Steven; Nowak, Martin A.; Lee, James J.

    2008-01-01

    When people speak, they often insinuate their intent indirectly rather than stating it as a bald proposition. Examples include sexual come-ons, veiled threats, polite requests, and concealed bribes. We propose a three-part theory of indirect speech, based on the idea that human communication involves a mixture of cooperation and conflict. First, indirect requests allow for plausible deniability, in which a cooperative listener can accept the request, but an uncooperative one cannot react adversarially to it. This intuition is supported by a game-theoretic model that predicts the costs and benefits to a speaker of direct and indirect requests. Second, language has two functions: to convey information and to negotiate the type of relationship holding between speaker and hearer (in particular, dominance, communality, or reciprocity). The emotional costs of a mismatch in the assumed relationship type can create a need for plausible deniability and, thereby, select for indirectness even when there are no tangible costs. Third, people perceive language as a digital medium, which allows a sentence to generate common knowledge, to propagate a message with high fidelity, and to serve as a reference point in coordination games. This feature makes an indirect request qualitatively different from a direct one even when the speaker and listener can infer each other's intentions with high confidence. PMID:18199841

  11. Indirect effects of recovery strategies

    DEFF Research Database (Denmark)

    Andersen, Ken Haste; Rice, Jake

    -based models of fish communities indicate that theserelationships have lawful dynamics that continue to be expressed, even when individualspecies become rarer - as predators or as prey. An ecosystem based management recoverystrategies of a given species or group of species should therefore not be seen...... in isolation,but the expected consequences for the rest of the ecosystem must be analyzed. We use ageneral size- and trait-based model to calculate the ecosystem effects of fishing andrecovery. We present a general analysis of a recovery strategies targeting either large fishes(consumer fishery), small fishes...

  12. 43 CFR 426.23 - Recovery of operation and maintenance (O&M) costs.

    Science.gov (United States)

    2010-10-01

    ... operation and maintenance (O&M) costs. (a) General. All new, amended, and renewed contracts shall provide... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recovery of operation and maintenance (O&M) costs. 426.23 Section 426.23 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF...

  13. Cost-effective treatment of swine wastes through recovery of energy and nutrients.

    Science.gov (United States)

    Amini, Adib; Aponte-Morales, Veronica; Wang, Meng; Dilbeck, Merrill; Lahav, Ori; Zhang, Qiong; Cunningham, Jeffrey A; Ergas, Sarina J

    2017-11-01

    Wastes from concentrated animal feeding operations (CAFOs) are challenging to treat because they are high in organic matter and nutrients. Conventional swine waste treatment options in the U.S., such as uncovered anaerobic lagoons, result in poor effluent quality and greenhouse gas emissions, and implementation of advanced treatment introduces high costs. Therefore, the purpose of this paper is to evaluate the performance and life cycle costs of an alternative system for treating swine CAFO waste, which recovers valuable energy (as biogas) and nutrients (N, P, K + ) as saleable fertilizers. The system uses in-vessel anaerobic digestion (AD) for methane production and solids stabilization, followed by struvite precipitation and ion exchange (IX) onto natural zeolites (chabazite or clinoptilolite) for nutrient recovery. An alternative approach that integrated struvite recovery and IX into a single reactor, termed STRIEX, was also investigated. Pilot- and bench-scale reactor experiments were used to evaluate the performance of each stage in the treatment train. Data from these studies were integrated into a life cycle cost analysis (LCCA) to assess the cost-effectiveness of various process alternatives. Significant improvement in water quality, high methane production, and high nutrient recovery (generally over 90%) were observed with both the AD-struvite-IX process and the AD-STRIEX process. The LCCA showed that the STRIEX system can provide considerable financial savings compared to conventional systems. AD, however, incurs high capital costs compared to conventional anaerobic lagoons and may require larger scales to become financially attractive. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals

    Directory of Open Access Journals (Sweden)

    Laetitia C. Rispel

    2015-05-01

    Full Text Available Background: Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective: The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods: Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices. Results: In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million. The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467 and at Hospital 2 the value was R300,121 (US$42,874, thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion

  15. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals.

    Science.gov (United States)

    Rispel, Laetitia C; Moorman, Julia

    2015-01-01

    Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Hospital managers and policy-makers need to address the effective

  16. An Insight Into Budgeting, The Funding And Cost Recovery of ...

    African Journals Online (AJOL)

    The study further revealed that Institutions' financial support for students was woefully inadequate. Students' fee payment was also identified as the main modality for cost recovery of tertiary education. It was recommended that communities and industries should be made to make meaningful contributions towards tertiary ...

  17. 76 FR 54223 - Notice of Proposed Administrative Cost Recovery Settlement Pursuant to the Comprehensive...

    Science.gov (United States)

    2011-08-31

    ... Costs Incurred at Marine Corps Logistics Base Barstow, CA AGENCY: Department of the Navy, DoD. ACTION... of response costs incurred by the DON at the Site. The proposed Administrative Settlement resolves... DEPARTMENT OF DEFENSE Department of the Navy Notice of Proposed Administrative Cost Recovery...

  18. A Stochastic Market Design With Revenue Adequacy and Cost Recovery by Scenario: Benefits and Costs

    DEFF Research Database (Denmark)

    Kazempour, Jalal; Pinson, Pierre; Hobbs, Benjamin F.

    2018-01-01

    Two desirable properties of electricity market mechanisms include: i) revenue adequacy for the market, and ii) cost recovery for all generators. Previously proposed stochastic market-clearing mechanisms satisfy both properties in expectation only, or satisfy one property by scenario and another...... scheme that ensures both properties by scenario. However, this approach is cost-inefficient in general and may sacrifice other desirable market attributes. Undesirable consequences include: one group of participants will have to pay more to ensure that all other participants have their costs covered......, and thus their prices will not be equilibrium supporting; and day-ahead and real-time prices are not arbitraged in expectation, although this can be fixed by allowing virtual bidders to arbitrage but at the potential cost of increased market inefficiency. Considering these pros and cons, we propose our...

  19. Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both.

    Science.gov (United States)

    Ghushchyan, Vahram; Nair, Kavita V; Page, Robert L

    2015-01-01

    The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS) alone and with common cardiovascular comorbidities. A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exclusive cohorts were evaluated: ACS only, ACS with atrial fibrillation (AF), ACS with heart failure (HF), and ACS with both conditions. Direct costs were calculated for all-cause and cardiovascular-related health care resource utilization. Indirect costs were determined from productivity losses from missed days of work. Regression analysis was developed for each outcome controlling for age, US census region, insurance coverage, sex, race, ethnicity, education attainment, family income, and comorbidity burden. A negative binomial regression model was used for health care utilization variables. A Tobit model was utilized for health care costs and productivity loss variables. Total health care costs were greatest for those with ACS and both AF and HF ($38,484±5,191) followed by ACS with HF ($32,871±2,853), ACS with AF ($25,192±2,253), and ACS only ($17,954±563). Compared with the ACS only cohort, the mean all-cause adjusted health care costs associated with ACS with AF, ACS with HF, and ACS with AF and HF were $5,073 (95% confidence interval [CI] 719-9,427), $11,297 (95% CI 5,610-16,985), and $15,761 (95% CI 4,784-26,738) higher, respectively. Average wage losses associated with ACS with and without AF and/or HF amounted to $5,266 (95% CI -7,765, -2,767), when compared with patients without these conditions. ACS imposes a significant economic burden at both the individual and society level, particularly when with comorbid AF and HF.

  20. SOR/93-163 AECB Cost Recovery Fees Regulations, 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The Atomic Energy Control Board (Cost Recovery Fees Regulations 1990 and subsequent amendments have been revoked and replaced by those new Regulations of 30 march 1993 which entered into force on 1 April 1993. The regulations were first made in 1990 in order to carry out the Government's policy of introducing the principle of ''user pay'' for the cost incurred by the AECB in its regulatory activities. The objective of the policy was to shift the cost of Government regulatory efforts for the taxpayer at large to those who most benefited from or whose activities were the reason for such effort. This new version of the Regulations reflects licensees' comments, e.g. extension of the period for review of proposed fees, and sets out increases in the fees. (NEA)

  1. Understanding the direct and indirect costs of patients with schizophrenia [v2; ref status: indexed, http://f1000r.es/5ow

    Directory of Open Access Journals (Sweden)

    Kazuhiro Tajima-Pozo

    2015-08-01

    Full Text Available Background: Schizophrenia is a disabling mental disorder with high prevalence and that usually  requires long-term follow-up and expensive lifelong treatment. The cost of schizophrenia treatment consumes a significant amount of the health services' budget in western countries. Objective: The aim of the study was to find out about the costs related to schizophrenia across different european countries and compare them. Results: Schizophrenia treatment costs an estimated 18 billion euros annually worldwide. The direct costs associated with medical help are only part of the total expenditure. The indirect costs are an equally (or even moreimportant part of the total cost. These expenses are related to the lack of productivity of schizophrenic patients and the cost that relatives have to bear as a result of taking care of their affected relatives. Conclusions: Although data on the cost of schizophrenia may vary slightly between different european countries, the general conclusion that can be drawn is that schizophrenia is a very costly disorder. Not only because of direct costs related to medical procedures, but also due to the non-medical (indirect costs. Together this suggests the need to investigate cost-efficient strategies that could provide a better outcome for schizophrenic patients, as well as the people who care for them.

  2. Health-related quality of life, work productivity, and indirect costs among patients with irritable bowel syndrome with diarrhea.

    Science.gov (United States)

    Buono, Jessica L; Carson, Robyn T; Flores, Natalia M

    2017-02-14

    Irritable bowel syndrome (IBS) affects 10-15% of adults in the US, and is associated with significant impairment in health-related quality of life (HRQoL); however, information specific to the diarrhea subtype (IBS-D) is lacking. We assessed the impact of IBS-D on HRQoL, work productivity, and daily activities, and the associated indirect costs, among a sample of the US population. Respondents (≥18 years) from the 2012 US National Health and Wellness Survey who reported an IBS-D diagnosis by a physician or symptoms consistent with Rome II criteria for IBS-D were identified as having IBS-D. Controls included respondents without IBS-D or inflammatory bowel disease. HRQoL was assessed via the Short Form 36 Health Survey version 2 questionnaire and summarized into Mental and Physical Component Summary (MCS; PCS) scores and a Short Form-6 dimension (SF-6D) utility score. Work and activity impairment were assessed via the Work Productivity and Activity Impairment Questionnaire: General Health version (WPAI:GH), which measures absenteeism, presenteeism, overall work productivity loss, and daily activity impairment. Indirect costs were calculated using unit cost data from the Bureau of Labor Statistics and variables from the WPAI:GH. Generalized linear models were used to examine differences in health outcomes between respondents with IBS-D and controls, controlling for demographic and health characteristics. In total, 66,491 respondents (1102 IBS-D; 65,389 controls) were analyzed. Mean age was 48.7 years; 50% were female. Compared with controls, the IBS-D cohort reported significantly lower HRQoL (mean MCS: 45.16 vs. 49.48; p work productivity loss (20.7% vs. 13.2%; p work and daily activities, and higher indirect costs, imposing a substantial burden on patients and employers. These findings suggest a significant unmet need exists for effective IBS-D treatments.

  3. Novel model of direct and indirect cost-benefit analysis of mechanical embolectomy over IV tPA for large vessel occlusions: a real-world dollar analysis based on improvements in mRS.

    Science.gov (United States)

    Mangla, Sundeep; O'Connell, Keara; Kumari, Divya; Shahrzad, Maryam

    2016-01-20

    Ischemic strokes result in significant healthcare expenditures (direct costs) and loss of quality-adjusted life years (QALYs) (indirect costs). Interventional therapy has demonstrated improved functional outcomes in patients with large vessel occlusions (LVOs), which are likely to reduce the economic burden of strokes. To develop a novel real-world dollar model to assess the direct and indirect cost-benefit of mechanical embolectomy compared with medical treatment with intravenous tissue plasminogen activator (IV tPA) based on shifts in modified Rankin scores (mRS). A cost model was developed including multiple parameters to account for both direct and indirect stroke costs. These were adjusted based upon functional outcome (mRS). The model compared IV tPA with mechanical embolectomy to assess the costs and benefits of both therapies. Direct stroke-related costs included hospitalization, inpatient and outpatient rehabilitation, home care, skilled nursing facilities, and long-term care facility costs. Indirect costs included years of life expectancy lost and lost QALYs. Values for the model cost parameters were derived from numerous resources and functional outcomes were derived from the MR CLEAN study as a reflective sample of LVOs. Direct and indirect costs and benefits for the two treatments were assessed using Microsoft Excel 2013. This cost-benefit model found a cost-benefit of mechanical embolectomy over IV tPA of $163 624.27 per patient and the cost benefit for 50 000 patients on an annual basis is $8 181 213 653.77. If applied widely within the USA, mechanical embolectomy will significantly reduce the direct and indirect financial burden of stroke ($8 billion/50 000 patients). 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/

  4. Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

    CERN Document Server

    Wood, M Sandra

    2013-01-01

    This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

  5. Influencing Factor of Postoperation Fast-track Recovery and in Hospital Cost after Lobctomy for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Jianhua SU

    2014-07-01

    Full Text Available Background and objective It is unknown that the postoperation fast-track recovery and in hospital cost of the lobectomy in lung cancer, we explored the influencing factor of postoperative fast-track recovery and in hospital cost after undergoing lobectomy for lung cancer. Methods We retrospectively reviewed the medical records of all patients (n=176 who underwent lobectomy for lung cancer between January 2010 and November 2011 by a thoracic surgeon. Results The hospital costs of video-assisted thoracic surgery (VATS lobectomy (47,308.21 ¥ is significantly higher than open lobectomy (45,664.31 ¥(P=0.007. The hospital costs of body mass index (BMI ≥ 24 kg/m2 (51,186.99 ¥ is significantly higher than BMI < 24 kg/m2 (41,701.64 ¥(P=0.032. The hospital stay of VATS lobectomy (5.70 d is significantly less than open lobectomy (7.10 d(P<0.001. Conclusion These findings indicate that preoperative pulmonary rehabilitation and VATS lobectomy is contributed to fast-track recovery for patients who undergo lobectomy, but increase the hospital costs.

  6. Costs, CO{sub 2}- and primary energy balances of forest-fuel recovery systems at different forest productivity

    Energy Technology Data Exchange (ETDEWEB)

    Eriksson, Lisa; Gustavsson, Leif [Ecotechnology, Department of Engineering and Sustainable Development, Mid Sweden University, SE-831 25 Oestersund (Sweden)

    2010-05-15

    Here we examine the cost, primary energy use, and net carbon emissions associated with removal and use of forest residues for energy, considering different recovery systems, terrain, forwarding distance and forest productivity. We show the potential recovery of forest fuel for Sweden, its costs and net carbon emissions from primary energy use and avoided fossil carbon emissions. The potential annual net recovery of forest fuel is about 66 TWh, which would cost one billion EUR{sub 2005} to recover and would reduce fossil emissions by 6.9 Mt carbon if coal were replaced. Of the forest fuel, 56% is situated in normal terrain with productivity of >30 t dry-matter ha{sup -1} and of this, 65% has a forwarding distance of <400 m. In normal terrain with >30 t dry-matter ha{sup -1} the cost increase for the recovery of forest fuel, excluding stumps, is around 4-6% and 8-11% for medium and longer forwarding distances, respectively. The stump and small roundwood systems are less cost-effective at lower forest fuel intensity per area. For systems where loose material is forwarded, less dry-matter per hectare increases costs by 6-7%, while a difficult terrain increases costs by 3-4%. Still, these systems are quite cost-effective. The cost of spreading ash is around 40 EUR{sub 2005} ha{sup -1}, while primary energy use for spreading ash in areas where logging residues, stumps, and small roundwood are recovered is about 0.025% of the recovered bioenergy. (author)

  7. Life-Cycle Costing of Food Waste Management in Denmark: Importance of Indirect Effects.

    Science.gov (United States)

    Martinez-Sanchez, Veronica; Tonini, Davide; Møller, Flemming; Astrup, Thomas Fruergaard

    2016-04-19

    Prevention has been suggested as the preferred food waste management solution compared to alternatives such as conversion to animal fodder or to energy. In this study we used societal life-cycle costing, as a welfare economic assessment, and environmental life-cycle costing, as a financial assessment combined with life-cycle assessment, to evaluate food waste management. Both life-cycle costing assessments included direct and indirect effects. The latter are related to income effects, accounting for the marginal consumption induced when alternative scenarios lead to different household expenses, and the land-use-changes effect, associated with food production. The results highlighted that prevention, while providing the highest welfare gains as more services/goods could be consumed with the same income, could also incur the highest environmental impacts if the monetary savings from unpurchased food commodities were spent on goods/services with a more environmentally damaging production than that of the (prevented) food. This was not the case when savings were used, e.g., for health care, education, and insurances. This study demonstrates that income effects, although uncertain, should be included whenever alternative scenarios incur different financial costs. Furthermore, it highlights that food prevention measures should not only demote the purchase of unconsumed food but also promote a low-impact use of the savings generated.

  8. The indirect costs and benefits of greenhouse gas limitations: Hungary Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Zilahy, G.; Zsoka, A.N.; Szeszler, A.; Urge-Vorsatz, D.; Markandya, A.; Hunt, A.

    2000-05-01

    A methodology has been developed which provides a framework for the assessment of the wider impacts arising from GHG limitation projects, and advice on how to incorporate them into the decision-making framework. The purpose of this report is to apply the methodology to a set of selected GHG limitation projects currently being considered for implementation in Hungary. In total, four GHG limitation projects were selected for application of the methodology. This second phase of the research in Hungary, concentrated on four mitigation options in the household sector: Specifically, the selected GHG limitation projects involve: 1. The installation of new, better insulated windows. 2. The installation of water saving devices on water taps. 3. The installation of active solar cells to prepare domestic hot water. 4. The replacement of traditional light bulbs by compact fluorescent bulbs. This study has shown the potential, as well as the current pratical limitations, of the methodology. The value of the employment created has been estimated by adding gains in income effects with health effects. The environmental effects that have been quantified suggest that the reduction of pollution and associated health effects would be significant. The options that have been investigated are too small-scale to generate distributional impacts or macro-economic effects but the estimated effects on sustainability are positive and significant. The principal policy conclusion that can be drawn from the analysis thus far is that it is imperative to consider indirect effects. It is possible that inclusion of indirect effects will make the net economic cost of an option negative thereby making it much more easy to 'sell' as a policy measure - though the assumptions will have to be made explicit and therefore defensible. It is important for policy makers to note that whilst there is a general pattern of lower economic costs derived from this analysis, the reductions are not uniform and

  9. The indirect costs and benefits of greenhouse gas limitations: Hungary Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Zilahy, G; Zsoka, A N; Szeszler, A; Urge-Vorsatz, D; Markandya, A; Hunt, A

    2000-05-01

    A methodology has been developed which provides a framework for the assessment of the wider impacts arising from GHG limitation projects, and advice on how to incorporate them into the decision-making framework. The purpose of this report is to apply the methodology to a set of selected GHG limitation projects currently being considered for implementation in Hungary. In total, four GHG limitation projects were selected for application of the methodology. This second phase of the research in Hungary, concentrated on four mitigation options in the household sector: Specifically, the selected GHG limitation projects involve: 1. The installation of new, better insulated windows. 2. The installation of water saving devices on water taps. 3. The installation of active solar cells to prepare domestic hot water. 4. The replacement of traditional light bulbs by compact fluorescent bulbs. This study has shown the potential, as well as the current pratical limitations, of the methodology. The value of the employment created has been estimated by adding gains in income effects with health effects. The environmental effects that have been quantified suggest that the reduction of pollution and associated health effects would be significant. The options that have been investigated are too small-scale to generate distributional impacts or macro-economic effects but the estimated effects on sustainability are positive and significant. The principal policy conclusion that can be drawn from the analysis thus far is that it is imperative to consider indirect effects. It is possible that inclusion of indirect effects will make the net economic cost of an option negative thereby making it much more easy to 'sell' as a policy measure - though the assumptions will have to be made explicit and therefore defensible. It is important for policy makers to note that whilst there is a general pattern of lower economic costs derived from this analysis, the reductions are not uniform and

  10. Disease activity, quality of life and indirect costs of reduced productivity at work, generated by Polish patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Paweł Kawalec

    2016-02-01

    Full Text Available Objectives: The aim of the study was to investigate the association between activity of ankylosing spondylitis (AS and decrease in quality of life as well as productivity loss of affected patients in a specified group of patients in the Polish setting. Material and methods : An questionnaire survey was conducted using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI to assess disease activity, as well as the Work Productivity and Activity Impairment Questionnaires to assess productivity loss; quality of life was presented as utility calculated using the EuroQol 5 questionnaire and also measured on a visual analogue scale (VAS. Indirect costs were assessed with the human capital approach implying gross domestic product per capita or gross value added per worker in Poland in 2014 and were expressed in Polish zlotys (PLN as well as in euros. Correlation was presented using Spearman’s rank correlation coefficient. Results : We performed our analysis based on 78 full questionnaires collected. A mean BASDAI score of 5.91 in the analysed group of patients was detected and mean utility of 0.5135 was observed. Average quality of life measured on the visual analogue scale was 46.55. Mean number of days off work was 45.26 days per year and mean on-the-job productivity loss was 49.29%. Average annual indirect costs per patient were €4241 (17 686 PLN calculated using gross domestic product and €10 172 (42 417 PLN estimated using gross value added. Total productivity loss was significantly correlated with disease activity (strong correlation of 0.6005 and utility (moderate correlation of –0.3698. Conclusions : Ankylosing spondylitis causes a great decrease in quality of life as well as patients’ productivity loss associated with both absenteeism and presenteeism. The greater the disease activity is, the lower is the utility, the lower is the quality of life measured on the VAS, and the greater are the total annual indirect costs. Total

  11. The economic impact of chronic fatigue syndrome in Georgia: direct and indirect costs

    Directory of Open Access Journals (Sweden)

    Brimmer Dana J

    2011-01-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating chronic illness affecting at least 4 million people in the United States. Understanding its cost improves decisions regarding resource allocation that may be directed towards treatment and cure, and guides the evaluation of clinical and community interventions designed to reduce the burden of disease. Methods This research estimated direct and indirect costs of CFS and the impact on educational attainment using a population-based, case-control study between September 2004 and July 2005, Georgia, USA. Participants completed a clinical evaluation to confirm CFS, identify other illnesses, and report on socioeconomic factors. We estimated the effect of CFS on direct medical costs (inpatient hospitalizations, provider visits, prescription medication spending, other medical supplies and services and loss in productivity (employment and earnings with a stratified sample (n = 500 from metropolitan, urban, and rural Georgia. We adjusted medical costs and earnings for confounders (age, sex, race/ethnicity, education, and geographic strata using econometric models and weighted estimates to reflect response-rate adjusted sampling rates. Results Individuals with CFS had mean annual direct medical costs of $5,683. After adjusting for confounding factors, CFS accounted for $3,286 of these costs (p Conclusions Study results indicate that chronic fatigue syndrome may lead to substantial increases in healthcare costs and decreases in individual earnings. Studies have estimated up to 2.5% of non-elderly adults may suffer from CFS. In Georgia, a state with roughly 5.5 million people age 18-59, illness could account for $452 million in total healthcare expenditures and $1.2 billion of lost productivity.

  12. New Federal Cost Accounting Regulations

    Science.gov (United States)

    Wolff, George J.; Handzo, Joseph J.

    1973-01-01

    Discusses a new set of indirect cost accounting procedures which must be followed by school districts wishing to recover any indirect costs of administering federal grants and contracts. Also discusses the amount of indirect costs that may be recovered, computing indirect costs, classifying project costs, and restricted grants. (Author/DN)

  13. Productivity loss and resource utilization, and associated indirect and direct costs in individuals providing care for adults with schizophrenia in the EU5

    Directory of Open Access Journals (Sweden)

    Gupta S

    2015-11-01

    Full Text Available Shaloo Gupta,1 Gina Isherwood,2 Kevin Jones,3 Kristel Van Impe4 1Kantar Health, Princeton, NJ, USA; 2Kantar Health, Epsom, Surrey, UK; 3European Federation of Associations of Families of People with Mental Illness, Diestsevest, Leuven, Belgium; 4Janssen-Cilag GmbH, Neuss, Germany Objective: This study aimed to understand the impact of providing care for adults with schizophrenia on productivity, resource utilization, and costs in the EU5 (France, Germany, Italy, Spain, and UK. Methods: Data from the 2010, 2011, and 2013 EU5 National Health and Wellness Survey, an online questionnaire of a nationwide sample of adults, were analyzed. Schizophrenia caregivers (n=398 were matched to noncaregivers (n=158,989 and other caregivers (n=14,341 via propensity scores. Outcome measures included health care utilization, Work Productivity and Activity Impairment questionnaire-based scores, and associated direct and indirect costs (estimated from the literature. Significant differences between schizophrenia caregivers vs noncaregivers and other caregivers (eg, cancer and Alzheimer's disease were examined. Results: After matching, schizophrenia caregivers reported greater activity impairment (38.4% vs 26.1%, provider visits (8.0 vs 5.7, emergency room visits (0.9 vs 0.2, hospitalizations (0.8 vs 0.1, and direct costs (€2,258 vs €617 than noncaregivers, all P<0.001. Employed schizophrenia caregivers reported greater absenteeism, presenteeism, overall work impairment (35.0% vs 20.7%, and indirect costs (€6,667 vs €3,795 than noncaregivers, all P<0.001. Schizophrenia caregivers (vs other caregivers reported greater activity impairment (38.4% vs 32.3% and provider visits (8.0 vs 6.6, P<0.05. A greater proportion of schizophrenia caregivers (vs other caregivers reported at least one emergency room visit (26.1% vs 20.2% and hospitalization (20.4% vs 14.3%, P<0.05. Employed schizophrenia caregivers incurred greater indirect costs than other caregivers (€6

  14. Indirect and direct costs of acute coronary syndromes with comorbid atrial fibrillation, heart failure, or both

    Directory of Open Access Journals (Sweden)

    Ghushchyan V

    2014-12-01

    Full Text Available Vahram Ghushchyan,1,2 Kavita V Nair,2 Robert L Page II2,3 1College of Business and Economics, American University of Armenia, Yerevan, Armenia; 2Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA; 3Department of Physical Medicine, School of Medicine, University of Colorado, Aurora, CO, USA Background: The objective of this study was to determine the direct and indirect costs of acute coronary syndromes (ACS alone and with common cardiovascular comorbidities. Methods: A retrospective analysis was conducted using the Medical Expenditure Panel Survey from 1998 to 2009. Four mutually exclusive cohorts were evaluated: ACS only, ACS with atrial fibrillation (AF, ACS with heart failure (HF, and ACS with both conditions. Direct costs were calculated for all-cause and cardiovascular-related health care resource utilization. Indirect costs were determined from productivity losses from missed days of work. Regression analysis was developed for each outcome controlling for age, US census region, insurance coverage, sex, race, ethnicity, education attainment, family income, and comorbidity burden. A negative binomial regression model was used for health care utilization variables. A Tobit model was utilized for health care costs and productivity loss variables. Results: Total health care costs were greatest for those with ACS and both AF and HF ($38,484±5,191 followed by ACS with HF ($32,871±2,853, ACS with AF ($25,192±2,253, and ACS only ($17,954±563. Compared with the ACS only cohort, the mean all-cause adjusted health care costs associated with ACS with AF, ACS with HF, and ACS with AF and HF were $5,073 (95% confidence interval [CI] 719–9,427, $11,297 (95% CI 5,610–16,985, and $15,761 (95% CI 4,784–26,738 higher, respectively. Average wage losses associated with ACS with and without AF and/or HF amounted to $5,266 (95% CI -7,765, -2,767, when compared with patients

  15. Direct benefits of choosing a high-fitness mate can offset the indirect costs associated with intralocus sexual conflict.

    Science.gov (United States)

    Pischedda, Alison; Chippindale, Adam K

    2017-06-01

    Intralocus sexual conflict generates a cost to mate choice: high-fitness partners transmit genetic variation that confers lower fitness to offspring of the opposite sex. Our earlier work in the fruit fly, Drosophila melanogaster, revealed that these indirect genetic costs were sufficient to reverse potential "good genes" benefits of sexual selection. However, mate choice can also confer direct fitness benefits by inducing larger numbers of progeny. Here, we consider whether direct benefits through enhanced fertility could offset the costs associated with intralocus sexual conflict in D. melanogaster. Using hemiclonal analysis, we found that females mated to high-fitness males produced 11% more offspring compared to those mated to low-fitness males, and high-fitness females produced 34% more offspring than low-fitness females. These direct benefits more than offset the reduction in offspring fitness caused by intralocus sexual conflict, creating a net fitness benefit for each sex to pairing with a high-fitness partner. Our findings highlight the need to consider both direct and indirect effects when investigating the fitness impacts of mate choice. Direct fitness benefits may shelter sexually antagonistic alleles from selection, suggesting a novel mechanism for the maintenance of fitness variation. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  16. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Science.gov (United States)

    2010-10-01

    ... Payment System for Inpatient Hospital Capital Costs Basic Methodology for Determining the Federal Rate for Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data. CMS.... The indirect teaching adjustment factor equals [e (raised to the power of .2822×the ratio of residents...

  17. 77 FR 58989 - Proposed CERCLA Administrative Cost Recovery Settlement for the Buckbee-Mears Co. Superfund Site...

    Science.gov (United States)

    2012-09-25

    ... paid $150,000 attributable to the costs of marketing and selling the Properties; (b) The Bank will pay... ENVIRONMENTAL PROTECTION AGENCY [FRL-9720-7] Proposed CERCLA Administrative Cost Recovery... costs concerning the Buckbee-Mears Co. Superfund Site located in Cortland, Cortland County, New York...

  18. A conceptional design, cost and sensitivity analysis on adsorption process for uranium recovery from seawater

    International Nuclear Information System (INIS)

    Ogata, Noboru

    1986-01-01

    The system model for a conceptional design and cost estimation was studied on a multi-layered fluidizing bed with a pump which used hydrous titanium oxide (HTO) and amidoxime resin (AOR) as adsorbents. The cost effect of some parameters, namely characteristics of adsorbent, operating conditions, price of materials and some others, were estimated, and finally there was shown a direction of improvement and a possibility of cost reduction. The conceptional design and operating condition were obtained from the balance point on expansion ratio, recovery and characteristics of adsorbent. A suitable plan was obtained from the minimum cost condition in some level of the expansion ratio and some parameters. HTO was heavy in density and cheap in price. The main results of the study indicated that the thickness of the bed was 1 m, the linear velocity of seawater was 52 m/hr, the number of bed layers was 4, the construction cost of a 100 t/y plant was 10 billion yen, and the uranium cost was 160 $/1b. AOR had a large adsorption capacity. As the main results, the thickness of bed was 0.08 m, the linear velosity of seawater was 11.6 m, the number of the bed layers was 27, the construction cost of a 100 t/y plant was 15 billion yen, and the uranium cost was 280 $/1b. The size of the 100 t/y plant was about 800 m length x 80 m depth x 30 m height at 80 % of recovery. An increase of adsorption capacity in HTO, and an increase of density and particle size in AOR had the greatest merit for cost reduction. Other effective parameters were the adsorption velocity, the recovery, temperature, the price of adsorbent, the manufacturing cost of instrument, and the rate of interest. The cost of uranium by this process had a possibility of cost reduction to 67 $/1b at HTO and 79 $/1b at AOR. (author)

  19. Regional economic activity and absenteeism: a new approach to estimating the indirect costs of employee productivity loss.

    Science.gov (United States)

    Bankert, Brian; Coberley, Carter; Pope, James E; Wells, Aaron

    2015-02-01

    This paper presents a new approach to estimating the indirect costs of health-related absenteeism. Productivity losses related to employee absenteeism have negative business implications for employers and these losses effectively deprive the business of an expected level of employee labor. The approach herein quantifies absenteeism cost using an output per labor hour-based method and extends employer-level results to the region. This new approach was applied to the employed population of 3 health insurance carriers. The economic cost of absenteeism was estimated to be $6.8 million, $0.8 million, and $0.7 million on average for the 3 employers; regional losses were roughly twice the magnitude of employer-specific losses. The new approach suggests that costs related to absenteeism for high output per labor hour industries exceed similar estimates derived from application of the human capital approach. The materially higher costs under the new approach emphasize the importance of accurately estimating productivity losses.

  20. Mechanical work as an indirect measure of subjective costs influencing human movement.

    Directory of Open Access Journals (Sweden)

    Karl E Zelik

    Full Text Available To descend a flight of stairs, would you rather walk or fall? Falling seems to have some obvious disadvantages such as the risk of pain or injury. But the preferred strategy of walking also entails a cost for the use of active muscles to perform negative work. The amount and distribution of work a person chooses to perform may, therefore, reflect a subjective valuation of the trade-offs between active muscle effort and other costs, such as pain. Here we use a simple jump landing experiment to quantify the work humans prefer to perform to dissipate the energy of landing. We found that healthy normal subjects (N = 8 preferred a strategy that involved performing 37% more negative work than minimally necessary (P<0.001 across a range of landing heights. This then required additional positive work to return to standing rest posture, highlighting the cost of this preference. Subjects were also able to modulate the amount of landing work, and its distribution between active and passive tissues. When instructed to land softly, they performed 76% more work than necessary (P<0.001, with a higher proportion from active muscles (89% vs. 84%, P<0.001. Stiff-legged landings, performed by one subject for demonstration, exhibited close to the minimum of work, with more of it performed passively through soft tissue deformations (at least 30% in stiff landings vs. 16% preferred. During jump landings, humans appear not to minimize muscle work, but instead choose to perform a consistent amount of extra work, presumably to avoid other subjective costs. The degree to which work is not minimized may indirectly quantify the relative valuation of costs that are otherwise difficult to measure.

  1. The impact of consumer awareness of water sector issues on willingness to pay and cost recovery in Zambia

    Science.gov (United States)

    Ntengwe, F. W.

    The recovery of costs in water utilities is a key element in sustainability of both the provider and of the water resource itself. This paper examines the role played by consumer awareness in their willingness to pay for water supply in two cities in Zambia. Research conducted in Kitwe and Lusaka reveals that level of awareness, willingness to pay and cost recovery all vary directly. Whereas awareness may increase consumers’ willingness to pay, therefore assisting service provider’s cost recovery, the research presented here also reveals that factors such as ability to pay, affordability of bills, quality of water and of the service provided, as well as good business-consumer relations are important factors affecting a utility’s ability to recover its costs. If water utilities are to attain sustainability over the long-term, they will have to embark on and maintain consumer awareness programmes, raise the quality of service (e.g., through improved operation and maintenance), and develop and apply the right water tariff.

  2. DROUGHTS IN THE TIETÊ-PARANÁ WATERWAY: IMPACTS ON THE DIRECT, INDIRECT AND HIDDEN COSTS IN THE TRANSPORTATION OF SOYBEAN.

    Directory of Open Access Journals (Sweden)

    Rodrigo Carlo Toloi

    2016-05-01

    Full Text Available Brazil's agricultural economy is growing and increasing productivity. Therefore, it has required transportation systems with high load capacity and lower transportation costs. However, with the drought in the Southeast region of Brazil, the waterway Tietê-Paraná closed since May 2014 generating a loss of more than 30 million last year. Thus, this study investigates the impacts on direct, indirect and hidden costs resulting from this change of route for soy transport. The methodology consists of an exploratory, descriptive and bibliographic research that seeks to raise the main costs. The results show that failing to ensure the production of soybeans by the Tiete-Parana waterway and using the highway transportation costs for waterway users are increased by US$ 37,760,146.86.

  3. Transaction Costs in Collective Waste Recovery Systems in the EU

    OpenAIRE

    Nozharov, Shteryo

    2018-01-01

    The study aims to identify the institutional flaws of the current EU waste management model by analysing the economic model of extended producer responsibility and collective waste management systems and to create a model for measuring the transaction costs borne by waste recovery organizations. The model was approbated by analysing the Bulgarian collective waste management systems that have been complying with the EU legislation for the last 10 years. The analysis focuses on waste oils becau...

  4. Cost Recovery in Urban Water Services : Select Experiences in Indian Cities

    OpenAIRE

    Gupta, Anjali Sen

    2011-01-01

    The report draws on a Water and Sanitation Program (WSP) study from 2008 which made a comparative analysis of 23 Urban Local Bodies (ULBs)-looking at seven cities in detail and another 16 based on secondary data-to understand the factors affecting cost recovery in India and provide an indication of current performance. It also draws out examples and lessons to inform reform approaches and ...

  5. Decommissioning cost recovery in the United States: lessons learned from Connecticut Yankee NPP

    International Nuclear Information System (INIS)

    Joosten, J.

    1999-01-01

    The international audience at ICONE-7 is already familiar with the roles of the owner and the NRC in ensuring the technical and safety performance goals of nuclear plant decommissioning. This paper addresses the role of the economic regulator since the pursuit of technical and safety goals must necessarily carry with them -a price tag- and owners must be concerned with the recovery of those costs. Answers to questions about how to pay and who should pay for decommissioning can very often influence nuclear power plant owner's decision-making. In the United States, most nuclear power plants are privately owned. Nevertheless, their owners are not totally free to determine the plant's economics or profitability. Instead, plant owners must sell their electricity to consumers in a regulated market wherein the price of electricity and terms of sale are controlled by the government. Under this regulatory regime, utilities are generally allowed to recover their investment costs -including decommissioning costs- provided that such costs are prudently, incurred. However, when an owner retires the plant prematurely, the prudence of his actions -up to and including the shutdown- are likely to be challenged. In 1997, for example, the owners of the Connecticut Yankee reactor faced a stiff challenge to the recovery of decommissioning costs when they shut down the plant ten years before license expiration. The Connecticut Yankee case thus provides valuable insights into the role of economic regulation on a nuclear plant's decommissioning strategy. (author)

  6. Promoting mental health recovery after hurricanes Katrina and Rita: what can be done at what cost.

    Science.gov (United States)

    Schoenbaum, Michael; Butler, Brittany; Kataoka, Sheryl; Norquist, Grayson; Springgate, Benjamin; Sullivan, Greer; Duan, Naihua; Kessler, Ronald C; Wells, Kenneth

    2009-08-01

    Concerns about mental health recovery persist after the 2005 Gulf storms. We propose a recovery model and estimate costs and outcomes. To estimate the costs and outcomes of enhanced mental health response to large-scale disasters using the 2005 Gulf storms as a case study. Decision analysis using state-transition Markov models for 6-month periods from 7 to 30 months after disasters. Simulated movements between health states were based on probabilities drawn from the clinical literature and expert input. A total of 117 counties/parishes across Louisiana, Mississippi, Alabama, and Texas that the Federal Emergency Management Agency designated as eligible for individual relief following hurricanes Katrina and Rita. Hypothetical cohort, based on the size and characteristics of the population affected by the Gulf storms. Intervention Enhanced mental health care consisting of evidence-based screening, assessment, treatment, and care coordination. Morbidity in 6-month episodes of mild/moderate or severe mental health problems through 30 months after the disasters; units of service (eg, office visits, prescriptions, hospital nights); intervention costs; and use of human resources. Full implementation would cost $1133 per capita, or more than $12.5 billion for the affected population, and yield 94.8% to 96.1% recovered by 30 months, but exceed available provider capacity. Partial implementation would lower costs and recovery proportionately. Evidence-based mental health response is feasible, but requires targeted resources, increased provider capacity, and advanced planning.

  7. Cost of stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Iversen, Helle K; Ibsen, Rikke

    2015-01-01

    . The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls......BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients...

  8. The impact of cost recovery on electric utilities' Clean Air Act compliance strategies

    International Nuclear Information System (INIS)

    Bensinger, D.L.

    1993-01-01

    By 1995, over 200 electric power plant units in twenty one states must comply with Phase I of the acid rain requirements in Title IV of the 1990 Clean Air Act Amendments (CAAA). By the year 2000, an additional 2200 units must comply with the Title IV. Compliance costs are expected to necessitate significant electricity rate increases. In order to recover their compliance costs, utilities must file rate increase requests with state public utility commissions (PUC's), and undergo a rate proceeding involving public heatings. Because of the magnitude of cost and the complexity of compliance options, including interaction with Titles I and III of the CAAA, extensive PUC reviews of compliance strategies are likely. These reviews could become as adversarial as the nuclear prudence reviews of the 1980's. A lack of understanding of air pollution and the CAA by much of the general public and the flexibility of compliance options creates an environment conducive to adverse public reaction to the cost of complying with the Clean Air Act. Public attitudes toward pollution control technologies will be greatly affected by these hearings, and the early plant hearings will shape the utility rate making process under the Clean Air Act. Inadequate cost recovery due to constrained compliance strategies or adverse hearings could significantly inhibit industry willingness to invest in certain control technologies or advanced combustion technologies. There are already signs that Clean Air Act compliance will be the prudence issue of the 1990's for utilities, even where state statutes mandate particular compliance approaches. Specific actions should be undertaken now by the utility industry to improve the probability of sound cost recovery decisions, preserve compliance options, including multimedia strategies, and avoid the social- and cost-acceptance problems of nuclear power

  9. Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

    Science.gov (United States)

    Joliat, Gaëtan-Romain; Labgaa, Ismaïl; Hübner, Martin; Blanc, Catherine; Griesser, Anne-Claude; Schäfer, Markus; Demartines, Nicolas

    2016-10-01

    Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery. A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed. Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were €38,726 and €42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of €3080 per patient after ERAS implementation. ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.

  10. Indirect costs of absenteeism due to rheumatoid arthritis, psoriasis, multiple sclerosis, insulin-dependent diabetes mellitus, and ulcerative colitis in 2012: a study based on real-life data from the Social Insurance Institution in Poland.

    Science.gov (United States)

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

    2016-01-01

    The aim of this study is to assess the indirect costs of six major autoimmune diseases including seropositive rheumatoid arthritis, other types of rheumatoid arthritis, psoriasis, multiple sclerosis, Type 1 diabetes, and ulcerative colitis. Relevant data for 2012 on sick leave and short- and long-term work disabilities were obtained from the Social Insurance Institution in Poland. Indirect costs were estimated using the human capital approach based on gross domestic product per capita, gross value added per worker, and gross income per worker in Poland in 2012 and expressed in euro. We recorded data on the total number of 45,500 patients. The total indirect costs were EUR 146,862,569; 353,683,508; and 108,154,271, calculated using gross domestic product, gross value added, and gross income, respectively. Considering only data on absenteeism collected by the Social Insurance Institution in Poland, we can conclude that the selected autoimmune diseases are associated with great indirect costs.

  11. Direct and indirect responses of tallgrass prairie butterflies to prescribed burning

    Science.gov (United States)

    Vogel, Jennifer A.; Koford, Rolf R.; Debinski, Diane M.

    2010-01-01

    Fire is an important tool in the conservation and restoration of tallgrass prairie ecosystems. We investigated how both the vegetation composition and butterfly community of tallgrass prairie remnants changed in relation to the elapsed time (in months) since prescribed fire. Butterfly richness and butterfly abundance were positively correlated with the time since burn. Habitat-specialist butterfly richness recovery time was greater than 70 months post-fire and habitat-specialist butterfly abundance recovery time was approximately 50 months post-fire. Thus, recovery times for butterfly populations after prescribed fires in our study were potentially longer than those previously reported. We used Path Analysis to evaluate the relative contributions of the direct effect of time since fire and the indirect effects of time since fire through changes in vegetation composition on butterfly abundance. Path models highlighted the importance of the indirect effects of fire on habitat features, such as increases in the cover of bare ground. Because fire return intervals on managed prairie remnants are often less than 5 years, information on recovery times for habitat-specialist insect species are of great importance. ?? 2010 Springer Science+Business Media B.V.

  12. Lowering operation costs by energy recovery

    Energy Technology Data Exchange (ETDEWEB)

    Wegener, W; Hausmann, H; Hausmann, K H

    1976-01-01

    Heat recovery and the heat sources available as well as possible applications of the heat recovered are discussed. Groundwater, shower water and waste air are considered as energy sources. Energy recovery by means of finned-tube systems and the heat pump, and economic aspects of the techniques are described.

  13. Mastitis therapy: Direct and indirect costs

    OpenAIRE

    Boboš, S.; Radinović, M.; Vidić, B.; Pajić, M.; Vidić, V.; Galfi, A.

    2013-01-01

    One of the most important problems in milk production, causing great economic loses is certainly mastitis. In order to minimize economic losses from mastitis dairy farms introduce different mastitis management programs. These programs include mastitis therapy and prevention. In mastitis control prevention is most important and when mastitis occurs cost of therapy and milk discharge is very important. In our study we examined cost of mastitis treatment and m...

  14. Study on performance prediction and energy saving of indirect evaporative cooling system

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Seong Yeon; Kim, Tae Ho; Kim, Myung Ho [Dept. of Mechanical Design Engineering, Chungnam National University, Daejeon (Korea, Republic of)

    2015-09-15

    The purpose of this study is to predict the performance of an indirect evaporative cooling system, and to evaluate its energy saving effect when applied to the exhaust heat recovery system of an air-handling unit. We derive the performance correlation of the indirect evaporative cooling system using a plastic heat exchanger based on experimental data obtained in various conditions. We predict the variations in the performance of the system for various return and outdoor air conditioning systems using the obtained correlation. We also analyze the energy saving of the system realized by the exhaust heat recovery using the typical meteorological data for several cities in Korea. The average utilization rate of the sensible cooling system for the exhaust heat recovery is 44.3% during summer, while that of the evaporative cooling system is 96.7%. The energy saving of the evaporative cooling system is much higher compared to the sensible cooling system, and was about 3.89 times the value obtained in Seoul.

  15. Energy Recovery Hydropower: Prospects for Off-Setting Electricity Costs for Agricultural, Municipal, and Industrial Water Providers and Users; July 2017 - September 2017

    Energy Technology Data Exchange (ETDEWEB)

    Levine, Aaron L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Curtis, Taylor L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Johnson, Kurt [Telluride Energy; Telluride, CO (United States)

    2018-01-11

    Energy recovery hydropower is one of the most cost-effective types of new hydropower development because it is constructed utilizing existing infrastructure, and it is typically able to complete Federal Energy Regulatory Commission (FERC) review in 60 days. Recent changes in federal and state policy have supported energy recovery hydropower. In addition, some states have developed programs and policies to support energy recovery hydropower, including resource assessments, regulatory streamlining initiatives, and grant and loan programs to reduce project development costs. This report examines current federal and state policy drivers for energy recovery hydropower, reviews market trends, and looks ahead at future federal resource assessments and hydropower reform legislation.

  16. Forecasting of indirect consumables for a Job Shop

    Science.gov (United States)

    Shakeel, M.; Khan, S.; Khan, W. A.

    2016-08-01

    A job shop has an arrangement where similar machines (Direct consumables) are grouped together and use indirect consumables to produce a product. The indirect consumables include hack saw blades, emery paper, painting brush etc. The job shop is serving various orders at a particular time for the optimal operation of job shop. Forecasting is required to predict the demand of direct and indirect consumables in a job shop. Forecasting is also needed to manage lead time, optimize inventory cost and stock outs. The objective of this research is to obtain the forecast for indirect consumables. The paper shows how job shop can manage their indirect consumables more accurately by establishing a new technique of forecasting. This results in profitable use of job shop by multiple users.

  17. 77 FR 4997 - Proposed Information Collection; Comment Request; Alaska Individual Fishing Quota Cost Recovery...

    Science.gov (United States)

    2012-02-01

    ... Jessup, Departmental Paperwork Clearance Officer, Department of Commerce, Room 6616, 14th and... about the value of landings of IFQ species and to calculate and submit fees. The Cost Recovery Program.... Estimated Number of Respondents: 2,500. Estimated Time per Response: 2 hours to complete IFQ Permit Holder...

  18. Treated Seawater as a Magnesium Source for Phosphorous Recovery from Wastewater—A Feasibility and Cost Analysis

    Directory of Open Access Journals (Sweden)

    Cejna Anna Quist-Jensen

    2016-12-01

    Full Text Available Conventional resources of phosphorous are at high risk of depletion in the near future due to current practices of its exploitation, thus new and improved exploration methodologies need to be developed to ensure phosphorous security. Today, some treatment plants recover phosphorous from municipal wastewater as struvite (MgNH4PO4·6H2O. Magnesium is often added to the wastewater as MgCl2·6H2O to facilitate the phosphorous recovery. However, the use of magnesium increases the costs of the process and is not aligned with sustainable development, therefore, alternative magnesium sources have to be found. The current study analyzes the feasibility of integrated membrane processes for magnesium recovery from seawater for utilization in the phosphorous recovery process. The integrated membrane systems consist of nanofiltration (NF, membrane distillation (MD, and membrane crystallization (MCr. The lowest associated cost is found for standalone NF treatment. However, the additional treatment with MD and MCr produces fresh water and salts like NaCl or potentially other valuable minerals at the expense of low-grade heat.

  19. A finite and stable exponential growth-adjusted indirect cost of cancer associated with discounted years of life lost in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Omar B. Da'ar

    2018-05-01

    Conclusion: Our findings reveal evidence of indirect cost associated with cancer premature deaths in Saudi Arabia. In order to develop cancer control actions, the results of this study can inform health system policymakers not only of the extent of the enormous economic burden but also drawing attention to epidemiological and economic factors that explain the variability of the burden.

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

    International Nuclear Information System (INIS)

    Westmacott, Chad; Cameron, Ron

    2012-02-01

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

  1. Direct and indirect punishment among strangers in the field.

    Science.gov (United States)

    Balafoutas, Loukas; Nikiforakis, Nikos; Rockenbach, Bettina

    2014-11-11

    Many interactions in modern human societies are among strangers. Explaining cooperation in such interactions is challenging. The two most prominent explanations critically depend on individuals' willingness to punish defectors: In models of direct punishment, individuals punish antisocial behavior at a personal cost, whereas in models of indirect reciprocity, they punish indirectly by withholding rewards. We investigate these competing explanations in a field experiment with real-life interactions among strangers. We find clear evidence of both direct and indirect punishment. Direct punishment is not rewarded by strangers and, in line with models of indirect reciprocity, is crowded out by indirect punishment opportunities. The existence of direct and indirect punishment in daily life indicates the importance of both means for understanding the evolution of cooperation.

  2. Water augmented indirectly-fired gas turbine systems and method

    Science.gov (United States)

    Bechtel, Thomas F.; Parsons, Jr., Edward J.

    1992-01-01

    An indirectly-fired gas turbine system utilizing water augmentation for increasing the net efficiency and power output of the system is described. Water injected into the compressor discharge stream evaporatively cools the air to provide a higher driving temperature difference across a high temperature air heater which is used to indirectly heat the water-containing air to a turbine inlet temperature of greater than about 1,000.degree. C. By providing a lower air heater hot side outlet temperature, heat rejection in the air heater is reduced to increase the heat recovery in the air heater and thereby increase the overall cycle efficiency.

  3. Assessing the indirect effects due to natural hazards on a mesoscale

    Science.gov (United States)

    Pfurtscheller, C.; Schwarze, R.

    2009-04-01

    Measuring indirect economic costs and other effects from natural hazards, especially floods in alpine and other mountainous regions, are a necessary part of a comprehensive economic assessment. Their omission seriously affects the relative economic benefits of structural or non structural measures of flood defence. Surpassing controversial, IO-model-based economic estimates, analysing indirect economic effects lead to the key question of identifying and evaluating the drivers of indirect economic effects and resilience to system effects in the regional economy, i.e. at the meso-level. This investigation takes place for the catastrophic floods in summer 2005 in the provinces of Tyrol and Vorarlberg, Austria, which caused an estimated € 670 Mio direct loss on private and public assets and severe interruptions in lifeline services. The paper starts out with differentiating the concept of indirect economic costs from direct costs, examing different temporal (short vs. long-term) and spatial (macro-, meso- vs. microeconomic) system boundaries. It surveys common theories of economic resilience and vulnerability at the regional economy level. Indirect effects at the regional economy level can be defined as interferences of the economic exchange of goods and services triggered by breakdowns of transport lines and critical production inputs. The extent and persistence of indirect effects of natural hazards is not only by parameters of the extreme event, such as duration and amplitude of the flood, but much more by resilience parameters of the regional economy such as size of enterprises, the network structure (linkages) of the regional economy, availability of insurance and relief funds, and the stock of inventory. These effects can only be dissected by means of expert judgement and event studies. This paper presents the results of a survey conducted among business practioneers, members of chamber of commerce, civil protection agencies to identify and scale the drivers of

  4. Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney: Findings From the KDOC Study.

    Science.gov (United States)

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

    2015-09-01

    Limited information exists on the predonation costs incurred by eventual living kidney donors (LKDs). Expenses related to completion of the donation evaluation were collected from 194 LKDs participating in the multi-center, prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 187, 96%) reported one or more direct costs, including ground transportation (80%), healthcare (24%), lodging (17%) and air transportation (14%), totaling $101 484 (USD; mean = $523 ± 942). Excluding paid vacation or sick leave, donor and companion lost wages totaled $35 918 (mean = $187 ± 556) and $14 378 (mean = $76 ± 311), respectively. One-third of LKDs used paid vacation or sick leave to avoid incurring lost wages. Few LKDs reported receiving financial support from the transplant candidate (6%), transplant candidate's family (3%), a nonprofit organization (3%), the National Living Donor Assistance Center (7%), or transplant center (3%). Higher total costs were significantly associated with longer distance traveled to the transplant center (p costs were not associated with age, sex, race/ethnicity, household income, marital status, insurance status, or transplant center. Moderate predonation direct and indirect costs are common for adults who complete the donation evaluation. Potential LKDs should be advised of these possible costs, and the transplant community should examine additional strategies to reimburse donors for them. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. Development of a simple, low cost, indirect ion beam fluence measurement system for ion implanters, accelerators

    Science.gov (United States)

    Suresh, K.; Balaji, S.; Saravanan, K.; Navas, J.; David, C.; Panigrahi, B. K.

    2018-02-01

    We developed a simple, low cost user-friendly automated indirect ion beam fluence measurement system for ion irradiation and analysis experiments requiring indirect beam fluence measurements unperturbed by sample conditions like low temperature, high temperature, sample biasing as well as in regular ion implantation experiments in the ion implanters and electrostatic accelerators with continuous beam. The system, which uses simple, low cost, off-the-shelf components/systems and two distinct layers of in-house built softwarenot only eliminates the need for costly data acquisition systems but also overcomes difficulties in using properietry software. The hardware of the system is centered around a personal computer, a PIC16F887 based embedded system, a Faraday cup drive cum monitor circuit, a pair of Faraday Cups and a beam current integrator and the in-house developed software include C based microcontroller firmware and LABVIEW based virtual instrument automation software. The automatic fluence measurement involves two important phases, a current sampling phase lasting over 20-30 seconds during which the ion beam current is continuously measured by intercepting the ion beam and the averaged beam current value is computed. A subsequent charge computation phase lasting 700-900 seconds is executed making the ion beam to irradiate the samples and the incremental fluence received by the sampleis estimated usingthe latest averaged beam current value from the ion beam current sampling phase. The cycle of current sampling-charge computation is repeated till the required fluence is reached. Besides simplicity and cost-effectiveness, other important advantages of the developed system include easy reconfiguration of the system to suit customisation of experiments, scalability, easy debug and maintenance of the hardware/software, ability to work as a standalone system. The system was tested with different set of samples and ion fluences and the results were verified using

  6. Cost-benefit analysis of copper recovery in remediation projects: A case study from Sweden.

    Science.gov (United States)

    Volchko, Yevheniya; Norrman, Jenny; Rosén, Lars; Karlfeldt Fedje, Karin

    2017-12-15

    Contamination resulting from past industrial activity is a problem throughout the world and many sites are severely contaminated by metals. Advances in research in recent years have resulted in the development of technologies for recovering metal from metal-rich materials within the framework of remediation projects. Using cost-benefit analysis (CBA), and explicitly taking uncertainties into account, this paper evaluates the potential social profitability of copper recovery as part of four remediation alternatives at a Swedish site. One alternative involves delivery of copper-rich ash to a metal production company for refining. The other three alternatives involve metal leaching from materials and sale of the resulting metal sludge for its further processing at a metal production company using metallurgical methods. All the alternatives are evaluated relative to the conventional excavation and disposal method. Metal recovery from the ash, metal sludge sale, and disposal of the contaminated soil and the ash residue at the local landfill site, was found to be the best remediation alternative. However, given the present conditions, its economic potential is low relative to the conventional excavation and disposal method but higher than direct disposal of the copper-rich ash for refining. Volatile copper prices, the high cost of processing equipment, the highly uncertain cost of the metal leaching and washing process, coupled with the substantial project risks, contribute most to the uncertainties in the CBA results for the alternatives involving metal leaching prior to refining. However, investment in processing equipment within the framework of a long-term investment project, production of safe, reusable soil residue, and higher copper prices on the metal market, can make metal recovery technology socially profitable. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    2012-01-01

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

  8. Cost-of-illness studies.

    Science.gov (United States)

    Oderda, Gary M

    2003-01-01

    Cost-of-illness studies measure the overall economic impact of a disease on society. Such studies are important in setting public health priorities and for economic evaluation of new treatments. These studies should take the societal perspective and include both direct and indirect costs. Often indirect costs exceed direct costs. Comparison of cost-of-illness studies from different countries is difficult because of differences in population, currency, the way health care is provided, and other social and political factors.

  9. The effect of pre-existing health conditions on the cost of recovery from road traffic injury: insights from data linkage of medicare and compensable injury claims in Victoria, Australia.

    Science.gov (United States)

    Hassani-Mahmooei, Behrooz; Berecki-Gisolf, Janneke; Hahn, Youjin; McClure, Roderick J

    2016-04-29

    Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury. Individuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost. Out of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs

  10. Efficient recovery of environmental DNA for expression cloning by indirect extraction methods

    NARCIS (Netherlands)

    Gabor, Esther; de Vries, Erik; Janssen, DB

    2003-01-01

    Using direct and cell extraction-based (indirect) isolation methods, DNA was obtained from environmental samples with largely differing characteristics (loam soil, sand soil, sediment, activated sludge, and compost) and evaluated with respect to the comprised bacterial diversity and its suitability

  11. Recovery Risk and Labor Costs in Public-Private Partnerships : Contractual Choice in the US Water industry

    OpenAIRE

    Albalate, Daniel, 1980-; Bel i Queralt, Germà, 1963-; Geddes, R. Richard

    2012-01-01

    We use an ordered logistic model to empirically examine the factors that explain varying degrees of private involvement in the U.S. water sector through public-private partnerships. Our estimates suggest that a variety of factors help explain greater private participation in this sector. We find that the risk to private participants regarding cost recovery is an important driver of private participation. The relative cost of labor is also a key factor in determining the degree of private invo...

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

    International Nuclear Information System (INIS)

    2012-09-01

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

  13. External costs of atmospheric lead emissions from a waste-to-energy plant: a follow-up assessment of indirect neurotoxic impacts via topsoil ingestion

    DEFF Research Database (Denmark)

    Pizzol, Massimo; Møller, Flemming; Thomsen, Marianne

    2013-01-01

    The link between anthropogenic emissions and the monetary value of their impacts, so-called external cost, can be determined via the impact pathway approach. This method is used in the present study to calculate the indirect costs, via topsoil ingestion, of lead emitted into atmosphere from a waste......-to-energy facility in Denmark. The Operational Meteorological air-quality model, the Simplified Fate and Speciation Model, and the Age Dependent Biokinetic Model are used to determine the metals’ atmospheric transport, its deposition and accumulation in topsoil, and its bio-accumulation in the human body...

  14. The 'indirect costs' of underfunding foreign partners in global health research: A case study.

    Science.gov (United States)

    Crane, Johanna T; Andia Biraro, Irene; Fouad, Tamer M; Boum, Yap; R Bangsberg, David

    2017-09-16

    This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work. MGH: Massachusetts General Hospital; MUST: Mbarara University of Science and Technology; NIH: National Institutes of Health; UCSF: University of California San Francisco; URI: Uganda Research Institute.

  15. 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...

  16. 48 CFR 1631.203 - Indirect costs.

    Science.gov (United States)

    2010-10-01

    ... Section 1631.203 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND... general practice in the insurance industry. [70 FR 31391, June 1, 2005] ...

  17. Recovery of Utility Fixed Costs: Utility, Consumer, Environmental and Economist Perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Lisa [Inst. for Electric Innovation and The Edison Foundation, Washington DC (United States); Hemphill, Ross [RCHemphill Solutions, Columbus, OH (United States); Howat, John [National Consumer Law Center, Boston, MA (United States); Cavanagh, Ralph [Natural Resources Defense Council, New York, NY (United States); Borenstein, Severin [Univ. of California, Berkeley, CA (United States); Deason, Jeff [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-06-14

    Utilities recover costs for providing electric service to retail customers through a combination of rate components that together comprise customers’ monthly electric bills. Rates and rate designs are set by state regulators and vary by jurisdiction, utility and customer class. In addition to the fundamental tenet of setting fair and reasonable rates, rate design balances economic efficiency, equity and fairness, customer satisfaction, utility revenue stability, and customer price and bill stability.1 At the most basic level, retail electricity bills in the United States typically include a fixed monthly customer charge — a set dollar amount regardless of energy usage — and a volumetric energy charge for each kilowatt-hour consumed.2 The energy charge may be flat across all hours, vary by usage level (for example, higher rates at higher levels of usage), or vary based on time of consumption.3 While some utility costs, such as fuel costs, clearly vary according to electricity usage, other costs are “fixed” over the short run — generally, those that do not vary over the course of a year. Depending on your point of view, and whether the state’s electricity industry has been restructured or remains vertically integrated, the set of costs that are “fixed” may be quite limited. Or the set may extend to all capacity costs for generation, transmission and distribution. In the long run, all costs are variable. In the context of flat or declining loads in some regions, utilities are proposing a variety of changes to retail rate designs, particularly for residential customers, to recover fixed costs. In this report, authors representing utility (Chapter 1), consumer (Chapter 2), environmentalist (Chapter 3) and economist (Chapter 4) perspectives discuss fixed costs for electric utilities and set out their principles for recovering those costs. The table on the next page summarizes each author’s relative preferences for various options for fixed cost

  18. The economic effect of electricity net-metering with solar PV: Consequences for network cost recovery, cross subsidies and policy objectives

    International Nuclear Information System (INIS)

    Eid, Cherrelle; Reneses Guillén, Javier; Frías Marín, Pablo; Hakvoort, Rudi

    2014-01-01

    Net-metering is commonly known as a practice by which owners of distributed generation (DG) units may offset their electricity consumption from the grid with local generation. The increasing number of prosumers (consumers that both produce and consume electricity) with solar photovoltaic (PV) generation combined with net-metering results in reduced incomes for many network utilities worldwide. Consequently, this pushes utilities to increase charges per kW h in order to recover costs. For non-PV owners, this could result into inequality issues due to the fact that also non-PV owners have to pay higher chargers for their electricity consumed to make up for netted costs of PV-owners. In order to provide insight in those inequality issues caused by net-metering, this study presents the effects on cross-subsidies, cost recovery and policy objectives evolving from different applied netmetering and tariff designs for a residential consumer. Eventually this paper provides recommendations regarding tariffs and metering that will result in more explicit incentives for PV, instead of the current implicit incentives which are present to PV owners due to net-metering. - Highlights: • Network users are frequently charged by energy charging and fixed charging. • Net-metering with energy charging causes potential problems for DSO cost recovery. • Increasing rolling credit timeframes amplify net-metering impacts on cost recovery. • Observed capacity charging can incentivize local storage and self-consumption. • PV owners should receive direct incentives in order to avoid cross subsidization

  19. Indirect reciprocity with optional interactions.

    Science.gov (United States)

    Ghang, Whan; Nowak, Martin A

    2015-01-21

    Indirect reciprocity is a mechanism for the evolution of cooperation that is relevant for prosocial behavior among humans. Indirect reciprocity means that my behavior towards you also depends on what you have done to others. Indirect reciprocity is associated with the evolution of social intelligence and human language. Most approaches to indirect reciprocity assume obligatory interactions, but here we explore optional interactions. In any one round a game between two players is offered. A cooperator accepts a game unless the reputation of the other player indicates a defector. For a game to take place, both players must accept. In a game between a cooperator and a defector, the reputation of the defector is revealed to all players with probability Q. After a sufficiently large number of rounds the identity of all defectors is known and cooperators are no longer exploited. The crucial condition for evolution of cooperation can be written as hQB>1, where h is the average number of rounds per person and B=(b/c)-1 specifies the benefit-to-cost ratio. We analyze both stochastic and deterministic evolutionary game dynamics. We study two extensions that deal with uncertainty: hesitation and malicious gossip. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

    Science.gov (United States)

    Ganapathy, Vaidyanathan; Graham, Glenn D; DiBonaventura, Marco D; Gillard, Patrick J; Goren, Amir; Zorowitz, Richard D

    2015-01-01

    Objective Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity. Methods Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale), Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages). Results Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71) had overall work restriction (32%), absenteeism (9%), and presenteeism (27%). Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism). Conclusion These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor. PMID:26609225

  1. The health economics of ankle and foot sprains and fractures: A systematic review of English-language published papers. Part 2: The direct and indirect costs of injury.

    Science.gov (United States)

    Bielska, Iwona A; Wang, Xiang; Lee, Raymond; Johnson, Ana P

    2017-07-20

    Ankle and foot sprains and fractures are prevalent injuries, which may result in substantial physical and economic consequences for the patient and place a financial burden on the health care system. Therefore, the objectives of this paper are to examine the direct and indirect costs of treating ankle and foot injuries (sprains, dislocations, fractures), as well as to provide an overview of the outcomes of full economic analyses of different treatment strategies. A systematic review was carried out among seven databases to identify English language publications on the health economics of ankle and foot injury treatment published between 1980 and 2014. The direct and indirect costs were abstracted by two independent reviewers. All costs were adjusted for inflation and reported in 2016 US dollars (USD). Among 2047 identified studies, 32 were selected for analysis. The direct costs of ankle sprain management ranged from $292 to $2268 per patient (2016 USD), depending on the injury severity and treatment strategy. The direct costs of managing ankle fractures were higher ($1908-$19,555). Foot fracture treatment had similar direct costs ranging from $998 to $21,801. The economic evaluations were conducted from the societal or payer's perspectives. The costs of treating ankle and foot sprains and fractures varied among the studies, mostly due to differences in injury type and study characteristics, which impacted the ability of directly comparing the financial burden of treatment. Nonetheless, the review showed that the costs experienced by the patient and the health care system increased with injury complexity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. [Cost recovery for the treatment of retinal and vitreal diseases by pars plana vitrectomy under the German DRG system].

    Science.gov (United States)

    Framme, C; Franz, D; Mrosek, S; Helbig, H

    2007-10-01

    Since 2004 inpatient health care in Germany is paid according to calculated DRGs. Only a few university hospitals participated in distinct cost calculations of clinical treatment. It was the aim of this study to check the cost recovery at a University Eye Hospital for the surgical treatment of retinal and vitreal diseases by pars plana vitrectomy (ppV), which are included in DRGs C03Z and C17Z. The performance data for both DRGs were collected for the years 2005 and 2006 using the E1 sheets according to section 21 KHEntG. The mean duration of all procedures was collected by data from the internal controlling. Costs for single operations were calculated from fixed and variable costs for the operation theatre and the ward including costs for personnel and material. In the 2-year period of 4,721 inpatient procedures 1,307 ppVs were performed. Each ppV had fixed surgical costs of 130.60 EUR; personnel costs varied between 575 EUR (C03Z; including cataract surgery; mean OP duration: 85 min) and 510 EUR (C17Z; no cataract surgery; mean OP duration: 73 min) at a proportion between general anaesthesia and local anaesthesia of 80/20. For a pure ppV material costs were 255 EUR. Additional adjuncts such as an encircling band, perfluorcarbon, ICG, tPA, gas and silicon oil or cataract surgery led to extra costs between 51 EUR and 250 EUR per adjunct und were used in 56% (C03Z) and 74.5% (C17Z) of all procedures. Costs for hospitalisation were about 1765 EUR at a mean residence time of 6.5 days. Thus, the overall costs of a pure basic ppV amounted to 2975 EUR (C03Z) and 2661 EUR (C17Z). In consideration of the current relative DRG weights of 1.08 and 0.957 and a current base rate of 2787.19 EUR in Bavaria, cost recovery is only given for basic ppV but not for complex ppVs having higher material and personnel costs. Additionally, the costs for multiple surgeries as occur in 5.9% of cases are not compensated by the DRG system. The reimbursement for inpatient ppVs in a University

  3. Copper recovery from slag by indirect bio leaching

    International Nuclear Information System (INIS)

    Mazuelos, A.; Iglesias, N.; Romero, R.; Forcat, O.; Carranza, F.

    2009-01-01

    The main source of copper loss from a smelter is copper in discard slag. Slag can contain Cu in concentrations very much higher than those of many ores. Cu is present in slag entrained in very small drops of matte, white metal and blister copper occluded in fayalitic phase. In this work, the technical viability of the BRISA process, that is based on the indirect bio leaching, for this residue has been proved. A sample of slag, containing 2 % of copper, has been chemical, granulometric and metallographic characterized and it has been leached with ferric sulphate solutions in agitated reactors. The influence of several variables have been investigated. Once the best operating conditions had been selecting and an economic estimation had been done (with very really attractive results), the leaching stage has been designed for a plant of 30 tonnes per hour capacity. Cu extractions higher than 70% can be achieved with a residence time of only five hours. Despite of Cu(II) concentration in fed is as high as 30 g/l, bio oxidation stage can supply Fe(III) demanded by ferric leaching stage. (Author) 17 refs

  4. Numerical simulation of a semi-indirect evaporative cooler

    Energy Technology Data Exchange (ETDEWEB)

    Martin, R. Herrero [Departamento de Ingenieria Termica y de Fluidos, Universidad Politecnica de Cartagena, C/Dr. Fleming, s/n (Campus Muralla), 30202 Cartagena, Murcia (Spain)

    2009-11-15

    This paper presents the experimental study and numerical simulation of a semi-indirect evaporative cooler (SIEC), which acts as an energy recovery device in air conditioning systems. The numerical simulation was conducted by applying the CFD software FLUENT implementing a UDF to model evaporation/condensation. The numerical model was validated by comparing the simulation results with experimental data. Experimental data and numerical results agree for the lower relative humidity series but not for higher relative humidity values. (author)

  5. Estimated cost of overactive bladder in Thailand.

    Science.gov (United States)

    Prasopsanti, Kriangsak; Santi-Ngamkun, Apirak; Pornprasit, Kanokwan

    2007-11-01

    To estimate the annual direct and indirect costs of overactive bladder (OAB) in indigenous Thai people aged 18 years and over in the year 2005. Economically based models using diagnostic and treatment algorithms from clinical practice guidelines and current disease prevalence data were used to estimate direct and indirect costs of OAB. Prevalence and event probability estimates were obtained from the literature, national data sets, and expert opinion. Costs were estimated from a small survey using a cost questionnaire and from unit costs of King Chulalongkorn Memorial Hospital. The annual cost of OAB in Thailand is estimated as 1.9 billion USD. It is estimated to consume 1.14% of national GDP The cost includes 0.33 billion USD for direct medical costs, 1.3 billion USD for direct, nonmedical costs and 0.29 billion USD for indirect costs of lost productivity. The largest costs category was direct treatment costs of comorbidities associated with OAB. Costs of OAB medication accountedfor 14% of the total costs ofOAB.

  6. Modelling and analysis of a desiccant cooling system using the regenerative indirect evaporative cooling process

    DEFF Research Database (Denmark)

    Bellemo, Lorenzo; Elmegaard, Brian; Reinholdt, Lars O.

    2013-01-01

    This paper focuses on the numerical modeling and analysis of a Desiccant Cooling (DEC) system with regenerative indirect evaporative cooling, termed Desiccant Dewpoint Cooling (DDC) system. The DDC system includes a Desiccant Wheel (DW), Dew Point Coolers (DPCs), a heat recovery unit and a heat...... in different climates: temperate in Copenhagen and Mediterranean in Venice. Cheap and clean heat sources (e.g. solar energy) strongly increase the attractiveness of the DDC system. For the Mediterranean climate the DDC system represents a convenient alternative to chiller-based systems in terms of energy costs...... and CO2 emissions. The electricity consumption for auxiliaries in the DDC system is higher than in the chiller-based systems. The number of commercial-size DPC units required to cover the cooling load during the whole period is high: 8 in Copenhagen and 12 in Venice....

  7. Cost-benefit analysis of a green electricity system in Japan considering the indirect economic impacts of tropical cyclones

    International Nuclear Information System (INIS)

    Esteban, Miguel; Zhang, Qi; Longarte-Galnares, Gorka

    2012-01-01

    Global warming is likely to profoundly influence future weather patterns, and one consequence of this is the likelihood of an increase in tropical cyclone intensity. The present paper presents a cost-benefit analysis of introducing significant amounts of green energy in the electricity system in Japan in the light of the economic damage that an increase in tropical cyclone intensity could have on GDP growth between 2010 and 2085. Essentially the passage of a tropical cyclone will result not only in physical damage but also on a decrease in economic productivity due to precautionary cessation of the economic activity, which has an effect on GDP growth. By comparing the economic performance of different electricity system scenarios with the indirect economic damage of tropical cyclones from 2010 to 2085, based on the yearly economic data of green electricity, fossil fuel, GDP and population, it can be seen that the green scenarios are generally a cost-effective way of mitigating the effects of these weather systems, despite the large amount of initial investments necessary. - Highlights: ► Climate change is likely to increase the future strength of tropical cyclones. ► An increase in tropical cyclone strength would reduce GDP growth in Japan. ► Reducing green-house gas emissions is a cost-effective mitigation strategy.

  8. The friction cost method: a comment.

    Science.gov (United States)

    Johannesson, M; Karlsson, G

    1997-04-01

    The friction cost method has been proposed as an alternative to the human-capital approach of estimating indirect costs. We argue that the friction cost method is based on implausible assumptions not supported by neoclassical economic theory. Furthermore consistently applying the friction cost method would mean that the method should also be applied in the estimation of direct costs, which would mean that the costs of health care programmes are substantially decreased. It is concluded that the friction cost method does not seem to be a useful alternative to the human-capital approach in the estimation of indirect costs.

  9. Maintenance cost models in deregulated power systems under opportunity costs

    International Nuclear Information System (INIS)

    Al-Arfaj, K.; Dahal, K.; Azaiez, M.N.

    2007-01-01

    In a centralized power system, the operator is responsible for scheduling maintenance. There are different types of maintenance, including corrective maintenance; predictive maintenance; preventive maintenance; and reliability-centred maintenance. The main cause of power failures is poor maintenance. As such, maintenance costs play a significant role in deregulated power systems. They include direct costs associated with material and labor costs as well as indirect costs associated with spare parts inventory, shipment, test equipment, indirect labor, opportunity costs and cost of failure. In maintenance scheduling and planning, the cost function is the only component of the objective function. This paper presented the results of a study in which different components of maintenance costs were modeled. The maintenance models were formulated as an optimization problem with single and multiple objectives and a set of constraints. The maintenance costs models could be used to schedule the maintenance activities of power generators more accurately and to identify the best maintenance strategies over a period of time as they consider failure and opportunity costs in a deregulated environment. 32 refs., 4 tabs., 4 figs

  10. 76 FR 10028 - Settlement Agreement for Recovery of Past Response Costs 10,000 Havana Street Site, Commerce City...

    Science.gov (United States)

    2011-02-23

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9269-7] Settlement Agreement for Recovery of Past Response Costs 10,000 Havana Street Site, Commerce City, Adams County, CO AGENCY: Environmental Protection Agency. ACTION: Notice and request for public comment. SUMMARY: In accordance with the requirements of Section...

  11. NATIONAL SCIENCE FOUNDATION. Preliminary Observations on Indirect Costs for Research

    Science.gov (United States)

    2017-05-24

    involvement between NSF and the awardee in carrying out the activity supported by the award. 2Office of Management and Budget , Uniform Administrative...NSF’s Award Cash Management $ervice—NSF’s online approach to award payments and post-award financial processes—does not collect data about indirect...percent. 16NSF’s Award Cash Management $ervice implements the OMB-approved form for awardees to report financial data on their federal awards. The

  12. [Macroeconomic costs of eye diseases].

    Science.gov (United States)

    Hirneiß, C; Kampik, A; Neubauer, A S

    2014-05-01

    Eye diseases that are relevant regarding their macroeconomic costs and their impact on society include cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors. The aim of this article is to provide a comprehensive overview of direct and indirect costs for major eye disease categories for Germany, based on existing literature and data sources. A semi-structured literature search was performed in the databases Medline and Embase and in the search machine Google for relevant original papers and reviews on costs of eye diseases with relevance for or transferability to Germany (last research date October 2013). In addition, manual searching was performed in important national databases and information sources, such as the Federal Office of Statistics and scientific societies. The direct costs for these diseases add up to approximately 2.6 billion Euros yearly for the Federal Republic of Germany, including out of the pocket payments from patients but excluding optical aids (e.g. glasses). In addition to those direct costs there are also indirect costs which are caused e.g. by loss of employment or productivity or by a reduction in health-related quality of life. These indirect costs can only be roughly estimated. Including the indirect costs for the eye diseases investigated, a total yearly macroeconomic cost ranging between 4 and 12 billion Euros is estimated for Germany. The costs for the eye diseases cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors have a macroeconomic relevant dimension. Based on the predicted demographic changes with an ageing society an increase of the prevalence and thus also an increase of costs for eye diseases is expected in the future.

  13. Resource Recovery. Redefining the 3 Rs. Reduce...Reuse...Recycle. Resources in Technology.

    Science.gov (United States)

    Technology Teacher, 1991

    1991-01-01

    Discusses the problems of waste disposal, recycling, and resource recovery. Includes information on the social and cultural impact, the three classes of resource recovery (reuse, direct recycling, and indirect recycling), and specific products (paper, glass, plastics, metals, and so on). Includes a student quiz and possible outcomes. (JOW)

  14. Indirect Reciprocity with Optional Interactions and Private Information

    Directory of Open Access Journals (Sweden)

    Jason Olejarz

    2015-09-01

    Full Text Available We consider indirect reciprocity with optional interactions and private information. A game is offered between two players and accepted unless it is known that the other person is a defector. Whenever a defector manages to exploit a cooperator, his or her reputation is revealed to others in the population with some probability. Therefore, people have different private information about the reputation of others, which is a setting that is difficult to analyze in the theory of indirect reciprocity. Since a defector loses a fraction of his social ties each time he exploits a cooperator, he is less efficient at exploiting cooperators in subsequent rounds. We analytically calculate the critical benefit-to-cost ratio above which cooperation is successful in various settings. We demonstrate quantitative agreement with simulation results of a corresponding Wright–Fisher process with optional interactions and private information. We also deduce a simple necessary condition for the critical benefit-to-cost ratio.

  15. Economic Cost of Breast Cancer in Ghana: The Komfo Anokye ...

    African Journals Online (AJOL)

    The aim is to assist in the efficient and effective allocation of scarce health ... Again, the study found the direct annual cost per patient to be GH¢2,070.83 and the indirect ... Cost, Breast Cancer, Direct Cost, Indirect Cost, Human Capital Method ...

  16. Costs of dementia in the Czech Republic.

    Science.gov (United States)

    Holmerová, Iva; Hort, Jakub; Rusina, Robert; Wimo, Anders; Šteffl, Michal

    2017-11-01

    The aim of this study was to estimate the cost of dementia in the Czech Republic. One hundred and nineteen patient-caregiver dyads participated in our multicenter observational cost-of-illness study. The modified Resource Utilization in Dementia Questionnaire was used as the main tool to collect data from patients and caregivers. Medical specialists provided additional data from medical records. The average costs of dementia were calculated and patients were then divided by the level of cognitive impairment. A generalized linear model was used to determine if differences were present for selected cost variables. The mean (standard deviation) for direct cost per a patient in a month was estimated to be €243.0 (138.0), €1727.1 (1075.6) for the indirect cost, and €1970.0 (1090.3) for the total cost of dementia in the Czech Republic. All of the costs increased as dementia severity increased. Both the indirect and total costs significantly (p Republic. Both total and indirect care costs increased significantly the cognition declined.

  17. Cost Analysis of Direct versus Indirect and Individual versus Group Modes of Manual-Based Speech-and-Language Therapy for Primary School-Age Children with Primary Language Impairment

    Science.gov (United States)

    Dickson, Kirstin; Marshall, Marjorie; Boyle, James; McCartney, Elspeth; O'Hare, Anne; Forbes, John

    2009-01-01

    Background: The study is the first within trial cost analysis of direct versus indirect and individual versus group modes of speech-and-language therapy for children with primary language impairment. Aims: To compare the short-run resource consequences of the four interventions alongside the effects achieved measured by standardized scores on a…

  18. Economic evaluation of indirect use activities in a private natural heritage reserve

    Directory of Open Access Journals (Sweden)

    Keila Lima Sanches

    2011-06-01

    Full Text Available This study aimed to evaluate the economic viability of indirect use activities as developed in a private natural heritage reserve (RPPN. Activities developed in the RPPN include Adventure Tourism and an Ecological Trail. Data were obtained relating to annual number of people visiting the reserve, prices paid to participate in activities, cost of land, maintenance costs and labor costs. Economic criteria used include Net Present Value (VPL and Equivalent Periodic Benefit (BPE. In the 1996-2008 period the number of visitors increased by 6% a year, and the average annual number of visitors to the RPPN was 8,889. It was concluded that indirect use activities in the RPPN are economically viable and can coexist with other direct soil use activities such as eucalyptus cultivation.

  19. Monitoring and Controlling Engineering and Construction Management Cost Performance Within the Corps of Engineers

    Science.gov (United States)

    1988-12-01

    COST MANAGEMENT The CMIF approach addresses total costs but does not permit the analysis of indirect costs. We found that indirect costs vary...responsibility USACE/divisions Increasing CMIF Districts/divisions level of by fund type detail G&A, technical indirect, burden Districts by fund type

  20. Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis.

    Science.gov (United States)

    Parker, Scott L; Adogwa, Owoicho; Davis, Brandon J; Fulchiero, Erin; Aaronson, Oran; Cheng, Joseph; Devin, Clinton J; McGirt, Matthew J

    2013-02-01

    Two-year cost-utility study comparing minimally invasive (MIS) versus open multilevel hemilaminectomy in patients with degenerative lumbar spinal stenosis. The objective of the study was to determine whether MIS versus open multilevel hemilaminectomy for degenerative lumbar spinal stenosis is a cost-effective advancement in lumbar decompression surgery. MIS-multilevel hemilaminectomy for degenerative lumbar spinal stenosis allows for effective treatment of back and leg pain while theoretically minimizing blood loss, tissue injury, and postoperative recovery. No studies have evaluated comprehensive healthcare costs associated with multilevel hemilaminectomy procedures, nor assessed cost-effectiveness of MIS versus open multilevel hemilaminectomy. Fifty-four consecutive patients with lumbar stenosis undergoing multilevel hemilaminectomy through an MIS paramedian tubular approach (n=27) versus midline open approach (n=27) were included. Total back-related medical resource utilization, missed work, and health state values [quality adjusted life years (QALYs), calculated from EuroQuol-5D with US valuation] were assessed after 2-year follow-up. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost) and work-day losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Difference in mean total cost per QALY gained for MIS versus open hemilaminectomy was assessed as incremental cost-effectiveness ratio (ICER: COST(MIS)-COST(OPEN)/QALY(MIS)-QALY(OPEN)). MIS versus open cohorts were similar at baseline. MIS and open hemilaminectomy were associated with an equivalent cumulative gain of 0.72 QALYs 2 years after surgery. Mean direct medical costs, indirect societal costs, and total 2-year cost ($23,109 vs. $25,420; P=0.21) were similar between MIS and open hemilaminectomy. MIS versus open approach was associated with similar total costs and utility, making it a cost equivalent technology

  1. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

    Directory of Open Access Journals (Sweden)

    Ganapathy V

    2015-11-01

    Full Text Available Vaidyanathan Ganapathy,1 Glenn D Graham,2 Marco D DiBonaventura,3 Patrick J Gillard,1 Amir Goren,3 Richard D Zorowitz41Allergan, Irvine, CA, USA; 2Department of Veterans Affairs, San Francisco, CA, USA; 3Health Outcomes Practice, Kantar Health, New York, NY, USA; 4Johns Hopkins Bayview Medical Center, Baltimore, MD, USAObjective: Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity.Methods: Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale, Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages.Results: Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71 had overall work restriction (32%, absenteeism (9%, and presenteeism (27%. Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism.Conclusion: These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor.Keywords: burden, caregiver, productivity, spasticity, stroke

  2. European Union-28: An annualised cost-of-illness model for venous thromboembolism.

    Science.gov (United States)

    Barco, Stefano; Woersching, Alex L; Spyropoulos, Alex C; Piovella, Franco; Mahan, Charles E

    2016-04-01

    Annual costs for venous thromboembolism (VTE) have been defined within the United States (US) demonstrating a large opportunity for cost savings. Costs for the European Union-28 (EU-28) have never been defined. A literature search was conducted to evaluate EU-28 cost sources. Median costs were defined for each cost input and costs were inflated to 2014 Euros (€) in the study country and adjusted for Purchasing Power Parity between EU countries. Adjusted costs were used to populate previously published cost-models based on adult incidence-based events. In the base model, annual expenditures for total, hospital-associated, preventable, and indirect costs were €1.5-2.2 billion, €1.0-1.5 billion, €0.5-1.1 billion and €0.2-0.3 billion, respectively (indirect costs: 12 % of expenditures). In the long-term attack rate model, total, hospital-associated, preventable, and indirect costs were €1.8-3.3 billion, €1.2-2.4 billion, €0.6-1.8 billion and €0.2-0.7 billion (indirect costs: 13 % of expenditures). In the multiway sensitivity analysis, annual expenditures for total, hospital-associated, preventable, and indirect costs were €3.0-8.5 billion, €2.2-6.2 billion, €1.1-4.6 billion and €0.5-1.4 billion (indirect costs: 22 % of expenditures). When the value of a premature life-lost increased slightly, aggregate costs rose considerably since these costs are higher than the direct medical costs. When evaluating the models aggregately for costs, the results suggests total, hospital-associated, preventable, and indirect costs ranging from €1.5-13.2 billion, €1.0-9.7 billion, €0.5-7.3 billion and €0.2-6.1 billion, respectively. Our study demonstrates that VTE costs have a large financial impact upon the EU-28's healthcare systems and that significant savings could be realised if better preventive measures are applied.

  3. Cost Allocation Plans for Municipalities for Internal Management and Grant Programs.

    Science.gov (United States)

    1981-03-01

    21 3. Indirect Cost --------------------------------- 23 4. S ummary--------------------------------------- 25 D. RESPONSIBILITY ACCOUNTING ...depart- ments or operating units. Z-7:6747 In Cost Accounting - A Managerial Emphasis by Charles T. Horngren the word direct refers to the practicable...INDIRECT COST POOL -- COST ALLOCATION BASE -- COST FINDING In Cost Accounting : A Managerial Emphasis, Charles T. Horngren states: There are

  4. [Estimation on the indirect economic burden of disease-related premature deaths in China, 2012].

    Science.gov (United States)

    Yang, Juan; Feng, Luzhao; Zheng, Yaming; Yu, Hongjie

    2014-11-01

    To estimate the indirect economic burden of disease-related premature deaths in China, 2012. Both human capital approach and friction cost methods were used to compute the indirect economic burden of premature deaths from the following sources: mortality from the national disease surveillance system in 2012, average annual income per capita from the China Statistic Yearbook in 2012, population size from the 2010 China census, and life expectancy in China from the World Health Organization life table. Data from the Human Capital Approach Estimates showed that the indirect economic burden of premature deaths in China was 425.1 billion in 2012, accounting for 8‰ of the GDP. The indirect economic burden of chronic non-communicable diseases associated premature deaths was accounted for the highest proportion(67.1%, 295.4 billion), followed by those of injuries related premature deaths (25.6% , 108.9 billion), infectious diseases, maternal and infants diseases, and malnutrition related deaths (6.4% , 26.9 billion). The top five premature deaths that cause the indirect economic burden were malignancy, cardiovascular diseases, unintentional injuries, intentional injuries, and diseases of the respiratory system. The indirect economic burden of premature deaths mainly occurred in the population of 20-59 year-olds. Under the Friction Cost method, the estimates appeared to be 0.11%-3.49% of the total human capital approach estimates. Premature death caused heavy indirect economic burden in China. Chronic non-communicable diseases and injuries seemed to incur the major disease burden. The indirect economic burden of premature deaths mainly occurred in the working age group.

  5. Chemical cocktails in aquatic systems: Pesticide effects on the response and recovery of >20 animal taxa

    International Nuclear Information System (INIS)

    Hua, Jessica; Relyea, Rick

    2014-01-01

    Natural systems are often exposed to individual insecticides or combinations of multiple insecticides. Using an additive and substitutive design, we examined how populations and communities containing >20 animal taxa are affected by four insecticides applied individually and as a mixture for 18 wks in aquatic mesocosms. The four insecticides had distinct lethal effects on the response and recovery of cladocerans, copepods, amphipods, isopods, and amphibians but not snails. The lethal effect on cladocerans and copepods induced trophic cascades that facilitated algal blooms and abiotic changes (higher pH and dissolved oxygen, but lower light transmission). Exposure to endosulfan resulted in a lag effect reducing cladocerans and spring-breeding amphibian abundance. The reduction in spring-breeding amphibian abundance led to cascading indirect effects on summer-breeding amphibians. Finally, the mixture treatment had lethal effects throughout the community that led to long-term effects on amphibian mass and unique indirect consequences on phytoplankton and abiotic variables. - Highlights: • Insecticides had unique direct and indirect effects on response and recovery. • Due to lag effects, endosulfan was more toxic than expected based on 4d tests. • Variation in oviposition phenology led to positive effects on amphibians. • Lethal direct effects of mixtures were pervasive and led to unique indirect effects. - Insecticides applied individually and in a mixture have complex direct and indirect consequences on aquatic system response and recovery

  6. Indirect Comprehensive Review Board (ICRB). Final Report

    International Nuclear Information System (INIS)

    1996-12-01

    Lockheed Martin Idaho Technologies Company (LMITCO) used a systems engineering approach to take the first step toward defining a requirements baseline for all indirect work at the Idaho National Engineering Laboratory. The intent of this effort was to define the requirements for indirect work, identify the activities necessary to meet the requirements, and to produce defensible cost estimates for the work. The result of this effort is a scrubbed-down, defensible budget for all indirect work in FY 1997. Buying power for each dollar of direct work was increased by $.02. Recommendations are identified for improvements to this process in FY 1998. The purpose of this report is twofold. First is to report the final results of the 1996 ICRB process, and second is to document the process used such that incremental improvements may be made in future years. Objectives, processes, and approaches are described to provide a trail for future boards. Appendices contain copies of board composition, documentation of the process, as well as the actual training materials

  7. Interactive indirect illumination using adaptive multiresolution splatting.

    Science.gov (United States)

    Nichols, Greg; Wyman, Chris

    2010-01-01

    Global illumination provides a visual richness not achievable with the direct illumination models used by most interactive applications. To generate global effects, numerous approximations attempt to reduce global illumination costs to levels feasible in interactive contexts. One such approximation, reflective shadow maps, samples a shadow map to identify secondary light sources whose contributions are splatted into eye space. This splatting introduces significant overdraw that is usually reduced by artificially shrinking each splat's radius of influence. This paper introduces a new multiresolution approach for interactively splatting indirect illumination. Instead of reducing GPU fill rate by reducing splat size, we reduce fill rate by rendering splats into a multiresolution buffer. This takes advantage of the low-frequency nature of diffuse and glossy indirect lighting, allowing rendering of indirect contributions at low resolution where lighting changes slowly and at high-resolution near discontinuities. Because this multiresolution rendering occurs on a per-splat basis, we can significantly reduce fill rate without arbitrarily clipping splat contributions below a given threshold-those regions simply are rendered at a coarse resolution.

  8. Understanding Costs of Care in the Operating Room.

    Science.gov (United States)

    Childers, Christopher P; Maggard-Gibbons, Melinda

    2018-04-18

    Increasing value requires improving quality or decreasing costs. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely. No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect. This cross-sectional and longitudinal analysis examined annual financial disclosure documents from all comparable short-term general and specialty care hospitals in California from fiscal year (FY) 2005 to FY2014 (N = 3044; FY2014, n = 302). The analysis focused on 2 revenue centers: (1) surgery and recovery and (2) ambulatory surgery. Mean cost of 1 minute of OR time, stratified by setting (inpatient vs ambulatory), teaching status, and hospital ownership. The proportion of cost attributable to indirect and direct expenses was identified; direct expenses were further divided into salary, benefits, supplies, and other direct expenses. In FY2014, a total of 175 of 302 facilities (57.9%) were not for profit, 78 (25.8%) were for profit, and 49 (16.2%) were government owned. Thirty facilities (9.9%) were teaching hospitals. The mean (SD) cost for 1 minute of OR time across California hospitals was $37.45 ($16.04) in the inpatient setting and $36.14 ($19.53) in the ambulatory setting (P = .65). There were no differences in mean expenditures when stratifying by ownership or teaching status except that teaching hospitals had lower mean (SD) expenditures than nonteaching hospitals in the inpatient setting ($29.88 [$9.06] vs $38.29 [$16.43]; P = .006). Direct expenses accounted for 54.6% of total expenses ($20.40 of $37.37) in the inpatient setting and 59.1% of total expenses ($20.90 of $35.39) in the ambulatory setting. Wages and benefits accounted for approximately two-thirds of direct expenses (inpatient, $14.00 of $20

  9. Bioenergy, material, and nutrients recovery from household waste: Advanced material, substance, energy, and cost flow analysis of a waste refinery process

    International Nuclear Information System (INIS)

    Tonini, Davide; Dorini, Gianluca; Astrup, Thomas Fruergaard

    2014-01-01

    Highlights: • We modeled material, substance, energy, and cost flows of a waste refinery process. • Ca. 56% of 1 Mg dry waste input can be recovered as bioliquid yielding 6.2 GJ biogas. • Nutrients and carbon recovery in the bioliquid was estimated to 81–89%. • The biogenic carbon in the input waste was 63% of total carbon based on 14 C analyses. • The quality of the digestate may be critical with respect to use on land. - Abstract: Energy, materials, and resource recovery from mixed household waste may contribute to reductions in fossil fuel and resource consumption. For this purpose, legislation has been enforced to promote energy recovery and recycling. Potential solutions for separating biogenic and recyclable materials are offered by waste refineries where a bioliquid is produced from enzymatic treatment of mixed waste. In this study, potential flows of materials, energy, and substances within a waste refinery were investigated by combining sampling, analyses, and modeling. Existing material, substance, and energy flow analysis was further advanced by development of a mathematical optimization model for determination of the theoretical recovery potential. The results highlighted that the waste refinery may recover ca. 56% of the dry matter input as bioliquid, yielding 6.2 GJ biogas-energy. The potential for nitrogen, phosphorous, potassium, and biogenic carbon recovery was estimated to be between 81% and 89% of the input. Biogenic and fossil carbon in the mixed household waste input was determined to 63% and 37% of total carbon based on 14 C analyses. Additional recovery of metals and plastic was possible based on further process optimization. A challenge for the process may be digestate quality, as digestate may represent an emission pathway when applied on land. Considering the potential variability of local revenues for energy outputs, the costs for the waste refinery solution appeared comparable with alternatives such as direct incineration

  10. 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.

  11. Stability Concerns for Indirect Consumer Control in Smart Grids

    DEFF Research Database (Denmark)

    Juelsgaard, Morten; Andersen, Palle; Wisniewski, Rafal

    2013-01-01

    by an external third party, and indirect consumer control through incentives and price signals. In this work we present a simple formulation of indirect control, where the behavior of each consumer, is governed by local optimization of energy consumption. The local optimization accounts for both cost of energy...... and distribution losses, as well as any discomfort incurred by consumers from any shift in energy consumption. Our work will illustrate that in the simplest formulation of indirect control, the stability is greatly affected of both the behavior of consumers, and the number of consumers to include. We will show how......Demand side management will be an important tool for maintaining a balanced electrical grid in the future, when the penetration of volatile resources, such as wind and solar energy increases. Recent research focuses on two different management approaches, namely direct consumer control...

  12. U.S. DOE indirect coal liquefaction program: An overview

    Energy Technology Data Exchange (ETDEWEB)

    Shen, J.; Schmetz, E.; Winslow, J.; Tischer, R. [Dept. of Energy, Germantown, MD (United States); Srivastava, R.

    1997-12-31

    Coal is the most abundant domestic energy resource in the United States. The Fossil Energy Organization within the US Department of Energy (DOE) has been supporting a coal liquefaction program to develop improved technologies to convert coal to clean and cost-effective liquid fuels to complement the dwindling supply of domestic petroleum crude. The goal of this program is to produce coal liquids that are competitive with crude at $20 to $25 per barrel. Indirect and direct liquefaction routes are the two technologies being pursued under the DOE coal liquefaction program. This paper will give an overview of the DOE indirect liquefaction program. More detailed discussions will be given to the F-T diesel and DME fuels which have shown great promises as clean burning alternative diesel fuels. The authors also will briefly discuss the economics of indirect liquefaction and the hurdles and opportunities for the early commercial deployment of these technologies. Discussions will be preceded by two brief reviews on the liquid versus gas phase reactors and the natural gas versus coal based indirect liquefaction.

  13. Allocation base of general production costs as optimization of prime costs

    Directory of Open Access Journals (Sweden)

    Levytska I.O.

    2017-03-01

    Full Text Available Qualified management aimed at optimizing financial results is the key factor in today's society. Effective management decisions depend on the necessary information about the costs of production process in all its aspects – their structure, types, accounting policies of reflecting costs. General production costs, the so-called indirect costs that are not directly related to the production process, but provide its functioning in terms of supporting structural divisions and create the necessary conditions of production, play a significant role in calculating prime costs of goods (works, services. However, the accurate estimate of prime costs of goods (works, services should be determined with the value of indirect costs (in other words, general production costs, and properly determined with the base of their allocation. The choice of allocation base of general production costs is the significant moment, depending on the nature of business, which must guarantee fair distribution regarding to the largest share of direct expenses in the total structure of production costs. The study finds the essence of general production costs based on the analysis of key definitions of leading Ukrainian economists. The optimal allocation approach of general production costs is to calculate these costs as direct production costs within each subsidiary division (department separately without selecting a base as the main one to the their total amount.

  14. Photovoltaic energy cost limit

    International Nuclear Information System (INIS)

    Coiante, D.

    1992-01-01

    Referring to a photovoltaic system for grid connected applications, a parametric expression of kWh cost is derived. The limit of kWh cost is carried out extrapolating the values of cost components to their lowest figure. The reliability of the forecast is checked by disaggregating kWh cost in direct and indirect costs and by discussing the possible cost reduction of each component

  15. 40 CFR 791.50 - Costs.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Costs. 791.50 Section 791.50 Protection...) DATA REIMBURSEMENT Basis for Proposed Order § 791.50 Costs. (a) All costs reasonable and necessary to... tests, are eligible for reimbursement. Necessary costs include: (1) Direct and indirect costs of...

  16. Dual-earner couples' weekend recovery support, state of recovery, and work engagement: Work-linked relationship as a moderator.

    Science.gov (United States)

    Park, YoungAh; Haun, Verena C

    2017-10-01

    Despite growing recovery research, little is known about couple-dyadic processes of recovery from work. Given that dual-earner couples experience most of their recovery opportunities during nonwork times when they are together, partners in a couple relationship may substantially affect recovery and work engagement. In this study, we propose a couple-dyadic model in which weekend partner recovery support (reported by the recipient partner) is positively related to the recipient partner's state of recovery after the weekend which, in turn, increases the recipient's work engagement the following week (actor-actor mediation effect). We also test the effect of one's state of recovery on the partner's subsequent work engagement (partner effect). Additionally, work-linked relationship status is tested as a moderator of the partner effect. Actor-partner interdependence mediation modeling is used to analyze the data from 167 dual-earner couples who answered surveys on 4 measurement occasions. The results support the indirect effect of partner recovery support on work engagement through the postweekend state of recovery. Multigroup analysis results reveal that the partner effect of state of recovery on work engagement is significant for work-linked couples only and is absent for non-work-linked couples. Theoretical and practical implications, limitations, and future research directions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Cost Accounting for Decision Makers.

    Science.gov (United States)

    Kaneklides, Ann L.

    1985-01-01

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

  18. Excess costs of social anxiety disorder in Germany.

    Science.gov (United States)

    Dams, Judith; König, Hans-Helmut; Bleibler, Florian; Hoyer, Jürgen; Wiltink, Jörg; Beutel, Manfred E; Salzer, Simone; Herpertz, Stephan; Willutzki, Ulrike; Strauß, Bernhard; Leibing, Eric; Leichsenring, Falk; Konnopka, Alexander

    2017-04-15

    Social anxiety disorder is one of the most frequent mental disorders. It is often associated with mental comorbidities and causes a high economic burden. The aim of our analysis was to estimate the excess costs of patients with social anxiety disorder compared to persons without anxiety disorder in Germany. Excess costs of social anxiety disorder were determined by comparing two data sets. Patient data came from the SOPHO-NET study A1 (n=495), whereas data of persons without anxiety disorder originated from a representative phone survey (n=3213) of the general German population. Missing data were handled by "Multiple Imputation by Chained Equations". Both data sets were matched using "Entropy Balancing". Excess costs were calculated from a societal perspective for the year 2014 using general linear regression with a gamma distribution and log-link function. Analyses considered direct costs (in- and outpatient treatment, rehabilitation, and professional and informal care) and indirect costs due to absenteeism from work. Total six-month excess costs amounted to 451€ (95% CI: 199€-703€). Excess costs were mainly caused by indirect excess costs due to absenteeism from work of 317€ (95% CI: 172€-461€), whereas direct excess costs amounted to 134€ (95% CI: 110€-159€). Costs for medication, unemployment and disability pension was not evaluated. Social anxiety disorder was associated with statistically significant excess costs, in particular due to indirect costs. As patients in general are often unaware of their disorder or its severity, awareness should be strengthened. Prevention and early treatment might reduce long-term indirect costs. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. [Cost of lost productivity in pharmacoeconomics analysis. Part II. Survey in the expert group].

    Science.gov (United States)

    Wrona, Witold; Hermanowski, Tomasz; Jakubczyk, Michał; Golicki, Dominik; Czech, Marcin; Niewada, Maciej; Kolasa, Katarzyna

    2011-01-01

    The aim of the survey was to collect data on practice and preferences of decision-makers and experts in health economics concerning the role of indirect costs in Poland. The questionnaire contained 18 questions covering the need for indirect costs calculation in economic evaluations and measures used to calculate indirect cost. Fifty four respondents related to health economics returned completed questionnaires. Mean age of respondents was 33,3 years; mean experience in health economics 4.7 years; 43% (23/54) of responders had non-economic background; 30% each were users and doers of health technology assessment reports. All (excluding one) responders indicated that indirect costs should be calculated in pharmacoeconomic studies. Twenty three (i.e., 43%) responders indicated human capital approach as the best method to estimate costs from societal perspective; friction cost method came second best 11%; 42% respondents had no opinion. The doers of economics evaluations pointed to GDP per capita (61%, 11/18), average salary (61%, 11/18), and costs of sick pay or injury benefit (61%, 11/18) as measures which could be used to value production losses. Indirect costs are considered important component of economic evaluations of healthcare interventions in Poland. The lack of widely accepted methods for indirect cost evaluation support further research.

  20. Life cycle cost of a hybrid forward osmosis - low pressure reverse osmosis system for seawater desalination and wastewater recovery.

    Science.gov (United States)

    Valladares Linares, R; Li, Z; Yangali-Quintanilla, V; Ghaffour, N; Amy, G; Leiknes, T; Vrouwenvelder, J S

    2016-01-01

    In recent years, forward osmosis (FO) hybrid membrane systems have been investigated as an alternative to conventional high-pressure membrane processes (i.e. reverse osmosis (RO)) for seawater desalination and wastewater treatment and recovery. Nevertheless, their economic advantage in comparison to conventional processes for seawater desalination and municipal wastewater treatment has not been clearly addressed. This work presents a detailed economic analysis on capital and operational expenses (CAPEX and OPEX) for: i) a hybrid forward osmosis - low-pressure reverse osmosis (FO-LPRO) process, ii) a conventional seawater reverse osmosis (SWRO) desalination process, and iii) a membrane bioreactor - reverse osmosis - advanced oxidation process (MBR-RO-AOP) for wastewater treatment and reuse. The most important variables affecting economic feasibility are obtained through a sensitivity analysis of a hybrid FO-LPRO system. The main parameters taken into account for the life cycle costs are the water quality characteristics (similar feed water and similar water produced), production capacity of 100,000 m(3) d(-1) of potable water, energy consumption, materials, maintenance, operation, RO and FO module costs, and chemicals. Compared to SWRO, the FO-LPRO systems have a 21% higher CAPEX and a 56% lower OPEX due to savings in energy consumption and fouling control. In terms of the total water cost per cubic meter of water produced, the hybrid FO-LPRO desalination system has a 16% cost reduction compared to the benchmark for desalination, mainly SWRO. Compared to the MBR-RO-AOP, the FO-LPRO systems have a 7% lower CAPEX and 9% higher OPEX, resulting in no significant cost reduction per m(3) produced by FO-LPRO. Hybrid FO-LPRO membrane systems are shown to have an economic advantage compared to current available technology for desalination, and comparable costs with a wastewater treatment and recovery system. Based on development on FO membrane modules, packing density, and

  1. CONTRIBUTION OF INDIRECT TAXES

    Directory of Open Access Journals (Sweden)

    CHIRCULESCU MARIA FELICIA

    2015-08-01

    Full Text Available The work is based on the fact that at any time and in any society, taxation is regarded as undesirable for all taxpayers. The existence and it's manifestation is justified, because the operation of any company involves costs that must be covered by sufficient resources. Since ancient times, each state has adopted its own tax system, more or less perfected, as the state has experienced a greater or lesser economic and military power At the base of this work stays the fact that tax systems are a key factor influencing the overall efficiency of the economy. They determine the size tendency to save, invest and work, influencing the increase in production and employment, which is essential sights integral economic strategy, making tax reform an important component of economic reform. This paper aims to analyze the indirect taxes and their contribution to the public revenues in Romania, the purpose paper contains an analysis based on statistical series as indirect taxation is where tax harmonization was possible. Through analyzes, the paper aims to provide answers to the problem of the contradiction between the growing need for budgetary revenues, which entails a continuous amplification and diversification of taxation, on the one hand, and the need to stimulate economic development, on the other hand. The harmonization of indirect taxation had been achieved since this touches the free movement of goods and the freedom to supply services, not being able to say the same thing about direct taxation, which is why the European Community Treaty does not specify expressly the alignment of direct taxation, considering that direct taxation is a matter of Internal Policies that, for a country free option.

  2. LOWER COST METHODS FOR IMPROVED OIL RECOVERY (IOR) VIA SURFACTANT FLOODING

    Energy Technology Data Exchange (ETDEWEB)

    William A. Goddard III; Yongchun Tang; Patrick Shuler; Mario Blanco; Seung Soon Jang; Shiang-Tai Lin; Prabal Maiti; Yongfu Wu; Stefan Iglauer; Xiaohang Zhang

    2004-09-01

    This report provides a summary of the work performed in this 3-year project sponsored by DOE. The overall objective of this project is to identify new, potentially more cost-effective surfactant formulations for improved oil recovery (IOR). The general approach is to use an integrated experimental and computational chemistry effort to improve our understanding of the link between surfactant structure and performance, and from this knowledge, develop improved IOR surfactant formulations. Accomplishments for the project include: (1) completion of a literature review to assemble current and new surfactant IOR ideas, (2) Development of new atomistic-level MD (molecular dynamic) modeling methodologies to calculate IFT (interfacial tension) rigorously from first principles, (3) exploration of less computationally intensive mesoscale methods to estimate IFT, Quantitative Structure Property Relationship (QSPR), and cohesive energy density (CED) calculations, (4) experiments to screen many surfactant structures for desirable low IFT and solid adsorption behavior, and (5) further experimental characterization of the more promising new candidate formulations (based on alkyl polyglycosides (APG) and alkyl propoxy sulfate surfactants). Important findings from this project include: (1) the IFT between two pure substances may be calculated quantitatively from fundamental principles using Molecular Dynamics, the same approach can provide qualitative results for ternary systems containing a surfactant, (2) low concentrations of alkyl polyglycoside surfactants have potential for IOR (Improved Oil Recovery) applications from a technical standpoint (if formulated properly with a cosurfactant, they can create a low IFT at low concentration) and also are viable economically as they are available commercially, and (3) the alkylpropoxy sulfate surfactants have promising IFT performance also, plus these surfactants can have high optimal salinity and so may be attractive for use in higher

  3. Energy and cost savings potential of oscillating heat pipes for waste heat recovery ventilation

    Directory of Open Access Journals (Sweden)

    Govinda Mahajan

    2017-11-01

    Full Text Available The feasibility of using finned oscillating heat pipes (OHPs for heat exchange between counter-flowing air streams in HVAC air systems (i.e., outdoor and exhaust air flows, along with the associated cost savings in typical North American climates, is investigated. For a prescribed temperature difference and volumetric flow rate of air, rudimentary design parameters for a viable OHP Heat Recovery Ventilator (OHP-HRV were determined using the ε-NTU (effectiveness-Number of Transfer Unit method. The two-phase heat transfer within the OHP-HRV is modeled via effective evaporation/condensation heat transfer coefficients, while the latent heat transfer required to initiate OHP operation via boiling and evaporation is also considered. Results suggest that an OHP-HRV can possess a reasonable pressure drop (5 kW. The proposed OHP-HRV can possess an effectiveness near 0.5 and can pre-cool/heat HVAC air by >5°C. Potential energy and cost savings associated with using an OHP-HRV were estimated for commercial building envelopes in various regions of the United States. It is found that the proposed OHP-HRV can save more than $2500 annually in cities that have continental climatic conditions, such as Chicago and Denver, and for the selected locations the average yearly cost savings per building is found to be on-the-order of $700. Overall, the OHP-HRV shows potential in effectively reducing energy consumption and the operational cost of air handling units in buildings.

  4. Forensic Archaeological Recovery of a Large-Scale Mass Disaster Scene: Lessons Learned from Two Complex Recovery Operations at the World Trade Center Site.

    Science.gov (United States)

    Warnasch, Scott C

    2016-05-01

    In 2006, unexpected discoveries of buried World Trade Center (WTC) debris and human remains were made at the World Trade Center mass disaster site. New York City's Office of Chief Medical Examiner (OCME) was given the task of systematically searching the site for any remaining victims' remains. The subsequent OCME assessment and archaeological excavation conducted from 2006 until 2013, resulted in the recovery of over 1,900 victims' remains. In addition, this operation demonstrated the essential skills archaeologists can provide in a mass disaster recovery operation. The OCME excavation data illustrates some of the challenges encountered during the original recovery effort of 2001/2002. It suggests that when understood within the larger site recovery context, certain fundamental components of the original recovery effort, such as operational priorities and activities in effect during the original recovery, directly or indirectly resulted in unsearched deposits that contained human remains. © 2016 American Academy of Forensic Sciences.

  5. Relationship intention and satisfaction following service recovery: The mediating role of perceptions of service recovery in the cell phone industry

    Directory of Open Access Journals (Sweden)

    L Kruger

    2015-11-01

    Full Text Available In an industry characterised by fierce competition, cell phone network providers find it increasingly difficult to retain their customers after service failure. It is therefore essential for cell phone network providers to offer effective service recovery when they attempt to restore customer satisfaction following service failure. As it has been argued that relationships between customers and service providers should be considered a key determinant of the service recovery required to restore post-recovery attitudes and behavioural intentions, the purpose of this study was to determine the relationships between South African cell phone customers’ relationship intentions, their perceptions of service recovery and their satisfaction following service recovery. Personal in-home interviews were conducted to collect data from 605 cell phone customers residing in the Johannesburg metropolitan area. In addition to the significant positive relationships found between cell phone users’ relationship intentions, perceived service recovery and satisfaction after service recovery, this study found that perceived service recovery played a mediating role in the relationship between relationship intention and satisfaction following service recovery. The study concludes that, although a direct relationship exists between relationship intention and satisfaction following service recovery, perceived service recovery plays an additional indirect complementary role in this relationship. It is recommended that, in addition to focusing their relationship efforts on customers with relationship intentions, cell phone network providers also offer positively perceived service recovery to these customers, as this would lead to greater satisfaction following service recovery.

  6. An experimental test for indirect benefits in Drosophila melanogaster

    Directory of Open Access Journals (Sweden)

    Ödeen Anders

    2007-03-01

    Full Text Available Abstract Background Despite much empirical attention, tests for indirect benefits of mate choice have rarely considered the major components of sexual and nonsexual offspring fitness relevant to a population. Here we use a novel experimental design to test for the existence of any indirect benefits in a laboratory adapted population of D. melanogaster. Our experiment compared the fitness (mating success, longevity, and productivity of individuals possessing genomes that derived two generations previously from males that were either entirely successful (studs or wholly unsuccessful (duds at achieving mates in three subsequent rounds of mating trials. Results Males from the stud treatment were 30% more successful on average at securing mates than males from the dud treatment. In contrast, we found no difference between treatments in measures of productivity or of longevity when measured in a mixed-sex environment. In the absence of females, however, males in the stud treatment outlived males in the dud treatment. Conclusion Our results suggest that mating with successful males in this population provides an indirect benefit to females and that, at least in this environment, the benefit arises primarily through the production of more attractive male offspring. However, it is unclear whether this represents solely a traditional sexy sons benefit or whether there is an additional good genes component (with male offspring simply allocating their surplus condition to traits that enhance their mating success. The lack of any detectable differences in female fitness between the two treatments suggests the former, although the longevity advantage of males in the stud treatment when females were absent is consistent with the latter. Determining the effect of this indirect benefit on the evolution of female mate preferences (or resistance will require comparable data on the direct costs of mating with various males, and an understanding of how these costs

  7. Longitudinal Recovery and Reduced Costs After 120 Sessions of Locomotor Training for Motor Incomplete Spinal Cord Injury.

    Science.gov (United States)

    Morrison, Sarah A; Lorenz, Douglas; Eskay, Carol P; Forrest, Gail F; Basso, D Michele

    2018-03-01

    To determine the impact of long-term, body weight-supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers. Prospective observational cohort with longitudinal follow-up. Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network (NRN). Individuals with motor incomplete chronic SCI (American Spinal Injury Association Impairment Scale C or D; N=69; 0.1-45y after SCI) who completed at least 120 NRN physical therapy sessions. Manually assisted locomotor training (LT) in a body weight-supported treadmill environment, overground standing and stepping activities, and community integration tasks. International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores, orthostatic hypotension, bowel/bladder/sexual function, Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI), Berg Balance Scale, Modified Functional Reach, 10-m walk test, and 6-minute walk test. Longitudinal outcome measure collection occurred every 20 treatments and at 6- to 12-month follow-up after discharge from therapy. Significant improvement occurred for upper and lower motor strength, functional activities, psychological arousal, sensation of bowel movement, and SCI-FAI community ambulation. Extended training enabled minimal detectable changes at 60, 80, 100, and 120 sessions. After detectable change occurred, it was sustained through 120 sessions and continued 6 to 12 months after treatment. Delivering at least 120 sessions of LT improves recovery from incomplete chronic SCI. Because walking reduces rehospitalization, LT delivered beyond the average 20-session insurance limit can reduce rehospitalizations and long-term health costs. Copyright © 2018 American Congress of Rehabilitation Medicine

  8. Cost of epilepsy: a systematic review.

    Science.gov (United States)

    Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M

    2008-01-01

    The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI

  9. 48 CFR 31.202 - Direct costs.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.202 Direct... amount as an indirect cost if the accounting treatment— (1) Is consistently applied to all final cost... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Direct costs. 31.202...

  10. Relevance of indirect transmission for wildlife disease surveillance

    Directory of Open Access Journals (Sweden)

    Martin Lange

    2016-11-01

    Full Text Available Epidemiological models of infectious diseases are essential tools in support of risk assessment, surveillance design and contingency planning in public and animal health. Direct pathogen transmission from host to host is an essential process of each host-pathogen system and respective epidemiological modelling concepts. It is widely accepted that numerous diseases involve indirect transmission through pathogens shed by infectious hosts to their environment. However, epidemiological models largely do not represent pathogen persistence outside the host explicitly. We hypothesize that this simplification might bias management-related model predictions for disease agents that can persist outside their host for a certain time span. We adapted an individual-based, spatially explicit epidemiological model that can mimic both transmission processes. One version explicitly simulated indirect pathogen transmission through a contaminated environment. A second version simulated direct host-to-host transmission only. We aligned the model variants by the transmission potential per infectious host (i.e. basic reproductive number R0 and the spatial transmission kernel of the infection to allow unbiased comparison of predictions. The quantitative model results are provided for the example of surveillance plans for early detection of foot-and-mouth disease in wild boar, a social host.We applied systematic sampling strategies on the serological status of randomly selected host individuals in both models. We compared between the model variants the time to detection and the area affected prior to detection, measures that strongly influence mitigation costs. Moreover, the ideal sampling strategy to detect the infection in a given time frame was compared between both models.We found the simplified, direct transmission model to underestimate necessary sample size by up to one order of magnitude, but to overestimate the area put under control measures. Thus, the model

  11. Changes in transcription during recovery from heat injury in Salmonella typhimurium and effects of BCAA on recovery.

    Science.gov (United States)

    Hsu-Ming, Wen; Naito, Kimitaka; Kinoshita, Yoshimasa; Kobayashi, Hiroshi; Honjoh, Ken-ichi; Tashiro, Kousuke; Miyamoto, Takahisa

    2012-06-01

    Mechanisms of recovery from heat injury in Salmonella typhimurium were elucidated. Recovery of the heat-injured S. typhimurium cells in TSB resulted in full recovery after 3 h of incubation at 37°C. The DNA microarray analysis of 30- and 60-min recovering cells resulted in an increase in transcription of 89 and 141 genes, respectively. Among them, 15 genes, with known function, seemed to be somewhat involved in recovery. They encoded proteins involved in branched-chain amino acid (BCAA) transport (livJ, livH), cell envelope integrity (ddg), heat-shock response (cpxP, rrmJ), phage shock protein (pspA), ribosome modulation factor (rmf), virulence (sseB) transcriptional regulation (rpoE, rpoH, rseA, rseB, rseC) and ArcB signal transduction (sixA) and cytoplasmic membrane protein (fxsA). Among them, the effects of BCAA supplementation on recovery from heat injury were studied to confirm the importance of the BCAA transport liv genes during recovery. It was found that supplementation of TSB with 0.1% BCAA resulted in an enhanced recovery of injured cells in comparison to those recovered in TSB without BCAA. Supplementation of BCAA at 0.1% resulted in a cell count increase 4.4-fold greater than that of the control after 1 h incubation. It seems that BCAA promoted the recovery by promoting protein synthesis either directly through their use in translation or indirectly through stimulation of protein synthesis by activation of the Lrp protein.

  12. Cost analysis of in vitro fertilization.

    Science.gov (United States)

    Stern, Z; Laufer, N; Levy, R; Ben-Shushan, D; Mor-Yosef, S

    1995-08-01

    In vitro fertilization (IVF) has become a routine tool in the arsenal of infertility treatments. Assisted reproductive techniques are expensive, as reflected by the current "take home baby" rate of about 15% per cycle, implying the need for repeated attempts until success is achieved. Israel, today is facing a major change in its health care system, including the necessity to define a national package of health care benefits. The issue of infertility and whether its treatment should be part of the "health basket" is in dispute. Therefore an exact cost analysis of IVF is important. Since the cost of an IVF cycle varies dramatically between countries, we sought an exact breakdown of the different components of the costs involved in an IVF cycle and in achieving an IVF child in Israel. The key question is not how much we spend on IVF cycles but what is the cost of a successful outcome, i.e., a healthy child. This study intends to answer this question, and to give the policy makers, at various levels of the health care system, a crucial tool for their decision-making process. The cost analysis includes direct and indirect costs. The direct costs are divided into fixed costs (labor, equipment, maintenance, depreciation, and overhead) and variable costs (laboratory tests, chemicals, disposable supplies, medications, and loss of working days by the couples). The indirect costs are the costs of premature IVF babies, hospitalization of the IVF pregnant women in a high risk unit, and the cost of complications of the procedure. According to our economic analysis, an IVF cycle in Israel costs $2,560, of which fixed costs are about 50%. The cost of a "take home baby" is $19,267, including direct and indirect costs.

  13. Cost of treating sagittal synostosis in the first year of life.

    Science.gov (United States)

    Abbott, Megan M; Rogers, Gary F; Proctor, Mark R; Busa, Kathleen; Meara, John G

    2012-01-01

    Endoscopically assisted suturectomy (EAS) has been reported to reduce the morbidity and cost of treating sagittal synostosis when compared with traditional open cranial vault remodeling (CVR) procedures. Whereas the former claim is well substantiated and intuitive, the latter has not been validated by rigorous cost analysis. Patient medical records and financial database reports were culled retrospectively to determine the total cost associated with both EAS and CVR during 1 year of care. Recorded cost data included physician and hospital services, orthotic equipment and fittings, and indirect patient cost. Ten patients treated with CVR were compared with 10 patients who underwent EAS. The CVR patients incurred greater costs in nearly all categories studied, including overall 1-year costs, physician services, hospital services, supplies/equipment, medications/intravenous fluids, and laboratory and blood bank services. Postoperative costs were greater in the EAS group, primarily because of the cost associated with orthotic services and indirect patient costs for travel and lost work. However, overall indirect patient costs for the whole year did not differ between the groups. One-year median costs were $55,121 for CVR and $23,377 for EAS. Early clinical results were similar for the 2 groups. Cranial vault remodeling was more costly in the first year of treatment than EAS, although indirect patient costs were similar. The favorable cost of EAS compared with CVR provides further justification to consider this procedure as first-line treatment of sagittal synostosis in young infants.

  14. Battleground Energy Recovery Project

    Energy Technology Data Exchange (ETDEWEB)

    Bullock, Daniel [USDOE Gulf Coast Clean Energy Application Center, Woodlands, TX (United States)

    2011-12-31

    In October 2009, the project partners began a 36-month effort to develop an innovative, commercial-scale demonstration project incorporating state-of-the-art waste heat recovery technology at Clean Harbors, Inc., a large hazardous waste incinerator site located in Deer Park, Texas. With financial support provided by the U.S. Department of Energy, the Battleground Energy Recovery Project was launched to advance waste heat recovery solutions into the hazardous waste incineration market, an area that has seen little adoption of heat recovery in the United States. The goal of the project was to accelerate the use of energy-efficient, waste heat recovery technology as an alternative means to produce steam for industrial processes. The project had three main engineering and business objectives: Prove Feasibility of Waste Heat Recovery Technology at a Hazardous Waste Incinerator Complex; Provide Low-cost Steam to a Major Polypropylene Plant Using Waste Heat; and Create a Showcase Waste Heat Recovery Demonstration Project.

  15. 10 CFR 600.30 - Cost sharing.

    Science.gov (United States)

    2010-01-01

    ... research and development except where: (1) A research or development activity of a basic or fundamental... with the applicable cost principles: (i) Cash; (ii) Personnel costs; (iii) The value of a service... circular of the Office of Management and Budget; (iv) Indirect costs or facilities and administrative costs...

  16. The difference between energy consumption and energy cost: Modelling energy tariff structures for water resource recovery facilities.

    Science.gov (United States)

    Aymerich, I; Rieger, L; Sobhani, R; Rosso, D; Corominas, Ll

    2015-09-15

    The objective of this paper is to demonstrate the importance of incorporating more realistic energy cost models (based on current energy tariff structures) into existing water resource recovery facilities (WRRFs) process models when evaluating technologies and cost-saving control strategies. In this paper, we first introduce a systematic framework to model energy usage at WRRFs and a generalized structure to describe energy tariffs including the most common billing terms. Secondly, this paper introduces a detailed energy cost model based on a Spanish energy tariff structure coupled with a WRRF process model to evaluate several control strategies and provide insights into the selection of the contracted power structure. The results for a 1-year evaluation on a 115,000 population-equivalent WRRF showed monthly cost differences ranging from 7 to 30% when comparing the detailed energy cost model to an average energy price. The evaluation of different aeration control strategies also showed that using average energy prices and neglecting energy tariff structures may lead to biased conclusions when selecting operating strategies or comparing technologies or equipment. The proposed framework demonstrated that for cost minimization, control strategies should be paired with a specific optimal contracted power. Hence, the design of operational and control strategies must take into account the local energy tariff. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Life cycle cost of a hybrid forward osmosis – low pressure reverse osmosis system for seawater desalination and wastewater recovery

    KAUST Repository

    Valladares Linares, Rodrigo

    2015-10-19

    In recent years, forward osmosis (FO) hybrid membrane systems have been investigated as an alternative to conventional high-pressure membrane processes (i.e. reverse osmosis (RO)) for seawater desalination and wastewater treatment and recovery. Nevertheless, their economic advantage in comparison to conventional processes for seawater desalination and municipal wastewater treatment has not been clearly addressed. This work presents a detailed economic analysis on capital and operational expenses (CAPEX and OPEX) for: i) a hybrid forward osmosis – low-pressure reverse osmosis (FO-LPRO) process, ii) a conventional seawater reverse osmosis (SWRO) desalination process, and iii) a membrane bioreactor – reverse osmosis – advanced oxidation process (MBR-RO-AOP) for wastewater treatment and reuse. The most important variables affecting economic feasibility are obtained through a sensitivity analysis of a hybrid FO-LPRO system. The main parameters taken into account for the life cycle costs are the water quality characteristics (similar feed water and similar water produced), production capacity of 100,000 m3 d−1 of potable water, energy consumption, materials, maintenance, operation, RO and FO module costs, and chemicals. Compared to SWRO, the FO-LPRO systems have a 21% higher CAPEX and a 56% lower OPEX due to savings in energy consumption and fouling control. In terms of the total water cost per cubic meter of water produced, the hybrid FO-LPRO desalination system has a 16% cost reduction compared to the benchmark for desalination, mainly SWRO. Compared to the MBR-RO-AOP, the FO-LPRO systems have a 7% lower CAPEX and 9% higher OPEX, resulting in no significant cost reduction per m3 produced by FO-LPRO. Hybrid FO-LPRO membrane systems are shown to have an economic advantage compared to current available technology for desalination, and comparable costs with a wastewater treatment and recovery system. Based on development on FO membrane modules, packing density, and

  18. Isolation and recovery of microbial polyhydroxyalkanoates

    Directory of Open Access Journals (Sweden)

    2011-07-01

    Full Text Available The deleterious environmental impacts caused by plastic wastes have attracted worldwide concern. The biobased and biodegradable polyhydroxyalkanoate (PHA appears to be one of the potential candidates to replace some conventional plastics. However, high production cost of PHAs has limited their market penetration. The major cost absorbing factors are the upstream fermentation processes and the downstream PHA recovery technologies. The latter significantly affects the overall process economics. Various recovery technologies have been proposed and studied in small scales in the laboratory as well as in industrial scales. These include solvent extraction, chemical digestion, enzymatic treatment and mechanical disruption, supercritical fluid disruption, flotation techniques, use of gamma irradiation and aqueous two-phase system. This paper reviews all the recovery methods known to date and compares their efficiency and the quality of the resulting PHA. Some of the large-scale production of PHA and the strategies employed to reduce the production cost are also discussed.

  19. Measuring individual disaster recovery: a socioecological framework.

    Science.gov (United States)

    Abramson, David M; Stehling-Ariza, Tasha; Park, Yoon Soo; Walsh, Lauren; Culp, Derrin

    2010-09-01

    Disaster recovery is a complex phenomenon. Too often, recovery is measured in singular fashion, such as quantifying rebuilt infrastructure or lifelines, without taking in to account the affected population's individual and community recovery. A comprehensive framework is needed that encompasses a much broader and far-reaching construct with multiple underlying dimensions and numerous causal pathways; without the consideration of a comprehensive framework that investigates relationships between these factors, an accurate measurement of recovery may not be valid. This study proposes a model that encapsulates these ideas into a single framework, the Socio-Ecological Model of Recovery. Using confirmatory factor analysis, an operational measure of recovery was developed and validated using the five measures of housing stability, economic stability, physical health, mental health, and social role adaptation. The data were drawn from a sample of displaced households following Hurricane Katrina. Measures of psychological strength, risk, disaster exposure, neighborhood contextual effects, and formal and informal help were modeled to examine their direct and indirect effects on recovery using a structural equation model. All five elements of the recovery measure were positively correlated with a latent measure of recovery, although mental health and social role adaptation displayed the strongest associations. An individual's psychological strength had the greatest association with positive recovery, followed by having a household income greater than $20,000 and having informal social support. Those factors most strongly associated with an absence of recovery included the time displaced since the hurricane, being disabled, and living in a community with substantial social disorder. The socio-ecological framework provides a robust means for measuring recovery, and for testing those factors associated with the presence or absence of recovery.

  20. Indirection and computer security.

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Michael J.

    2011-09-01

    The discipline of computer science is built on indirection. David Wheeler famously said, 'All problems in computer science can be solved by another layer of indirection. But that usually will create another problem'. We propose that every computer security vulnerability is yet another problem created by the indirections in system designs and that focusing on the indirections involved is a better way to design, evaluate, and compare security solutions. We are not proposing that indirection be avoided when solving problems, but that understanding the relationships between indirections and vulnerabilities is key to securing computer systems. Using this perspective, we analyze common vulnerabilities that plague our computer systems, consider the effectiveness of currently available security solutions, and propose several new security solutions.

  1. Can treatment and disposal costs be reduced through metal recovery?

    Science.gov (United States)

    Smith, Kathleen S.; Figueroa, Linda; Plumlee, Geoffrey S.

    2015-01-01

    This paper describes a framework to conduct a “metal-recovery feasibility assessment” for mining influenced water (MIW) and associated treatment sludge. There are multiple considerations in such a determination, including the geologic/geochemical feasibility, market feasibility, technical feasibility, economic feasibility, and administrative feasibility. Each of these considerations needs to be evaluated to determine the practicality of metal recovery from a particular MIW.

  2. Computerized cost estimation spreadsheet and cost data base for fusion devices

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Rothe, K.E.

    1985-01-01

    Component design parameters (weight, surface area, etc.) and cost factors are input and direct and indirect costs are calculated. The cost data base file derived from actual cost experience within the fusion community and refined to be compatible with the spreadsheet costing approach is a catalog of cost coefficients, algorithms, and component costs arranged into data modules corresponding to specific components and/or subsystems. Each data module contains engineering, equipment, and installation labor cost data for different configurations and types of the specific component or subsystem. This paper describes the assumptions, definitions, methodology, and architecture incorporated in the development of the cost estimation spreadsheet and cost data base, along with the type of input required and the output format

  3. Estimating Power Outage Cost based on a Survey for Industrial Customers

    Science.gov (United States)

    Yoshida, Yoshikuni; Matsuhashi, Ryuji

    A survey was conducted on power outage cost for industrial customers. 5139 factories, which are designated energy management factories in Japan, answered their power consumption and the loss of production value due to the power outage in an hour in summer weekday. The median of unit cost of power outage of whole sectors is estimated as 672 yen/kWh. The sector of services for amusement and hobbies and the sector of manufacture of information and communication electronics equipment relatively have higher unit cost of power outage. Direct damage cost from power outage in whole sectors reaches 77 billion yen. Then utilizing input-output analysis, we estimated indirect damage cost that is caused by the repercussion of production halt. Indirect damage cost in whole sectors reaches 91 billion yen. The sector of wholesale and retail trade has the largest direct damage cost. The sector of manufacture of transportation equipment has the largest indirect damage cost.

  4. The cost of dementia in an unequal country: The case of Chile.

    Directory of Open Access Journals (Sweden)

    Daniel A Hojman

    Full Text Available We study the economic cost of dementia in Chile, and its variation according to socioeconomic status (SES. We use primary data from a survey of 330 informal primary caregivers who completed both a RUD-Lite and a socio-demographic questionnaire to evaluate the severity of dementia and caregiver's burden. The costs of dementia are broken into three components: direct medical costs (medical care, drugs, tests; direct social costs (social service, daycare; and indirect costs (mostly associated to informal care. The average monthly cost per patient is estimated at US$ 1,463. Direct medical costs account for 20 per cent, direct social costs for 5 per cent and indirect costs for 75 per cent of the total cost. The mean monthly cost is found to be inversely related to SES, a pattern largely driven by indirect costs. The monthly cost for high SES is US$ 1,083 and US$ 1,588 for low SES. A multivariate regression analysis suggests that severity of dementia and caregiver's burden account for between 49 and 70 per cent of the difference in the indirect cost across SES. However, between one-third and one-half of the variation across SES is not due to gradient in severity of dementia. Direct medical costs increase in higher SES, reflecting differences in purchasing power, while indirect costs are inversely related to SES and more than compensate differences in medical costs. Moreover, in lower SES groups, female caregivers, typically family members who are inactive in the labor market, mostly provide informal care. The average annual cost of dementia in Chile (US$ 17,559 is lower in comparison to high-income countries (US$ 39,595 and the proportion of cost related to informal cost is higher (74 per cent compared to 40 per cent. SES is a key determinant in the cost of dementia. In the absence of universal access to treatment, part of the social cost of dementia potentially preserves or increases income and gender inequality.

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

    Directory of Open Access Journals (Sweden)

    Anastasia Papadopoulou

    2012-01-01

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

  6. Supplying synthetic crude oil from Canadian oil sands: A comparative study of the costs and CO2 emissions of mining and in-situ recovery

    International Nuclear Information System (INIS)

    Méjean, Aurélie; Hope, Chris

    2013-01-01

    High crude oil prices and the eventual decline of conventional oil production raise the issue of alternative fuels such as non-conventional oil. The paper describes a simple probabilistic model of the costs of synthetic crude oil produced from Canadian oil sands. Synthetic crude oil is obtained by upgrading bitumen that is first produced through mining or in-situ recovery techniques. This forward-looking analysis quantifies the effects of learning and production constraints on the costs of supplying synthetic crude oil. The sensitivity analysis shows that before 2035, the most influential parameters are the learning parameter in the case of in-situ bitumen and the depletion parameter in the case of mined bitumen. After 2035, depletion dominates in both cases. The results show that the social cost of CO 2 has a large impact on the total costs of synthetic crude oil, in particular in the case of synthetic crude oil from in-situ bitumen, due to the carbon intensity of the recovery techniques: taking into account the social cost of CO 2 adds more than half to the cost of producing synthetic crude oil from mined bitumen in 2050 (mean value), while the cost of producing synthetic crude oil from in-situ bitumen more than doubles. - Highlights: • We model the cost of Canadian synthetic crude oil (SCO) using Monte-Carlo techniques. • We reveal the uncertainty associated with each input parameter. • We quantify the effect of learning, depletion and CO 2 using sensitivity analyses. • Accounting for the social cost of CO 2 doubles the cost of SCO from in-situ bitumen. • CO 2 pricing could have a large effect on the economics of the oil sands

  7. Design manual. [High temperature heat pump for heat recovery system

    Energy Technology Data Exchange (ETDEWEB)

    Burch, T.E.; Chancellor, P.D.; Dyer, D.F.; Maples, G.

    1980-01-01

    The design and performance of a waste heat recovery system which utilizes a high temperature heat pump and which is intended for use in those industries incorporating indirect drying processes are described. It is estimated that use of this heat recovery system in the paper, pulp, and textile industries in the US could save 3.9 x 10/sup 14/ Btu/yr. Information is included on over all and component design for the heat pump system, comparison of prime movers for powering the compressor, control equipment, and system economics. (LCL)

  8. Fluid diversion in oil recovery

    International Nuclear Information System (INIS)

    Nimir, Hassan B.

    1999-01-01

    In any oil recovery process, large scale heterogeneities, such as fractures, channels, or high-permeability streaks, can cause early break through of injected fluid which will reduce oil recovery efficiency. In waterflooding, enhanced oil recovery, and acidizing operations, this problem is particularly acute because of the cost of the injected fluid. On the other hand coping with excess water production is always a challenging task for field operators. The cost of handling and disposing produced water can significantly shorten the economic production life of an oil well. The hydrostatic pressure created by high fluid levels in a well (water coning) is also detrimental to oil production. In this paper, the concept of fluid diversion is explained. Different methods that are suggested to divert the fluid into the oil-bearing-zones are briefly discussed, to show their advantages and disadvantages. Methods of reducing water production in production well are also discussed. (Author)

  9. Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

    Science.gov (United States)

    Richardson, John; Di Fabio, Francesco; Clarke, Hannah; Bajalan, Mohammed; Davids, Joe; Abu Hilal, Mohammed

    2015-01-01

    The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  10. Selective Cooperation in the Supermarket : Field Experimental Evidence for Indirect Reciprocity.

    Science.gov (United States)

    Lange, Florian; Eggert, Frank

    2015-12-01

    Numerous laboratory experiments suggest that mechanisms of indirect reciprocity might account for human cooperation. However, conclusive field data supporting the predictions of indirect reciprocity in everyday life situations is still scarce. Here, we attempt to compensate for this lack by examining the determinants of cooperative behavior in a German supermarket. Our methods were as follows: Confederates of the experimenter lined up at the checkout, apparently to buy a single item. As an act of cooperation, the waiting person in front (the potential helper) could allow the confederate to go ahead. By this means, the potential helper could take a cost (additional waiting time) by providing the confederate with a benefit (saved waiting time). We recorded the potential helpers' behavior and the number of items they purchased as a quantitative measure proportional to the confederate's benefit. Moreover, in a field experimental design, we varied the confederates' image by manipulating the item they purchased (beer vs. water). As predicted, the more waiting time they could save, the more likely the confederates were to receive cooperation. This relationship was moderated by the confederates' image. Cost-to-benefit ratios were required to be more favorable for beer-purchasing individuals to receive cooperation. Our results demonstrate that everyday human cooperation can be studied unobtrusively in the field and that cooperation among strangers is selective in a way that is consistent with current models of indirect reciprocity.

  11. The costs of hepatitis A infections in South Korea

    Directory of Open Access Journals (Sweden)

    Kyohyun Kim

    2014-08-01

    Full Text Available OBJECTIVES: The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies. METHODS: We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008. RESULTS: There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case. Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group. CONCLUSIONS: This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate.

  12. Energy recovery from wastes

    International Nuclear Information System (INIS)

    De Stefanis, P.

    1999-01-01

    In this paper are reported analysis of some energy recovery form wastes plants. In this work are considered materials and energy flows, environmental impacts and related treatment costs and financial resources [it

  13. Two-step optimization of pressure and recovery of reverse osmosis desalination process.

    Science.gov (United States)

    Liang, Shuang; Liu, Cui; Song, Lianfa

    2009-05-01

    Driving pressure and recovery are two primary design variables of a reverse osmosis process that largely determine the total cost of seawater and brackish water desalination. A two-step optimization procedure was developed in this paper to determine the values of driving pressure and recovery that minimize the total cost of RO desalination. It was demonstrated that the optimal net driving pressure is solely determined by the electricity price and the membrane price index, which is a lumped parameter to collectively reflect membrane price, resistance, and service time. On the other hand, the optimal recovery is determined by the electricity price, initial osmotic pressure, and costs for pretreatment of raw water and handling of retentate. Concise equations were derived for the optimal net driving pressure and recovery. The dependences of the optimal net driving pressure and recovery on the electricity price, membrane price, and costs for raw water pretreatment and retentate handling were discussed.

  14. The health-related social costs of alcohol in Belgium.

    Science.gov (United States)

    Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

    2017-12-16

    Alcohol is associated with adverse health effects causing a considerable economic impact to society. A reliable estimate of this economic impact for Belgium is lacking. This is the aim of the study. A prevalence-based approach estimating the direct, indirect and intangible costs for the year 2012 was used. Attributional fractions for a series of health effects were derived from literature. The human capital approach was used to estimate indirect costs, while the concept of disability-adjusted life years was used to estimate intangible costs. Sensitivity and scenario analyses were conducted to assess the uncertainty around cost estimates and to evaluate the impact of alternative modelling assumptions. In 2012, total alcohol-attributable direct costs were estimated at €906.1 million, of which the majority were due to hospitalization (€743.7 million, 82%). The indirect costs amounted to €642.6 million, of which 62% was caused by premature mortality. Alcohol was responsible for 157,500 disability-adjusted life years representing €6.3 billion intangible costs. Despite a number of limitations intrinsic to this kind of research, the study can be considered as the most comprehensive analysis thus far of the health-related social costs of alcohol in Belgium.

  15. Spatially Dispersed Employee Recovery

    DEFF Research Database (Denmark)

    Hvass, Kristian Anders; Torfadóttir, Embla

    2014-01-01

    Employee recovery addresses either employee well-being or management's practices in aiding employees in recovering themselves following a service failure. This paper surveys the cabin crew at a small, European, low-cost carrier and investigates employees' perceptions of management practices to aid...... personnel achieve service recovery. Employee recovery within service research often focuses on front-line employees that work in a fixed location, however a contribution to the field is made by investigating the recovery of spatially dispersed personnel, such as operational personnel in the transport sector......, who have a work place away from a fixed or central location and have minimal management contact. Results suggest that the support employees receive from management, such as recognition, information sharing, training, and strategic awareness are all important for spatially dispersed front...

  16. Integrating Life-cycle Assessment into Transport Cost-benefit Analysis

    DEFF Research Database (Denmark)

    Manzo, Stefano; Salling, Kim Bang

    2016-01-01

    Traditional transport Cost-Benefit Analysis (CBA) commonly ignores the indirect environmental impacts of an infrastructure project deriving from the overall life-cycle of the different project components. Such indirect impacts are instead of key importance in order to assess the long......-term sustainability of a transport infrastructure project. In the present study we suggest to overcome this limit by combining a conventional life-cycle assessment approach with standard transport cost-benefit analysis. The suggested methodology is tested upon a case study project related to the construction of a new...... fixed link across the Roskilde fjord in Frederikssund (Denmark). The results are then compared with those from a standard CBA framework. The analysis shows that indirect environmental impacts represent a relevant share of the estimated costs of the project, clearly affecting the final project evaluation...

  17. Direct and indirect fluorescent detection of tetracyclines using dually emitting carbon dots

    International Nuclear Information System (INIS)

    Qu, Fei; Sun, Zhe; Liu, Dongya; Zhao, Xianen; You, Jinmao

    2016-01-01

    The authors describe dual-emission carbon nanodots containing blue emitters (BE; peak emission at 385 nm under 315 nm excitation) and yellow emitters (YE; peak emission at 530 nm under 365 nm excitation), and how they can be applied to direct and indirect determination of tetracyclines (TCs). The direct detection scheme is based on the finding that tetracycline (TET), oxytetracycline, chlortetracycline and doxycycline quench the two emissions of the carbon dots. While direct determination is rapid and convenient, it cannot differentiate between TCs. The indirect detection scheme, in contrast, is based on the finding that Al (III) ions enhance the fluorescence of the YE in the carbon dots, and that they cause a blue shift in emission. It is, however, known that TET forms a strong complex with Al (III), and this can inhibit the interaction between Al (III) and the YE, so that the fluorescence of YE is not enhanced and blue-shifted by Al (III) in the presence of TET. This finding is exploited in a fluorescence turn-on/off assay for TET that can distinguish TET from other TCs. The linear range of indirect determination for TET extends from 1 nM to 30 μM, and the limit of detection is 0.52 nM. The indirect method was successfully applied to the determination of TET in spiked milk, fish and pork, and recoveries ranged from 91.7 to 102 %. (author)

  18. An Ownership/Lease Cost Comparison Analysis of Heavy Equipment Motor Vehicles in Air Force Materiel Command

    Science.gov (United States)

    1994-09-01

    costs are the costs associated with a particular piece of equipment that do not change despite change in variable operating cost ( Horngren and Foster...The Operating and maintenance costs account for direct and indirect costs associated with their respective functions and vary with the utilization of...each vehicle. The operating direct cost includes all on-base and off- base fuel cost . Indirect operations costs account for bench 28 stock items

  19. A wood-waste fuelled indirectly-fired gas turbine cogeneration plant for sawmill application. Preliminay engineering and financial evaluation. Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    1986-02-01

    The overall objective of this project is to develop a cost-effective wood waste-fired power generation and lumber drying system for Canadian sawmill applications. The system proposed and evaluated in this project is a wood waste-fuelled, indirectly-fired gas turbine cogeneration plant. Research, design and development of the system has been planned to take place in a number of phases. The first phase consists of a preliminary engineering design and financial evaluation of the system and is the subject of this report. This analysis focuses on British Columbia since it is the largest potential market for the sawmill cogeneration system. In order to provide design parameters for the cogeneration system, operational characteristics were compiled for a typical sawmill in the interior of British Columbia. A number of alternative design concepts were reviewed before arriving at the indirect-fired turbine concept selected for development in this project. The general concept involves the use of an open Brayton-cycle gas turbine as the prime mover to generate electrical power, while process heat for the dry-kiln is obtained by waste heat recovery from the turbine exhaust gas. The proposed system has many advantages over a conventional steam based cogeneration system and economic analysis indicates that the system generates very attractive financial returns over a variety of conditions. 7 refs., 8 figs., 8 tabs.

  20. New Approaches in Reuseable Booster System Life Cycle Cost Modeling

    Science.gov (United States)

    Zapata, Edgar

    2013-01-01

    This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model

  1. New Approaches in Reusable Booster System Life Cycle Cost Modeling

    Science.gov (United States)

    Zapata, Edgar

    2013-01-01

    This paper presents the results of a 2012 life cycle cost (LCC) study of hybrid Reusable Booster Systems (RBS) conducted by NASA Kennedy Space Center (KSC) and the Air Force Research Laboratory (AFRL). The work included the creation of a new cost estimating model and an LCC analysis, building on past work where applicable, but emphasizing the integration of new approaches in life cycle cost estimation. Specifically, the inclusion of industry processes/practices and indirect costs were a new and significant part of the analysis. The focus of LCC estimation has traditionally been from the perspective of technology, design characteristics, and related factors such as reliability. Technology has informed the cost related support to decision makers interested in risk and budget insight. This traditional emphasis on technology occurs even though it is well established that complex aerospace systems costs are mostly about indirect costs, with likely only partial influence in these indirect costs being due to the more visible technology products. Organizational considerations, processes/practices, and indirect costs are traditionally derived ("wrapped") only by relationship to tangible product characteristics. This traditional approach works well as long as it is understood that no significant changes, and by relation no significant improvements, are being pursued in the area of either the government acquisition or industry?s indirect costs. In this sense then, most launch systems cost models ignore most costs. The alternative was implemented in this LCC study, whereby the approach considered technology and process/practices in balance, with as much detail for one as the other. This RBS LCC study has avoided point-designs, for now, instead emphasizing exploring the trade-space of potential technology advances joined with potential process/practice advances. Given the range of decisions, and all their combinations, it was necessary to create a model of the original model

  2. Evaluation of resource recovery from waste incineration residues--the case of zinc.

    Science.gov (United States)

    Fellner, J; Lederer, J; Purgar, A; Winterstetter, A; Rechberger, H; Winter, F; Laner, D

    2015-03-01

    Solid residues generated at European Waste to Energy plants contain altogether about 69,000 t/a of Zn, of which more than 50% accumulates in air pollution control residues, mainly boiler and filter ashes. Intensive research activities aiming at Zn recovery from such residues recently resulted in a technical scale Zn recovery plant at a Swiss waste incinerator. By acidic leaching and subsequent electrolysis this technology (FLUREC) allows generating metallic Zn of purity>99.9%. In the present paper the economic viability of the FLUREC technology with respect to Zn recovery from different solid residues of waste incineration has been investigated and subsequently been categorised according to the mineral resource classification scheme of McKelvey. The results of the analysis demonstrate that recovery costs for Zn are highly dependent on the costs for current fly ash disposal (e.g. cost for subsurface landfilling). Assuming current disposal practice costs of 220€/ton fly ash, resulting recovery costs for Zn are generally higher than its current market price of 1.6€/kg Zn. With respect to the resource classification this outcome indicates that none of the identified Zn resources present in incineration residues can be economically extracted and thus cannot be classified as a reserve. Only for about 4800 t/a of Zn an extraction would be marginally economic, meaning that recovery costs are only slightly (less than 20%) higher than the current market price for Zn. For the remaining Zn resources production costs are between 1.5 and 4 times (7900 t/a Zn) and 10-80 times (55,300 t/a Zn) higher than the current market value. The economic potential for Zn recovery from waste incineration residues is highest for filter ashes generated at grate incinerators equipped with wet air pollution control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Diabetes: cost of illness in Norway

    Directory of Open Access Journals (Sweden)

    Jenssen Trond

    2010-09-01

    Full Text Available Abstract Background Diabetes mellitus places a considerable burden on patients in terms of morbidity and mortality and on society in terms of costs. Costs related to diabetes are expected to increase due to increasing prevalence of type 2 diabetes. The aim of this study was to estimate the health care costs attributable to type 1 and type 2 diabetes in Norway in 2005. Methods Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, medical equipment, nutrition guidance, physiotherapy, acupuncture, foot therapy and indirect costs were collected from national registers and responses to a survey of 584 patients with diabetes. The study was performed with a prevalence approach. Uncertainty was explored by means of bootstrapping. Results When hospital stays with diabetes as a secondary diagnosis were excluded, the total costs were €293 million, which represents about 1.4% of the total health care expenditure. Pharmaceuticals accounted for €95 million (32%, disability pensions €48 million (16%, medical devices €40 million (14% and hospital admissions €21 million (7%. Patient expenditures for acupuncture, physiotherapy and foot therapy were many times higher than expenditure for nutritional guidance. Indirect costs (lost production from job absenteeism accounted for €70.1 million (24% of the €293 million and included sick leave (€16.7 million, disability support and disability pensions (€48.2 million and other indirect costs (€5.3 million. If all diabetes related hospital stays are included (primary- and secondary diagnosis total costs amounts to €535 million, about 2.6% of the total health care expenditure in Norway. Conclusions Diabetes represents a considerable burden to society in terms of health care costs and productivity losses.

  4. The economic cost of Alzheimer's disease: Family or public-health burden?

    Directory of Open Access Journals (Sweden)

    Diego M. Castro

    Full Text Available Abstract Alzheimer's disease (AD patients suffer progressive cognitive, behavioral and functional impairment which result in a heavy burden to patients, families, and the public-health system. AD entails both direct and indirect costs. Indirect costs (such as loss or reduction of income by the patient or family members are the most important costs in early and community-dwelling AD patients. Direct costs (such as medical treatment or social services increase when the disorder progresses, and the patient is institutionalized or a formal caregiver is required. Drug therapies represent an increase in direct cost but can reduce some other direct or indirect costs involved. Several studies have projected overall savings to society when using drug therapies and all relevant cost are considered, where results depend on specific patient and care setting characteristics. Dementia should be the focus of analysis when public health policies are being devised. South American countries should strengthen their policy and planning capabilities by gathering more local evidence about the burden of AD and how it can be shaped by treatment options.

  5. The Global Economic Cost of Osteoarthritis: How the UK Compares

    Directory of Open Access Journals (Sweden)

    A. Chen

    2012-01-01

    Full Text Available Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £19.2 million and £25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £850 million, arthroscopic surgery for osteoarthritis was estimated to be £1.34 million. Indirect costs from OA caused a loss of economic production over £3.2 billion, £43 million was spent on community services and £215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult.

  6. Cost-of-illness analysis of type 2 diabetes mellitus in Iran.

    Directory of Open Access Journals (Sweden)

    Mehdi Javanbakht

    Full Text Available Diabetes is a worldwide high prevalence chronic progressive disease that poses a significant challenge to healthcare systems. The aim of this study is to provide a detailed economic burden of diagnosed type 2 diabetes mellitus (T2DM and its complications in Iran in 2009 year.This is a prevalence-based cost-of-illness study focusing on quantifying direct health care costs by bottom-up approach. Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, laboratory test, education and non-medical cost were collected from two national registries. The human capital approach was used to calculate indirect costs separately in male and female and also among different age groups.The total national cost of diagnosed T2DM in 2009 is estimated at 3.78 billion USA dollars (USD including 2.04±0.28 billion direct (medical and non-medical costs and indirect costs of 1.73 million. Average direct and indirect cost per capita was 842.6±102 and 864.8 USD respectively. Complications (48.9% and drugs (23.8% were main components of direct cost. The largest components of medical expenditures attributed to diabetes's complications are cardiovascular disease (42.3% of total Complications cost, nephropathy (23% and ophthalmic complications (14%. Indirect costs include temporarily disability (335.7 million, permanent disability (452.4 million and reduced productivity due to premature mortality (950.3 million.T2DM is a costly disease in the Iran healthcare system and consume more than 8.69% of total health expenditure. In addition to these quantified costs, T2DM imposes high intangible costs on society in terms of reduced quality of life. Identification of effective new strategies for the control of diabetes and its complications is a public health priority.

  7. The indirect costs and benefits of greenhouse gas limitations

    Energy Technology Data Exchange (ETDEWEB)

    Markandya, A

    1999-12-31

    The purpose of this report is to evaluate GHG limitation issues in a broader context. This includes the impacts of projects on vulnerable groups, the impacts on the environment more generally and the impacts on sustainability in a wider sense. It also offers some advice on how a decision-making framework can bring together these different dimensions. The structure of the guidelines is as follows. Section 2 introduces essential cost concepts and discusses the adjustments needed to the financial costs of different components, to arrive at the true economic costs. Section 3 looks at the macro-economic impacts of different GHG limitation project/policies. Section 4 discusses the way in which the sustainability concerns of such projects/policies can be monitored. Section 5 brings these different components together and looks at different methods of project selection. Section 6 provides a basic framework of impacts that are likely to arise in different GHG-related projects/policies, and what kind of method of estimation is available for these different impacts. Sections 7 to 9 go into greater depth on specific impacts. Sections 7 and 8 look at the employment and distributional effects respectively, and how they might be estimated. Section 9 evaluates the benefits in terms of changes in environmental damage resulting from GHG projects/policies. Section 10 provides three case studies in which the methods outlined in the report are applied. These case studies consider a biogas plant in Tanzania, a forestry project in the Russian Federation, and an energy efficiency project in Thailand. Section 11 concludes the report. (au) 59 refs.

  8. The indirect costs and benefits of greenhouse gas limitations

    Energy Technology Data Exchange (ETDEWEB)

    Markandya, A.

    1998-12-31

    The purpose of this report is to evaluate GHG limitation issues in a broader context. This includes the impacts of projects on vulnerable groups, the impacts on the environment more generally and the impacts on sustainability in a wider sense. It also offers some advice on how a decision-making framework can bring together these different dimensions. The structure of the guidelines is as follows. Section 2 introduces essential cost concepts and discusses the adjustments needed to the financial costs of different components, to arrive at the true economic costs. Section 3 looks at the macro-economic impacts of different GHG limitation project/policies. Section 4 discusses the way in which the sustainability concerns of such projects/policies can be monitored. Section 5 brings these different components together and looks at different methods of project selection. Section 6 provides a basic framework of impacts that are likely to arise in different GHG-related projects/policies, and what kind of method of estimation is available for these different impacts. Sections 7 to 9 go into greater depth on specific impacts. Sections 7 and 8 look at the employment and distributional effects respectively, and how they might be estimated. Section 9 evaluates the benefits in terms of changes in environmental damage resulting from GHG projects/policies. Section 10 provides three case studies in which the methods outlined in the report are applied. These case studies consider a biogas plant in Tanzania, a forestry project in the Russian Federation, and an energy efficiency project in Thailand. Section 11 concludes the report. (au) 59 refs.

  9. 20 CFR 633.304 - Section 402 cost allocation.

    Science.gov (United States)

    2010-04-01

    ... accounted for as follows: (1) Administration. Administration costs consist of all direct and indirect costs... direct program administrative positions such as supervisors, program analysts, labor market analysts, and... to participants, classroom space and utility costs; job search assistance, labor market orientation...

  10. NPP construction cost in Canada

    International Nuclear Information System (INIS)

    Gorshkov, A.L.

    1988-01-01

    The structure of capital costs during NPP construction in Canada is considered. Capital costs comprise direct costs (cost of the ground and ground rights, infrastructure, reactor equipment, turbogenerators, electrotechnical equipment, auxiliary equipment), indirect costs (construction equipment and services, engineering works and management services, insurance payments, freight, training, operating expenditures), capital per cents for the period of construction and cost of heavy water storages. It proceeds from the analysis of the construction cost structure for a NPP with the CANDU reactor of unit power of 515, 740 and 880 MW, that direct costs make up on the average 62%

  11. Incineration with energy recovery

    Energy Technology Data Exchange (ETDEWEB)

    Mahoney, T.G.

    1986-02-01

    Motherwell Bridge Tacol Ltd. operate a 'Licence Agreement' with Deutsche Babcock Anlagen of Krefeld, West Germany, for the construction of Municipal Refuse Incineration plant and Industrial Waste plant with or without the incorporation of waste heat recovery equipment. The construction in the UK of a number of large incineration plants incorporating the roller grate incinerator unit is discussed. The historical background, combustion process, capacity, grate details, refuse analysis and use as fuel, heat recovery and costs are outlined.

  12. Recalculating the Economic Cost of Suicide

    Science.gov (United States)

    Yang, Bijou; Lester, David

    2007-01-01

    These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide. There are potential savings from (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of…

  13. Cost analysis of a commercial pyroprocess facility on the basis of a conceptual design in Korea

    International Nuclear Information System (INIS)

    Kim, S.K.; Ko, W.I.; Youn, S.R.; Gao, Ruxing

    2015-01-01

    Highlights: • Pyroprocess facility’s direct cost was calculated based on the conceptual design. • The unit cost of pyroprocess was calculated as $781/kgHM. • The unit cost was increased by 3%, considering labor allocation standards. • The operating and maintenance cost was identified as a main cost driver. - Abstract: This study postulated a commercial pyroprocess facility (KAPF+: Korea Advanced Pyroprocess Facility Plus) with a processing capacity of 400 tons/year as a cost object, and utilized an engineering cost estimation method based on a conceptual design to present the results of the total cost and unit cost estimation. According to the calculation results, the total cost and unit cost were calculated with k$779,386 and $781/kgHM, respectively. Moreover, the key cost driver was manifested as the operating and maintenance costs. In particular, equipment replacement cost was identified as an important cost driver. In addition, for an increasingly accurate cost estimation, the calculation results and allocation method of the indirect cost were reanalyzed. Finally the pyroprocess unit cost increased $5 when calculated the indirect cost using the labor time as the allocation standard. Meanwhile, the pyroprocess unit cost increased $22 as a result of allocating the indirect cost using the uniform labor cost as the cost allocation standard. Accordingly, an indirect cost allocation standard was manifested as the factor that exerts a significant effect on the pyroprocess unit cost

  14. Precious Metals Recovery from Electroplating Wastewater: A Review

    Science.gov (United States)

    Azmi, A. A.; Jai, J.; Zamanhuri, N. A.; Yahya, A.

    2018-05-01

    Metal bearing electroplating wastewater posts great health and environmental concerns, but could also provide opportunities for precious and valuable metal recovery, which can make the treatment process more cost-effective and sustainable. Current conventional electroplating wastewater treatment and metal recovery methods include chemical precipitation, coagulation and flocculation, ion exchange, membrane filtration, adsorption, electrochemical treatment and photocatalysis. However, these physico-chemical methods have several disadvantages such as high initial capital cost, high operational cost due to expensive chemical reagents and electricity supply, generation of metal complexes sludge which requires further treatment, ineffective in diluted and/or concentrated wastewater, low precious metal selectivity, and slow recovery process. On the other hand, metal bio-reduction assisted by bioactive phytochemical compounds extracted from plants and plant parts is a new found technology explored by several researchers in recent years aiming to recover precious and valuable metals from secondary sources mainly industrial wastewater by utilizing low-cost and eco-friendly biomaterials as reagents. Extract of plants contains polyphenolic compounds which have great antioxidant properties and reducing capacities, able to reduce metal ions into zerovalent metal atoms and stabilize the metal particles formed. This green bio-recovery method has a value added in their end products since the metals are recovered in nano-sized particles which are more valuable and have high commercial demand in other fields ranging from electrochemistry to medicine.

  15. ANALYSIS OF THE COST OF THE DISEASE — PROBLEMS AND SOLUTIONS

    Directory of Open Access Journals (Sweden)

    V.V. Omel'yanovskii

    2011-01-01

    Full Text Available The article discusses the estimation of the disease value, which includes direct, indirect and «intangible» costs. Advantages and disadvantages of different approaches to cost accounting, including the method of direct costs microcalculation compared with established norms of reimbursement are presented. It is demonstrated that disease’s cost not only reveals the burden of a pathology, but also allows the State to rationally allocate resources. The authors conclude that lack of comparability of the results of studies with different approaches to cost accounting does not allow their use in health care management. To solve this problem is necessary to develop a common methodology for analyzing the cost of the disease.Key words: cost of illness study, clinical and economical analysis, direct cost, indirect cost, impalpable costs, microcalculation of costs, human capital method, friction costs method, absenteeism, presenteeism.

  16. The impact of cost recovery and sharing system on water policy implementation and human right to water: a case of Ileje, Tanzania.

    Science.gov (United States)

    Kibassa, Deusdedit

    2011-01-01

    In Tanzania, the National Water Policy (NAWAPO) of 2002 clearly stipulates that access to water supply and sanitation is a right for every Tanzanian and that cost recovery is the foundation of sustainable service delivery. To meet these demands, water authorities have introduced cost recovery and a water sharing system. The overall objective of this study was to assess the impact of cost recovery and the sharing system on water policy implementation and human rights to water in four villages in the Ileje district. The specific objectives were: (1) to assess the impact of cost recovery and the sharing system on the availability of water to the poor, (2) to assess user willingness to pay for the services provided, (3) to assess community understanding on the issue of water as a human right, (4) to analyse the implications of the results in relation to policies on human rights to water and the effectiveness of the implementation of the national water policy at the grassroots, and (5) to establish the guidelines for water pricing in rural areas. Questionnaires at water demand, water supply, ability and willingness to pay and revenue collection were the basis for data collection. While 36.7% of the population in the district had water supply coverage, more than 73,077 people of the total population of 115,996 still lacked access to clean and safe water and sanitation services in the Ileje district. The country's rural water supply coverage is 49%. Seventy-nine percent of the interviewees in all four villages said that water availability in litres per household per day had decreased mainly due to high water pricing which did not consider the income of villagers. On the other hand, more than 85% of the villagers were not satisfied with the amount they were paying because the services were still poor. On the issue of human rights to water, more than 92% of the villagers know about their right to water and want it exercised by the government. In all four villages, more than

  17. Cruel intentions on television and in real life: can viewing indirect aggression increase viewers' subsequent indirect aggression?

    Science.gov (United States)

    Coyne, Sarah M; Archer, John; Eslea, Mike

    2004-07-01

    Numerous studies have shown that viewing violence in the media can influence an individual's subsequent aggression, but none have examined the effect of viewing indirect aggression. This study examines the immediate effect of viewing indirect and direct aggression on subsequent indirect aggression among 199 children ages 11 to 14 years. They were shown an indirect, direct, or no-aggression video and their subsequent indirect aggression was measured by negative evaluation of a confederate and responses to a vignette. Participants viewing indirect or direct aggression gave a more negative evaluation of and less money to a confederate than participants viewing no-aggression. Participants viewing indirect aggression gave less money to the confederate than those viewing direct aggression. Participants viewing indirect aggression gave more indirectly aggressive responses to an ambiguous situation and participants viewing direct aggression gave more directly aggressive responses. This study provides the first evidence that viewing indirect aggression in the media can have an immediate impact on subsequent aggression.

  18. Application of the High Temperature Gas Cooled Reactor to oil shale recovery

    International Nuclear Information System (INIS)

    Wadekamper, D.C.; Arcilla, N.T.; Impellezzeri, J.R.; Taylor, I.N.

    1983-01-01

    Current oil shale recovery processes combust some portion of the products to provide energy for the recovery process. In an attempt to maximize the petroleum products produced during recovery, the potentials for substituting nuclear process heat for energy generated by combustion of petroleum were evaluated. Twelve oil shale recovery processes were reviewed and their potentials for application of nuclear process heat assessed. The High Temperature Gas Cooled Reactor-Reformer/Thermochemical Pipeline (HTGR-R/TCP) was selected for interfacing process heat technology with selected oil shale recovery processes. Utilization of these coupling concepts increases the shale oil product output of a conventional recovery facility from 6 to 30 percent with the same raw shale feed rate. An additional benefit of the HTGR-R/TCP system was up to an 80 percent decrease in emission levels. A detailed coupling design for a typical counter gravity feed indirect heated retorting and upgrading process were described. Economic comparisons prepared by Bechtel Group Incorporated for both the conventional and HTGR-R/TCP recovery facility were summarized

  19. 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.

  20. The cost of severe haemophilia in Europe: the CHESS study.

    Science.gov (United States)

    O'Hara, Jamie; Hughes, David; Camp, Charlotte; Burke, Tom; Carroll, Liz; Diego, Daniel-Anibal Garcia

    2017-05-31

    Severe haemophilia is associated with major psychological and economic burden for patients, caregivers, and the wider health care system. This burden has been quantified and documented for a number of European countries in recent years. However, few studies have taken a standardised methodology across multiple countries simultaneously, and sought to amalgamate all three levels of burden for severe disease. The overall aim of the 'Cost of Haemophilia in Europe: a Socioeconomic Survey' (CHESS) study was to capture the annualised economic and psychosocial burden of severe haemophilia in five European countries. A cross-section of haemophilia specialists (surveyed between January and April 2015) provided demographic and clinical information and 12-month ambulatory and secondary care activity for patients via an online survey. In turn, patients provided corresponding direct and indirect non-medical cost information, including work loss and out-of-pocket expenses, as well as information on quality of life and adherence. The direct and indirect costs for the patient sample were calculated and extrapolated to population level. Clinical reports for a total of 1,285 patients were received. Five hundred and fifty-two patients (43% of the sample) provided information on indirect costs and health-related quality of life via the PSC. The total annual cost of severe haemophilia across the five countries for 2014 was estimated at EUR 1.4 billion, or just under EUR 200,000 per patient. The highest per-patient costs were in Germany (mean EUR 319,024) and the lowest were in the United Kingdom (mean EUR 129,365), with a study average of EUR 199,541. As expected, consumption of clotting factor replacement therapy represented the vast majority of costs (up to 99%). Indirect costs are driven by patient and caregiver work loss. The results of the CHESS study reflect previous research findings suggesting that costs of factor replacement therapy account for the vast majority of the cost

  1. 49 CFR 594.9 - Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits or obligations of the United States in lieu of sureties on... indirect costs the agency incurs for receipt, processing, handling, and disbursement of cash deposits or...

  2. How do dispersal costs and habitat selection influence realized population connectivity?

    Science.gov (United States)

    Burgess, Scott C; Treml, Eric A; Marshall, Dustin J

    2012-06-01

    Despite the importance of dispersal for population connectivity, dispersal is often costly to the individual. A major impediment to understanding connectivity has been a lack of data combining the movement of individuals and their survival to reproduction in the new habitat (realized connectivity). Although mortality often occurs during dispersal (an immediate cost), in many organisms costs are paid after dispersal (deferred costs). It is unclear how such deferred costs influence the mismatch between dispersal and realized connectivity. Through a series of experiments in the field and laboratory, we estimated both direct and indirect deferred costs in a marine bryozoan (Bugula neritina). We then used the empirical data to parameterize a theoretical model in order to formalize predictions about how dispersal costs influence realized connectivity. Individuals were more likely to colonize poor-quality habitat after prolonged dispersal durations. Individuals that colonized poor-quality habitat performed poorly after colonization because of some property of the habitat (an indirect deferred cost) rather than from prolonged dispersal per se (a direct deferred cost). Our theoretical model predicted that indirect deferred costs could result in nonlinear mismatches between spatial patterns of potential and realized connectivity. The deferred costs of dispersal are likely to be crucial for determining how well patterns of dispersal reflect realized connectivity. Ignoring these deferred costs could lead to inaccurate predictions of spatial population dynamics.

  3. Phosphorus recovery from municipal wastewater: An integrated comparative technological, environmental and economic assessment of P recovery technologies.

    Science.gov (United States)

    Egle, L; Rechberger, H; Krampe, J; Zessner, M

    2016-11-15

    Phosphorus (P) is an essential and limited resource. Municipal wastewater is a promising source of P via reuse and could be used to replace P derived from phosphate rocks. The agricultural use of sewage sludge is restricted by legislation or is not practiced in several European countries due to environmental risks posed by organic micropollutants and pathogens. Several technologies have been developed in recent years to recover wastewater P. However, these technologies target different P-containing flows in wastewater treatment plants (effluent, digester supernatant, sewage sludge, and sewage sludge ash), use diverse engineering approaches and differ greatly with respect to P recycling rate, potential of removing or destroying pollutants, product quality, environmental impact and cost. This work compares 19 relevant P recovery technologies by considering their relationships with existing wastewater and sludge treatment systems. A combination of different methods, such as material flow analysis, damage units, reference soil method, annuity method, integrated cost calculation and a literature study on solubility, fertilizing effects and handling of recovered materials, is used to evaluate the different technologies with respect to technical, ecological and economic aspects. With regard to the manifold origins of data an uncertainty concept considering validity of data sources is applied. This analysis revealed that recovery from flows with dissolved P produces clean and plant-available materials. These techniques may even be beneficial from economic and technical perspectives under specific circumstances. However, the recovery rates (a maximum of 25%) relative to the wastewater treatment plant influent are relatively low. The approaches that recover P from sewage sludge apply complex technologies and generally achieve effective removal of heavy metals at moderate recovery rates (~40-50% relative to the WWTP input) and comparatively high costs. Sewage sludge ash is

  4. 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.

  5. Cost competitive “soft sensor” for determining product recovery in industrial methanol

    DEFF Research Database (Denmark)

    S.B.A. Udugama, Isuru; Mansouri, Seyed Soheil; Huusom, Jakob Kjøbsted

    2017-01-01

    The measurement of ratio of product recovery in industrial methanol distillation is of high economic importance and represent a key performance index (KPI) of the distillation unit. In current operations, the product recovery of many industrial distillation units are not actively monitored, instead...

  6. Deception Undermines the Stability of Cooperation in Games of Indirect Reciprocity.

    Science.gov (United States)

    Számadó, Szabolcs; Szalai, Ferenc; Scheuring, István

    2016-01-01

    Indirect reciprocity is often claimed as one of the key mechanisms of human cooperation. It works only if there is a reputational score keeping and each individual can inform with high probability which other individuals were good or bad in the previous round. Gossip is often proposed as a mechanism that can maintain such coherence of reputations in the face of errors of transmission. Random errors, however, are not the only source of uncertainty in such situations. The possibility of deceptive communication, where the signallers aim to misinform the receiver cannot be excluded. While there is plenty of evidence for deceptive communication in humans the possibility of deception is not yet incorporated into models of indirect reciprocity. Here we show that when deceptive strategies are allowed in the population it will cause the collapse of the coherence of reputations and thus in turn it results the collapse of cooperation. This collapse is independent of the norms and the cost and benefit values. It is due to the fact that there is no selection for honest communication in the framework of indirect reciprocity. It follows that indirect reciprocity can be only proposed plausibly as a mechanism of human cooperation if additional mechanisms are specified in the model that maintains honesty.

  7. Deception Undermines the Stability of Cooperation in Games of Indirect Reciprocity.

    Directory of Open Access Journals (Sweden)

    Szabolcs Számadó

    Full Text Available Indirect reciprocity is often claimed as one of the key mechanisms of human cooperation. It works only if there is a reputational score keeping and each individual can inform with high probability which other individuals were good or bad in the previous round. Gossip is often proposed as a mechanism that can maintain such coherence of reputations in the face of errors of transmission. Random errors, however, are not the only source of uncertainty in such situations. The possibility of deceptive communication, where the signallers aim to misinform the receiver cannot be excluded. While there is plenty of evidence for deceptive communication in humans the possibility of deception is not yet incorporated into models of indirect reciprocity. Here we show that when deceptive strategies are allowed in the population it will cause the collapse of the coherence of reputations and thus in turn it results the collapse of cooperation. This collapse is independent of the norms and the cost and benefit values. It is due to the fact that there is no selection for honest communication in the framework of indirect reciprocity. It follows that indirect reciprocity can be only proposed plausibly as a mechanism of human cooperation if additional mechanisms are specified in the model that maintains honesty.

  8. Strontium-90 and promethium-147 recovery

    International Nuclear Information System (INIS)

    Hoisington, J.E.; McDonell, W.R.

    1982-01-01

    Strontium-90 and promethium-147 are fission product radionuclides with potential for use as heat source materials in high reliability, non-interruptible power supplies. Interest has recently been expressed in their utilization for Department of Defense (DOD) applications. This memorandum summarizes the current inventories, the annual production rates, and the possible recovery of Sr-90 and Pm-147 from nuclear materials production operations at Hanford and Savannah River. Recovery of these isotopes from LWR spend fuel utilizing the Barnwell Nuclear Fuels Plant (BNFP) is also considered. Unit recovery costs at each site are provided

  9. Assessment of gas cooled fast reactor with indirect supercritical CO2 cycle

    International Nuclear Information System (INIS)

    Hejzlar, P.; Driscoll, M. J.; Dostal, V.; Dumaz, P.; Poullennec, G.; Alpy, N.

    2006-01-01

    Various indirect power cycle options for a helium cooled Gas cooled Fast Reactor (GFR) with particular focus on a supercritical CO 2 (SCO 2 ) indirect cycle are investigated as an alternative to a helium cooled direct cycle GFR. The Balance Of Plant (BOP) options include helium-nitrogen Brayton cycle, supercritical water Rankine cycle, and SCO 2 recompression Brayton power cycle in three versions: (1) basic design with turbine inlet temperature of 550 .deg. C, (2) advanced design with turbine inlet temperature of 650 .deg. C and (3) advanced design with the same turbine inlet temperature and reduced compressor inlet temperature. The indirect SCO 2 recompression cycle is found attractive since in addition to easier BOP maintenance it allows significant reduction of core outlet temperature, making design of the primary system easier while achieving very attractive efficiencies comparable to or slightly lower than, the efficiency of the reference GFR direct cycle design. In addition, the indirect cycle arrangement allows significant reduction of the GFR 'proximate-containment' and the BOP for the SCO 2 cycle is very compact. Both these factors will lead to reduced capital cost

  10. Determination production costs using PBC method

    Directory of Open Access Journals (Sweden)

    Todić Vladimir V.

    2014-01-01

    Full Text Available Basic characteristics of modern markets make requirements in quality increasing, decreasing prices and shortening delivery of products. In the middle of this requirements are production costs for whose determination are developed many traditional and alternative methods including PBC method (Process Based Costing. This method enables precisely locating and calculating indirect production costs, and with determined direct costs enables determination of total production costs. This paper shows usage of PBC method for determination production costs for three forms of processing cutting tools.

  11. Enhanced Recovery in Thoracic Surgery: A Review

    Directory of Open Access Journals (Sweden)

    Vesna D. Dinic

    2018-02-01

    Full Text Available The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery. In the era of enhanced recovery protocols, non-intubated thoracoscopic procedures present a step forward. This article focuses on the key elements of the enhanced recovery program in thoracic surgery. Having reviewed recent literature, the authors highlight potential procedures and techniques that might be incorporated into the program.

  12. Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

    Science.gov (United States)

    2014-01-01

    Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

  13. Indirect Climatic Effects of Major Volcanic Eruptions

    Science.gov (United States)

    Hofmann, D. J.

    2007-05-01

    The direct effects on climate, related to atmospheric emissions to the atmosphere following major volcanic eruptions, are well-known although the sparseness of such eruptions make detailed study on the range of such variations difficult. In general terms, infrared absorption by volcanic emissions to the stratosphere result in local heating early in the event when gaseous sulfur compounds exist. This early period is followed by gas to particle conversion, on a time scale of 1-2 months, promoting the formation of sulfuric acid-water droplets. Coagulation and droplet growth result in the "volcanic stratospheric aerosol layer" which is related to the predominant direct climatic effect of large eruptions, the cooling of the troposphere by backscattering of solar visible radiation to space with a recovery time scale of 1-2 years. In this paper we will discuss some of the less-known "indirect" effects of the volcanic stratospheric aerosol on climate. We label them indirect as they act on climate through intermediary atmospheric constituents. The intermediaries in the volcanic indirect climatic effect are generally atmospheric greenhouse gases or other atmospheric gases and conditions which affect greenhouse gases. For example, cooling of the troposphere following major eruptions reduces the growth rate of atmospheric carbon dioxide related to respiration by the terrestrial biosphere. In addition, redirection of part of the direct solar beam into diffuse radiation by the volcanic stratospheric aerosol stimulates plant photosynthesis, further reducing the carbon dioxide growth rate. The growth rate of the second-most important atmospheric greenhouse gas, methane, is also affected by volcanic emissions. Volcanic stratospheric aerosol particles provide surface area which catalyzes heterogeneous chemical reactions thus stimulating removal of stratospheric ozone, also a greenhouse gas. Although major droughts usually related to ENSO events have opposite effects on carbon

  14. [Financial burden of hepatitis B-related diseases and factors influencing the costs in Shenzhen, China].

    Science.gov (United States)

    Liang, Sen; Zhang, Shun-xiang; Ma, Qi-shan; Xiao, He-wei; Lü, Qiu-ying; Xie, Xu; Mei, Shu-jiang; Hu, Dong-sheng; Zhou, Bo-ping; Li, Bing; Chen, Jing-fang; Cui, Fu-qiang; Wang, Fu-zhen; Liang, Xiao-feng

    2010-12-01

    To investigate the direct, indirect and intangible costs due to hepatitis B-related diseases and to explore main factors associated with the costs in Shenzhen. Cluster sampling for cases collected consecutively during the study period was administrated. Subjects were selected from eligible hepatitis B-related patients. By pre-trained professional investigators, health economics-related information was collected, using a structured questionnaire. Hospitalization expenses were obtained through hospital records after the patients were discharged from hospital. Total economic burden of hepatitis B-related patients would involve direct, indirect and intangible costs. Direct costs were further divided into direct medical costs and direct nonmedical costs. Human Capital Approach was employed to measure the indirect costs both on patients and the caregivers in 1-year time span. Willing to pay method was used to estimate the intangible costs. Multiple linear stepwise regression models were conducted to determine the factors linked to the economic burden. On average, the total annual cost of per patient with hepatitis B-related diseases was 81 590.23 RMB Yuan. Among which, direct, indirect and intangible costs were 30 914.79 Yuan (account for 37.9%), 15 258.01 Yuan (18.7%), 35 417.43 Yuan (43.4%), respectively. The total annual costs per patient for hepatocellular carcinoma, severe hepatitis B, decompensated cirrhosis, compensated cirrhosis, chronic hepatitis B and acute hepatitis B were 194 858.40 Yuan, 144 549.20 Yuan, 120 333.60 Yuan, 79 528.81 Yuan, 66 282.46 Yuan and 39 286.81 Yuan, respectively. The ratio of direct to indirect costs based on the base-case estimation foot add to 2.0:1, increased from hepato-cellular carcinoma (0.7:1) to compensated cirrhosis (3.5:1), followed by acute hepatitis B (3.3:1), severe hepatitis B (2.8:1), decompensate cirrhosis (2.3:1) and chronic hepatitis B (2.2:1). Direct medical costs were more than direct nonmedical. Ratio between the

  15. 20 CFR 632.37 - Allowable costs.

    Science.gov (United States)

    2010-04-01

    ... otherwise indicated below, direct and indirect costs shall be charged in accordance with 41 CFR 29-70 and 41... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Allowable costs. 632.37 Section 632.37 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR INDIAN AND NATIVE AMERICAN...

  16. Double-Shell Tanks System Maintenance and Recovery Needs Report

    International Nuclear Information System (INIS)

    SMITH, D.F.

    2002-01-01

    This report represents an initial effort to identify maintenance equipment needed to support critical components used for delivery of waste feed to the Waste Isolation and Treatment Plant (WTP). Rough estimates of cost benefits for selected maintenance capabilities are provided. A follow-on to this report should include a detailed cost analysis showing cost benefits and tradeoffs in selection and development of specific maintenance capabilities. Critical component failures during delivery of waste feed from the DSTs to the WTP have the potential to idle WTP facilities if the duration of the recovery operations are long enough to allow the WTP to exhaust a planned 60-day lag storage capacity for waste feed. If a critical component within the transfer route fails, current planning does not provide for an alternative HLW feed source. Critical components with relatively high failure frequencies and recovery times are identified, along with a summary of documentation regarding historical maintenance and recovery operations and planning. Components, such as mixer pumps and transfer pumps, are estimated to have relatively long recovery times due, in part, to the current practice of sending spare pumps, when needed, off-site to a remote location, for vendor refurbishment and testing prior to installation in a tank. No capability is provided on-site for pump ''run-in''. As neither the spare pumps in storage, installed pumps, or other critical components are subjected to periodic preventive maintenance, and these critical components are planned to be operated intermittently over a long period of time, component failures are to be expected. Recommendations are made for further analysis to identify specific equipment cost benefits, development costs, and tradeoffs in selection of alternatives. This new equipment will provide capabilities for component storage and maintenance in line with vendor recommendations, reduce the duration of recovery operations, and support personnel

  17. Indirect taxation in the European Union

    OpenAIRE

    Ene, Sebastian; Micuda, Dan

    2007-01-01

    Indirect taxes are levied on the production and consumption of goods and services. They influence the retail price, and hence affect patterns of trade and consumption. Indirect taxes are ultimately paid by the final consumer. Sales and turnover taxes, excise duties and tariffs are the basic indirect taxes. In contrast with direct taxes, indirect taxes are seldom progressive. The principles for the levying of these taxes will be considered before the analysis of indirect taxes.

  18. Comparing methodologies for the allocation of overhead and capital costs to hospital services.

    Science.gov (United States)

    Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona

    2009-06-01

    Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

  19. The economics of aquifer storage recovery technology

    Energy Technology Data Exchange (ETDEWEB)

    David, R.; Pyne, G.

    2014-10-01

    Aquifer storage recovery (ASR) technology is increasingly being utilized around the world for storing water underground through one or more wells during wet months and other times when water is available for storage. The water is then recovered from the same wells when needed to meet a growing variety of water supply objectives. The economics of ASR constitute the principal reason for its increasing utilization. ASR unit capital costs are typically less than half those of other water supply and water storage alternatives. Unit operating costs are usually only slightly greater than for conventional production well-fields. Marginal costs for ASR storage and recovery provide a powerful tool for making more efficient use of existing infrastructure, providing water supply sustainability and reliability at relatively low cost. The opportunity exists for a careful analysis of the net present value of ASR well-fields, addressing not only the associated capital and operating costs but also the value of the benefits achieved for each of the water supply objectives at each site. (Author)

  20. The economics of aquifer storage recovery technology

    International Nuclear Information System (INIS)

    David, R.; Pyne, G.

    2014-01-01

    Aquifer storage recovery (ASR) technology is increasingly being utilized around the world for storing water underground through one or more wells during wet months and other times when water is available for storage. The water is then recovered from the same wells when needed to meet a growing variety of water supply objectives. The economics of ASR constitute the principal reason for its increasing utilization. ASR unit capital costs are typically less than half those of other water supply and water storage alternatives. Unit operating costs are usually only slightly greater than for conventional production well-fields. Marginal costs for ASR storage and recovery provide a powerful tool for making more efficient use of existing infrastructure, providing water supply sustainability and reliability at relatively low cost. The opportunity exists for a careful analysis of the net present value of ASR well-fields, addressing not only the associated capital and operating costs but also the value of the benefits achieved for each of the water supply objectives at each site. (Author)

  1. The economic costs of childhood disability.

    Science.gov (United States)

    Stabile, Mark; Allin, Sara

    2012-01-01

    Childhood disabilities entail a range of immediate and long-term economic costs that have important implications for the well-being of the child, the family, and society but that are difficult to measure. In an extensive research review, Mark Stabile and Sara Allin examine evidence about three kinds of costs-direct, out-of-pocket costs incurred as a result of the child's disability; indirect costs incurred by the family as it decides how best to cope with the disability; and long-term costs associated with the child's future economic performance. Not surprisingly, the evidence points to high direct costs for families with children with disabilities, though estimates vary considerably within these families. Out-of-pocket expenditures, particularly those for medical costs, for example, are higher among families with children with a special health care need. An important indirect cost for these families involves decisions about employment. Stabile and Allin examine several studies that, taken together, show that having a child with disabilities increases the likelihood that the mother (and less often the father) will either curtail hours of work or stop working altogether. Researchers also find that having a child with disabilities can affect a mother's own health and put substantial strains on the parents' relationship. In the longer term, disabilities also compromise a child's schooling and capacity to get and keep gainful employment as an adult, according to the studies Stabile and Allin review. Negative effects on future well-being appear to be much greater, on average, for children with mental health problems than for those with physical disabilities. Stabile and Allin calculate that the direct costs to families, indirect costs through reduced family labor supply, direct costs to disabled children as they age into the labor force, and the costs of safety net programs for children with disabilities average $30,500 a year per family with a disabled child. They note

  2. Thermal comfort analysis of a low temperature waste energy recovery system. SIECHP

    Energy Technology Data Exchange (ETDEWEB)

    Herrero Martin, R. [Departamento de Ingenieria Termica y de Fluidos, Universidad Politecnica de Cartagena, C/Dr. Fleming, s/n (Campus Muralla), 30202 Cartagena, Murcia (Spain); Rey Martinez, F.J.; Velasco Gomez, E. [Departamento de Ingenieria Energetica y Fluidomecanica, ETSII, Universidad de Valladolid, Paseo del Cauce s/n, 47011 Valladolid (Spain)

    2008-07-01

    The use of a recovery device is justified in terms of energy savings and environmental concerns. But it is clear that the use of a recovery system also has to lead to controlling indoor environmental quality, nowadays a priority concern. In this article, experimental research has been carried out whose aim is to study the thermal comfort provided by a combined recovery equipment (SIECHP), consisting of a ceramic semi-indirect evaporative cooler (SIEC) and a heat pipe device (HP) to recover energy at low temperature in air-conditioning systems. To characterize this device empirically in terms of thermal comfort (TC), Fanger's predicted mean vote (PMV), draught rate, and vertical air temperature difference were used in this study as the TC criteria. (author)

  3. Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection.

    Science.gov (United States)

    Yamin, Dan; Atkins, Katherine E; Remy, Vanessa; Galvani, Alison P

    Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission. To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule. We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course. Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode. Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by

  4. Can chronic disease management programs for patients with type 2 diabetes reduce productivity-related indirect costs of the disease? Evidence from a randomized controlled trial.

    Science.gov (United States)

    Adepoju, Omolola E; Bolin, Jane N; Ohsfeldt, Robert L; Phillips, Charles D; Zhao, Hongwei; Ory, Marcia G; Forjuoh, Samuel N

    2014-04-01

    The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; Pmanagement programs examined in this trial affect indirect productivity losses.

  5. Cost analysis of microtia treatment in the Netherlands.

    Science.gov (United States)

    Kolodzynski, M N; van Hövell Tot Westerflier, C V A; Kon, M; Breugem, C C

    2017-09-01

    Ear reconstruction for microtia is a challenging procedure. Although analyzing esthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia. Ten consecutive children with autologous ear reconstruction of a unilateral microtia were included in this analysis. All patients had completed their treatment protocol for ear reconstruction. Direct costs (admission to hospital, diagnostics, and surgery) and indirect cost (travel expenses and absence from work) were obtained retrospectively. The overall mean cumulative cost per patient was €14,753. Direct and indirect costs were €13,907 and €846, respectively. Hospital admission and surgery cover 55% and 32% of all the costs, respectively. This study analyzes the costs for autologous ear reconstruction. Hospital admission and surgery are the most important factors of the total costs. Total costs could be decreased by possibly decreasing admission days and surgical time. These data can be used for choosing and developing future treatment strategies. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. The Vessel Schedule Recovery Problem

    DEFF Research Database (Denmark)

    Brouer, Berit Dangaard; Plum, Christian Edinger Munk; Vaaben, Bo

    Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker cons...... consumption and the impact on the remaining network and the customer service level. The model is applied to 4 real cases from Maersk Line. Solutions are comparable or superior to those chosen by operations managers. Cost savings of up to 58% may be achieved.......Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker...

  7. Recovery of energy in a gaseous diffusion plant

    International Nuclear Information System (INIS)

    Ergalant, Jacques; Guais, J.-C.; Perrault, Michel; Vignet, Paul

    1975-01-01

    Any energy recovery, even partial, goes in the direction of savings in energy and should be sought for. The Tricastin plant, now in the course of being built, will be able to deliver several hundreds of MW for the purpose of urban and agricultural heating. The new Coredif project will more completely integrate the valorization of calories in its definition (choice of temperatures, design of the heat exchangers, recovery cycles). In fact the recent evolution in energy costs renders the otpimization of a plant equipped with a heat recovery system (1 to 2% on the cost of the uranium produced) now economically worth-while. In the same way, the choice of the site of the future plant may be conditioned by the possible uses of calories in its vicinity [fr

  8. Enhanced Recovery Pathways for Improving Outcomes After Minimally Invasive Gynecologic Oncology Surgery.

    Science.gov (United States)

    Chapman, Jocelyn S; Roddy, Erika; Ueda, Stefanie; Brooks, Rebecca; Chen, Lee-Lynn; Chen, Lee-May

    2016-07-01

    To estimate whether an enhanced recovery after surgery pathway facilitates early recovery and discharge in gynecologic oncology patients undergoing minimally invasive surgery. This was a retrospective case-control study. Consecutive gynecologic oncology patients undergoing laparoscopic or robotic surgery between July 1 and November 5, 2014, were treated on an enhanced recovery pathway. Enhanced recovery pathway components included patient education, multimodal analgesia, opioid minimization, nausea prophylaxis as well as early catheter removal, ambulation, and feeding. Cases were matched in a one-to-two ratio with historical control patients on the basis of surgery type and age. Primary endpoints were length of hospital stay, rates of discharge by noon, 30-day hospital readmission rates, and hospital costs. There were 165 patients included in the final cohort, 55 of whom were enhanced recovery pathway patients. Enhanced recovery patients were more likely to be discharged on postoperative day 1 compared with patients in the control group (91% compared with 60%, Pcontrol patients (P=.03). Postoperative pain scores decreased (2.6 compared with 3.12, P=.03) despite a 30% reduction in opioid use. Average total hospital costs were decreased by 12% in the enhanced recovery group ($13,771 compared with $15,649, P=.01). Readmission rates, mortality, and reoperation rates did not differ between the two groups. An enhanced recovery pathway in patients undergoing gynecologic oncology minimally invasive surgery is associated with significant improvements in recovery time, decreased pain despite reduced opioid use, and overall lower hospital costs.

  9. Costs of examinations performed in a hospital laboratory in Chile.

    Science.gov (United States)

    Andrade, Germán Lobos; Palma, Carolina Salas

    2018-01-01

    To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.

  10. Altruism and Indirect Reciprocity: The Interaction of Person and Situation in Prosocial Behavior

    Science.gov (United States)

    Simpson, Brent; Willer, Robb

    2008-01-01

    A persistent puzzle in the social and biological sciences is the existence of prosocial behavior, actions that benefit others, often at a cost to oneself. Recent theoretical models and empirical studies of indirect reciprocity show that actors behave prosocially in order to develop an altruistic reputation and receive future benefits from third…

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

    Science.gov (United States)

    Adesina, Adebiyi; Bollinger, Lori A

    2013-01-01

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

  12. Incentive pricing and cost recovery at the basin scale.

    Science.gov (United States)

    Ward, Frank A; Pulido-Velazquez, Manuel

    2009-01-01

    Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.

  13. Development of a Practical Costing Method for Hospitals

    OpenAIRE

    Cao, Pengyu; Toyabe, Shin-ichi; Akazawa, Kouhei

    2006-01-01

    To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate r...

  14. Effects of worksite health interventions involving reduced work hours and physical exercise on sickness absence costs.

    Science.gov (United States)

    von Thiele Schwarz, Ulrica; Hasson, Henna

    2012-05-01

    To investigate the effects of physical exercise during work hours (PE) and reduced work hours (RWH) on direct and indirect costs associated with sickness absence (SA). Sickness absence and related costs at six workplaces, matched and randomized to three conditions (PE, RWH, and referents), were retrieved from company records and/or estimated using salary conversion methods or value-added equations on the basis of interview data. Although SA days decreased in all conditions (PE, 11.4%; RWH, 4.9%; referents, 15.9%), costs were reduced in the PE (22.2%) and RWH (4.9%) conditions but not among referents (10.2% increase). Worksite health interventions may generate savings in SA costs. Costs may not be linear to changes in SA days. Combing the friction method with indirect cost estimates on the basis of value-added productivity may help illuminate both direct and indirect SA costs.

  15. The costs and benefits of a vaccination programme for Haemophilus ...

    African Journals Online (AJOL)

    Costs were calculated by summing the estimated direct medical care costs together with the indirect costs of Hib disease. The latter were calculated by valuing human life using alternative, and conservative human capital and willingness-to-pay measures. The difference between Hib disease costs (Le. the benefits which ...

  16. Indirect and non-medical economic burden, quality-of-life, and disabilities of the myelofibrosis disease in Spain.

    Science.gov (United States)

    Gimenez, Emmanuel; Besses, Carles; Boque, Concepcion; Velez, Patricia; Kerguelen, Ana; Cervantes, Francisco; Ferrer-Marin, Francisca; Perez-Encinas, Manuel; Rodriguez, Mercedes; Gonzalez, Juan Diego; Calzada, Reyes; Hernandez-Boluda, Juan Carlos

    2014-06-01

    Myelofibrosis is a non-frequent chronic myeloproliferative Philadelphia-negative chromosome neoplasm. It is a heavy incapacitating orphan disease and associated with high morbidity and mortality. In this context, indirect and non-medical costs are expected to be high. The main objective of this project is to estimate the economic burden of this disease in Spain. Thirty-three patients with a diagnosis of myelofibrosis for at least 1 year participated in a questionnaire in three Spanish centers. The study consisted of analyzing in various aspects the cost and impact of the disease; indeed, daily life time limitations with a need of informal care, symtomatology. Additionally, information concerning the clinical management of the disease was collected through a focus group of eight experts. The mean age was 65 years. 15 of 33 patients were at their productive stage. Six had difficulties at work and eight have received informal care. Bone and muscular pain were the main symptoms of patients (72%). The estimated global indirect and non-medical costs of the disease were 86,315€ per patient (20% working and 80% informal care), which reached 104,153€ at productive stage patients (45%) and 168,459€ for more symptomatic patients. The economic burden of indirect and non-medical costs of myelofibrosis are important (15,142€/annual) as a result, and should be considered in economic evaluation, as well as in preventive plans for patients and caregivers, despite the fact that studies with larger numbers of patients should be done.

  17. Indirect Self-Destructiveness and Emotional Intelligence.

    Science.gov (United States)

    Tsirigotis, Konstantinos

    2016-06-01

    While emotional intelligence may have a favourable influence on the life and psychological and social functioning of the individual, indirect self-destructiveness exerts a rather negative influence. The aim of this study has been to explore possible relations between indirect self-destructiveness and emotional intelligence. A population of 260 individuals (130 females and 130 males) aged 20-30 (mean age of 24.5) was studied by using the Polish version of the chronic self-destructiveness scale and INTE, i.e., the Polish version of the assessing emotions scale. Indirect self-destructiveness has significant correlations with all variables of INTE (overall score, factor I, factor II), and these correlations are negative. The intensity of indirect self-destructiveness differentiates significantly the height of the emotional intelligence and vice versa: the height of the emotional intelligence differentiates significantly the intensity of indirect self-destructiveness. Indirect self-destructiveness has negative correlations with emotional intelligence as well as its components: the ability to recognize emotions and the ability to utilize emotions. The height of emotional intelligence differentiates the intensity of indirect self-destructiveness, and vice versa: the intensity of indirect self-destructiveness differentiates the height of emotional intelligence. It seems advisable to use emotional intelligence in the prophylactic and therapeutic work with persons with various types of disorders, especially with the syndrome of indirect self-destructiveness.

  18. An indirect comparison and cost per responder analysis of adalimumab, methotrexate and apremilast in the treatment of methotrexate-naïve patients with psoriatic arthritis.

    Science.gov (United States)

    Betts, Keith A; Griffith, Jenny; Friedman, Alan; Zhou, Zheng-Yi; Signorovitch, James E; Ganguli, Arijit

    2016-01-01

    Apremilast was recently approved for the treatment of active psoriatic arthritis (PsA). However, no studies compare apremilast with methotrexate or biologic therapies, so its relative comparative efficacy remains unknown. This study compared the response rates and incremental costs per responder associated with methotrexate, apremilast, and biologics for the treatment of active PsA. A systematic literature review was performed to identify phase 3 randomized controlled clinical trials of approved biologics, methotrexate, and apremilast in the methotrexate-naïve PsA population. Using Bayesian methods, a network meta-analysis was conducted to indirectly compare rates of achieving a ≥20% improvement in American College of Rheumatology component scores (ACR20). The number needed to treat (NNT) and the incremental costs per ACR20 responder (2014 US$) relative to placebo were estimated for each of the therapies. Three trials (MIPA for methotrexate, PALACE-4 for apremilast, and ADEPT for adalimumab) met all inclusion criteria. The NNTs relative to placebo were 2.63 for adalimumab, 6.69 for apremilast, and 8.31 for methotrexate. Among methotrexate-naïve PsA patients, the 16 week incremental costs per ACR20 responder were $3622 for methotrexate, $26,316 for adalimumab, and $45,808 for apremilast. The incremental costs per ACR20 responder were $222,488 for apremilast vs. methotrexate. Among methotrexate-naive PsA patients, adalimumab was found to have the lowest NNT for one additional ACR20 response and methotrexate was found to have the lowest incremental costs per ACR20 responder. There was no statistical evidence of greater efficacy for apremilast vs. methotrexate. A head-to-head trial between apremilast and methotrexate is recommended to confirm this finding.

  19. Turning lights into flights: Estimating direct and indirect rebound effects for UK households

    International Nuclear Information System (INIS)

    Chitnis, Mona; Sorrell, Steve; Druckman, Angela; Firth, Steven K.; Jackson, Tim

    2013-01-01

    Energy efficiency improvements by households lead to rebound effects that offset the potential energy and emissions savings. Direct rebound effects result from increased demand for cheaper energy services, while indirect rebound effects result from increased demand for other goods and services that also require energy to provide. Research to date has focused upon the former, but both are important for climate change. This study estimates the combined direct and indirect rebound effects from seven measures that improve the energy efficiency of UK dwellings. The methodology is based upon estimates of the income elasticity and greenhouse gas (GHG) intensity of 16 categories of household goods and services, and allows for the embodied emissions of the energy efficiency measures themselves, as well as the capital cost of the measures. Rebound effects are measured in GHG terms and relate to the adoption of these measures by an average UK household. The study finds that the rebound effects from these measures are typically in the range 5–15% and arise mostly from indirect effects. This is largely because expenditure on gas and electricity is more GHG-intensive than expenditure on other goods and services. However, the anticipated shift towards a low carbon electricity system in the UK may lead to much larger rebound effects. - Highlights: ► We estimate the direct and indirect rebound effects from energy efficiency improvements by UK households. ► We allow for the capital cost of the improvement, together with the emissions embodied in the relevant equipment. ► We find rebound effects to be relatively modest, in the range 5–15%. ► The anticipated shift towards a low carbon electricity system will lead to larger rebound effects

  20. Consumer and case manager perspectives of service empowerment: relationship to mental health recovery.

    Science.gov (United States)

    Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee

    2006-04-01

    This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.

  1. A Novel Design Method for Optimizing an Indirect Forced Circulation Solar Water Heating System Based on Life Cycle Cost Using a Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Myeong Jin Ko

    2015-10-01

    Full Text Available To maximize the energy performance and economic benefits of solar water heating (SWH systems, the installation and operation-related design variables as well as those related to capacity must be optimized. This paper presents a novel design method for simultaneously optimizing the various design variables of an indirect forced-circulation SWH system that is based on the life cycle cost and uses a genetic algorithm. The effectiveness of the proposed method is assessed by evaluating the long-term performance corresponding to four cases, which are optimized using different annual solar fractions and sets of the design variables. When the installation and operation-related design variables were taken into consideration, it resulted in an efficient and economic design and an extra cost reduction of 3.2%–6.1% over when only the capacity-related design variables were considered. In addition, the results of parametric studies show that the slope and mass flow rate of the collector have a significant impact on the energy and economic performances of SWH systems. In contrast, the mass flow rate in the secondary circuit and the differences in the temperatures of the upper and lower dead bands of the differential controller have a smaller impact.

  2. Changes in Federal Water Project Repayment Policies Can Reduce Federal Costs.

    Science.gov (United States)

    1981-08-07

    a reimburs - able purpose, the users should share in cost recovery. RECOMMENDATIONS To provide for equitable cost reimbursement on underutilized...Department of the Interior’s Bureau of Reclamation that do not ensure fair and timely recovery of water projects’ reimbursable costs. We made this...such costs for reimbursable project purposes and considering them in future water price determinations, agencies often reas- signed them to

  3. Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003.

    Science.gov (United States)

    Cumps, E; Verhagen, E; Annemans, L; Meeusen, R

    2008-09-01

    This study determines the injury rate (%) and the associated direct medical and indirect costs of sports injuries in Flanders. Epidemiological cohort designs and a human capital method were set up to measure respectively the medical direct and indirect cost of sports injuries. 72 out of 82 Flemish sports federations participated. Insurance statistics from 2003 were used to determine the overall rate of injury and injury localisations. Using these data, the medical direct cost and the impact sports injuries have on indirect costs were estimated. The indirect costs were determined by multiplying the days of absence from work with the daily cost resulting from a loss of production, being 200 euros. The total direct medical cost extrapolated for the Flemish sports participants was 15,027,423 euros, which amounted to 0.07% to 0.08% of the total budget spent on healthcare. The indirect cost extrapolated for the Flemish sports participants was 111,420,813 euros, which is about 3.4% of the costs arising from absenteeism from work. Of the 14 in-depth analysed sports, the rate of injury was highest in European team handball (8.96%; 95% confidence interval (CI) 8.95-8.96) and lowest in swimming (0.62%; 95% CI 0.62-0.62). The highest direct medical cost was found for anterior cruciate ligament (ACL) injuries (1358 euros per injury) and the lowest for foot injuries (52 euros per injury). The costs calculated in this study could become critical statistics in medical care debates. Data obtained here will enable a cost-benefit analysis of the impact of preventive measures to be made.

  4. Computerized cost estimation spreadsheet and cost data base for fusion devices

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Rothe, K.E.

    1985-01-01

    An automated approach to performing and cataloging cost estimates has been developed at the Fusion Engineering Design Center (FEDC), wherein the cost estimate record is stored in the LOTUS 1-2-3 spreadsheet on an IBM personal computer. The cost estimation spreadsheet is based on the cost coefficient/cost algorithm approach and incorporates a detailed generic code of cost accounts for both tokamak and tandem mirror devices. Component design parameters (weight, surface area, etc.) and cost factors are input, and direct and indirect costs are calculated. The cost data base file derived from actual cost experience within the fusion community and refined to be compatible with the spreadsheet costing approach is a catalog of cost coefficients, algorithms, and component costs arranged into data modules corresponding to specific components and/or subsystems. Each data module contains engineering, equipment, and installation labor cost data for different configurations and types of the specific component or subsystem. This paper describes the assumptions, definitions, methodology, and architecture incorporated in the development of the cost estimation spreadsheet and cost data base, along with the type of input required and the output format

  5. The economic costs of alcohol consumption in Thailand, 2006.

    Science.gov (United States)

    Thavorncharoensap, Montarat; Teerawattananon, Yot; Yothasamut, Jomkwan; Lertpitakpong, Chanida; Thitiboonsuwan, Khannika; Neramitpitagkul, Prapag; Chaikledkaew, Usa

    2010-06-09

    There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity). The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP) or about 1.99% of the total Gross Domestic Product (GDP). Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP

  6. 73 Activity Based Costing and Product Pricing Decision: the Nigerian Case

    Directory of Open Access Journals (Sweden)

    Ebipanipre Gabriel Mieseigha

    2014-06-01

    Full Text Available This paper examined activity based costing and product pricing decisions in Nigeria so as to ascertain whether activity based costing have the ability to enhance profitability and control cost of manufacturing firms. Towards this end, a multiple correlation and regression estimation technique was used in analyzing the data obtained in the study. The study found that activity based costing affects product costing and pricing decision. In addition, the results showed that improved profitability and cost control can be achieved by implementing activity based costing approach by manufacturing firms. The implication is that traditional costing approach fails in many pricing situations by arbitrarily allocating indirect cost and activity based costing helps in allocating indirect cost accurately. Thus, it was recommended amongst others that activity based costing need to be practiced, maintained and implemented by manufacturing firms since it has a broad range of uses for a wide variety of company functions and operations in the area of process analysis, strategy support, time-based accounting, monitoring wastage, as well as quality and productivity management.

  7. Indirect land use change and biofuel policy

    International Nuclear Information System (INIS)

    Kocoloski, Matthew; Griffin, W Michael; Matthews, H Scott

    2009-01-01

    Biofuel debates often focus heavily on carbon emissions, with parties arguing for (or against) biofuels solely on the basis of whether the greenhouse gas emissions of biofuels are less than (or greater than) those of gasoline. Recent studies argue that land use change leads to significant greenhouse gas emissions, making some biofuels more carbon intensive than gasoline. We argue that evaluating the suitability and utility of biofuels or any alternative energy source within the limited framework of plus and minus carbon emissions is too narrow an approach. Biofuels have numerous impacts, and policy makers should seek compromises rather than relying solely on carbon emissions to determine policy. Here, we estimate that cellulosic ethanol, despite having potentially higher life cycle CO 2 emissions (including from land use) than gasoline, would still be cost-effective at a CO 2 price of $80 per ton or less, well above estimated CO 2 mitigation costs for many alternatives. As an example of the broader approach to biofuel policy, we suggest the possibility of using the potential cost reductions of cellulosic ethanol relative to gasoline to balance out additional carbon emissions resulting from indirect land use change as an example of ways in which policies could be used to arrive at workable solutions.

  8. Indirect land use change and biofuel policy

    Science.gov (United States)

    Kocoloski, Matthew; Griffin, W. Michael; Matthews, H. Scott

    2009-09-01

    Biofuel debates often focus heavily on carbon emissions, with parties arguing for (or against) biofuels solely on the basis of whether the greenhouse gas emissions of biofuels are less than (or greater than) those of gasoline. Recent studies argue that land use change leads to significant greenhouse gas emissions, making some biofuels more carbon intensive than gasoline. We argue that evaluating the suitability and utility of biofuels or any alternative energy source within the limited framework of plus and minus carbon emissions is too narrow an approach. Biofuels have numerous impacts, and policy makers should seek compromises rather than relying solely on carbon emissions to determine policy. Here, we estimate that cellulosic ethanol, despite having potentially higher life cycle CO2 emissions (including from land use) than gasoline, would still be cost-effective at a CO2 price of 80 per ton or less, well above estimated CO2 mitigation costs for many alternatives. As an example of the broader approach to biofuel policy, we suggest the possibility of using the potential cost reductions of cellulosic ethanol relative to gasoline to balance out additional carbon emissions resulting from indirect land use change as an example of ways in which policies could be used to arrive at workable solutions.

  9. Comparison of viral RNA electrophoresis and indirect ELISA methods in the diagnosis of human rotavirus infection

    International Nuclear Information System (INIS)

    Avendano, L.F.; Dubinovsky, S.

    1984-01-01

    A total of 177 stool samples from Chilean diarrhea patients under two years of age were tested for rotavirus by two methods - the indirect enzyme-linked immunosorbent assay (indirect ELISA) and viral RNA electrophoresis in agarose gels (v RNA EPH). Fifty of the specimens came from patients with acute diarrhea and 127 came from patients with protracted diarrhea. The indirect ELISA testing was performed at the National Institutes of Health in the United States: the electrophoretic testing was carried out in Santiago, Chile by the authors. The electrophoretic method detected rotavirus in 36% of the acute samples and 25% of the samples from protracted cases, while the indirect ELISA method detected rotavirus in higher percentages of samples - 46% and 38%, respectively. These results support the conclusion that v RNA EPH is a less sensitive method for detecting rotavirus than the indirect ELISA. Nevertheless, the former method's high specificity, ease of application, and low cost make it a worthwhile alternative to indirect ELISA. Thus, considering the important role played by rotavirus in infant diarrhea and the need for a diagnostic technique that can be incorporated into the routines of medical center laboratories in developing countries, there is good reason to conclude that v RNA EPH is a useful tool for studying rotavirus diarrhea. (author)

  10. Economic costs associated with an MS relapse

    LENUS (Irish Health Repository)

    O'Connell, K.

    2014-09-01

    This was an prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner\\'s loss of earnings, childcare, meals and travel costs.

  11. Indirect reciprocity with negative assortment and limited information can promote cooperation.

    Science.gov (United States)

    Brush, Eleanor; Brännström, Åke; Dieckmann, Ulf

    2018-04-14

    Cooperation is ubiquitous in biological and social systems, even though cooperative behavior is often costly and at risk of exploitation by non-cooperators. Several studies have demonstrated that indirect reciprocity, whereby some members of a group observe the behaviors of their peers and use this information to discriminate against previously uncooperative agents in the future, can promote prosocial behavior. Some studies have shown that differential propensities of interacting among and between different types of agents (interaction assortment) can increase the effectiveness of indirect reciprocity. No previous studies have, however, considered differential propensities of observing the behaviors of different types of agents (information assortment). Furthermore, most previous studies have assumed that discriminators possess perfect information about others and incur no costs for gathering and storing this information. Here, we (1) consider both interaction assortment and information assortment, (2) assume discriminators have limited information about others, and (3) introduce a cost for information gathering and storage, in order to understand how the ability of discriminators to stabilize cooperation is affected by these steps toward increased realism. We report the following findings. First, cooperation can persist when agents preferentially interact with agents of other types or when discriminators preferentially observe other discriminators, even when they have limited information. Second, contrary to intuition, increasing the amount of information available to discriminators can exacerbate defection. Third, introducing costs of gathering and storing information makes it more difficult for discriminators to stabilize cooperation. Our study is one of only a few studies to date that show how negative interaction assortment can promote cooperation and broadens the set of circumstances in which it is know that cooperation can be maintained. Copyright © 2018

  12. A time-driven activity-based costing model to improve health-care resource use in Mirebalais, Haiti.

    Science.gov (United States)

    Mandigo, Morgan; O'Neill, Kathleen; Mistry, Bipin; Mundy, Bryan; Millien, Christophe; Nazaire, Yolande; Damuse, Ruth; Pierre, Claire; Mugunga, Jean Claude; Gillies, Rowan; Lucien, Franciscka; Bertrand, Karla; Luo, Eva; Costas, Ainhoa; Greenberg, Sarah L M; Meara, John G; Kaplan, Robert

    2015-04-27

    delivery at HUM was US$62 and the direct cost of a caesarean delivery was US$249. The direct costs of breast cancer care (including diagnostics, chemotherapy, and mastectomy) totalled US$1393. A mastectomy, including post-anaesthesia recovery and inpatient stay, totalled US$282 in direct costs. Indirect costs comprised 26-38% of total costs, and salaries were the largest percentage of total costs (51-72%). Accurate costing of health services is vital for financial officers and funders. TDABC showed opportunities at HUM to optimise use of resources and reduce costs-for instance, by streamlining sterilisation procedures and redistributing certain tasks to improve teamwork. TDABC has also improved budget forecasting and informed financing decisions. HUM leadership recognised its value to improve health-care delivery and expand access in low-resource settings. Boston Children's Hospital, Harvard Business School, and Partners in Health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Dynamic Modeling of Cost-effectiveness of Rotavirus Vaccination, Kazakhstan

    Science.gov (United States)

    Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at costs would be entirely offset. To further evaluate efficacy of a vaccine program, benefits of indirect protection conferred by vaccination warrant further study. PMID:24378188

  14. Comment traduire en japonais les styles indirect et indirect libre de Madame Bovary ?

    Directory of Open Access Journals (Sweden)

    Hisaki Sawasaki

    2012-03-01

    Full Text Available Parmi les difficultés rencontrées lors de la traduction des textes littéraires occidentaux, en japonais, nous examinons le problème des styles indirect et indirect libre. Pour cela, en effectuant une petite mise au point grammaticale, nous comparons sept traductions de Madame Bovary de Gustave Flaubert, dont les dates de parution s’étendent sur une cinquantaine d’années. Cette période s’apparente, de notre point de vue, à un long itinéraire pour assimiler la notion occidentale des styles direct et indirect, tout en la conciliant avec les particularités du japonais. D’un autre côté, ce travail acharné des traducteurs a influencé quelque peu la langue japonaise. On trouve dans l’annexe tous les textes en japonais examinés.We will examine the difficulties met when translating Western literary texts in Japanese, in particular the problem of indirect and free indirect styles. We will define the grammatical issue and compare seven translations of Madame Bovary, published over a fifty year period. This time can be likened to a long path taken to digest the Western notion of direct and indirect styles, while reconciling it with Japanese language characteristics. On the other hand the translators’ relentless work has somewhat influenced the Japanese language. The annex will present all the Japanese texts examined.

  15. Language shifts in free indirect discourse

    NARCIS (Netherlands)

    Maier, Emar

    Free indirect discourse is a way of reporting what a protagonist thinks or says that is distinct from both direct and indirect discourse. In particular, while pronouns and tenses are presented from the narrator's perspective, as in indirect discourse, other indexical and expressive elements reflect

  16. Directe en indirecte werknemersparticipatie in Europa

    NARCIS (Netherlands)

    van Houten, Gijs; Akkerman, Agnes; Sluiter, Roderick; Jansen, Giedo; Vermeylen, Greet

    2016-01-01

    This study looks at different forms of direct and indirect employee participation in the EU. The research questions are: (1) which forms of direct and indirect employee participation can we distinguish?; (2) to what extent do forms of direct and indirect employee participation coincide within

  17. An Analysis of Unit Costs at a Consolidated Supply Depot

    Science.gov (United States)

    1990-12-01

    Not-For-Profit Setting,"The Accounting Review,July 1990. Horngren , C. T., Cost Accountinq:A Managerial Emphasis,3rd ed, Prentice-Hall Inc.,1972...sector has used concepts of unit costs for 4 decades. Any managerial or cost accounting text discusses in some length unit costs . For Defense contractors...the Cost Accounting Standards Board (CASB) provides guidance for contract costs . Unit costs include direct, indirect, and general and administrative

  18. Resource recovery. A report for the Royal Commission of Environmental Pollution

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    A report for the Royal Commission on Environmental Pollution describes the key factors influencing the level of resource recovery in the UK and compares the level in other European countries and the US. Aspects covered include waste paper, oils and batteries, cost allocation, waste disposal cost and charges, separation of waste streams and energy from waste. Finally the report identifies a number of specific areas where action might be taken to increase resource recovery. (UK).

  19. A freshwater food web model for the combined effects of nutrients and insecticide stress and subsequent recovery

    NARCIS (Netherlands)

    Traas, T.P.; Janse, J.H.; Brink, van den P.J.; Brock, T.C.M.; Aldenberg, T.

    2004-01-01

    A microcosm experiment that addressed the interaction between eutrophication processes and contaminants was analyzed using a food web model. Both direct and indirect effects of nutrient additions and a single insecticide application (chlorpyrifos) on biomass dynamics and recovery of functional

  20. Simple Recovery of Intracellular Gold Nanoparticles from Peanut Seedling Roots.

    Science.gov (United States)

    Raju, D; Mehta, Urmil J; Ahmad, Absar

    2015-02-01

    Fabrication of inorganic nanomaterials via a biological route witnesses the formation either extracellularly, intracellulary or both. Whereas extracellular formation of these nanomaterials is cherished owing to their easy and economical extraction and purification processes; the intracellular formation of nanomaterials, due to the lack of a proper recovery protocol has always been dreaded, as the extraction processes used so far were tedious, costly, time consuming and often resulting in very low recovery. The aim of the present study was to overcome the problems related with the extraction and recovery of intracellularly synthesized inorganic nanoparticles, and to devise a method to increasing the output, the shape, size, composition and dispersal of nanoparticles is not altered. Water proved to be much better system as it provided well dispersed, stable gold nanoparticles and higher recovery. This is the first report, where intracellular nanoparticles have been recovered using a very cost-effective and eco-friendly approach.

  1. Cost Effective Surfactant Formulations for Improved Oil Recovery in Carbonate Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    William A. Goddard; Yongchun Tang; Patrick Shuler; Mario Blanco; Yongfu Wu

    2007-09-30

    This report summarizes work during the 30 month time period of this project. This was planned originally for 3-years duration, but due to its financial limitations, DOE halted funding after 2 years. The California Institute of Technology continued working on this project for an additional 6 months based on a no-cost extension granted by DOE. The objective of this project is to improve the performance of aqueous phase formulations that are designed to increase oil recovery from fractured, oil-wet carbonate reservoir rock. This process works by increasing the rate and extent of aqueous phase imbibition into the matrix blocks in the reservoir and thereby displacing crude oil normally not recovered in a conventional waterflood operation. The project had three major components: (1) developing methods for the rapid screening of surfactant formulations towards identifying candidates suitable for more detailed evaluation, (2) more fundamental studies to relate the chemical structure of acid components of an oil and surfactants in aqueous solution as relates to their tendency to wet a carbonate surface by oil or water, and (3) a more applied study where aqueous solutions of different commercial surfactants are examined for their ability to recover a West Texas crude oil from a limestone core via an imbibition process. The first item, regarding rapid screening methods for suitable surfactants has been summarized as a Topical Report. One promising surfactant screening protocol is based on the ability of a surfactant solution to remove aged crude oil that coats a clear calcite crystal (Iceland Spar). Good surfactant candidate solutions remove the most oil the quickest from the surface of these chips, plus change the apparent contact angle of the remaining oil droplets on the surface that thereby indicate increased water-wetting. The other fast surfactant screening method is based on the flotation behavior of powdered calcite in water. In this test protocol, first the calcite

  2. Costs of Medically Attended Acute Gastrointestinal Infections: The Polish Prospective Healthcare Utilization Survey.

    Science.gov (United States)

    Czech, Marcin; Rosinska, Magdalena; Rogalska, Justyna; Staszewska, Ewa; Stefanoff, Pawel

    The burden of acute gastrointestinal infections (AGIs) on the society has not been well studied in Central European countries, which prevents the implementation of effective, targeted public health interventions. We investigated patients of 11 randomly selected general practices and 8 hospital units. Each patient meeting the international AGI case definition criteria was interviewed on costs incurred related to the use of health care resources. Follow-up interview with consenting patients was conducted 2 to 4 weeks after the general practitioner (GP) visit or discharge from hospital, collecting information on self-medication costs and indirect costs. Costs were recalculated to US dollars by using the purchasing power parity exchange rate for Poland. Weighting the inpatient costs by age-specific probability of hospital referral by GPs, the societal cost of a medically attended AGI case was estimated to be US $168. The main cost drivers of direct medical costs were cost of hospital bed days (US $28), cost of outpatient pharmacotherapy (US $20), and cost of GP consultation (US $10). Patients covered only the cost of outpatient pharmacotherapy. Considering the AGI population GP consultation rate, the age-adjusted societal cost of medically attended AGI episodes was estimated at US $2222 million, of which 53% was attributable to indirect costs. Even though AGIs generate a low cost for individuals, they place a high burden on the society, attributed mostly to indirect costs. Higher resources could be allocated to the prevention and control of AGIs. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

  3. The economics of recovery after pancreatic surgery: detailed cost minimization analysis of an enhanced recovery program.

    Science.gov (United States)

    Kagedan, Daniel J; Devitt, Katharine S; Tremblay St-Germain, Amélie; Ramjaun, Aliya; Cleary, Sean P; Wei, Alice C

    2017-11-01

    Clinical pathways (CPW) are considered safe and effective at decreasing postoperative length of stay (LoS), but the effect on economic costs is uncertain. This study sought to elucidate the effect of a CPW on direct hospitalization costs for patients undergoing pancreaticoduodenectomy (PD). A CPW for PD patients at a single Canadian institution was implemented. Outcomes included LoS, 30-day readmissions, and direct costs of hospital care. A retrospective cost minimization analysis compared patients undergoing PD prior to and following CPW implementation, using a bootstrapped t test and deviation-based cost modeling. 121 patients undergoing PD after CPW implementation were compared to 74 controls. Index LoS was decreased following CPW implementation (9 vs. 11 days, p = 0.005), as was total LoS (10 vs. 11 days, p = 0.003). The mean total cost of postoperative hospitalization per patient decreased in the CPW group ($15,678.45 CAD vs. $25,732.85 CAD, p = 0.024), as was the mean 30-day cost including readmissions ($16,627.15 CAD vs. $29,872.72 CAD, p = 0.016). Areas of significant cost savings included laboratory tests and imaging investigations. CPWs may generate cost savings by reducing unnecessary investigations, and improve quality of care through process standardization and decreasing practice variation. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  4. The costs of breast cancer in a Mexican public health institution

    Directory of Open Access Journals (Sweden)

    Jacobo Alejandro Gómez-Rico

    2008-11-01

    Full Text Available Jacobo Alejandro Gómez-Rico1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Rosario Cárdenas-Elizalde1, Consuelo Rubio-Poo21Universidad Autónoma Metropolitano–Xochimilco (UAM-X, Departments: Biological Systems and Healthcare, Biological and Health Sciences Division (DCBS; 2Universidad Nacional Autónoma de México (UNAM, Faculty of Professional Studies-Zaragoza (FES-ZaragozaAbstract: Breast cancer (BC is the second leading cause of death as a result of neoplasia in Mexico. This study aimed to identify the direct and indirect costs of treating female outpatients diagnosed with BC at a Mexican public hospital. A cross-sectional, observational, analytical study was conducted. A total of 506 medical records were analyzed and 102 were included in the cost analysis. The micro-costing process was used to estimate treatment costs. A 17-item questionnaire was used to obtain information on direct and indirect costs. Of the 102 women with BC included in the study, 92.2% (94 were at Stage II, and only 7.8% at Stage I. Total direct costs over six months for the 82 women who had modified radical mastectomy (MRM surgury were US$733,821.15. Total direct costs for the 15 patients with conservative surgery (CS were US$138,190.39. We found that the total economic burden in the study population was much higher for patients with MRM than for patients with CS.Keywords: breast cancer, Mexican women, direct and indirect costs

  5. Dietary Supplements for Health, Adaptation, and Recovery in Athletes.

    Science.gov (United States)

    Rawson, Eric S; Miles, Mary P; Larson-Meyer, D Enette

    2018-03-01

    Some dietary supplements are recommended to athletes based on data that supports improved exercise performance. Other dietary supplements are not ergogenic per se, but may improve health, adaptation to exercise, or recovery from injury, and so could help athletes to train and/or compete more effectively. In this review, we describe several dietary supplements that may improve health, exercise adaptation, or recovery. Creatine monohydrate may improve recovery from and adaptation to intense training, recovery from periods of injury with extreme inactivity, cognitive processing, and reduce severity of or enhance recovery from mild traumatic brain injury (mTBI). Omega 3-fatty acid supplementation may also reduce severity of or enhance recovery from mTBI. Replenishment of vitamin D insufficiency or deficiency will likely improve some aspects of immune, bone, and muscle health. Probiotic supplementation can reduce the incidence, duration, and severity of upper respiratory tract infection, which may indirectly improve training or competitive performance. Preliminary data show that gelatin and/or collagen may improve connective tissue health. Some anti-inflammatory supplements, such as curcumin or tart cherry juice, may reduce inflammation and possibly delayed onset muscle soreness (DOMS). Beta-hydroxy beta-methylbutyrate (HMB) does not consistently increase strength and/or lean mass or reduce markers of muscle damage, but more research on recovery from injury that includes periods of extreme inactivity is needed. Several dietary supplements, including creatine monohydrate, omega 3-fatty acids, vitamin D, probiotics, gelatin, and curcumin/tart cherry juice could help athletes train and/or compete more effectively.

  6. Household costs of leprosy reactions (ENL in rural India.

    Directory of Open Access Journals (Sweden)

    David J Chandler

    2015-01-01

    Full Text Available Erythema nodosum leprosum (ENL is a common immune-mediated complication of lepromatous (LL and borderline lepromatous (BL leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL is essential to provide effective patient support, yet this area has not been investigated.Ninety-one patients with LL or BL leprosy attending a leprosy hospital in Purulia district of West Bengal, India, were interviewed using a structured questionnaire. Cases (n = 53 were identified as those who had one or more episodes of ENL within the last 3 years. Controls (n = 38 had LL or BL leprosy but no history of ENL. Data were collected on household income, direct and indirect costs, and coping strategies.The total household cost was Rs 1543 per month or 27.9% (IQR 13.2-52.6 of monthly household income for cases, and Rs 237 per month or 4.9% (IQR 1.7-13.4 of monthly household income for controls. Indirect costs accounted for 65% of total household costs for cases. Direct costs accounted for the remaining 35% of household costs, and resulted almost entirely from treatment-seeking in the private sector. Total household costs exceeded 40% of household income for 37.7% of cases (n = 20 and 2.6% of controls (n = 1 [1 USD = 59 INR].Households affected by ENL face significant economic burden and are at risk of being pushed further into poverty. Health policy should acknowledge the importance of private sector provision and the significant contribution to total household costs of lost productivity (indirect cost. Further work is needed to explore this area and identify solutions.

  7. Recovery and use of fission product noble metals

    International Nuclear Information System (INIS)

    Jensen, G.A.; Rohmann, C.A.; Perrigo, L.D.

    1980-06-01

    Noble metals in fission products are of strategic value. Market prices for noble metals are rising more rapidly than recovery costs. A promising concept has been developed for recovery of noble metals from fission product waste. Although the assessment was made only for the three noble metal fission products (Rh, Pd, Ru), there are other fission products and actinides which have potential value

  8. Experimental study on an innovative enthalpy recovery technology based on indirect flash evaporative cooling

    DEFF Research Database (Denmark)

    Nie, Jinzhe; Yuan, Shu; Fang, Lei

    2018-01-01

    recovery unit. The principle of the technology is to over saturate indoor exhaust air by ultrasonic atomizing humidification. The evaporation of ultrafine mists cools down indoor exhaust air to its wet-bulb temperature and makes not only sensible heat transfer but also moisture condensed in outdoor supply...... were measured to investigate and analyze its energy recover efficiencies. The results showed that in hot and humid climate, up to 71% of total heat recover efficiency could be achieved by the prototype unit, and more than 50% of the enthalpy recovered was contributed by moisture condensation...

  9. Community financing of local ivermectin distribution in Nigeria: potential payment and cost-recovery outlook.

    Science.gov (United States)

    Onwujekwe, O E; Shu, E N; Okonkwo, P O

    2000-04-01

    The preferred payment mechanism in a community financing scheme for local ivermectin distribution was elicited from randomly selected household heads from three communities in Nigeria using interviewer-administered structured questionnaires. The majority of the respondents in the three communities were prepared to pay for local ivermectin distribution. Additionally, the average amounts the respondents were prepared to pay per person treated ($0.28, $0.30 and $0.38 in Nike, Achi and Toro, respectively) were all more than the $0.20 ceiling recommended by the partners of the African Programme on Onchocerciasis Control (APOC). Thus, the cost-recovery outlook is bright in these communities. However, the preferred payment modality varied. Fee-for-service was the predominant payment modality in the Achi and Nike communities, while the Toro community preferred pre-payment. This study demonstrates that many communities have different payment preferences for endemic disease control efforts. This knowledge will help in developing acceptable and sustainable schemes. The imposition of unacceptable payment mechanisms will lead to an unwillingness to pay.

  10. The cost of the tax transaction in the commercial enterprises of the province of Tungurahua

    OpenAIRE

    Edgar Fabian Mera Bozano; Gina Elizabeth Vargas Núñez; Santiago Xavier Flores Brito

    2017-01-01

    The present article includes an important contribution for the tax administration, since it allows identifying the indirect cost to taxpayers when complying with tax obligations, the cost that is doctrinally known as indirect tax pressure, although the obligations are Several, Not all of them fall on the same obligated subject, the tendency in Ecuador is the reduction of the costs of tracking, hence the value given by the Internal Revenue service to the use of information technologies, throug...

  11. Maximising the recovery of low grade heat: An integrated heat integration framework incorporating heat pump intervention for simple and complex factories

    International Nuclear Information System (INIS)

    Miah, J.H.; Griffiths, A.; McNeill, R.; Poonaji, I.; Martin, R.; Leiser, A.; Morse, S.; Yang, A.; Sadhukhan, J.

    2015-01-01

    Highlights: • A new practical heat integration framework incorporating heat pump technology for simple and complex food factories. • A decision making procedure was proposed to select process or utility heat integration in complex and diverse factories. • New stream classifications proposed to identify and compare streams linked between process and utility, especially waste heat. • A range of ‘Heat Pump Thresholds’ to identify and compare heat pump configurations with steam generation combustion boiler. - Abstract: The recovery of heat has long been a key measure to improving energy efficiency and maximising the heat recovery of factories by Pinch analysis. However, a substantial amount of research has been dedicated to conventional heat integration where low grade heat is often ignored. Despite this, the sustainability challenges facing the process manufacturing community are turning interest on low grade energy recovery systems to further advance energy efficiency by technological interventions such as heat pumps. This paper presents a novel heat integration framework incorporating technological interventions for both simple and complex factories to evaluate all possible heat integration opportunities including low grade and waste heat. The key features of the framework include the role of heat pumps to upgrade heat which can significantly enhance energy efficiency; the selection process of heat pump designs which was aided by the development of ‘Heat Pump Thresholds’ to decide if heat pump designs are cost-competitive with steam generation combustion boiler; a decision making procedure to select process or utility heat integration in complex and diverse factories; and additional stream classifications to identify and separate streams that can be practically integrated. The application of the framework at a modified confectionery factory has yielded four options capable of delivering a total energy reduction of about 32% with an economic payback

  12. Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa--a systematic review.

    Science.gov (United States)

    Barter, Devra M; Agboola, Stephen O; Murray, Megan B; Bärnighausen, Till

    2012-11-14

    Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment and care, both within and outside of

  13. Tax incentives and enhanced oil recovery techniques

    International Nuclear Information System (INIS)

    Stathis, J.S.

    1991-05-01

    Tax expenditures-reductions in income tax liability resulting from a special tax provision-are often used to achieve economic and social objectives. The arguments for petroleum production tax incentives usually encompass some combination of enhancing energy security, rewarding risk, or generating additional investment in new technologies. Generally, however, some portion of any tax expenditure is spend on activities that would have occurred anyway. This paper is a review of tax incentives for petroleum production found two to be of questionable merit. Others, including tax preferences for enhanced oil recovery methods, which offered the potential for better returns on the tax dollar. Increased use of enhanced oil recovery techniques could lead to additional environmental costs, however, and these need to be factored into any cost-benefit calculation

  14. INDIRECT COSTS ALLOCATION AND DECISION MAKING IN AGRICULTURAL PRODUCTION

    Directory of Open Access Journals (Sweden)

    M. Karić

    2001-06-01

    Full Text Available The paper introduces a research on the changes occurred inside the accounting system of agricultural organisations in the transitional period. Changes of structure and accounting information system being results of privatisation processes were analysed. The introduction of modern methods in the preparation of relevant management information represents one of the preconditions for development of the privatised agricultural organisation during the transition period. Information prepared by the accounting, especially adapted to management requirements, is essential for rational decision making. Modern management system of reporting is fundamental task of management and a precondition for securing competitive production in agricultural industry. For this reason, it is necessary to define areas of responsibility and to enable application of a modern techniques for calculating expenses. The purpose of this paper is to emphasise the specialised use of accounting information by managers and to develop methods of management reporting in agricultural organisations. We propose an emphasis upon the application of modern management accounting techniques rather than financial accounting reporting approach. We support the contention that the need for high-quality management accounting is not debatable and tend to explain how and why accounting information is developed for the individual parts of a business entity, that is for each department or enterprise of an agricultural organisation. The responsibility accounting system should be introduced in agricultural business entities within our conditions, especially in larger organisations, as a measure of securing competitive production. We emphasise the importance of distinguishing between direct and indirect expenses and of using appropriate methods to allocate expenses among departments or enterprises. The research is based on information directly received from the largest agricultural companies in the area of

  15. Costs of construction, operation and maintenance of nuclear power plants - determinant factors

    International Nuclear Information System (INIS)

    Silva, R.A. da

    1981-01-01

    A study about the construction costs of the Angra-1 nuclear power plant, including direct costs, equipment costs, installation and indirect costs such as: engineering, job-training and administration is presented. The operation and maintenance costs of the Angra-1 nuclear power plant and costs of energy generation are still studied. (E.G.) [pt

  16. Inherently safe in situ uranium recovery

    International Nuclear Information System (INIS)

    Krumhansl, James Lee; Beauheim, Richard Louis; Brady, Patrick Vane; Arnold, Bill Walter; Kanney, Joseph F.; McKenna, Sean Andrew

    2009-01-01

    Expansion of uranium mining in the United States is a concern to some environmental groups and sovereign Native American Nations. An approach which may alleviate some problems is to develop inherently safe in situ uranium recovery ('ISR') technologies. Current ISR technology relies on chemical extraction of trace levels of uranium from aquifers that, once mined, can still contain dissolved uranium and other trace metals that are a health concern. Existing ISR operations are few in number; however, high uranium prices are driving the industry to consider expanding operations nation-wide. Environmental concerns and enforcement of the new 30 ppb uranium drinking water standard may make opening new mining operations more difficult and costly. Here we propose a technological fix: the development of inherently safe in situ recovery (ISISR) methods. The four central features of an ISISR approach are: (1) New 'green' leachants that break down predictably in the subsurface, leaving uranium, and associated trace metals, in an immobile form; (2) Post-leachant uranium/metals-immobilizing washes that provide a backup decontamination process; (3) An optimized well-field design that increases uranium recovery efficiency and minimizes excursions of contaminated water; and (4) A combined hydrologic/geochemical protocol for designing low-cost post-extraction long-term monitoring. ISISR would bring larger amounts of uranium to the surface, leave fewer toxic metals in the aquifer, and cost less to monitor safely - thus providing a 'win-win-win' solution to all stakeholders.

  17. QUANTIFYING BENEFITS FOR COST-BENEFIT ANALYSIS

    OpenAIRE

    Attila GYORGY; Nicoleta VINTILA; Florian GAMAN

    2014-01-01

    Cost Benefit Analysis is one of the most widely used financial tools to select future investment projects in public and private sector. This method is based on comparing costs and benefits in terms of constant prices. While costs are easier to predict and monetize, the benefits should be identified not only in direct relation with the investment, but also widening the sphere of analysis to indirect benefits experienced by the community from the neighbourhood or the whole society. During finan...

  18. The Shuttle Cost and Price model

    Science.gov (United States)

    Leary, Katherine; Stone, Barbara

    1983-01-01

    The Shuttle Cost and Price (SCP) model was developed as a tool to assist in evaluating major aspects of Shuttle operations that have direct and indirect economic consequences. It incorporates the major aspects of NASA Pricing Policy and corresponds to the NASA definition of STS operating costs. An overview of the SCP model is presented and the cost model portion of SCP is described in detail. Selected recent applications of the SCP model to NASA Pricing Policy issues are presented.

  19. [Costing nuclear medicine diagnostic procedures].

    Science.gov (United States)

    Markou, Pavlos

    2005-01-01

    To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

  20. Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era

    Directory of Open Access Journals (Sweden)

    Catay E

    2012-08-01

    Full Text Available Erika Catay,1 Cecilia Castel del Cid,1 Lorena Narváez,1 Edson J Velozo,1 Javier E Rosa,1,2 Luis J Catoggio,1,2 Enrique R Soriano1,21Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, 2University Institute Hospital Italiano de Buenos Aires, School of Medicine, PM Catoggio Foundation, Buenos Aires, ArgentinaBackground: The present study aimed to estimate the cost of rheumatoid arthritis and its components in a university hospital-based health management organization in Argentina, during the prebiologic era.Methods: A one-year (2002 observational prevalence, cost-of illness study of patients with rheumatoid arthritis from the societal perspective was performed in a hospital-based health management organization population. Direct medical costs were obtained using administrative databases. Direct nonmedical and indirect costs were obtained from a semistructured questionnaire. Indirect costs included work absenteeism, permanent work disability, and housework lost for housewives, using the human capital approach. Costs are expressed in 2002 US dollars per patient per year.Results: A total of 165 patients (84% females, of mean age 61 ± 15 years and with a mean disease duration of 8.5 ± 8.3 years were included. Mean total direct medical costs were US$1862 (95% confidence interval [CI] 828–2899. Mean direct nonmedical costs were US$222 (95% CI 149–294. Mean indirect costs were US$1008 (95% CI 606–1412. The annual mean total cost was US$3093 without biologics. Hospitalizations represented 73% of total direct medical costs while drugs and outpatient procedures represented 16% and 8% of total direct medical costs, respectively. Sixty percent of the total costs were related to direct medical costs, while indirect costs represented 33% of total costs.Conclusion: In our population, annual mean total costs in the prebiologic therapy era were mainly driven by direct medical costs. Even without the use of biologic agents

  1. Impediments to the success of management actions for species recovery.

    Directory of Open Access Journals (Sweden)

    Chooi Fei Ng

    Full Text Available Finding cost-effective management strategies to recover species declining due to multiple threats is challenging, especially when there are limited resources. Recent studies offer insights into how costs and threats can influence the best choice of management actions. However, when implementing management actions in the real-world, a range of impediments to management success often exist that can be driven by social, technological and land-use factors. These impediments may limit the extent to which we can achieve recovery objectives and influence the optimal choice of management actions. Nonetheless, the implications of these impediments are not well understood, especially for recovery planning involving multiple actions. We used decision theory to assess the impact of these types of impediments for allocating resources among recovery actions to mitigate multiple threats. We applied this to a declining koala (Phascolarctos cinereus population threatened by habitat loss, vehicle collisions, dog attacks and disease. We found that the unwillingness of dog owners to restrain their dogs at night (a social impediment, the effectiveness of wildlife crossings to reduce vehicle collisions (a technological impediment and the unavailability of areas for restoration (a land-use impediment significantly reduced the effectiveness of our actions. In the presence of these impediments, achieving successful recovery may be unlikely. Further, these impediments influenced the optimal choice of recovery actions, but the extent to which this was true depended on the target koala population growth rate. Given that species recovery is an important strategy for preserving biodiversity, it is critical that we consider how impediments to the success of recovery actions modify our choice of actions. In some cases, it may also be worth considering whether investing in reducing or removing impediments may be a cost-effective course of action.

  2. Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003

    NARCIS (Netherlands)

    Cumps, E.D.; Verhagen, E.A.L.M.; Annemans, L.; Meeusen, R.

    2008-01-01

    Objective: This study determines the injury rate (%) and the associated direct medical and indirect costs of sports injuries in Flanders. Setting: Epidemiological cohort designs and a human capital method were set up to measure respectively the medical direct and indirect cost of sports injuries.

  3. A Mixed Bi-level Model to Correspond Service Recovery Chain

    OpenAIRE

    Abdolalipour, Amirhossein; Nazemi, Jamshid; Eshlaghi, Abbas Toloie; Lotfi, Farhad Hosseinzadeh

    2017-01-01

    In the competitive environment, minimizing time space between service failure perception and service recovery with lowest cost is one of fast responsiveness company’s requirements. In this article, modeling service failure response time is considered. It was not only service recovery chain profit optimization carefully planned but also satisfaction of consumers who disturbed by a service failure was considered profoundly. Inconsistency between optimization of service recovery chain’s total be...

  4. Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial.

    Directory of Open Access Journals (Sweden)

    Caroline de Sonneville-Koedoot

    Full Text Available Stuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter.In this multicenter randomized controlled trial with an 18 month follow-up, preschool children who stutter who were referred for treatment were randomized to direct treatment (Lidcombe Program; n = 99 or indirect treatment (RESTART-DCM treatment; n = 100. Main inclusion criteria were age 3-6 years, ≥3% syllables stuttered (%SS, and time since onset ≥6 months. The primary outcome was the percentage of non-stuttering children at 18 months. Secondary outcomes included stuttering frequency (%SS, stuttering severity ratings by the parents and therapist, severity rating by the child, health-related quality of life, emotional and behavioral problems, and speech attitude.Percentage of non-stuttering children for direct treatment was 76.5% (65/85 versus 71.4% (65/91 for indirect treatment (Odds Ratio (OR, 0.6; 95% CI, 0.1-2.4, p = .42. At 3 months, children treated by direct treatment showed a greater decline in %SS (significant interaction time x therapy: β = -1.89; t(282.82 = -2.807, p = .005. At 18 months, stuttering frequency was 1.2% (SD 2.1 for direct treatment and 1.5% (SD 2.1 for indirect treatment. Direct treatment had slightly better scores on most other secondary outcome measures, but no differences between treatment approaches were significant.Direct treatment decreased stuttering more quickly during the first three months of treatment. At 18 months, however, clinical outcomes for direct and indirect treatment were comparable. These results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery. Follow-up data are needed to confirm these findings in the longer term

  5. Selection and application of effective LNAPL recovery techniques

    International Nuclear Information System (INIS)

    Fulton, D.E.

    1996-01-01

    The accumulation of light non-aqueous phase liquids (LNAPL) such as gasoline, diesel, fuel oil and lubricating oil resulting from historical or catastrophic releases, is present at numerous industrial and hazardous waste sites. Initiating LNAPL removal is the first step in remediating impacted groundwater with the LNAPL recovery process having a profound effect on the ability to cost effectively achieve site closure. In many cases, LNAPL recovery precedes full-scale groundwater design activities or even final site characterization due to regulatory compliance issues. Therefore, the timely and effective implementation of a LNAPL recovery system can result in reduced project costs by mitigating further plume migration, achieving maximum volume of recoverable hydrocarbons, eliminating the source area associated with dissolved phase contamination, and allowing comprehensive groundwater remediation to be employed sooner. Effective LNAPL recovery systems begin with evaluating a number of site-specific parameters to quantify the physical characteristics of the type of LNAPL to be recovered, the hydrogeological environment, LNAPL, plume geometry, and the specified client or regulatory cleanup goals. These parameters are discussed along with their significance in developing a conceptual understanding of the site

  6. Indirect Calorimetry in Mechanically Ventilated Patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Kondrup, Jens; Perner, Anders

    2017-01-01

    Background and Aims: The 2 currently available indirect calorimeters, CCM Express Indirect Calorimeter (MedGraphics, St Paul, MN) and Quark RMR ICU Indirect Calorimeter (COSMED, Rome, Italy), have not been validated against a gold standard in mechanically ventilated patients. Our aim was to do so...... using a gold-standard, modified Tissot bell-spirometer method in mechanically ventilated patients who were hemodynamically, respiratory, and metabolically stable. Methods: We studied 30 patients undergoing general anesthesia and major gynecological surgery. We measured oxygen consumption ((Formula...... of 77 (167) with limits of agreement −249 to 404 kcal/d. Conclusions: The QUARK RMR ICU Indirect Calorimeter compared better with the gold standard for values of (Formula presented.) O2 and REE than did the CCM Express Indirect Calorimeter in mechanically ventilated patients who were circulatory...

  7. Recovery of light nonaqueous-phase liquids without groundwater pumping

    International Nuclear Information System (INIS)

    Markley, D.E.; Prince-Larsen, N.

    1995-01-01

    This paper outlines recovery of light nonaqueous-phase liquids (LNAPL) encountered in the subsurface at a remote natural gas facility. Remediation of LNAPL in the subsurface usually begins with dual pumping of LNAPL and groundwater. However, regulations required that only LNAPL be recovered. Methods were sought for recovering LNAPL from groundwater without pumping groundwater to the surface. Alternative methods of LNAPL recovery, using a variety of skimming pumps, included: LNAPL recovery from large-diameter wells; LNAPL recovery from trenches; LNAPL recovery from small-diameter wells; and vacuum-enhanced recovery of LNAPL while skimming with a belt skimmer. Based on the goals of the site owner and the costs associated with each alternative examined, the recommended method for recovering LNAPL without groundwater pumping was recovery of LNAPL while skimming with a belt skimmer. This paper discusses both the advantages and limitations of this technique

  8. Platforms for energy and nutrient recovery from domestic wastewater: A review.

    Science.gov (United States)

    Batstone, D J; Hülsen, T; Mehta, C M; Keller, J

    2015-12-01

    Alternative domestic wastewater treatment processes that recover energy and nutrients while achieving acceptable nutrient limits (650mgCODL(-1). PRR offers the possibility for recovery of nitrogen and other nutrients (including potassium) through assimilative recovery. However, the energetic overhead of this is substantial, requiring 5kWhkgN(-1) as electricity, which compares to ammonia fixation costs. The lower energy costs, and near to market status of LEM treatment make it likely as a recovery platform in the shorter term, while ability to recover other elements such as nitrogen and potassium, as well as enhance favourability on concentrated wastewaters may enhance the desirability of partitioning in the longer term. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Heat recovery and energy saving using a Baker Perkins Simplex 2000 bread baking oven. A demonstration at Mothers Pride Bakery. (Nottingham)

    Energy Technology Data Exchange (ETDEWEB)

    1986-02-01

    The first installation of a new type of British bread oven capable of producing 6,800 loaves/hour has reduced energy costs at British Bakeries' Watnall plant by Pound 45,900/year, including Pound 23,500/year due to the inclusion of heat recovery equipment on the oven. Additional benefits of this new oven include reduced production labour requirements - a reduction of one man per shift due to automatic handling of the bread-tin lids - and an increase in productivity of 100% compared with previous models. The new oven - a Baker Perkins Simplex 2000 - is indirect-fired which means that the burners can use either gas or oil without fear of contamination of the product. A new layout of the burners gives a better heat distribution than in previous models, thus requiring less fuel to achieve a given temperature in each zone. In addition there is heat recovery from both the combustion flue products and the oven chamber exhaust. The prover is heated by means of hot water coils using recovered heat from the oven exhaust. The combustion flue products are used to provide some pre-heating of the combustion air. (author).

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

    Science.gov (United States)

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

    2010-06-01

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

  11. Patterns of Cost for Patients Dying in the Intensive Care Unit and Implications for Cost Savings of Palliative Care Interventions.

    Science.gov (United States)

    Khandelwal, Nita; Benkeser, David; Coe, Norma B; Engelberg, Ruth A; Teno, Joan M; Curtis, J Randall

    2016-11-01

    Terminal intensive care unit (ICU) stays represent an important target to increase value of care. To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. Secondary analysis of an intervention study to improve quality of care for critically ill patients. 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center. Data were linked with hospital financial records. Costs were categorized into direct fixed, direct variable, and indirect costs. Patterns of daily costs were explored using generalized estimating equations stratified by length of stay, cause of death, ICU type, and insurance status. Estimates from the literature of effects of palliative care interventions on ICU utilization were used to simulate potential cost savings under different time horizons and reimbursement models. Mean cost for a terminal ICU stay was 39.3K ± 45.1K. Direct fixed costs represented 45% of total hospital costs, direct variable costs 20%, and indirect costs 34%. Day of admission was most expensive (mean 9.6K ± 7.6K); average cost for subsequent days was 4.8K ± 3.4K and stable over time and patient characteristics. Terminal ICU stays display consistent cost patterns across patient characteristics. Savings can be realized with interventions that align care with patient preferences, helping to prevent unwanted ICU utilization at end of life. Cost modeling suggests that implications vary depending on time horizon and reimbursement models.

  12. The Complexity of Indirect Translation

    DEFF Research Database (Denmark)

    Wenjie, L. I.

    2017-01-01

    its complex nature, and thus determined that many facets of ITr remain to be studied. The present article will try to encompass the complexity of ITr by looking into the reasons for translating indirectly, the challenge of finding out mediating texts (MTs), indirectness in both translation...... of which have been translated and interpreted indirectly through major languages like English, will be employed as examples. Hopefully, this study will offer more insights into the nature of translation as a social activity and raise further interests in studying translation as a complex phenomenon....

  13. A simplified indirect bonding technique

    Directory of Open Access Journals (Sweden)

    Radha Katiyar

    2014-01-01

    Full Text Available With the advent of lingual orthodontics, indirect bonding technique has become an integral part of practice. It involves placement of brackets initially on the models and then their transfer to teeth with the help of transfer trays. Problems encountered with current indirect bonding techniques used are (1 the possibility of adhesive flash remaining around the base of the brackets which requires removal (2 longer time required for the adhesive to gain enough bond strength for secure tray removal. The new simplified indirect bonding technique presented here overcomes both these problems.

  14. The economic costs of alcohol consumption in Thailand, 2006

    Directory of Open Access Journals (Sweden)

    Thitiboonsuwan Khannika

    2010-06-01

    Full Text Available Abstract Background There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. Methods This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity. Results The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP or about 1.99% of the total Gross Domestic Product (GDP. Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP, followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP, health care cost (5,491.2 million baht/339 million US$ PPP, cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP, and cost of law enforcement (242.4 million baht/15 million US$ PPP, respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214

  15. CLINSULF sub-dew-point process for sulphur recovery

    Energy Technology Data Exchange (ETDEWEB)

    Heisel, M.; Marold, F.

    1988-01-01

    In a 2-reactor system, the CLINSULF process allows very high sulphur recovery rates. When operated at 100/sup 0/C at the outlet, i.e. below the sulphur solidification point, a sulphur recovery rate of more than 99.2% was achieved in a 2-reactor series. Assuming a 70% sulphur recovery in an upstream Claus furnace plus sulphur condenser, an overall sulphur recovery of more than 99.8% results for the 2-reactor system. This is approximately 2% higher than in conventional Claus plus SDP units, which mostly consist of 4 reactors or more. This means the the CLINSULF SSP process promises to be an improvement both in respect of efficiency and low investment cost.

  16. Nuclear plant cancellations: causes, costs, and consequences

    International Nuclear Information System (INIS)

    1983-04-01

    This study was commissioned in order to help quantify the effects of nuclear plant cancellations on the Nation's electricity prices. This report presents a historical overview of nuclear plant cancellations through 1982, the costs associated with those cancellations, and the reasons that the projects were terminated. A survey is presented of the precedents for regulatory treatment of the costs, the specific methods of cost recovery that were adopted, and the impacts of these decisions upon ratepayers, utility stockholders, and taxpayers. Finally, the report identifies a series of other nuclear plants that remain at risk of canellation in the future, principally as a result of similar demand, finance, or regulatory problems cited as causes of cancellation in the past. The costs associated with these potential cancellations are estimated, along with their regional distributions, and likely methods of cost recovery are suggested

  17. 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.

  18. Stochasticity in economic losses increases the value of reputation in indirect reciprocity.

    Science.gov (United States)

    dos Santos, Miguel; Placì, Sarah; Wedekind, Claus

    2015-12-14

    Recent theory predicts harsh and stochastic conditions to generally promote the evolution of cooperation. Here, we test experimentally whether stochasticity in economic losses also affects the value of reputation in indirect reciprocity, a type of cooperation that is very typical for humans. We used a repeated helping game with observers. One subject (the "Unlucky") lost some money, another one (the "Passer-by") could reduce this loss by accepting a cost to herself, thereby building up a reputation that could be used by others in later interactions. The losses were either stable or stochastic, but the average loss over time and the average efficiency gains of helping were kept constant in both treatments. We found that players with a reputation of being generous were generally more likely to receive help by others, such that investing into a good reputation generated long-term benefits that compensated for the immediate costs of helping. Helping frequencies were similar in both treatments, but players with a reputation to be selfish lost more resources under stochastic conditions. Hence, returns on investment were steeper when losses varied than when they did not. We conclude that this type of stochasticity increases the value of reputation in indirect reciprocity.

  19. Indirect Fabrication of Lattice Metals with Thin Sections Using Centrifugal Casting.

    Science.gov (United States)

    Mun, Jiwon; Ju, Jaehyung; Thurman, James

    2016-05-14

    One of the typical methods to manufacture 3D lattice metals is the direct-metal additive manufacturing (AM) process such as Selective Laser Melting (SLM) and Electron Beam Melting (EBM). In spite of its potential processing capability, the direct AM method has several disadvantages such as high cost, poor surface finish of final products, limitation in material selection, high thermal stress, and anisotropic properties of parts. We propose a cost-effective method to manufacture 3D lattice metals. The objective of this study is to provide a detailed protocol on fabrication of 3D lattice metals having a complex shape and a thin wall thickness; e.g., octet truss made of Al and Cu alloys having a unit cell length of 5 mm and a cell wall thickness of 0.5 mm. An overall experimental procedure is divided into eight sections: (a) 3D printing of sacrificial patterns (b) melt-out of support materials (c) removal of residue of support materials (d) pattern assembly (e) investment (f) burn-out of sacrificial patterns (g) centrifugal casting (h) post-processing for final products. The suggested indirect AM technique provides the potential to manufacture ultra-lightweight lattice metals; e.g., lattice structures with Al alloys. It appears that the process parameters should be properly controlled depending on materials and lattice geometry, observing the final products of octet truss metals by the indirect AM technique.

  20. Life-Cycle Cost and Environmental Assessment of Decentralized Nitrogen Recovery Using Ion Exchange from Source-Separated Urine through Spatial Modeling.

    Science.gov (United States)

    Kavvada, Olga; Tarpeh, William A; Horvath, Arpad; Nelson, Kara L

    2017-11-07

    Nitrogen standards for discharge of wastewater effluent into aquatic bodies are becoming more stringent, requiring some treatment plants to reduce effluent nitrogen concentrations. This study aimed to assess, from a life-cycle perspective, an innovative decentralized approach to nitrogen recovery: ion exchange of source-separated urine. We modeled an approach in which nitrogen from urine at individual buildings is sorbed onto resins, then transported by truck to regeneration and fertilizer production facilities. To provide insight into impacts from transportation, we enhanced the traditional economic and environmental assessment approach by combining spatial analysis, system-scale evaluation, and detailed last-mile logistics modeling using the city of San Francisco as an illustrative case study. The major contributor to energy intensity and greenhouse gas (GHG) emissions was the production of sulfuric acid to regenerate resins, rather than transportation. Energy and GHG emissions were not significantly sensitive to the number of regeneration facilities. Cost, however, increased with decentralization as rental costs per unit area are higher for smaller areas. The metrics assessed (unit energy, GHG emissions, and cost) were not significantly influenced by facility location in this high-density urban area. We determined that this decentralized approach has lower cost, unit energy, and GHG emissions than centralized nitrogen management via nitrification-denitrification if fertilizer production offsets are taken into account.

  1. Capital-cost behavior: is nuclear different

    International Nuclear Information System (INIS)

    Lotze, C.D.; Riordan, B.J.

    1978-01-01

    The capital costs of coal-fired and nuclear power plants are found to be comparable when costs for pollution control are included. Trends in capital costs reveal a similar rate gain that retains the same economic balance. Graphs of selected cost indices are used to show that the rapid increase in direct construction costs is not unique to nuclear plants, those of hydroelectric plants as well as coal-fired having the same pattern. Comparisons of indirect capital costs, based on analyses of direct capital and total capital costs, show estimated average growth rates of total costs to be 14% for coal and 13.6% for nuclear, while direct cost growth rates are 10.2% and 10.4%. The economics of market competition can be expected to push alternative energy source projects into balance

  2. Work Engagement: Investigating the Role of Transformational Leadership, Job Resources, and Recovery.

    Science.gov (United States)

    Hawkes, Amy J; Biggs, Amanda; Hegerty, Erin

    2017-08-18

    While the relationship between job resources and engagement has been well established, a greater understanding of the upstream factors that shape job resources is required to develop strategies to promote work engagement. The current study addresses this need by exploring transformational leadership as an upstream job resource, and the moderating role of recovery experiences. It was hypothesized that job resources would mediate the relationship between transformational leadership and engagement. Recovery experiences were expected to moderate the relationship between resources and engagement. A sample of 277 employees from a variety of organizations and industries was obtained. Analysis showed direct relationships between: transformational leadership and engagement, and transformational leadership and job resources. Mediation analysis using bootstrapping found a significant indirect path between transformational leadership and engagement via job resources. Recovery experiences did not significantly moderate the relationship between job resources and engagement. To date, the majority of published literature on recovery has focused on job demands; hence the nonsignificant result offers insight of a potentially more complex relationship for recovery with resources and engagement. Overall, the current study extends the JD-R model and provides evidence for broadening the model to include upstream organizational variables such as transformational leadership.

  3. Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

    Science.gov (United States)

    2012-01-01

    Background Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment

  4. Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

    Directory of Open Access Journals (Sweden)

    Barter Devra M

    2012-11-01

    Full Text Available Abstract Background Tuberculosis (TB is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$. Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs

  5. 24 CFR 266.656 - Recovery of costs after final claim settlement.

    Science.gov (United States)

    2010-04-01

    ... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... project or otherwise, the total amount of such recovery shall be shared by HUD and the HFA in accordance...

  6. Multi-bits error detection and fast recovery in RISC cores

    International Nuclear Information System (INIS)

    Wang Jing; Yang Xing; Zhang Weigong; Shen Jiao; Qiu Keni; Zhao Yuanfu

    2015-01-01

    The particles-induced soft errors are a major threat to the reliability of microprocessors. Even worse, multi-bits upsets (MBUs) are ever-increased due to the rapidly shrinking feature size of the IC on a chip. Several architecture-level mechanisms have been proposed to protect microprocessors from soft errors, such as dual and triple modular redundancies (DMR and TMR). However, most of them are inefficient to combat the growing multi-bits errors or cannot well balance the critical paths delay, area and power penalty. This paper proposes a novel architecture, self-recovery dual-pipeline (SRDP), to effectively provide soft error detection and recovery with low cost for general RISC structures. We focus on the following three aspects. First, an advanced DMR pipeline is devised to detect soft error, especially MBU. Second, SEU/MBU errors can be located by enhancing self-checking logic into pipelines stage registers. Third, a recovery scheme is proposed with a recovery cost of 1 or 5 clock cycles. Our evaluation of a prototype implementation exhibits that the SRDP can successfully detect particle-induced soft errors up to 100% and recovery is nearly 95%, the other 5% will inter a specific trap. (paper)

  7. Multi-bits error detection and fast recovery in RISC cores

    Science.gov (United States)

    Jing, Wang; Xing, Yang; Yuanfu, Zhao; Weigong, Zhang; Jiao, Shen; Keni, Qiu

    2015-11-01

    The particles-induced soft errors are a major threat to the reliability of microprocessors. Even worse, multi-bits upsets (MBUs) are ever-increased due to the rapidly shrinking feature size of the IC on a chip. Several architecture-level mechanisms have been proposed to protect microprocessors from soft errors, such as dual and triple modular redundancies (DMR and TMR). However, most of them are inefficient to combat the growing multi-bits errors or cannot well balance the critical paths delay, area and power penalty. This paper proposes a novel architecture, self-recovery dual-pipeline (SRDP), to effectively provide soft error detection and recovery with low cost for general RISC structures. We focus on the following three aspects. First, an advanced DMR pipeline is devised to detect soft error, especially MBU. Second, SEU/MBU errors can be located by enhancing self-checking logic into pipelines stage registers. Third, a recovery scheme is proposed with a recovery cost of 1 or 5 clock cycles. Our evaluation of a prototype implementation exhibits that the SRDP can successfully detect particle-induced soft errors up to 100% and recovery is nearly 95%, the other 5% will inter a specific trap.

  8. Disaster recovery: mitigating loss through documentation.

    Science.gov (United States)

    Boisvert, Sue

    2011-01-01

    Flood, fire, tornado, hurricane. Whatever the cause, natural or man-made, the result on an organization can be devastating. Planning and preparation for disaster must include significant attention to disaster recovery. The ability to produce documentation of what existed, what was damaged, recovery costs and income losses will be essential to the claims adjustment process. This article discusses strategies for creating a historical record, leveraging contemporaneous incident command documentation and working with contractors to identify and record disaster-related expenses. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

  9. Prevalência e custos indiretos das cefaléias em uma empresa brasileira Prevalence and indirect costs of headache in a Brazilian company

    Directory of Open Access Journals (Sweden)

    MAURICE VINCENT

    1998-12-01

    indirect costs estimation for each headache, the company may loose up to US$125.98 per employee annually. Since among headaches migraine has the highest indirect cost, migraine prevention and treatment is particularly important at the working environment. Migraine frequency may be prevented to a large extent, resulting on positive effects in both the quality of life and productivity. The cost-benefit ratio clearly favours therapeutic and preventive programs against chronic headaches.

  10. [Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

    Science.gov (United States)

    Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

    2016-06-01

    To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

  11. 48 CFR 52.216-26 - Payments of Allowable Costs Before Definitization.

    Science.gov (United States)

    2010-10-01

    ... and placed in the production process for use on the contract; (iii) Direct labor; (iv) Direct travel; (v) Other direct in-house costs; and (vi) Properly allocable and allowable indirect costs as shown on... Costs Before Definitization. 52.216-26 Section 52.216-26 Federal Acquisition Regulations System FEDERAL...

  12. Total Value of Phosphorus Recovery.

    Science.gov (United States)

    Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

    2016-07-05

    Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies.

  13. 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

  14. Operating cost model for local service airlines

    Science.gov (United States)

    Anderson, J. L.; Andrastek, D. A.

    1976-01-01

    Several mathematical models now exist which determine the operating economics for a United States trunk airline. These models are valuable in assessing the impact of new aircraft into an airline's fleet. The use of a trunk airline cost model for the local service airline does not result in representative operating costs. A new model is presented which is representative of the operating conditions and resultant costs for the local service airline. The calculated annual direct and indirect operating costs for two multiequipment airlines are compared with their actual operating experience.

  15. Indirect Reciprocity; A Field Experiment.

    Science.gov (United States)

    van Apeldoorn, Jacobien; Schram, Arthur

    2016-01-01

    Indirect reciprocity involves cooperative acts towards strangers, either in response to their kindness to third parties (downstream) or after receiving kindness from others oneself (upstream). It is considered to be important for the evolution of cooperative behavior amongst humans. Though it has been widely studied theoretically, the empirical evidence of indirect reciprocity has thus far been limited and based solely on behavior in laboratory experiments. We provide evidence from an online environment where members can repeatedly ask and offer services to each other, free of charge. For the purpose of this study we created several new member profiles, which differ only in terms of their serving history. We then sent out a large number of service requests to different members from all over the world. We observe that a service request is more likely to be rewarded for those with a profile history of offering the service (to third parties) in the past. This provides clear evidence of (downstream) indirect reciprocity. We find no support for upstream indirect reciprocity (in this case, rewarding the service request after having previously received the service from third parties), however. Our evidence of downstream indirect reciprocity cannot be attributed to reputational effects concerning one's trustworthiness as a service user.

  16. Mate-sampling costs and sexy sons.

    Science.gov (United States)

    Kokko, H; Booksmythe, I; Jennions, M D

    2015-01-01

    Costly female mating preferences for purely Fisherian male traits (i.e. sexual ornaments that are genetically uncorrelated with inherent viability) are not expected to persist at equilibrium. The indirect benefit of producing 'sexy sons' (Fisher process) disappears: in some models, the male trait becomes fixed; in others, a range of male trait values persist, but a larger trait confers no net fitness advantage because it lowers survival. Insufficient indirect selection to counter the direct cost of producing fewer offspring means that preferences are lost. The only well-cited exception assumes biased mutation on male traits. The above findings generally assume constant direct selection against female preferences (i.e. fixed costs). We show that if mate-sampling costs are instead derived based on an explicit account of how females acquire mates, an initially costly mating preference can coevolve with a male trait so that both persist in the presence or absence of biased mutation. Our models predict that empirically detecting selection at equilibrium will be difficult, even if selection was responsible for the location of the current equilibrium. In general, it appears useful to integrate mate sampling theory with models of genetic consequences of mating preferences: being explicit about the process by which individuals select mates can alter equilibria. © 2014 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

  17. [Costs of temporary disability in Spain related to diabetes mellitus and its complications].

    Science.gov (United States)

    Vicente-Herrero, M Teófila; Terradillos García, M Jesús; Capdevila García, Luisa M; Ramírez Iñiguez de la Torre, M Victoria; López-González, Angel Arturo

    2013-10-01

    To ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes. For this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated. In 2011, diabetes and its complications were related to 2.567 TD processes, which resulted in the loss of 154.214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297.095.3 €, with an estimated cost per patient and year of 141 €. These data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  18. Laboratory simulations of the mixed solvent extraction recovery of dominate polymers in electronic waste.

    Science.gov (United States)

    Zhao, Yi-Bo; Lv, Xu-Dong; Yang, Wan-Dong; Ni, Hong-Gang

    2017-11-01

    The recovery of four dominant plastics from electronic waste (e-waste) using mixed solvent extraction was studied. The target plastics included polycarbonate (PC), polystyrene (PS), acrylonitrile butadiene styrene (ABS), and styrene acrylonitrile (SAN). The extraction procedure for multi-polymers at room temperature yielded PC, PS, ABS, and SAN in acceptable recovery rates (64%, 86%, 127%, and 143%, respectively, where recovery rate is defined as the mass ratio of the recovered plastic to the added standard polymer). Fourier transform infrared spectroscopy (FTIR) was used to verify the recovered plastics' purity using a similarity analysis. The similarities ranged from 0.98 to 0.99. Another similar process, which was denoted as an alternative method for plastic recovery, was examined as well. Nonetheless, the FTIR results showed degradation may occur over time. Additionally, the recovery cost estimation model of our method was established. The recovery cost estimation indicated that a certain range of proportion of plastics in e-waste, especially with a higher proportion of PC and PS, can achieve a lower cost than virgin polymer product. It also reduced 99.6%, 30.7% and 75.8% of energy consumptions and CO 2 emissions during the recovery of PC, PS and ABS, and reduced the amount of plastic waste disposal via landfill or incineration and associated environmental impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. A new helium gas recovery and purification system

    International Nuclear Information System (INIS)

    Yamamotot, T.; Suzuki, H.; Ishii, J.; Hamana, I.; Hayashi, S.; Mizutani, S.; Sanjo, S.

    1974-01-01

    A helium gas recovery and purification system, based on the principle of gas permeation through a membrane, is described. The system can be used for the purification of helium gas containing air as a contaminant. The apparatus, operating at ambient temperature does not need constant attention, the recovery ratio of helium gas is satisfactory and running costs are low. Gases other than helium can be processed with the apparatus. (U.K.)

  20. Cost of disorders of the brain in Denmark

    DEFF Research Database (Denmark)

    Olesen, J.; Sobocki, P.; Truelsen, T.

    2008-01-01

    The cost of brain disorders in Denmark is unknown and such information is important to decision makers. The aims of the study were to estimate the total number of subjects with brain diseases, and the associated direct and indirect expenses in Denmark. This was part of a larger pan-European study...... drug consumption was used for treatment of brain diseases. Expenses to brain diseases constituted 3% of the gross domestic product. Brain disorders are very prevalent in Denmark and they cause high societal and personal cost Udgivelsesdato: 2008......The cost of brain disorders in Denmark is unknown and such information is important to decision makers. The aims of the study were to estimate the total number of subjects with brain diseases, and the associated direct and indirect expenses in Denmark. This was part of a larger pan-European study......,000 and 340,000 patients, respectively. The total expenses for all selected brain diseases were 37.3 billion DKR. Affective disorders, dependency, dementia and stroke were the most costly diseases. An estimated 12% of all direct costs in the Danish health system were spent on brain diseases; 9% of the total...

  1. Cost of Illness of Chronic Hepatitis B Infection in Vietnam

    NARCIS (Netherlands)

    Tu, Hong Anh T.; Woerdenbag, Herman J.; Riewpaiboon, Arthorn; Kane, Sumit; Le, Diep M.; Postma, Maarten J.; Li, Shu Chuen

    2012-01-01

    To estimate the total financial burden of chronic hepatitis B virus (HBV) infection for Vietnam by quantifying the direct medical, the direct nonmedical, and indirect costs among patients with various stages of chronic HBV infection. Direct medical cost data were retrieved retrospectively from

  2. Pedal indirect lymphangiography

    International Nuclear Information System (INIS)

    Lee, Kil Woo; Hong, Myung Sun; Kim, In Jae

    1994-01-01

    Recently, indirect lymphangiography has been developed as a relatively good and noninvasive imaging modality of the lymphatic system at extremities. But the disadvantage of the indirect lymphangiography is a low contrast ratio between the surrounding tissues and the contrast media in lymphatic vessels, because dimeric nonionic contrast media is water soluble and diluted in the proximal leg lymphatic vessels. We could have relatively better image than previously published images for the leg lymphatic system, when we injected contrast media with adequate high pressure in intradermal space of the interdigital areas at the foot dorsum. So, we would like to report the results. We could study all 9 lymphedemas(primary: 6, secondary: 3) from April 1990 to May 1993 on outpatient base. They were diagnosed as lymphedema clinically and radiologically. Ten ml of dimeric nonionic aget, iotrolan(Isovist 300) was injected into intradermal space with five 30-gauge needles. The injection speed was more than 0.2 ml/min. We have done one side pedal lymphangiogram in 30 minutes. The evaluation of the anterior superficial lymphatics was according to the criteria of the Weissleder. The results were as follows: 1. All lymphatic vessels from foot to inguinal area could be visualized. 2. Two or three inferior inguinal lymph nodes could be visualized about 42%. 3. The most common abnormal finding of the lymphedma was the neovascularization of the lymphatics on indirect pedal lymphangiogram. If we use adequate technique relatively high pressure injection, correct intradermal needle insertion, adequate soft tissue exposure technique indirect lymphangiography is considered to be a safe and noninvasive imaging modality for the evaluation of the lymphedema of lower extremity lymphatics including inferior inguinal lymph nodes

  3. [Effect of postoperative precision nutrition therapy on postoperative recovery for advanced gastric cancer after neoadjuvant chemotherapy].

    Science.gov (United States)

    Zhao, Q; Li, Y; Yu, B; Yang, P G; Fan, L Q; Tan, B B; Tian, Y; Yang, A B

    2018-02-23

    Objective: To investigate the effect of postoperative precision nutrition therapy on postoperative recovery (PR) of patients with advanced gastric cancer (AGC) after neoadjuvant chemotherapy (NC). Methods: 71 subjects were randomly divided into 2 groups. The 34 patients of research group were treated with postoperative precision nutrition treatment according to the indirect energy measurement method. The 31 patients of control group were treated with traditional postoperative nutrition treatment. All participants were measured for body mass index (BMI), NRS2002, PG-SGA and relevant laboratory test within the 1st day before surgery and 7th day after surgery. Moreover, the difference between two groups in short-term effects were evaluated. Results: The daily energy supply of control group was 30.1%-43.74% higher than that of the experimental group ( P nutritional risk became lower in the research group ( P recovery of patients in the research group was comparable to that of the control group ( P >0.05). Moreover, the complication rate and hospitalization costs of in research group were significantly lower than that of in control group ( P nutritional risks before surgery, the nutritional index and inflammatory index in the research group were better than those in the control group. Conclusion: Postoperative precision nutrition therapy may improve the postoperative nutritional status and short-term effects of patients with AGC after NC.

  4. Indirect Solar Water Heating in Single-Family, Zero Energy Ready Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

    2016-02-17

    Solar water heating systems are not new, but they have not become prevalent in most of the U.S. Most of the country is cold enough that indirect solar thermal systems are required for freeze protection, and average installed cost of these systems is $9,000 to $10,000 for typical systems on single-family homes. These costs can vary significantly in different markets and with different contractors, and federal and regional incentives can reduce these up-front costs by 50% or more. In western Massachusetts, an affordable housing developer built a community of 20 homes with a goal of approaching zero net energy consumption. In addition to excellent thermal envelopes and PV systems, the developer installed a solar domestic water heating system (SDHW) on each home. The Consortium for Advanced Residential Buildings (CARB), a research consortium funded by the U.S. Department of Energy Building America program, commissioned some of the systems, and CARB was able to monitor detailed performance of one system for 28 months.

  5. Estimate of the cost of multiple sclerosis in Spain by literature review.

    Science.gov (United States)

    Fernández, Oscar; Calleja-Hernández, Miguel Angel; Meca-Lallana, José; Oreja-Guevara, Celia; Polanco, Ana; Pérez-Alcántara, Ferran

    2017-08-01

    Multiple Sclerosis (MS) is a progressive disease leading to increasing disability and costs. A literature review was carried out to identify MS costs and to estimate its economic burden in Spain. Areas Covered: The public electronic databases PubMed, ScienceDirect and IBECS were consulted and a manual review of communications presented at related congresses was carried out. A total of 225 references were obtained, of which 43 were finally included in the study. Expert Commentary: Three major cost groups were identified: direct healthcare costs, direct non-healthcare costs and indirect costs. There is a direct relationship between disease progression and increased costs, mainly direct non-healthcare costs (greater need for informal care) and indirect costs (greater loss of productivity). The total cost associated with MS in Spain is €1,395 million per year, and that the mean annual cost per patient is €30,050. Beyond costs, a large impact on the quality of life of patients, with an annual loss of up to 13,000 quality-adjusted life years was also estimated. MS has a large economic impact on Spanish society and a significant impact on the quality of life of patients.

  6. 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.

  7. Key Recovery Using Noised Secret Sharing with Discounts over Large Clouds

    OpenAIRE

    JAJODIA , Sushil; Litwin , Witold; Schwarz , Thomas

    2013-01-01

    Encryption key loss problem is the Achilles's heel of cryptography. Key escrow helps, but favors disclosures. Schemes for recoverable encryption keys through noised secret sharing alleviate the dilemma. Key owner escrows a specifically encrypted backup. The recovery needs a large cloud. Cloud cost, money trail should rarefy illegal attempts. We now propose noised secret sharing schemes supporting discounts. The recovery request with discount code lowers the recovery complexity, easily by orde...

  8. Comparison of viral RNA electrophoresis and indirect ELISA methods in the diagnosis of human rotavirus infection

    Energy Technology Data Exchange (ETDEWEB)

    Avendano, L F; Dubinovsky, S; James, Jr, H D

    1984-01-01

    A total of 177 stool samples from Chilean diarrhea patients under two years of age were tested for rotavirus by two methods - the indirect enzyme-linked immunosorbent assay (indirect ELISA) and viral RNA electrophoresis in agarose gels (v RNA EPH). Fifty of the specimens came from patients with acute diarrhea and 127 came from patients with protracted diarrhea. The indirect ELISA testing was performed at the National Institutes of Health in the United States: the electrophoretic testing was carried out in Santiago, Chile by the authors. The electrophoretic method detected rotavirus in 36% of the acute samples and 25% of the samples from protracted cases, while the indirect ELISA method detected rotavirus in higher percentages of samples - 46% and 38%, respectively. These results support the conclusion that v RNA EPH is a less sensitive method for detecting rotavirus than the indirect ELISA. Nevertheless, the former method's high specificity, ease of application, and low cost make it a worthwhile alternative to indirect ELISA. Thus, considering the important role played by rotavirus in infant diarrhea and the need for a diagnostic technique that can be incorporated into the routines of medical center laboratories in developing countries, there is good reason to conclude that v RNA EPH is a useful tool for studying rotavirus diarrhea. 18 refs, 3 tabs. Also published in the Bol. Oficina Sanit. Panam. (1984) v. 97(1), p. 1-7 (In Spanish).

  9. Supersymmetric dark matter: Indirect detection

    International Nuclear Information System (INIS)

    Bergstroem, L.

    2000-01-01

    Dark matter detection experiments are improving to the point where they can detect or restrict the primary particle physics candidates for non baryonic dark matter. The methods for detection are usually categorized as direct, i.e., searching for signals caused by passage of dark matter particles in terrestrial detectors, or indirect. Indirect detection methods include searching for antimatter and gamma rays, in particular gamma ray lines, in cosmic rays and high-energy neutrinos from the centre of the Earth or Sun caused by accretion and annihilation of dark matter particles. A review is given of recent progress in indirect detection, both on the theoretical and experimental side

  10. Examining the association of smoking with work productivity and associated costs in Japan.

    Science.gov (United States)

    Suwa, Kiyomi; Flores, Natalia M; Yoshikawa, Reiko; Goto, Rei; Vietri, Jeffrey; Igarashi, Ataru

    2017-09-01

    Smoking is associated with significant health and economic burden globally, including an increased risk of many leading causes of mortality and significant impairments in work productivity. This burden is attenuated by successful tobacco cessation, including reduced risk of disease and improved productivity. The current study aimed to show the benefits of smoking cessation for workplace productivity and decreased costs associated with loss of work impairment. The data source was the 2011 Japan National Health and Wellness Survey (n = 30,000). Respondents aged 20-64 were used in the analyses (n = 23,738) and were categorized into: current smokers, former smokers, and never smokers. Generalized linear models controlling for demographics and health characteristics examined the relationship of smoking status with the Work Productivity and Activity Impairment questionnaire (WPAI-GH) endpoints, as well as estimated indirect costs. Current smokers reported the greatest overall work impairment, including absenteeism (i.e. work time missed) and presenteeism (i.e. impairment while at work); however, after controlling for covariates, there were no significant differences between former smokers and never smokers on overall work impairment. Current smokers and former smokers had greater activity impairment (i.e. impairment in daily activities) than never smokers. Current smokers reported the highest indirect costs (i.e. costs associated with work impairment); however, after controlling for covariates, there were no significant differences between former smokers and never smokers on indirect costs. Smoking exerts a large health and economic burden; however, smoking cessation attenuates this burden. The current study provides important further evidence of this association, with former smokers appearing statistically indistinguishable from never smokers in terms of work productivity loss and associated indirect costs among a large representative sample of Japanese workers

  11. The cost of clinical mastitis in the first 30 days of lactation: An economic modeling tool.

    Science.gov (United States)

    Rollin, E; Dhuyvetter, K C; Overton, M W

    2015-12-01

    Clinical mastitis results in considerable economic losses for dairy producers and is most commonly diagnosed in early lactation. The objective of this research was to estimate the economic impact of clinical mastitis occurring during the first 30 days of lactation for a representative US dairy. A deterministic partial budget model was created to estimate direct and indirect costs per case of clinical mastitis occurring during the first 30 days of lactation. Model inputs were selected from the available literature, or when none were available, from herd data. The average case of clinical mastitis resulted in a total economic cost of $444, including $128 in direct costs and $316 in indirect costs. Direct costs included diagnostics ($10), therapeutics ($36), non-saleable milk ($25), veterinary service ($4), labor ($21), and death loss ($32). Indirect costs included future milk production loss ($125), premature culling and replacement loss ($182), and future reproductive loss ($9). Accurate decision making regarding mastitis control relies on understanding the economic impacts of clinical mastitis, especially the longer term indirect costs that represent 71% of the total cost per case of mastitis. Future milk production loss represents 28% of total cost, and future culling and replacement loss represents 41% of the total cost of a case of clinical mastitis. In contrast to older estimates, these values represent the current dairy economic climate, including milk price ($0.461/kg), feed price ($0.279/kg DM (dry matter)), and replacement costs ($2,094/head), along with the latest published estimates on the production and culling effects of clinical mastitis. This economic model is designed to be customized for specific dairy producers and their herd characteristics to better aid them in developing mastitis control strategies. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  12. 45 CFR 30.18 - Interest, penalties, and administrative costs.

    Science.gov (United States)

    2010-10-01

    ... delinquency, or as otherwise provided by law. For debts not paid by the date specified in the written demand... direct (personnel, supplies, etc.) and indirect collection costs, including the cost of providing a... consideration of waiver if statute prohibits collection of the debt during this period. (i) Common law or other...

  13. FORMALIZING PRODUCT COST DISTORTION: The Impact of Volume-Related Allocation Bases on Cost Information

    Directory of Open Access Journals (Sweden)

    Johnny Jermias

    2003-09-01

    Full Text Available The purpose o f this study is to formally analyze product cost distortions resulting from the process of allocating costs to products based on Activity-Based Costing (ABC and the conventional product costing systems. The model developed in this paper rigorously shows the impact of treating costs that are not volume related as if they are. The model demonstrates that the source of product cost distortion is the difference between the proportion of driver used by each product in ABC and the proportion of the base used by the same product in the conventional costing systems. The difference arises because the conventional costing systems ignore the existence of batch-related and product-related costs. The model predicts a positive association between volume and size diversity with product cost distortions. When interaction between volume and size diversity exists, the distortion is either mitigated or exacerbated. The magnitude of the distortion is jointly determined by the size of the differences and the size of the total indirect costs.

  14. Nerium oleander indirect leaf photosynthesis and light harvesting reductions after clipping injury or Spodoptera eridania herbivory: high sensitivity to injury.

    Science.gov (United States)

    Delaney, Kevin J

    2012-04-01

    Variable indirect photosynthetic rate (P(n)) responses occur on injured leaves after insect herbivory. It is important to understand factors that influence indirect P(n) reductions after injury. The current study examines the relationship between gas exchange and chlorophyll a fluorescence parameters with injury intensity (% single leaf tissue removal) from clipping or Spodoptera eridania Stoll (Noctuidae) herbivory on Nerium oleander L. (Apocynaceae). Two experiments showed intercellular [CO(2)] increases but P(n) and stomatal conductance reductions with increasing injury intensity, suggesting non-stomatal P(n) limitation. Also, P(n) recovery was incomplete at 3d post-injury. This is the first report of a negative exponential P(n) impairment function with leaf injury intensity to suggest high N. oleander leaf sensitivity to indirect P(n) impairment. Negative linear functions occurred between most other gas exchange and chlorophyll a fluorescence parameters with injury intensity. The degree of light harvesting impairment increased with injury intensity via lower (1) photochemical efficiency indicated lower energy transfer efficiency from reaction centers to PSII, (2) photochemical quenching indicated reaction center closure, and (3) electron transport rates indicated less energy traveling through PSII. Future studies can examine additional mechanisms (mesophyll conductance, carbon fixation, and cardenolide induction) to cause N. oleander indirect leaf P(n) reductions after injury. Published by Elsevier Ireland Ltd.

  15. The household costs of visceral leishmaniasis care in south-eastern Nepal.

    Directory of Open Access Journals (Sweden)

    Surendra Uranw

    Full Text Available BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. METHODS: Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. RESULTS: The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days. Direct and indirect costs (income losses represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71% or taking a loan (56%. CONCLUSIONS: The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control.

  16. 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.

  17. 30 CFR 220.013 - Unallowable costs.

    Science.gov (United States)

    2010-07-01

    ...)); (c) Depreciation, depletion, amortization, or any other charge for capital recovery for materiel... employee move that is for the primary benefit of the lessee's non-NPSL operations; (h) The lessee's own cost of administering employee benefit plans; (i) The cost of acquiring or constructing shore base...

  18. The cost of autism spectrum disorders.

    Directory of Open Access Journals (Sweden)

    Chiara Horlin

    Full Text Available A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis.A register based questionnaire study covering all families with a child with ASD in Western Australia.Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis.The median family cost of ASD was estimated to be AUD $34,900 per annum with almost 90% of the sum ($29,200 due to loss of income from employment. For each additional symptom reported, approximately $1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD.A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a child's long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia.

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

    Science.gov (United States)

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

    2016-03-01

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

  20. 26 CFR 1.471-3 - Inventories at cost.

    Science.gov (United States)

    2010-04-01

    ... article, including in such indirect production costs an appropriate portion of management expenses, but... and manufacturers who by a single process or uniform series of processes derive a product of two or...

  1. Analysis of indirect taxation in Ukraine

    Directory of Open Access Journals (Sweden)

    Khodyakova Olga V.

    2014-01-01

    Full Text Available The goal of the article is analysis of the structure and dynamics of indirect taxes for the previous five years and also the influence of indirect taxation upon formation of income of the State Budget of Ukraine. The article analyses the modern state of indirect taxation in Ukraine. Specific weight of the value added tax, excise tax and customs duty are considered in the structure of tax receipts of the consolidated budget of Ukraine as indirect taxes. The article shows that receipts of the State Budget of Ukraine are mostly provided by indirect taxes. The Ukrainian taxation system is mostly a factor of reduction of the level of economic growth and investment activity in the country and the existing system of administering is not completely capable of excluding the possibility of tax evasion. The prospect of further studies in this direction is improvement of organisation of tax control in Ukraine and differentiation of the value added tax rates depending on the level of consumption of goods and level of income of consumers.

  2. Development of a Field Demonstration for Cost-Effective Low-Grade Heat Recovery and Use Technology Designed to Improve Efficiency and Reduce Water Usage Rates for a Coal-Fired Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Noble, Russell [Southern Company Services, Incorporated, Birmingham, AL (United States); Dombrowski, K. [AECOM Technical Services, Austin, TX (United States); Bernau, M. [AECOM Technical Services, Austin, TX (United States); Morett, D. [AECOM Technical Services, Austin, TX (United States); Maxson, A. [EPRI, Palo Alto, CA (United States); Hume, S. [EPRI, Palo Alto, CA (United States)

    2016-06-30

    Coal-based power generation systems provide reliable, low-cost power to the domestic energy sector. These systems consume large amounts of fuel and water to produce electricity and are the target of pending regulations that may require reductions in water use and improvements in thermal efficiency. While efficiency of coal-based generation has improved over time, coal power plants often do not utilize the low-grade heat contained in the flue gas and require large volumes of water for the steam cycle make-up, environmental controls, and for process cooling and heating. Low-grade heat recovery is particularly challenging for coal-fired applications, due in large part to the condensation of acid as the flue gas cools and the resulting potential corrosion of the heat recovery materials. Such systems have also not been of significant interest as recent investments on coal power plants have primarily been for environmental controls due to more stringent regulations. Also, in many regions, fuel cost is still a pass-through to the consumer, reducing the motivation for efficiency improvements. Therefore, a commercial system combining low-grade heat-recovery technologies and associated end uses to cost effectively improve efficiency and/or reduce water consumption has not yet been widely applied. However, pressures from potential new regulations and from water shortages may drive new interest, particularly in the U.S. In an effort to address this issue, the U.S. Department of Energy (DOE) has sought to identify and promote technologies to achieve this goal.

  3. Determining infertility treatment costs and out of pocket payments ...

    African Journals Online (AJOL)

    The greatest portion of indirect costs was related to accommodation expenses and the least was due to travel costs (4.898.099 and 2.738.491 rial). ... Conclusion: Due to the high expenditures related to infertility treatment services also lack of insurance coverage, policy makers should pay a particular attention on meeting ...

  4. Direct and indirect costs of dinitrogen fixation in Crocosphaera watsonii WH8501 and possible implications for the nitrogen cycle

    Directory of Open Access Journals (Sweden)

    Tobias eGroßkopf

    2012-07-01

    Full Text Available The recent detection of heterotrophic nitrogen (N2 fixation in deep waters of the southern Californian and Peruvian OMZ questions our current understanding of marine N2 fixation as a process confined to oligotrophic surface waters of the oceans. In experiments with Crocosphaera watsonii WH8501, a marine unicellular diazotrophic (N2-fixing cyanobacterium, we demonstrated that the presence of high nitrate concentrations (up to 800 µM had no inhibitory effect on growth and N2 fixation over a period of two weeks. In contrast, the environmental oxygen concentration significantly influenced rates of N2 fixation and respiration, as well as carbon and nitrogen cellular content of C. watsonii over a 24 hour period. Cells grown under lowered oxygen atmosphere (5% had a higher nitrogenase activity and respired less carbon during the dark cycle than under normal oxygen atmosphere (20%. Respiratory oxygen drawdown during the dark period could be fully explained (104% by energetic needs due to basal metabolism and N2 fixation at low oxygen, while at normal oxygen these two processes could only account for 40% of the measured respiration rate. Our results revealed that under normal oxygen concentration most of the energetic costs during N2 fixation (~60% are not derived from the process of N2 fixation per se but rather from the indirect costs incurred for the removal of intracellular oxygen or by the reversal of oxidative damage (e.g. nitrogenase de novo synthesis. Theoretical calculations suggest a slight energetic advantage of N2 fixation relative to assimilatory nitrate uptake for heterotrophic and phototrophic growth, when oxygen supply is in balance with the oxygen requirement for cellular respiration (i.e. energy generation for basal metabolism and N2 fixation. Taken together our results imply the existence of a niche for diazotrophic organisms inside oxygen minimum zones, which are predicted to further expand in the future ocean.

  5. Direct versus Indirect and Individual versus Group Modes of Language Therapy for Children with Primary Language Impairment: Principal Outcomes from a Randomized Controlled Trial and Economic Evaluation

    Science.gov (United States)

    Boyle, James M.; McCartney, Elspeth; O'Hare, Anne; Forbes, John

    2009-01-01

    Background: Many school-age children with language impairments are enrolled in mainstream schools and receive indirect language therapy, but there have been, to the authors' knowledge, no previous controlled studies comparing the outcomes and costs of direct and indirect intervention delivered by qualified therapists and therapy assistants, and…

  6. An Assessment of Direct and Indirect Economic Losses of Climatic Extreme Events

    Science.gov (United States)

    Otto, C.; Willner, S. N.; Wenz, L.; Levermann, A.

    2015-12-01

    Risk of extreme weather events like storms, heat extremes, and floods has already risen due to anthropogenic climate change and is likely to increase further under future global warming. Additionally, the structure of the global economy has changed importantly in the last decades. In the process of globalization, local economies have become more and more interwoven forming a complex network. Together with a trend towards lean production, this has resulted in a strong dependency of local manufacturers on global supply and value added chains, which may render the economic network more vulnerable to climatic extremes; outages of local manufacturers trigger indirect losses, which spread along supply chains and can even outstrip direct losses. Accordingly, in a comprehensive climate risk assessment these inter-linkages should be considered. Here, we present acclimate, an agent based dynamic damage propagation model. Its agents are production and consumption sites, which are interlinked by economic flows accounting for the complexity as well as the heterogeneity of the global supply network. Assessing the economic response on the timescale of the adverse event, the model permits to study temporal and spatial evolution of indirect production losses during the disaster and in the subsequent recovery phase of the economy. In this study, we focus on the dynamic economic resilience defined here as the ratio of direct to total losses. This implies that the resilience of the system under consideration is low if the high indirect losses are high. We find and assess a nonlinear dependence of the resilience on the disaster size. Further, we analyze the influence of the network structure upon resilience and discuss the potential of warehousing as an adaptation option.

  7. 14 CFR Appendix A to Subpart 1214... - Costs for Which NASA Shall Be Reimbursed

    Science.gov (United States)

    2010-01-01

    ... Foreign Users Who Have Made Substantial Investment in the STS Program Pt. 1214, Subpt. 1214.2, App. A.... Total Operating Costs include all direct and indirect costs, excluding costs of composing the use charge. Such costs include direct program charges for manpower, expended hardware, refurbishment of hardware...

  8. Novel integrated gasification combined cycles with a carbon dioxide recovery option

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, J.

    1997-08-01

    Two novel combined cycle configurations offering potential to reduce the cost of electricity from coal-fired IGCCs were investigated - one based on the use of flue gas recycling with heat recovery to the recycled stream, the other, aimed at removing carbon dioxide, using flue gas recycle and heat recovery but with oxygen as the oxidant in the gas turbine. The investigation included the use of fuels other than coal. It was found that gasification efficiency was increased by use of a coal/Orimulsion slurry. Flue gas recycling at 1 bar for the industrial gas turbine offered a gain of about 0.4 percentage points. In a standard IGCC the industrial gas turbine showed an advantage of 1.5 percentage points over the aero-derived machine. The least cost electricity with CO{sub 2} removal was achieved using an oxygen-fed industrial gas turbine with flue gas recycling and recovery. Several recommendations are made for further studies to reduce costs of electricity production. 11 refs., 3 figs., 5 tabs., 1 app.

  9. An economic and legal perspective on electric utility transition costs

    Energy Technology Data Exchange (ETDEWEB)

    Rose, K.

    1996-07-01

    The issue of possibly unrecoverable cost incurred by a utility, or `stranded costs,` has emerged as a major obstacle to developing a competitive generation market. Stranded or transition costs are defined as costs incurred by a utility to serve its customers that were being recovered in rates but are no longer due to availability of lower-priced alternative suppliers. The idea of `stranded cost,` and more importantly arguments for its recovery, is a concept with little basis in economic theory, legal precedence, or precedence in other deregulated industries. The main argument recovery is that the ``regulatory compact`` requires it. This is based on the misconception that the regulator compact is simply: the utility incurs costs on behalf of its customers because of the ``obligation to serve`` so, therefore, customers are obligated to pay. This is a mischaracterization of what the compact was and how it developed. Another argument is that recovery is required for economic efficiency. This presumes, however, a very narrow definition of efficiency based on preventing ``uneconomic`` bypass of the utility and that utilities minimize costs. A broader definition of efficiency and the likelihood of cost inefficiencies in the industry suggest that the cost imposed on customers from inhibiting competition could exceed the gains from preventing uneconomic bypass. Both these issues are examined in this paper.

  10. Indirect Reciprocity under Incomplete Observation

    Science.gov (United States)

    Nakamura, Mitsuhiro; Masuda, Naoki

    2011-01-01

    Indirect reciprocity, in which individuals help others with a good reputation but not those with a bad reputation, is a mechanism for cooperation in social dilemma situations when individuals do not repeatedly interact with the same partners. In a relatively large society where indirect reciprocity is relevant, individuals may not know each other's reputation even indirectly. Previous studies investigated the situations where individuals playing the game have to determine the action possibly without knowing others' reputations. Nevertheless, the possibility that observers of the game, who generate the reputation of the interacting players, assign reputations without complete information about them has been neglected. Because an individual acts as an interacting player and as an observer on different occasions if indirect reciprocity is endogenously sustained in a society, the incompleteness of information may affect either role. We examine the game of indirect reciprocity when the reputations of players are not necessarily known to observers and to interacting players. We find that the trustful discriminator, which cooperates with good and unknown players and defects against bad players, realizes cooperative societies under seven social norms. Among the seven social norms, three of the four suspicious norms under which cooperation (defection) to unknown players leads to a good (bad) reputation enable cooperation down to a relatively small observation probability. In contrast, the three trustful norms under which both cooperation and defection to unknown players lead to a good reputation are relatively efficient. PMID:21829335

  11. Workplace incivility and employee sleep: The role of rumination and recovery experiences.

    Science.gov (United States)

    Demsky, Caitlin A; Fritz, Charlotte; Hammer, Leslie B; Black, Anne E

    2018-04-23

    This study examines the role of negative work rumination and recovery experiences in explaining the association between workplace incivility and employee insomnia symptoms. Drawing on the perseverative cognition model of stress and the effort-recovery model, we hypothesize a moderated mediation model in which workplace incivility is associated with insomnia symptoms via negative work rumination. This indirect effect is proposed to be conditional on employees' reported level of recovery experiences (i.e., psychological detachment from work and relaxation during nonwork time). In examining this model, we further establish a link between workplace incivility and sleep and identify one pathway to explain this relationship, as well as resources that may be used to halt the negative spillover of workplace incivility on sleep. Based on a sample of 699 U.S. Forest Service employees, we find support for a moderated mediation model in which the association between workplace incivility and increased insomnia symptoms via increased negative work rumination was weakest for employees reporting high levels of recovery experiences during nonwork time. Findings from the current study contribute to our understanding of why workplace incivility is associated with nonwork outcomes, as well as point to implications for interventions aimed at promoting employees' recovery from work. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. Quench and recovery characteristics of Au/YBCO thin film type SFCL

    International Nuclear Information System (INIS)

    Yim, S.-W.; Kim, H.-R.; Hyun, O.-B.; Sim, J.

    2007-01-01

    Although, a superconducting fault current limiter (SFCL) guarantees the fast limiting operation, it usually needs a considerably long time to recover to superconducting state after the quench. Considering the reclosing time in the protection coordination of power systems, the time required for the recovery should be investigated clearly. In this study, the quench and recovery characteristics of Au/YBCO thin films designed as an SFCL element with a bi-spiral pattern were investigated. The quench development of the SFCL was measured by two kinds of methods. Firstly, after applying the fault current of 5.5 cycles, we measured the resistance of the YBCO by a small current flowing through the pattern of Au/YBCO thin film. The temperature variation above the critical temperature, 85 K, was investigated indirectly from the resistance variation. Secondly, in order to measure the temperature from 85 K to 77 K, a meander line shape of Au thin film was evaporated on the back side and used as a temperature detecting sensor. The temperature variations detected by both methods were compared and analyzed. For the investigation of the recovery characteristics, the required time for the recovery of the superconductivity was measured for various magnitude and duration of the applied voltages. In addition, for the purpose of examining the dependence of the line impedance on the recovery time, resistors of various resistances were inserted in the fault current testing circuit and the recovery time was measured and analyzed

  13. Reconsidering Money: Monetary Exchange with Additive Transaction Costs

    DEFF Research Database (Denmark)

    Schröder, Philipp

    2001-01-01

    Under the assumption of purely additive transaction costs in exchange, the literature on money has a standard example of direct exchange dominating indirect (monetary) exchange. From here it is frequently concluded that subadditive costs (e.g. search costs) must be examined in order to explain...... money. In contrast, this paper presents an additive transaction costs model in which the mere absence of double coincidences of wants suffices to motivate monetary exchange. Furthermore it is found that not all commodity moneys, that are collectively desirable, qualify for the core, but that all fiat...

  14. Economic costs attributable to smoking in China: update and an 8-year comparison, 2000-2008.

    Science.gov (United States)

    Yang, Lian; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Rao, Keqin

    2011-07-01

    To estimate the health-related economic costs attributable to smoking in China for persons aged 35 and older in 2003 and in 2008 and to compare these costs with the respective results from 2000. A prevalence-based, disease-specific approach was used to estimate smoking-attributable direct and indirect economic costs. The primary data source was the 2003 and 2008 China National Health Services Survey, which contains individual participant's smoking status, healthcare use and expenditures. The total economic cost of smoking in China amounted to $17.1 billion in 2003 and $28.9 billion in 2008 (both measured in 2008 constant US$). Direct smoking-attributable healthcare costs in 2003 and 2008 were $4.2 billion and $6.2 billion, respectively. Indirect economic costs in 2003 and 2008 were $12.9 billion and $22.7 billion, respectively. Compared to 2000, the direct costs of smoking rose by 72% in 2003 and 154% in 2008, while the indirect costs of smoking rose by 170% in 2003 and 376% in 2008. The economic burden of cigarette smoking has increased substantially in China during the past decade and is expected to continue to increase as the national economy and the price of healthcare services grow. Stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking.

  15. Understanding the cost bases of Space Shuttle pricing policies for commercial and foreign customers

    Science.gov (United States)

    Stone, Barbara A.

    1984-01-01

    The principles and underlying cost bases of the 1977 and 1982 Space Shuttle Reimbursement Policies are compared and contrasted. Out-of-pocket cost recovery has been chosen as the base of the price for the 1986-1988 time period. With this cost base, it is NASA's intent to recover the total cost of consumables and the launch and flight operations costs added by commercial and foreign customers over the 1986-1988 time period. Beyond 1988, NASA intends to return to its policy of full cost recovery.

  16. Societal costs and burden of otitis media in Portugal

    Directory of Open Access Journals (Sweden)

    Speets AM

    2011-04-01

    Full Text Available Anouk Speets1, Judith Wolleswinkel1, Cristina Cardoso21Pallas health research and consultancy, Rotterdam, the Netherlands; 2GlaxoSmithKline, Algés, PortugalAbstract: This study aimed to estimate the resource consumption and societal impact of otitis media (OM in children younger than five years of age in Portugal. An Internet survey on generic childhood symptoms and diseases was administered to a sample of parents. This self-report survey had been previously implemented in other European countries. Medically confirmed OM was defined as symptoms of earache or “running ear” and/or a diagnosis of OM provided by a medical doctor. Direct medical, nonmedical, and indirect nonmedical costs were calculated for individual cases. Mean total costs per OM episode were estimated at €334. This corresponds to an estimated societal impact of 72 million €/year, of which 39% were indirect nonmedical costs. An epidemiological study should help to confirm the results of this study, and evaluate whether an intervention to reduce the occurrence and/or duration of OM may have an impact on societal costs and quality of life for affected families.Keywords: otitis media, costs, societal burden, Portugal

  17. Energy efficiency of substance and energy recovery of selected waste fractions

    International Nuclear Information System (INIS)

    Fricke, Klaus; Bahr, Tobias; Bidlingmaier, Werner; Springer, Christian

    2011-01-01

    In order to reduce the ecological impact of resource exploitation, the EU calls for sustainable options to increase the efficiency and productivity of the utilization of natural resources. This target can only be achieved by considering resource recovery from waste comprehensively. However, waste management measures have to be investigated critically and all aspects of substance-related recycling and energy recovery have to be carefully balanced. This article compares recovery methods for selected waste fractions with regard to their energy efficiency. Whether material recycling or energy recovery is the most energy efficient solution, is a question of particular relevance with regard to the following waste fractions: paper and cardboard, plastics and biowaste and also indirectly metals. For the described material categories material recycling has advantages compared to energy recovery. In accordance with the improved energy efficiency of substance opposed to energy recovery, substance-related recycling causes lower emissions of green house gases. For the fractions paper and cardboard, plastics, biowaste and metals it becomes apparent, that intensification of the separate collection systems in combination with a more intensive use of sorting technologies can increase the extent of material recycling. Collection and sorting systems must be coordinated. The objective of the overall system must be to achieve an optimum of the highest possible recovery rates in combination with a high quality of recyclables. The energy efficiency of substance related recycling of biowaste can be increased by intensifying the use of anaerobic technologies. In order to increase the energy efficiency of the overall system, the energy efficiencies of energy recovery plants must be increased so that the waste unsuitable for substance recycling is recycled or treated with the highest possible energy yield.

  18. Malaria treatment in Northern Ghana: What is the treatment cost per ...

    African Journals Online (AJOL)

    kemrilib

    indirect cost accounts for 71 percent of total cost of a malaria episode. While cost of malaria ... 2007; 14:70-79]. Introduction. Malaria ... episodes outside the formal health system, which can be a substantial ... in southern Ghana) of people live below the poverty line [13] .... ¢4,000 (US$1.07) for male and female respectively.

  19. Process options and projected mass flows for the HTGR refabrication scrap recovery system

    International Nuclear Information System (INIS)

    Tiegs, S.M.

    1979-03-01

    The two major uranium recovery processing options reviewed are (1) internal recovery of the scrap by the refabrication system and (2) transfer to and external recovery of the scrap by the head end of the reprocessing system. Each option was reviewed with respect to equipment requirements, preparatory processing, and material accountability. Because there may be a high cost factor on transfer of scrap fuel material to the reprocessing system for recovery, all of the scrap streams will be recycled internally within the refabrication system, with the exception of reject fuel elements, which will be transferred to the head end of the reprocessing system for uranium recovery. The refabrication facility will be fully remote; thus, simple recovery techniques were selected as the reference processes for scrap recovery. Crushing, burning, and leaching methods will be used to recover uranium from the HTGR refabrication scrap fuel forms, which include particles without silicon carbide coatings, particles with silicon carbide coatings, uncarbonized fuel rods, carbon furnace parts, perchloroethylene distillation bottoms, and analytical sample remnants. Mass flows through the reference scrap recovery system were calculated for the HTGR reference recycle facility operating with the highly enriched uranium fuel cycle. Output per day from the refabrication scrap recovery system is estimated to be 4.02 kg of 2355 U and 10.85 kg of 233 U. Maximum equipment capacities were determined, and future work will be directed toward the development and costing of the scrap recovery system chosen as reference

  20. A Bridge to Recovery

    Directory of Open Access Journals (Sweden)

    Rebecca M. Loya

    2015-02-01

    Full Text Available Sexual violence can trigger adverse economic events for survivors, including increased expenses and decreased earnings. Using interview data, this exploratory study examines how access to assets (liquid assets, familial financial assistance, and homeownership affects survivors’ economic well-being during recovery. In keeping with asset theory, liquid assets and familial assistance can help offset post-assault expenses and facilitate access to services. Homeownership, meanwhile, appears to have mixed effects on survivors’ economic well-being. These findings suggest that the economic costs of sexual violence can burden survivors with fewer financial resources more heavily than those who own significant assets. As such, these findings shift the focus toward a dimension of inequality in recovery from sexual violence that is often overlooked in research and that may have implications for public policy and victim services.

  1. Nutrition for recovery in aquatic sports.

    Science.gov (United States)

    Burke, Louise M; Mujika, Iñigo

    2014-08-01

    Postexercise recovery is an important topic among aquatic athletes and involves interest in the quality, quantity, and timing of intake of food and fluids after workouts or competitive events to optimize processes such as refueling, rehydration, repair, and adaptation. Recovery processes that help to minimize the risk of illness and injury are also important but are less well documented. Recovery between workouts or competitive events may have two separate goals: (a) restoration of body losses and changes caused by the first session to restore performance for the next and (b) maximization of the adaptive responses to the stress provided by the session to gradually make the body become better at the features of exercise that are important for performance. In some cases, effective recovery occurs only when nutrients are supplied, and an early supply of nutrients may also be valuable in situations in which the period immediately after exercise provides an enhanced stimulus for recovery. This review summarizes contemporary knowledge of nutritional strategies to promote glycogen resynthesis, restoration of fluid balance, and protein synthesis after different types of exercise stimuli. It notes that some scenarios benefit from a proactive approach to recovery eating, whereas others may not need such attention. In fact, in some situations it may actually be beneficial to withhold nutritional support immediately after exercise. Each athlete should use a cost-benefit analysis of the approaches to recovery after different types of workouts or competitive events and then periodize different recovery strategies into their training or competition programs.

  2. Free product recovery at spill sites with fluctuating water tables

    International Nuclear Information System (INIS)

    Parker, J.C.; Katyal, A.K.; Zhu, J.L.; Kremesec, V.J.; Hockman, E.L.

    1992-01-01

    Spills and leaks of hydrocarbons from underground storage tanks, pipelines and other facilities pose a serious potential for groundwater contamination which can be very costly to remediate. The severity of the impacts and the cost of remediation can be reduced by various means. Lateral spreading of free phase hydrocarbons on the groundwater table can be prevented by pumping water to control the hydraulic gradient. Recovery of floating product may be performed by skimming hydrocarbons from wells, usually in combination with water pumping to increase the gradient. The environmental variables (water table gradient, water table fluctuations due to regional recovery wells, rates of water pumping)

  3. CONCEPT-5 user's manual. [Power plant costs

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, C.R. II

    1979-01-01

    The CONCEPT computer code package was developed to provide conceptual capital cost estimates for nuclear-fueled and fossil-fired power plants. Cost estimates can be made as a function of plant type, size, location, and date of initial operation. The output includes a detailed breakdown of the estimate into direct and indirect costs similar to the accounting system described in document NUS--531. Cost models are currently provided in CONCEPT 5 for single- and multiunit pressurized-water reactors, boiling-water reactors, and cost-fired plants with and without flue gas desulfurization equipment.

  4. Study on Dynamic Characteristics of Microbial Enhanced Oil Recovery

    Science.gov (United States)

    Zhao, Yang; Shi, Fang; Qin, Wuying; Yan, Jing

    2018-01-01

    With the rapid development of economy, the demand for oil is increasing day by day. MEOR has the advantages of low cost and no pollution to the environment, attracted widespread attention. In this paper, the dynamic characteristics of microbial enhanced oil recovery were studied by laboratory experiments. The result showed that all the microbial flooding recovery rate could reach more than 5%, and the total recovery could reach more than 35% and if the injection period of microbial composite system was advanced, the whole oil displacement process could be shortened and the workload would be reduced.

  5. Activity-based Management of Logistic Costs in a Manufacturing Company: A Case of Increased Visibility of Logistics Costs in a Slovenian Paper Manufacturing Company

    OpenAIRE

    Julijana Krajnc; Klavdij Logožar; Bojana Korošec

    2012-01-01

    Both the transparent reporting of logistics costs and the related accounting of their cost drivers present a significant factor for the successful management of material flows and the related logistics activities in production companies. These costs, which are mainly reported as part of overhead (indirect) costs in such companies, usually remain hidden or are not explicitly visible when the traditional method of accounting is applied. The aim of this research is to create a model of activity-...

  6. An Indirect Route for Ethanol Production

    Energy Technology Data Exchange (ETDEWEB)

    Eggeman, T.; Verser, D.; Weber, E.

    2005-04-29

    The ZeaChem indirect method is a radically new approach to producing fuel ethanol from renewable resources. Sugar and syngas processing platforms are combined in a novel way that allows all fractions of biomass feedstocks (e.g. carbohydrates, lignins, etc.) to contribute their energy directly into the ethanol product via fermentation and hydrogen based chemical process technologies. The goals of this project were: (1) Collect engineering data necessary for scale-up of the indirect route for ethanol production, and (2) Produce process and economic models to guide the development effort. Both goals were successfully accomplished. The projected economics of the Base Case developed in this work are comparable to today's corn based ethanol technology. Sensitivity analysis shows that significant improvements in economics for the indirect route would result if a biomass feedstock rather that starch hydrolyzate were used as the carbohydrate source. The energy ratio, defined as the ratio of green energy produced divided by the amount of fossil energy consumed, is projected to be 3.11 to 12.32 for the indirect route depending upon the details of implementation. Conventional technology has an energy ratio of 1.34, thus the indirect route will have a significant environmental advantage over today's technology. Energy savings of 7.48 trillion Btu/yr will result when 100 MMgal/yr (neat) of ethanol capacity via the indirect route is placed on-line by the year 2010.

  7. The cost-effectiveness of rotavirus vaccination in Armenia.

    Science.gov (United States)

    Jit, Mark; Yuzbashyan, Ruzanna; Sahakyan, Gayane; Avagyan, Tigran; Mosina, Liudmila

    2011-11-08

    The cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to $830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by $34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about $650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI, $820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was $3800, rotavirus vaccination is likely to be regarded as "very cost-effective" from a WHO standpoint. Vaccination may still be "very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Wealth and health behavior: Testing the concept of a health cost

    NARCIS (Netherlands)

    J.L.W. van Kippersluis (Hans); T.J. Galama (Titus)

    2014-01-01

    textabstractWealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of

  9. Practitioners' Experiences Creating and Implementing an Emotional Recovery and Physical Activity Program Following a Natural Disaster

    Science.gov (United States)

    Wahl-Alexander, Zachary

    2015-01-01

    On April 27, 2011 a series of tornadoes tore through the southeast United States. Sixty-four percent of the counties in the state of Alabama were directly affected by these storms. After a natural disaster, children who are directly or indirectly affected show numerous intense emotional reactions. Recovery programs can be set up to enable them to…

  10. Bioelectrochemical Systems for Indirect Biohydrogen Production

    KAUST Repository

    Regan, John M.

    2014-01-01

    Bioelectrochemical systems involve the use of exoelectrogenic (i.e., anode-reducing) microbes to produce current in conjunction with the oxidation of reduced compounds. This current can be used directly for power in a microbial fuel cell, but there are alternate uses of this current. One such alternative is the production of hydrogen in a microbial electrolysis cell (MEC), which accomplishes cathodic proton reduction with a slight applied potential by exploiting the low redox potential produced by exoelectrogens at the anode. As an indirect approach to biohydrogen production, these systems are not subject to the hydrogen yield constraints of fermentative processes and have been proven to work with virtually any biodegradable organic substrate. With continued advancements in reactor design to reduce the system internal resistance, increase the specific surface area for anode biofilm development, and decrease the material costs, MECs may emerge as a viable alternative technology for biohydrogen production. Moreover, these systems can also incorporate other value-added functionalities for applications in waste treatment, desalination, and bioremediation.

  11. Simulation of exhaust gas heat recovery from a spray dryer

    International Nuclear Information System (INIS)

    Golman, Boris; Julklang, Wittaya

    2014-01-01

    This study explored various alternatives in improving the energy utilization of spray drying process through the exhaust gas heat recovery. Extensible and user-friendly simulation code was written in Visual Basic for Applications within Microsoft Excel for this purpose. The effects of process parameters were analyzed on the energy efficiency and energy saving in the industrial-scale spray drying system with exhaust gas heat recovery in an air-to-air heat exchanger and in the system with partial recirculation of exhaust air. The spray dryer is equipped with an indirect heater for heating the drying air. The maximum gains of 16% in energy efficiency and 50% in energy saving were obtained for spray drying system equipped with heat exchanger for exhaust air heat recovery. In addition, 34% in energy efficiency and 61% in energy saving for system with recirculation of exhaust air in the present range of process parameters. The high energy efficiency was obtained during drying of large amount of dilute slurry. The energy saving was increased using the large amount of hot drying air. - Highlights: • We model industrial-scale spray drying process with the exhaust gas heat recovery. • We develop an Excel VBA computer program to simulate spray dryer with heat recovery. • We examine effects of process parameters on energy efficiency and energy saving. • High energy efficiency is obtained during drying of large amount of dilute slurry. • Energy saving is increased using the large amount of hot drying air

  12. Error Recovery in the Time-Triggered Paradigm with FTT-CAN.

    Science.gov (United States)

    Marques, Luis; Vasconcelos, Verónica; Pedreiras, Paulo; Almeida, Luís

    2018-01-11

    Data networks are naturally prone to interferences that can corrupt messages, leading to performance degradation or even to critical failure of the corresponding distributed system. To improve resilience of critical systems, time-triggered networks are frequently used, based on communication schedules defined at design-time. These networks offer prompt error detection, but slow error recovery that can only be compensated with bandwidth overprovisioning. On the contrary, the Flexible Time-Triggered (FTT) paradigm uses online traffic scheduling, which enables a compromise between error detection and recovery that can achieve timely recovery with a fraction of the needed bandwidth. This article presents a new method to recover transmission errors in a time-triggered Controller Area Network (CAN) network, based on the Flexible Time-Triggered paradigm, namely FTT-CAN. The method is based on using a server (traffic shaper) to regulate the retransmission of corrupted or omitted messages. We show how to design the server to simultaneously: (1) meet a predefined reliability goal, when considering worst case error recovery scenarios bounded probabilistically by a Poisson process that models the fault arrival rate; and, (2) limit the direct and indirect interference in the message set, preserving overall system schedulability. Extensive simulations with multiple scenarios, based on practical and randomly generated systems, show a reduction of two orders of magnitude in the average bandwidth taken by the proposed error recovery mechanism, when compared with traditional approaches available in the literature based on adding extra pre-defined transmission slots.

  13. Performance comparison of direct and indirect lighting systems

    International Nuclear Information System (INIS)

    Rubinstein, F.; Morse, O.; Clark, T.

    1993-01-01

    The performance of a retrofitted indirect lighting system was compared to the performance of a typical de-lamped direct lighting system in a partitioned office space. Power, illuminance and luminance measurements were made for the de-lamped direct lighting system and after installation of the indirect lighting system with various lamp and ballast combinations. Using the same lamps and ballasts, average workplace illuminance was slightly higher with indirect lighting than with direct lighting. With indirect lighting, workplace lumen efficacy was 4.5% lower due to the higher power draw of the lamps in the more open and cooler indirect fixtures. Indirect lighting with 36 watt T-8 lamps and electronic ballasts achieved an initial average workplace illuminance of 45 foot-candles in the partitioned office space at only 1.1 w/ft 2

  14. Cost-of-Illness Trends Associated with Thyroid Disease in Korea

    Directory of Open Access Journals (Sweden)

    Kyung-Rae Hyun

    2014-09-01

    Full Text Available BackgroundThe purpose of this study is to analyze the scale of and trends associated with the cost-of-illness of thyroid disease in Korea at 2-year intervals during the last 10 years for which data are available.MethodsCost-of-illness was estimated in terms of direct and indirect costs. Direct costs include direct medical costs due to hospitalization, outpatient and pharmacy sectors, transportation, and care-giver costs. Indirect costs include future income loss due to premature death and loss of productivity as a result of absence from work.ResultsThe cost-of-illness of thyroid disease in Korea was estimated at 224.2 billion won in 2002, 303.4 billion won in 2004, 400.3 billion won in 2006, 570.4 billion won in 2008, and 762.2 billion won in 2010. For example, the cost-of-illness of thyroid disease in 2010 was 3.4 times greater compared to 2002. The direct cost of the total cost-of-illness was 69.7%, which accounted for the highest proportion of costs. Cost-of-illness for individuals between the ages of 30 and 50 accounted for the greatest share of costs.ConclusionThe cost-of-illness of thyroid disease was relatively large in economically active age groups, and demonstrated a very rapid growth rate compared to other major diseases in Korea. Therefore, we suggest nationwide recognition of the importance of prevention and management of thyroid disease and prioritization of the management of thyroid disease among current and future health promotion policies in Korea.

  15. Integrating Efficiency of Industry Processes and Practices Alongside Technology Effectiveness in Space Transportation Cost Modeling and Analysis

    Science.gov (United States)

    Zapata, Edgar

    2012-01-01

    This paper presents past and current work in dealing with indirect industry and NASA costs when providing cost estimation or analysis for NASA projects and programs. Indirect costs, when defined as those costs in a project removed from the actual hardware or software hands-on labor; makes up most of the costs of today's complex large scale NASA space/industry projects. This appears to be the case across phases from research into development into production and into the operation of the system. Space transportation is the case of interest here. Modeling and cost estimation as a process rather than a product will be emphasized. Analysis as a series of belief systems in play among decision makers and decision factors will also be emphasized to provide context.

  16. Advantage of fast reacting adsorbents like humic acids for the recovery of uranium from seawater

    International Nuclear Information System (INIS)

    Denzinger, H.; Schnell, C.; Heitkamp, D.; Wagener, K.

    1980-01-01

    This report is divided into two sections. The first part comprises experimental data of humic acid adsorbers; whereas, the second concerns design parameter and costs of a recovery plant using fast reacting adsorbents. Summarizing the experimental results, hydrogen-loaded humic acids on carriers show an exceptionally fast kinetics of uranium fixation in seawater which is practically temperature independent. This fast adsorption performance may be maintained in a technical recovery process if care is taken to minimize slow diffraction controlled steps preceding the uranium fixation reaction. When humic acid was used instead of titanium hydroxide in the recovery plant, there was a decrease of investment and production costs of about 50%. However, there was a higher percentage of energy costs, i.e., electric power consumption and investments for pumps

  17. Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya.

    Directory of Open Access Journals (Sweden)

    Ellen R Rafferty

    Full Text Available Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01, followed by Peru ($23.32, and Bangladesh ($7.62. The total annual economic impacts for the 0-11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M, followed by Kenya ($37.4M; range $1.6-$804.5M and Bangladesh ($9.6M, range $0.28-$91.5M. For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production.

  18. Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya.

    Science.gov (United States)

    Rafferty, Ellen R; Schurer, Janna M; Arndt, Michael B; Choy, Robert K M; de Hostos, Eugenio L; Shoultz, David; Farag, Marwa

    2017-01-01

    Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0-11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production.

  19. Preliminary fee methodology for recovering GTCC-LLW management costs

    International Nuclear Information System (INIS)

    Clark, L.L.

    1990-06-01

    The US Department of Energy (DOE) is currently planning a fee to recover costs of managing Greater-Than-Class-C Low-Level Waste (GTCC-LLW). A cash flow basis will be used for fee calculations to ensure recovery of all applicable program costs. Positive cash flows are revenues received from waste generators. Negative cash flows are program expenses for storage, transportation, treatment, and disposal of the wastes and for program development, evaluation, and administration. Program balances are the net result of positive and negative cash flows each year. The methodology calculates fees that will recovery all program expenses taking into account cost inflation. 3 refs., 1 tab

  20. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

    Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

    2011-11-01

    Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

  1. Indirect effects in dual radiation action

    International Nuclear Information System (INIS)

    Zaider, M.; Rossi, H.H.

    1988-01-01

    The basic aim in this paper is to establish the link between indirect effects of radiation action and the spatial distribution of radicals at the time of energy deposition as well as throughout subsequent diffusion and interaction. The fact that radicals diffuse for a finite distance before damaging a biomolecule has dramatic effects on their subsequent probability to result in lesions. Thus at very low DMSO concentrations, where p = 0.5, one expects - all other things being equal - some 75% of the lesions to result from indirect or semidirect lesions. The number calculated here is lower (15%), a direct result of the fact that such lesions involve proximity functions modulated by diffusion. At higher DMSO concentrations this percentage becomes progressively smaller, as expected. It appears thus that for low-LET radiation, the relative amount of indirect damage in single tracks (also termed intratrack or single events) action is very small. By contrast, intertrack (or two-event) contributions will have the ratio between direct and (indirect + semidirect) contributions given by p 2 /(1-p 2 ). The reason for this is that sublesions from different tracks are uniformly distributed throughout the cell nucleus; their probability of interaction should not depend on any previous diffusional processes. For the example given above (p = 0.5) they do expect 65% of intertrack (two-hit) lesions to have resulted from indirect or semidirect mechanisms. This contrast between the almost exclusively direct character of intratrack lesions and the dominant role of indirect action in intertrack lesions produced by low-LET radiation is an important conclusion of this study

  2. Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services.

    Science.gov (United States)

    Rajabi, A; Dabiri, A

    2012-01-01

    Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.

  3. Economic Costs Attributable to Smoking in China: Update and an 8-year Comparison, 2000–2008

    Science.gov (United States)

    Yang, Lian; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Rao, Keqin

    2013-01-01

    Objective To estimate the health-related economic costs attributable to smoking in China for persons aged 35 and older in 2003 and in 2008 and to compare these costs with the respective results from 2000. Methods A prevalence-based, disease-specific approach was used to estimate smoking-attributable direct and indirect economic costs. The primary data source was the 2003 and 2008 China National Health Services Survey, which contains individual participant’s smoking status, healthcare utilization, and expenditures. Results The total economic cost of smoking in China amounted to $17.1 billion in 2003 and $28.9 billion in 2008 (both measured in 2008 constant US dollars). Direct smoking-attributable healthcare costs in 2003 and 2008 were $4.2 billion and $6.2 billion, respectively. Indirect economic costs in 2003 and 2008 were $12.9 billion and $22.7 billion, respectively. Compared to 2000, the direct costs of smoking rose by 72% in 2003 and 154% in 2008, while the indirect costs of smoking rose by 170% in 2003 and 376% in 2008. Conclusion The economic burden of cigarette smoking has increased substantially in China during the past decade and is expected to continue to increase as the national economy and the price of healthcare services grow. Stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking. PMID:21339491

  4. Expression of future prospective in indirect speech

    Directory of Open Access Journals (Sweden)

    Bodnaruk Elena Vladimirovna

    2015-03-01

    Full Text Available The article analyzes the characteristics and use of grammatical semantics and lexical and grammatical means used to create future prospects in double indirect discourse. The material for the study were epic works by contemporary German writers. In the analysis of the empirical material it has been pointed out that indirect discourse has preterial basis and is the kind of most frequent inner speech of characters. The most widely used form with future semantics in preterial indirect speech is conditional I, formally having a conjunctive basis, but is mostly used with the indicative semantics. Competitive to conditional I in indirect speech is preterial indicative. A characteristic feature of the indirect speech is the use of modal verbs, which, thanks to its semantics is usually referred as an action at a later term, creating the prospect of future statements. The most frequent were modal verbs wollen and sollen in the form of the preterite, more rare verbs were m ssen and k nnen. German indirect speech distinguishes the ability to use forms on the basis of conjunctive: preterite and plusquamperfect of conjunctive. Both forms express values similar to those of the indicative. However, conjunctive forms the basis of the data shown in a slightly more pronounced seme of uncertainty that accompanies future uses of these forms in indirect speech. In addition, plusquamperfect conjunctive differs from others by the presence of the seme of completeness.

  5. Synchronization of indirectly coupled Lorenz oscillators

    Indian Academy of Sciences (India)

    Synchronization of indirectly coupled Lorenz oscillators: An experimental study. Amit Sharma Manish Dev Shrimali. Synchronization, Coupled Systems and Networks Volume 77 Issue 5 November 2011 pp 881-889 ... The in-phase and anti-phase synchronization of indirectly coupled chaotic oscillators reported in Phys. Rev ...

  6. Indirect estimators in US federal programs

    CERN Document Server

    1996-01-01

    In 1991, a subcommittee of the Federal Committee on Statistical Methodology met to document the use of indirect estimators - that is, estimators which use data drawn from a domain or time different from the domain or time for which an estimate is required. This volume comprises the eight reports which describe the use of indirect estimators and they are based on case studies from a variety of federal programs. As a result, many researchers will find this book provides a valuable survey of how indirect estimators are used in practice and which addresses some of the pitfalls of these methods.

  7. Recovery opportunities, work-home conflict, and emotional exhaustion among hematologists and oncologists in private practice.

    Science.gov (United States)

    Nitzsche, Anika; Neumann, Melanie; Groß, Sophie E; Ansmann, Lena; Pfaff, Holger; Baumann, Walter; Wirtz, Markus; Schmitz, Stephan; Ernstmann, Nicole

    2017-04-01

    Hematologists and oncologists in private practice play a central role in the care provided for cancer patients. The present study analyzes stress and relaxation aspects in the work of hematologists and oncologists in private practice in Germany in relation to emotional exhaustion, as a core dimension of burnout syndrome. The study focuses on the opportunities for internal recovery using breaks and time out during the working day, the frequency of working on weekends and on vacation, and the physician's work-home and home-work conflict. Postulated associations between the constructs were analyzed using a structural equation model. If work leads to conflicts in private life (work-home conflict), it is associated with greater emotional exhaustion. Working frequently at the weekend is associated with greater work-home conflict and indirectly with greater emotional exhaustion. By contrast, the availability of opportunities to relax and recover during the working day is associated with less work-home conflict and indirectly with less emotional exhaustion. These results underline the importance of internal recovery opportunities during the working day and a successful interplay between working and private life for the health of outpatient hematologists and oncologists.

  8. [Calculation of workers' health care costs].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2006-01-01

    In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reductio