The relative effectiveness of managed care penetration and the healthcare safety net in reducing avoidable hospitalizations.

Science.gov (United States)

Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia

2011-01-01

Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.

Organic fertilizer application increases the soil respiration and net ecosystem carbon dioxide absorption of paddy fields under water-saving irrigation.

Science.gov (United States)

Yang, Shihong; Xiao, Ya Nan; Xu, Junzeng

2018-04-01

Quantifying carbon sequestration in paddy soil is necessary to understand the effect of agricultural practices on carbon cycles. The objective of this study was to assess the effect of organic fertilizer addition (MF) on the soil respiration and net ecosystem carbon dioxide (CO 2 ) absorption of paddy fields under water-saving irrigation (CI) in the Taihu Lake Region of China during the 2014 and 2015 rice-growing seasons. Compared with the traditional fertilizer and water management (FC), the joint regulation of CI and MF (CM) significantly increased the rice yields and irrigation water use efficiencies of paddy fields by 4.02~5.08 and 83.54~109.97% (p < 0.05). The effects of organic fertilizer addition on soil respiration and net ecosystem CO 2 absorption rates showed inter-annual differences. CM paddy fields showed a higher soil respiration and net CO 2 absorption rates during some periods of the rice growth stage in the first year and during most periods of the rice growth stage in the second year. These fields also had significantly higher total CO 2 emission through soil respiration (total R soil ) and total net CO 2 absorption compared with FC paddy fields (p < 0.05). The total R soil and net ecosystem CO 2 absorption of CM paddy fields were 67.39~91.55 and 129.41~113.75 mol m -2 , which were 27.66~135.52 and 12.96~31.66% higher than those of FC paddy fields. The interaction between water and fertilizer management had significant effects on total net ecosystem CO 2 absorption. The frequent alternate wet-dry cycles of CI paddy fields increased the soil respiration and reduced the net CO 2 absorption. Organic fertilizer promoted the soil respiration of paddy soil but also increased its net CO 2 absorption and organic carbon content. Therefore, the joint regulation of water-saving irrigation and organic fertilizer is an effective measure for maintaining yield, increasing irrigation water use efficiency, mitigating CO 2 emission, and promoting paddy

Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals

OpenAIRE

Danae Manika; Diana Gregory-Smith; Victoria K. Wells; Lee Comerford; Lucy Aldrich-Smith

2017-01-01

Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS) hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset con...

Customer-economics of residential photovoltaic systems (Part 1): The impact of high renewable energy penetrations on electricity bill savings with net metering

International Nuclear Information System (INIS)

Darghouth, Naïm R.; Barbose, Galen; Wiser, Ryan H.

2014-01-01

Residential photovoltaic (PV) systems in the US are often compensated at the customer's underlying retail electricity rate through net metering. Given the uncertainty in future retail rates and the inherent links between rates and the customer–economics of behind-the-meter PV, there is growing interest in understanding how potential changes in rates may impact the value of bill savings from PV. In this article, we first use a production cost and capacity expansion model to project California hourly wholesale electricity market prices under two potential electricity market scenarios, including a reference and a 33% renewables scenario. Second, based on the wholesale electricity market prices generated by the model, we develop retail rates (i.e., flat, time-of-use, and real-time pricing) for each future scenario based on standard retail rate design principles. Finally, based on these retail rates, the bill savings from PV is estimated for 226 California residential customers under two types of net metering, for each scenario. We find that high renewable penetrations can drive substantial changes in residential retail rates and that these changes, together with variations in retail rate structures and PV compensation mechanisms, interact to place substantial uncertainty on the future value of bill savings from residential PV. - Highlights: • We investigate the impact of high renewables on customer economics of solar. • We model three types of residential retail electricity rates. • Based on the rates, we calculate the bill savings from photovoltaic (PV) generation. • High renewables penetration can lead to lower bill savings with time-varying rates. • There is substantial uncertainty in the future bill savings from residential PV

Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals\\ud

OpenAIRE

Manika, D.; Gregory-Smith, D.; Wells, V.K.; Comerford, L.; Aldrich-Smith, L.

2017-01-01

Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS) hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset con...

Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

Science.gov (United States)

Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P. F.; Carlberg, Jared G.; Jones, Peter J. H.

2015-01-01

Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. Methods: A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million–$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Conclusion: Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers’ general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada. PMID

ICU early physical rehabilitation programs: financial modeling of cost savings.

Science.gov (United States)

Lord, Robert K; Mayhew, Christopher R; Korupolu, Radha; Mantheiy, Earl C; Friedman, Michael A; Palmer, Jeffrey B; Needham, Dale M

2013-03-01

To evaluate the potential annual net cost savings of implementing an ICU early rehabilitation program. Using data from existing publications and actual experience with an early rehabilitation program in the Johns Hopkins Hospital Medical ICU, we developed a model of net financial savings/costs and presented results for ICUs with 200, 600, 900, and 2,000 annual admissions, accounting for both conservative- and best-case scenarios. Our example scenario provided a projected financial analysis of the Johns Hopkins Medical ICU early rehabilitation program, with 900 admissions per year, using actual reductions in length of stay achieved by this program. U.S.-based adult ICUs. Financial modeling of the introduction of an ICU early rehabilitation program. Net cost savings generated in our example scenario, with 900 annual admissions and actual length of stay reductions of 22% and 19% for the ICU and floor, respectively, were $817,836. Sensitivity analyses, which used conservative- and best-case scenarios for length of stay reductions and varied the per-day ICU and floor costs, across ICUs with 200-2,000 annual admissions, yielded financial projections ranging from -$87,611 (net cost) to $3,763,149 (net savings). Of the 24 scenarios included in these sensitivity analyses, 20 (83%) demonstrated net savings, with a relatively small net cost occurring in the remaining four scenarios, mostly when simultaneously combining the most conservative assumptions. A financial model, based on actual experience and published data, projects that investment in an ICU early rehabilitation program can generate net financial savings for U.S. hospitals. Even under the most conservative assumptions, the projected net cost of implementing such a program is modest relative to the substantial improvements in patient outcomes demonstrated by ICU early rehabilitation programs.

Net savings

International Nuclear Information System (INIS)

Roche, P.

2001-01-01

The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study was

Net savings

Energy Technology Data Exchange (ETDEWEB)

Roche, P.

2001-02-01

The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study

10 CFR 436.21 - Savings-to-investment ratio.

Science.gov (United States)

2010-01-01

... is the ratio of the present value savings to the present value costs of an energy or water conservation measure. The numerator of the ratio is the present value of net savings in energy or water and non... conservation measure. The denominator of the ratio is the present value of the net increase in investment and...

Construction of monophase nets

International Nuclear Information System (INIS)

Suarez A, Jose Antonio

1996-01-01

The paper refers to the use of monophase loads in commercial residential urbanizations and in small industries, for this reason it is considered unnecessary the construction of three-phase nets. The author makes a historical recount of these nets in Bogota, his capacities, uses and energy savings

Net one, net two: the primary care network income statement.

Science.gov (United States)

Halley, M D; Little, A W

1999-10-01

Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.

Analysis of genuine saving and potential green net national income. Portugal, 1990-2005

International Nuclear Information System (INIS)

Mota, Rui Pedro; Domingos, Tiago; Martins, Victor

2010-01-01

The context of this paper is the measurement of welfare and weak sustainability (defined as non-declining utility) in dynamic economies, i.e., comprehensive or green accounting. We estimate green net national income (GNNI) and genuine saving (GS) for Portugal, for the years 1990 to 2005, accounting for the disamenity of air pollution emissions, the depreciation of commercial forests and the value of time, discussing the implications of the assumptions underlying the inclusion of these terms in the green accounting model. The influence of short-run cycles is analyzed by estimating GNNI excluding business cycles. Our results suggest that business cycles affect the sustainability message of GNNI. We find that potential GNNI is growing and GS is positive in the analyzed period, thereby not indicating a weak sustainability problem in Portugal, although both depict a trend towards unsustainability. Excluding technological progress there is a contradiction in the sustainability message of GNNI and GS. (author)

Analysis of genuine saving and potential green net national income. Portugal, 1990-2005

Energy Technology Data Exchange (ETDEWEB)

Mota, Rui Pedro; Domingos, Tiago [Environment and Energy Section, DEM, Instituto Superior Tecnico (Portugal); Martins, Victor [Department of Economics, Instituto Superior de Economia e Gestao (Portugal)

2010-08-15

The context of this paper is the measurement of welfare and weak sustainability (defined as non-declining utility) in dynamic economies, i.e., comprehensive or green accounting. We estimate green net national income (GNNI) and genuine saving (GS) for Portugal, for the years 1990 to 2005, accounting for the disamenity of air pollution emissions, the depreciation of commercial forests and the value of time, discussing the implications of the assumptions underlying the inclusion of these terms in the green accounting model. The influence of short-run cycles is analyzed by estimating GNNI excluding business cycles. Our results suggest that business cycles affect the sustainability message of GNNI. We find that potential GNNI is growing and GS is positive in the analyzed period, thereby not indicating a weak sustainability problem in Portugal, although both depict a trend towards unsustainability. Excluding technological progress there is a contradiction in the sustainability message of GNNI and GS. (author)

Energy Consumption and Saving Analysis for Laser Engineered Net Shaping of Metal Powders

Directory of Open Access Journals (Sweden)

Zhichao Liu

2016-09-01

Full Text Available With the increasing awareness of environmental protection and sustainable manufacturing, the environmental impact of laser additive manufacturing (LAM technology has been attracting more and more attention. Aiming to quantitatively analyze the energy consumption and extract possible ways to save energy during the LAM process, this investigation studies the effects of input variables including laser power, scanning speed, and powder feed rate on the overall energy consumption during the laser deposition processes. Considering microhardness as a standard quality, the energy consumption of unit deposition volume (ECUDV, in J/mm3 is proposed as a measure for the average applied energy of the fabricated metal part. The potential energy-saving benefits of the ultrasonic vibration–assisted laser engineering net shaping (LENS process are also examined in this paper. The experimental results suggest that the theoretical and actual values of the energy consumption present different trends along with the same input variables. It is possible to reduce the energy consumption and, at the same time, maintain a good part quality and the optimal combination of the parameters referring to Inconel 718 as a material is laser power of 300 W, scanning speed of 8.47 mm/s and powder feed rate of 4 rpm. When the geometry shaping and microhardness are selected as evaluating criterions, American Iron and Steel Institute (AISI 4140 powder will cause the largest energy consumption per unit volume. The ultrasonic vibration–assisted LENS process cannot only improve the clad quality, but can also decrease the energy consumption to a considerable extent.

Energy-saving behavior and marginal abatement cost for household CO2 emissions

International Nuclear Information System (INIS)

Hamamoto, Mitsutsugu

2013-01-01

This paper attempts to measure consumers' perceived net benefits (or net costs) of energy-saving measures in using energy-consuming durable goods. Using the estimated net costs and the volume of CO 2 reduced by the measures, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. An analysis using the curve suggests that in order to provide households with an incentive to take actions that can lead to CO 2 emission reductions in using energy-consuming durables, a high level of carbon price is needed. In addition, a regression analysis reveals that the net benefits of the measures are larger for households that put a higher priority on energy saving, for those living in detached houses, for those with a smaller number of persons living together, and for those with less income. The result of the analysis using the MAC curve may suggest that promoting energy-saving behavior will require not only a policy to provide economic incentives but also interventions to influence psychological factors of household behavior. - Highlights: • Consumers' perceived net costs of energy-saving measures in using energy-consuming durables are measured. • Using the estimated net costs, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. • A high carbon price is needed in order to provide households with an incentive to take actions for energy-savings. • Households' attributes affecting their energy-saving behavior are revealed by a regression analysis

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

Age differences in IDA savings outcomes: findings from the American Dream Demonstration.

Science.gov (United States)

Putnam, Michelle; Sherraden, Michael; Zhang, Lin; Morrow-Howell, Nancy

2008-01-01

This study aims to develop a greater understanding of age differences in savings outcomes within Individual Development Accounts (IDAs). Participant data from the American Dream Demonstration (ADD) are examined for age differences in accumulated net deposits, average monthly net deposits, and deposit frequency. ADDprogram data are examined for savings match rates, monthly savings targets, direct deposit, and hours of financial education offered. Results indicate that, on average, older IDA participants have better savings outcomes than younger participants. Findings from this study suggest that impoverished middleaged and older adults can save if provided an opportunity and incentives. However, success will depend on the characteristics of the programs.

Medical savings accounts make waves.

Science.gov (United States)

Gardner, J

1995-02-27

MSAs: the theory. Medical savings account legislation would allow consumers to set aside pre-tax dollars to pay for day-to-day healthcare costs. The accounts are to be backed up by a catastropic policy with a deductible roughly equal to the maximum amount allowed in the MSA. The aim is to reduce healthcare cost inflation by making consumers more aware of the costs of healthcare than they are under comprehensive policies and enabling them to shop for the lowest-cost, highest-quality care.

Developing and measuring healthcare capacity and quality in Burundi: LifeNet International’s horizontal conversion franchise model

Directory of Open Access Journals (Sweden)

Michael F Brooks

2016-01-01

Full Text Available In a departure from traditional “vertical” healthcare interventions in low-resource settings that work to combat a single specific health issue, LifeNet International (LN uses a horizontal conversion franchise to develop and measure healthcare capacity and quality in primarily faith-based health centers in East Africa. Through a comprehensive franchise package of Medical Training, Management Training, Pharmaceutical Supply, and Growth Financing, LN is able to leverage existing resources and respond to a greater number of the obstacles preventing facilities from providing quality care. Through its Quality Score Card, LN measures improvements in quality of care within its network. This tool has measured consistent and significant improvements in quality of care following LN partnership. Together, these services improve quality of care at East African primary care facilities in ways that issue-specific, “vertical” interventions cannot.

'Nurture the sprouting bud; do not uproot it'. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda.

Science.gov (United States)

Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N

2017-08-01

Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members' access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members' views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like 'a sprouting bud that needs to be nurtured rather than uprooted', as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

Science.gov (United States)

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. 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/

The rise of corporate savings

OpenAIRE

Roc Armenter

2012-01-01

Over the past few decades, several developed economies have experienced large changes in how much households and firms save. In fact, a sharp increase in firms’ savings behavior has changed the net position of the (nonfinancial) corporate sector vis-à-vis the rest of the economy. ; Why have firms in the business of producing goods or services become lenders? This is quite at odds with traditional models of corporate finance, which suggest that firms issue debt and equity to fund their operati...

Can lean save lives?

Science.gov (United States)

Fillingham, David

2007-01-01

The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. This paper is a viewpoint. One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

Healthcare information technology infrastructures in Turkey.

Science.gov (United States)

Dogac, A; Yuksel, M; Ertürkmen, G L; Kabak, Y; Namli, T; Yıldız, M H; Ay, Y; Ceyhan, B; Hülür, U; Oztürk, H; Atbakan, E

2014-05-22

The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for "Health-Net"), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients' Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. With the introduction of the "Health Transformation Program" in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality.

Faith community nursing: real care, real cost savings.

Science.gov (United States)

Yeaworth, Rosalee C; Sailors, Ronnette

2014-01-01

At a time when healthcare costs are increasing more than other aspects of the economy, churches are stepping up to help fill needs through congregational health ministries. Faith Community Nursing (FCN) is a rapidly growing health service in the churches of many denominations. This article documents healthcare services and financial savings provided by FCNs and health ministries, showing the critical role faith community nursing can play in containing healthcare costs.

Saving lives: A meta-analysis of team training in healthcare.

Science.gov (United States)

Hughes, Ashley M; Gregory, Megan E; Joseph, Dana L; Sonesh, Shirley C; Marlow, Shannon L; Lacerenza, Christina N; Benishek, Lauren E; King, Heidi B; Salas, Eduardo

2016-09-01

As the nature of work becomes more complex, teams have become necessary to ensure effective functioning within organizations. The healthcare industry is no exception. As such, the prevalence of training interventions designed to optimize teamwork in this industry has increased substantially over the last 10 years (Weaver, Dy, & Rosen, 2014). Using Kirkpatrick's (1956, 1996) training evaluation framework, we conducted a meta-analytic examination of healthcare team training to quantify its effectiveness and understand the conditions under which it is most successful. Results demonstrate that healthcare team training improves each of Kirkpatrick's criteria (reactions, learning, transfer, results; d = .37 to .89). Second, findings indicate that healthcare team training is largely robust to trainee composition, training strategy, and characteristics of the work environment, with the only exception being the reduced effectiveness of team training programs that involve feedback. As a tertiary goal, we proposed and found empirical support for a sequential model of healthcare team training where team training affects results via learning, which leads to transfer, which increases results. We find support for this sequential model in the healthcare industry (i.e., the current meta-analysis) and in training across all industries (i.e., using meta-analytic estimates from Arthur, Bennett, Edens, & Bell, 2003), suggesting the sequential benefits of training are not unique to medical teams. Ultimately, this meta-analysis supports the expanded use of team training and points toward recommendations for optimizing its effectiveness within healthcare settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fibre in Canada

Directory of Open Access Journals (Sweden)

Mohammad eAbdullah

2015-08-01

Full Text Available Background: Consumption of fibre-rich diets is associated with favourable impacts on type 2 diabetes (T2D and cardiovascular disease (CVD, two of the most costly ailments worldwide, however the economic value of altered fibre intakes remains poorly understood. Methods: A cost-of-illness analysis was conducted to identify the percentage of adults expected to consume fibre-rich diets in Canada, estimate fibre intakes in relation to T2D and CVD reductions, and assess the potential annual savings in healthcare costs with reductions in rates of these two epidemics. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8-$1,295.7 million in CVD costs were calculated under a scenario where cereal fibre was used to increase current intakes of dietary fibre to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fibre consumption resulted in annual CAD$2.6-$51.1 and $4.6-$92.1 million savings for T2D and CVD, respectively. Conclusions: Strategies to increase consumers’ knowledge of the recommended dietary fibre intakes, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of costs associated with T2D and CVD in Canada.

Calculating the return on investment of mobile healthcare.

Science.gov (United States)

Oriol, Nancy E; Cote, Paul J; Vavasis, Anthony P; Bennet, Jennifer; Delorenzo, Darien; Blanc, Philip; Kohane, Isaac

2009-06-02

Mobile health clinics provide an alternative portal into the healthcare system for the medically disenfranchised, that is, people who are underinsured, uninsured or who are otherwise outside of mainstream healthcare due to issues of trust, language, immigration status or simply location. Mobile health clinics as providers of last resort are an essential component of the healthcare safety net providing prevention, screening, and appropriate triage into mainstream services. Despite the face value of providing services to underserved populations, a focused analysis of the relative value of the mobile health clinic model has not been elucidated. The question that the return on investment algorithm has been designed to answer is: can the value of the services provided by mobile health programs be quantified in terms of quality adjusted life years saved and estimated emergency department expenditures avoided? Using a sample mobile health clinic and published research that quantifies health outcomes, we developed and tested an algorithm to calculate the return on investment of a typical broad-service mobile health clinic: the relative value of mobile health clinic services = annual projected emergency department costs avoided + value of potential life years saved from the services provided. Return on investment ratio = the relative value of the mobile health clinic services/annual cost to run the mobile health clinic. Based on service data provided by The Family Van for 2008 we calculated the annual cost savings from preventing emergency room visits, $3,125,668 plus the relative value of providing 7 of the top 25 priority prevention services during the same period, US$17,780,000 for a total annual value of $20,339,968. Given that the annual cost to run the program was $567,700, the calculated return on investment of The Family Van was 36:1. By using published data that quantify the value of prevention practices and the value of preventing unnecessary use of emergency

Risk transfer via energy-savings insurance

International Nuclear Information System (INIS)

Mills, Evan

2003-01-01

Among the key barriers to investment in energy efficiency are uncertainties about attaining projected energy savings and potential disputes over stipulated savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building diagnostics and commissioning), financial methods are less developed in the energy management arena than in other segments of the economy. Energy-savings insurance (ESI) - formal insurance of predicted energy savings - transfers and spreads both types of risk over a larger pool of energy efficiency projects and reduces barriers to market entry of smaller energy service firms who lack sufficiently strong balance sheets to self-insure the savings. ESI encourages those implementing energy-saving projects to go beyond standard measures and thereby achieve more significant levels of energy savings. Insurance providers are proponents of improved savings measurement and verification techniques, as well as maintenance, thereby contributing to national energy-saving objectives. If properly applied, ESI can potentially reduce the net cost of energy-saving projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Governmental agencies have been pioneers in the use of ESI and could continue to play a role

Water-saving ground cover rice production system reduces net greenhouse gas fluxes in an annual rice-based cropping system

Science.gov (United States)

Yao, Z.; Du, Y.; Tao, Y.; Zheng, X.; Liu, C.; Lin, S.; Butterbach-Bahl, K.

2014-11-01

To safeguard food security and preserve precious water resources, the technology of water-saving ground cover rice production system (GCRPS) is being increasingly adopted for rice cultivation. However, changes in soil water status and temperature under GCRPS may affect soil biogeochemical processes that control the biosphere-atmosphere exchanges of methane (CH4), nitrous oxide (N2O) and carbon dioxide (CO2). The overall goal of this study is to better understand how net ecosystem greenhouse gas exchanges (NEGE) and grain yields are affected by GCRPS in an annual rice-based cropping system. Our evaluation was based on measurements of the CH4 and N2O fluxes and soil heterotrophic respiration (CO2 emissions) over a complete year, and the estimated soil carbon sequestration intensity for six different fertilizer treatments for conventional paddy and GCRPS. The fertilizer treatments included urea application and no N fertilization for both conventional paddy (CUN and CNN) and GCRPS (GUN and GNN), and solely chicken manure (GCM) and combined urea and chicken manure applications (GUM) for GCRPS. Averaging across all the fertilizer treatments, GCRPS increased annual N2O emission and grain yield by 40 and 9%, respectively, and decreased annual CH4 emission by 69%, while GCRPS did not affect soil CO2 emissions relative to the conventional paddy. The annual direct emission factors of N2O were 4.01, 0.09 and 0.50% for GUN, GCM and GUM, respectively, and 1.52% for the conventional paddy (CUN). The annual soil carbon sequestration intensity under GCRPS was estimated to be an average of -1.33 Mg C ha-1 yr-1, which is approximately 44% higher than the conventional paddy. The annual NEGE were 10.80-11.02 Mg CO2-eq ha-1 yr-1 for the conventional paddy and 3.05-9.37 Mg CO2-eq ha-1 yr-1 for the GCRPS, suggesting the potential feasibility of GCRPS in reducing net greenhouse effects from rice cultivation. Using organic fertilizers for GCRPS considerably reduced annual emissions of CH4

Characteristics of Patient-Centered Medical Home Initiatives that Generated Savings for Medicare: a Qualitative Multi-Case Analysis.

Science.gov (United States)

Burton, Rachel A; Lallemand, Nicole M; Peters, Rebecca A; Zuckerman, Stephen

2018-02-05

Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not. States' MAPCP Demonstration initiatives were comprehensively profiled in case studies based on secondary document review, three rounds of annual interviews with state staff, payers, practices, and other stakeholders, and other data sources. Case study findings were summarized in a case-ordered predictor-outcome matrix, which identified the presence or absence of key demonstration design features and experiences and arrayed states based on the amount of net savings or losses they generated for Medicare. We then used this matrix to identify initiative features that were present in at least three of the four states that generated net savings and absent from at least three of the four states that did not generate savings. A majority of the states that generated net savings: required practices to be recognized PCMHs to enter the demonstration, did not allow late entrants into the demonstration, used a consistent demonstration payment model across participating payers, and offered practices opportunities to earn performance bonuses. Practices in states that generated net savings also tended to report receiving the demonstration payments and bonuses they expected to receive, without any issues. Designers of future PCMH initiatives may increase their likelihood of generating net savings by

Verification of Timed Healthcare Workflows Using Component Timed-Arc Petri Nets

DEFF Research Database (Denmark)

Bertolini, Cristiano; Liu, Zhiming; Srba, Jiri

2013-01-01

Workflows in modern healthcare systems are becoming increasingly complex and their execution involves concurrency and sharing of resources. The definition, analysis and management of collaborative healthcare workflows requires abstract model notations with a precisely defined semantics and a supp......Workflows in modern healthcare systems are becoming increasingly complex and their execution involves concurrency and sharing of resources. The definition, analysis and management of collaborative healthcare workflows requires abstract model notations with a precisely defined semantics...

A little off the top. While overall healthcare hiring is up, some health systems are being forced to cut jobs, workers and find other savings.

Science.gov (United States)

Evans, Melanie

2008-06-02

Despite the oft-repeated theory that the healthcare industry is "recession-proof," some systems have found themselves resorting to layoffs and budget cuts during the current economic downturn. Lee Memorial Health System CFO John Wiest, left, said that the system is dealing with reduced operating income and net volume, and it has trimmed 415 jobs through attrition.

Six Sigma in healthcare delivery.

Science.gov (United States)

Liberatore, Matthew J

2013-01-01

The purpose of this paper is to conduct a comprehensive review and assessment of the extant Six Sigma healthcare literature, focusing on: application, process changes initiated and outcomes, including improvements in process metrics, cost and revenue. Data were obtained from an extensive literature search. Healthcare Six Sigma applications were categorized by functional area and department, key process metric, cost savings and revenue generation (if any) and other key implementation characteristics. Several inpatient care areas have seen most applications, including admission, discharge, medication administration, operating room (OR), cardiac and intensive care. About 42.1 percent of the applications have error rate as their driving metric, with the remainder focusing on process time (38 percent) and productivity (18.9 percent). While 67 percent had initial improvement in the key process metric, only 10 percent reported sustained improvement. Only 28 percent reported cost savings and 8 percent offered revenue enhancement. These results do not favorably assess Six Sigma's overall effectiveness and the value it offers healthcare. Results are based on reported applications. Future research can include directly surveying healthcare organizations to provide additional data for assessment. Future application should emphasize obtaining improvements that lead to significant and sustainable value. Healthcare staff can use the results to target promising areas. This article comprehensively assesses Six Sigma healthcare applications and impact.

Cost savings from a telemedicine model of care in northern Queensland, Australia.

Science.gov (United States)

Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

2013-09-16

To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

Savings in its sights for Somerset Trust.

Science.gov (United States)

Russell, Colin

2011-10-01

Colin Russell, healthcare specialist at Schneider Electric (pictured), explains how the company has recently worked with Taunton and Somerset NHS Foundation Trust to implement a major energy-saving project at the Trust's Musgrove Park Hospital in Taunton. He argues that, at a time when all areas of the service are being asked to reduce costs, such partnerships can potentially save the institution millions of pounds and significantly reduce carbon emissions, while "revitalising" parts of the NHS estate, and ensuring continuity of vital hospital services for facilities managers.

Evaluation of energy saving tasks performed by the energy transmission and distribution companies; Denmark; Evaluering af energiselskabernes energibespareaktiviteter

Energy Technology Data Exchange (ETDEWEB)

Togeby, M. (Ea Energianalyse A/S, Copenhagen (Denmark))

2012-05-15

The evaluation is described in the Agreement of 20 November 2009 between the Danish Climate and Energy Minister and the distribution companies for electricity, natural gas, district heating and oil about the companies' future energy conservation efforts. The evaluation was conducted to provide recommendations for adjusting the system. The results of the evaluation show that energy companies and utilities meet the overall savings obligation. In 2011, 2,098 GWh savings are recorded, which is more than the obligation. The evaluation shows that the net effect is about 760 GWh (36%). When looking at types of energy companies, then the oil companies' activities generally have a low net effect and additionally is assessed to be low in relation to the district heating companies' renovation of the district heating network. The greatest additionally exists among large savings in the industry. The means that energy companies use to achieve savings obligations are significantly different today than a few years ago. Today there are grants for more than 85% of registered savings. Before 2006 primarily information and advice was used. Thus an estimated 400 million DKK annually is used for grants. Socio-economics is positive for the part of the effort that is aimed at businesses. The socio-economic value of the savings is calculated to be twice as large as the total cost when you only look at the industry. The system can thus be readily seen as a useful instrument to promote energy conservation in industry. For households, it is estimated that the net effect is 20% of the reported savings, while for industry the net effect is estimated to be 45%. Also, for renovations of the heat distribution networks the net effect is estimated to be low. (LN)

29 CFR 1926.105 - Safety nets.

Science.gov (United States)

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false Safety nets. 1926.105 Section 1926.105 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Personal Protective and Life Saving Equipment § 1926.105...

Technical Support Document: Strategies for 50% Energy Savings in Large Office Buildings

Energy Technology Data Exchange (ETDEWEB)

Leach, M.; Lobato, C.; Hirsch, A.; Pless, S.; Torcellini, P.

2010-09-01

This Technical Support Document (TSD) documents technical analysis that informs design guidance for designing and constructing large office buildings that achieve 50% net site energy savings over baseline buildings defined by minimal compliance with respect to ANSI/ASHRAE/IESNA Standard 90.1-2004. This report also represents a step toward developing a methodology for using energy modeling in the design process to achieve aggressive energy savings targets. This report documents the modeling and analysis methods used to identify design recommendations for six climate zones that capture the range of U.S. climate variability; demonstrates how energy savings change between ASHRAE Standard 90.1-2007 and Standard 90.1-2004 to determine baseline energy use; uses a four-story 'low-rise' prototype to analyze the effect of building aspect ratio on energy use intensity; explores comparisons between baseline and low-energy building energy use for alternate energy metrics (net source energy, energy emissions, and energy cost); and examines the extent to which glass curtain construction limits achieve energy savings by using a 12-story 'high-rise' prototype.

Can home care services achieve cost savings in long-term care for older people?

Science.gov (United States)

Greene, V L; Ondrich, J; Laditka, S

1998-07-01

To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

Net fossil energy savings for alternative mixes in various electric supply systems

International Nuclear Information System (INIS)

Essam, P.; Stocks, K.J.

1978-11-01

The actual and projected electric power station building programs of several countries and regions have been examined to determine what effect the introduction of nuclear power has on fossil fuel usage by the electricity system. It was found that (1) nuclear power leads directly to savings in fossil fuel usage, a larger nuclear component leading to larger savings; (2) individual nuclear stations rapidly wipe out the energy 'debt' incurred during building; and (3) the relatively short periods of consolidation in the early stages of a nation's building program usually prevent the nuclear component from going into energy 'debt'. Assessments of the energy requirements to build and run various types of power station have been made from the available literature

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

Science.gov (United States)

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

2015-02-01

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

Methodology for National Water Savings Model and Spreadsheet Tool—Outdoor Water Use

Energy Technology Data Exchange (ETDEWEB)

Williams, Alison, A; Chen, Yuting; Dunham, Camilla; Fuchs, Heidi; Stratton, Hannah

2018-03-07

This report describes the method Lawrence Berkeley National Laboratory (LBNL) developed to estimate national impacts of the U.S. Environmental Protection Agency’s (EPA’s) WaterSense labeling program for weather-based irrigation controllers (WBIC). Estimated impacts include the national water savings attributable to the program and the net present value of the lifetime water savings for consumers of irrigation controllers.

CHP systems to save money and cut carbon.

Science.gov (United States)

Hopkins, Ian

2014-10-01

According to Ian Hopkins, a director of ENER-G Combined Power--which has delivered more than 50 CHP-led energy services contracts within the healthcare sector, having, for the past 30 years, designed and manufactured CHP systems at its global headquarters and R&D centre in Salford--'the energy cost and carbon-saving benefits of combined heat and power are difficult to match where there is a large heating/cooling demand over extended periods'. In this article, he explains how hospitals and other busy healthcare facilities thus 'make ideal bedfellows' for CHP, and outlines the key criteria and considerations, such as sizing, for healthcare engineers, when looking to specify such a system.

Overhauling America's healthcare machine: stop the bleeding and save trillions

National Research Council Canada - National Science Library

Perednia, Douglas A

2011-01-01

...: radical simplification. Now, the author a healthcare expert and entrepreneur reveals the system's shocking, unnecessary inefficiencies, and outlines a simple, logical, complete solution that offers greater security...

Economic Efficiency and Investment Implementation in Energy Saving Projects

Directory of Open Access Journals (Sweden)

Venelin Terziev

2017-09-01

Full Text Available Investment in building thermoinsulation is a subject to appraisal for efficiency from the position of discounted cash flows taken specifically by energy saving. The appraisal of investment as optimal is attended by achieving the shortest term for investment implementation, the lowest investment outlays, the maximum total net value of energy savings, the shortest investment payback period. The complex application of the dynamic methods for appraising economic efficiency of an investment – net present value, internal rate of return, profitability index and discounted payback period, involves drawing of particular values which comparison definitely will show if this kind of investment is practically “attractive”. However, the question for significance weight of each of these indicators above in decision making for implementation a particular real investment still remains unsolved. This requires working out a system of criteria, priorities that can determine which of the indicators for economic efficiency of specific investment project will have the highest significance.

Paternity leave in Sweden: costs, savings and health gains.

Science.gov (United States)

Månsdotter, Anna; Lindholm, Lars; Winkvist, Anna

2007-06-01

The initial objective is to examine the relationship between paternity leave in 1978-1979 and male mortality during 1981-2001, and the second objective is to calculate the cost-effectiveness of the 1974 parental insurance reform in Sweden. Based on a population of all Swedish couples who had their first child together in 1978 (45,801 males), the risk of death for men who took paternity leave, compared with men who did not, was estimated by odds ratios. The cost-effectiveness analysis considered costs for information, administration and production losses, minus savings due to decreased sickness leave and inpatient care, compared to health gains in life-years and quality-adjusted life-years (QALYs). It is demonstrated that fathers who took paternity leave have a statistically significant decreased death risk of 16%. Costs minus savings (discounted values) stretch from a net cost of EUR 19 million to a net saving of EUR 11 million, and the base case cost-effectiveness is EUR 8000 per QALY. The study indicates that that the right to paternity leave is a desirable reform based on commonly stated public health, economic, and feminist goals. The critical issue in future research should be to examine impact from health-related selection.

LTE UE Energy Saving by Applying Carrier Aggregation in a HetNet Scenario

DEFF Research Database (Denmark)

Lauridsen, Mads; Wang, Hua; Mogensen, Preben

2013-01-01

In this work it is examined if downlink Carrier Aggregation (CA) can be used to save UE energy. A dual-receiver LTE release 10 UE is compared with a single-receiver LTE release 8 UE. The models are based on scaling of an existing LTE release 8 UE power model. The energy consumption of the UEs...... is examined in a Heterogeneous Network scenario consisting of macro and small cells. The unexpected conclusion is that CA UEs can save energy, compared to LTE release 8 UEs, if they, depending on cell load, experience a throughput gain of 20%. However if the UE throughput is unaltered the energy consumption...

Near net shape of powder metallurgy rhenium parts

International Nuclear Information System (INIS)

Leonhardt, T.; Downs, J.

2001-01-01

In this paper, a description of the stages of processing necessary to produce a near-net shape (NNS) powder metallurgy (PM) rhenium component through the use of cold isostatic pressing (CIP) to form a complex shape will be explained. This method was primarily developed for the production of the 440 N and 490 N liquid apogee engine combustion chambers used in satellite positioning systems. The CIP to NNS process has been used in the manufacture and production of other rhenium aerospace components as well. Cold isostatic pressing (CIP) to a near net shape utilizing a one or two-part mandrel greatly reduces the quantity of rhenium required to produce the component, and also significantly reduces the number of secondary machining operations necessary to complete the manufacturing process. Further, the developments in near-net shape powder metallurgy rhenium manufacturing techniques have generated significant savings in the area of both time and budget. Overall, cost declined by as much as 35 % for the quantity of rhenium chambers, and manufacturing time was decreased by 30-40 %. The quantity of rhenium metal powder used to produce a rhenium chamber was reduced by approximately 70 %, with a subsequent reduction of nearly 50 % in secondary machining operation schedules. Thus, it is apparent that the overall savings provided by the production of near-net shape powder metallurgy rhenium components will be more than merely another aspect of any project involving high temperature applications, it will constitute significant benefit. (author)

Energy savings through self-backhauling for future heterogeneous networks

International Nuclear Information System (INIS)

Faruk, Nasir; Ruttik, Kalle; Mutafungwa, Edward; Jäntti, Riku

2016-01-01

Mobile operators face continuous challenge of enhancing network capacity and coverage so as to meet demand for ubiquitous high-speed mobile data connectivity. Unfortunately, these enhancements are typically accompanied by increased burden of network energy consumption. Heterogeneous network (HetNet) deployments of a large number of low power small base stations (SBS) to complement existing macro base stations is an approach that increases network capacity but potentially reduces overall network energy consumption. The SBS backhaul links in HetNets present a significant powering burden. In this paper, we show how self backhauling of SBS can reduce overall network power demand. A backhaul-energy consumption model is developed and used to investigate the energy efficiency of different backhauling options. We note that significant energy savings could be achieved through the use of self-backhauling when compared with the conventional microwave backhauling. The results presented would provide guidelines for energy- and cost-efficient backhaul implementation for future HetNets. - Highlights: • A backhaul-energy consumption model is developed. • Self backhauling of small base stations can reduce overall network power demand. • Energy saving strategy presented would relieved the burden on the power networks. • Results provide guidelines for energy and cost effective backhaul implementation.

Alberta Heritage Savings Trust Fund : 1998 annual report

International Nuclear Information System (INIS)

1999-01-01

A review of the Alberta Heritage Savings Trust Fund as it operated under the new investment framework established in 1997 was presented. The new statutory mission of the Fund is to provide stewardship of the savings from Alberta's non-renewable resources by providing the greatest financial returns on those savings for current and future generations of Albertans. In 1998, the Fund earned $947 million in income with nearly $25 million of income being retained to ensure that the value of the Fund grows to off-set the effects of inflation. Net assets of the Fund on March 31, 1998 was $ 12.3 billion. Operation of the Fund, the accounting method used, and details about the Transition Portfolio and the Endowment Portfolio are provided. An assessment of Alberta's economic climate accompanies the auditor's report and the detailed financial statements of the Fund. tabs

Heat Saving Strategies in Sustainable Smart Energy Systems

DEFF Research Database (Denmark)

Lund, Henrik; Thellufsen, Jakob Zinck; Aggerholm, Søren

2014-01-01

This paper investigates to which extent heat should be saved rather than produced and to which extent district heating infrastructures, rather than individual heating solutions, should be used in future sustainable smart energy systems. Based on a concrete proposal to implement the Danish...... governmental 2050 fossil-free vision, this paper identifies marginal heat production costs and compares these to marginal heat savings costs for two different levels of district heating. A suitable least-cost heating strategy seems to be to invest in an approximately 50% decrease in net heat demands in new...... buildings and buildings that are being renovated anyway, while the implementation of heat savings in buildings that are not being renovated hardly pays. Moreover, the analysis points in the direction that a least-cost strategy will be to provide approximately 2/3 of the heat demand from district heating...

Optimizing Energy Savings from Direct-DC in U.S. Residential Buildings

Energy Technology Data Exchange (ETDEWEB)

Garbesi, Karina; Vossos, Vagelis; Sanstad, Alan; Burch, Gabriel

2011-10-13

An increasing number of energy efficient appliances operate on direct current (DC) internally, offering the potential to use DC from renewable energy systems directly and avoiding the losses inherent in converting power to alternating current (AC) and back. This paper investigates that potential for net-metered residences with on-site photovoltaics (PV) by modeling the net power draw of the ‘direct-DC house’ with respect to today’s typical configuration, assuming identical DC-internal loads. Power draws were modeled for houses in 14 U.S. cities, using hourly, simulated PV-system output and residential loads. The latter were adjusted to reflect a 33% load reduction, representative of the most efficient DC-internal technology, based on an analysis of 32 electricity end-uses. The model tested the effect of climate, electric vehicle (EV) loads, electricity storage, and load shifting on electricity savings; a sensitivity analysis was conducted to determine how future changes in the efficiencies of power system components might affect savings potential. Based on this work, we estimate that net-metered PV residences could save 5% of their total electricity load for houses without storage and 14% for houses with storage. Based on residential PV penetration projections for year 2035 obtained from the National Energy Modeling System (2.7% for the reference case and 11.2% for the extended policy case), direct-DC could save the nation 10 trillion Btu (without storage) or 40 trillion Btu (with storage). Shifting the cooling load by two hours earlier in the day (pre-cooling) has negligible benefits for energy savings. Direct-DC provides no energy savings benefits for EV charging, to the extent that charging occurs at night. However, if charging occurred during the day, for example with employees charging while at work, the benefits would be large. Direct-DC energy savings are sensitive to power system and appliance conversion efficiencies but are not significantly

Risk transfer via energy savings insurance

Energy Technology Data Exchange (ETDEWEB)

Mills, Evan

2001-10-01

Among the key barriers to investment in energy efficiency improvements are uncertainties about attaining projected energy savings and apprehension about potential disputes over these savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building commissioning), financial risk transfer techniques are less developed in the energy management arena than in other more mature segments of the economy. Energy Savings Insurance (ESI) - formal insurance of predicted energy savings - is one method of transferring financial risks away from the facility owner or energy services contractor. ESI offers a number of significant advantages over other forms of financial risk transfer, e.g. savings guarantees or performance bonds. ESI providers manage risk via pre-construction design review as well as post-construction commissioning and measurement and verification of savings. We found that the two mos t common criticisms of ESI - excessive pricing and onerous exclusions - are not born out in practice. In fact, if properly applied, ESI can potentially reduce the net cost of energy savings projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Debt service can also be ensured by matching loan payments to projected energy savings while designing the insurance mechanism so that payments are made by the insurer in the event of a savings shortfall. We estimate the U.S. ESI market potential of $875 million/year in premium income. From an energy-policy perspective, ESI offers a number of potential benefits: ESI transfers performance risk from the balance sheet of the entity implementing the energy savings project, thereby freeing up capital otherwise needed to ''self-insure'' the savings. ESI reduces barriers to market entry of smaller energy services firms who do not have sufficiently strong balance

Effects of heat and electricity saving measures in district-heated multistory residential buildings

International Nuclear Information System (INIS)

Truong, Nguyen Le; Dodoo, Ambrose; Gustavsson, Leif

2014-01-01

Highlights: • We analyzed the potential for energy savings in district heated buildings. • Measures that reduce more peak load production give higher primary energy savings. • Efficient appliances increase heat demand but give net primary energy savings. • Efficient appliances give the largest net primary energy savings. - Abstract: The effects of heat and electricity saving measures in district-heated buildings can be complex because these depend not only on how energy is used on the demand side but also on how energy is provided from the supply side. In this study, we analyze the effects of heat and electricity saving measures in multistory concrete-framed and wood-framed versions of an existing district-heated building and examine the impacts of the reduced energy demand on different district heat (DH) production configurations. The energy saving measures considered are for domestic hot water reduction, building thermal envelope improvement, ventilation heat recovery (VHR), and household electricity savings. Our analysis is based on a measured heat load profile of an existing DH production system in Växjö, Sweden. Based on the measured heat load profile, we model three minimum-cost DH production system using plausible environmental and socio-political scenarios. Then, we investigate the primary energy implications of the energy saving measures applied to the two versions of the existing building, taking into account the changed DH demand, changed cogenerated electricity, and changed electricity use due to heat and electricity saving measures. Our results show that the difference between the final and primary energy savings of the concrete-framed and wood-framed versions of the case-study building is minor. The primary energy efficiency of the energy saving measures depends on the type of measure and on the composition of the DH production system. Of the various energy saving measures explored, electricity savings give the highest primary energy savings

Heat Saving Strategies in Sustainable Smart Energy Systems

Directory of Open Access Journals (Sweden)

Henrik Lund

2014-06-01

Full Text Available This paper investigates to which extent heat should be saved rather than produced and to which extent district heating infrastructures, rather than individual heating solutions, should be used in future sustainable smart energy systems. Based on a concrete proposal to implement the Danish governmental 2050 fossil-free vision, this paper identifies marginal heat production costs and compares these to marginal heat savings costs for two different levels of district heating. A suitable least-cost heating strategy seems to be to invest in an approximately 50% decrease in net heat demands in new buildings and buildings that are being renovated anyway, while the implementation of heat savings in buildings that are not being renovated hardly pays. Moreover, the analysis points in the direction that a least-cost strategy will be to provide approximately 2/3 of the heat demand from district heating and the rest from individual heat pumps.

Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA.

Science.gov (United States)

Verguet, S; Walsh, J A

2010-06-01

To determine the hypothetical cost-effectiveness of vaginal microbicides preventing male to female HIV transmission. A mathematical epidemiological and cost-effectiveness model using data from South Africa and the USA was used. The prospective 1-year-long intervention targeted a general population of women in a city of 1,000,000 inhabitants in two very different epidemiological settings, South Africa with a male HIV prevalence of 18.80% and the USA with a male HIV prevalence of 0.72%. The base case scenario assumes a microbicide effective at 55%, used in 30% of sexual episodes at a retail price for the public sector in South Africa of US$0.51 per use and in the USA of US$2.23 per use. In South Africa, over 1 year, the intervention would prevent 1908 infections, save US$6712 per infection averted as compared with antiretroviral treatment. In the USA, it would be more costly: over 1 year, the intervention would prevent 21 infections, amounting to a net cost per infection averted of US$405,077. However, in the setting of Washington DC, with a higher HIV prevalence, the same intervention would prevent 93 infections and save US$91,176 per infection averted. Sensitivity analyses were conducted and even a microbicide with a low effectiveness of 30% would still save healthcare costs in South Africa. A microbicide intervention is likely to be very cost-effective in a country undergoing a high-level generalised epidemic such as South Africa, but is unlikely to be cost-effective in a developed country presenting epidemiological features similar to the USA unless the male HIV prevalence exceeds 2.4%.

Large Hospital 50% Energy Savings: Technical Support Document

Energy Technology Data Exchange (ETDEWEB)

Bonnema, E.; Studer, D.; Parker, A.; Pless, S.; Torcellini, P.

2010-09-01

This Technical Support Document documents the technical analysis and design guidance for large hospitals to achieve whole-building energy savings of at least 50% over ANSI/ASHRAE/IESNA Standard 90.1-2004 and represents a step toward determining how to provide design guidance for aggressive energy savings targets. This report documents the modeling methods used to demonstrate that the design recommendations meet or exceed the 50% goal. EnergyPlus was used to model the predicted energy performance of the baseline and low-energy buildings to verify that 50% energy savings are achievable. Percent energy savings are based on a nominal minimally code-compliant building and whole-building, net site energy use intensity. The report defines architectural-program characteristics for typical large hospitals, thereby defining a prototype model; creates baseline energy models for each climate zone that are elaborations of the prototype models and are minimally compliant with Standard 90.1-2004; creates a list of energy design measures that can be applied to the prototype model to create low-energy models; uses industry feedback to strengthen inputs for baseline energy models and energy design measures; and simulates low-energy models for each climate zone to show that when the energy design measures are applied to the prototype model, 50% energy savings (or more) are achieved.

Process-oriented integration and coordination of healthcare services across organizational boundaries.

Science.gov (United States)

Tello-Leal, Edgar; Chiotti, Omar; Villarreal, Pablo David

2012-12-01

The paper presents a methodology that follows a top-down approach based on a Model-Driven Architecture for integrating and coordinating healthcare services through cross-organizational processes to enable organizations providing high quality healthcare services and continuous process improvements. The methodology provides a modeling language that enables organizations conceptualizing an integration agreement, and identifying and designing cross-organizational process models. These models are used for the automatic generation of: the private view of processes each organization should perform to fulfill its role in cross-organizational processes, and Colored Petri Net specifications to implement these processes. A multi-agent system platform provides agents able to interpret Colored Petri-Nets to enable the communication between the Healthcare Information Systems for executing the cross-organizational processes. Clinical documents are defined using the HL7 Clinical Document Architecture. This methodology guarantees that important requirements for healthcare services integration and coordination are fulfilled: interoperability between heterogeneous Healthcare Information Systems; ability to cope with changes in cross-organizational processes; guarantee of alignment between the integrated healthcare service solution defined at the organizational level and the solution defined at technological level; and the distributed execution of cross-organizational processes keeping the organizations autonomy.

Patient portal readiness among postpartum patients in a safety net setting.

Science.gov (United States)

Wieland, Daryl; Gibeau, Anne; Dewey, Caitlin; Roshto, Melanie; Frankel, Hilary

2017-07-05

Maternity patients interact with the healthcare system over an approximately ten-month interval, requiring multiple visits, acquiring pregnancy-specific education, and sharing health information among providers. Many features of a web-based patient portal could help pregnant women manage their interactions with the healthcare system; however, it is unclear whether pregnant women in safety-net settings have the resources, skills or interest required for portal adoption. In this study of postpartum patients in a safety net hospital, we aimed to: (1) determine if patients have the technical resources and skills to access a portal, (2) gain insight into their interest in health information, and (3) identify the perceived utility of portal features and potential barriers to adoption. We developed a structured questionnaire to collect demographics from postpartum patients and measure use of technology and the internet, self-reported literacy, interest in health information, awareness of portal functions, and perceived barriers to use. The questionnaire was administered in person to women in an inpatient setting. Of the 100 participants surveyed, 95% reported routine internet use and 56% used it to search for health information. Most participants had never heard of a patient portal, yet 92% believed that the portal functions were important. The two most appealing functions were to check results and manage appointments. Most participants in this study have the required resources such as a device and familiarity with the internet to access a patient portal including an interest in interacting with a healthcare institution via electronic means. Pregnancy is a critical episode of care where active engagement with the healthcare system can influence outcomes. Healthcare systems and portal developers should consider ways to tailor a portal to address the specific health needs of a maternity population including those in a safety net setting.

Net energy benefits of carbon nanotube applications

International Nuclear Information System (INIS)

Zhai, Pei; Isaacs, Jacqueline A.; Eckelman, Matthew J.

2016-01-01

Highlights: • Life cycle net energy benefits are examined. • CNT-enabled and the conventional technologies are compared. • Flash memory with CNT switches show significant positive net energy benefit. • Lithium-ion batteries with MWCNT cathodes show positive net energy benefit. • Lithium-ion batteries with SWCNT anodes tend to exhibit negative net energy benefit. - Abstract: Implementation of carbon nanotubes (CNTs) in various applications can reduce material and energy requirements of products, resulting in energy savings. However, processes for the production of carbon nanotubes (CNTs) are energy-intensive and can require extensive purification. In this study, we investigate the net energy benefits of three CNT-enabled technologies: multi-walled CNT (MWCNT) reinforced cement used as highway construction material, single-walled CNT (SWCNT) flash memory switches used in cell phones and CNT anodes and cathodes used in lithium-ion batteries used in electric vehicles. We explore the avoided or additional energy requirement in the manufacturing and use phases and estimate the life cycle net energy benefits for each application. Additional scenario analysis and Monte Carlo simulation of parameter uncertainties resulted in probability distributions of net energy benefits, indicating that net energy benefits are dependent on the application with confidence intervals straddling the breakeven line in some cases. Analysis of simulation results reveals that SWCNT switch flash memory and MWCNT Li-ion battery cathodes have statistically significant positive net energy benefits (α = 0.05) and SWCNT Li-ion battery anodes tend to have negative net energy benefits, while positive results for MWCNT-reinforced cement were significant only under an efficient CNT production scenario and a lower confidence level (α = 0.1).

Performance Analysis using Coloured Petri Nets

DEFF Research Database (Denmark)

Wells, Lisa Marie

Performance is often a central issue in the design, development, and configuration of systems. It is not always enough to know that systems work properly, they must also work effectively. There are numerous studies, e.g. in the areas of computer and telecommunication systems, manufacturing......, military, health care, and transportation, that have shown that time, money, and even lives can be saved if the performance of a system is improved. Performance analysis studies are conducted to evaluate existing or planned systems, to compare alternative configurations, or to find an optimal configuration...... of a system. There are three alternative techniques for analysing the performance of a system: measurement, analytical models, and simulation models. This dissertation focuses on the the use of coloured Petri nets for simulationbased performance analysis of industrial-sized systems. Coloured Petri nets...

Risk transfer via energy savings insurance; TOPICAL

International Nuclear Information System (INIS)

Mills, Evan

2001-01-01

Among the key barriers to investment in energy efficiency improvements are uncertainties about attaining projected energy savings and apprehension about potential disputes over these savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building commissioning), financial risk transfer techniques are less developed in the energy management arena than in other more mature segments of the economy. Energy Savings Insurance (ESI) - formal insurance of predicted energy savings - is one method of transferring financial risks away from the facility owner or energy services contractor. ESI offers a number of significant advantages over other forms of financial risk transfer, e.g. savings guarantees or performance bonds. ESI providers manage risk via pre-construction design review as well as post-construction commissioning and measurement and verification of savings. We found that the two mos t common criticisms of ESI - excessive pricing and onerous exclusions - are not born out in practice. In fact, if properly applied, ESI can potentially reduce the net cost of energy savings projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Debt service can also be ensured by matching loan payments to projected energy savings while designing the insurance mechanism so that payments are made by the insurer in the event of a savings shortfall. We estimate the U.S. ESI market potential of$875 million/year in premium income. From an energy-policy perspective, ESI offers a number of potential benefits: ESI transfers performance risk from the balance sheet of the entity implementing the energy savings project, thereby freeing up capital otherwise needed to ''self-insure'' the savings. ESI reduces barriers to market entry of smaller energy services firms who do not have sufficiently strong balance sheets to self

LEAN thinking in Finnish healthcare.

Science.gov (United States)

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

Economic evaluation of energy saving measures in a common type of Greek building

International Nuclear Information System (INIS)

Nikolaidis, Yiannis; Pilavachi, Petros A.; Chletsis, Alexandros

2009-01-01

This paper deals with the economic analysis and evaluation of various energy saving measures in the building sector, focusing on a domestic detached house in Greece, i.e. in a typical Mediterranean climate. In order to detect the energy saving measures that, in addition to energy benefits, can also provide economic profits, the study examines the following measures: all kinds of insulation; upgrading of the heating system; use of thermal solar systems; upgrading of lighting; upgrading of electric appliances; upgrading of the cooling system. The economic evaluation methods used for ranking the energy saving measures are the Net Present Value, the Internal Rate of Return, the Savings to Investment Ratio and the Depreciated Payback Period. It has been found that amongst the most effective energy saving methods are the upgrading of lighting, the insulation of the roof of the building and the installation of an automatic temperature control system.

Option pricing: a flexible tool to disseminate shared savings contracts.

Science.gov (United States)

Friedberg, Mark W; Buendia, Anthony M; Lauderdale, Katherine E; Hussey, Peter S

2013-08-01

Due to volatility in healthcare costs, shared savings contracts can create systematic financial losses for payers, especially when contracting with smaller providers. To improve the business case for shared savings, we calculated the prices of financial options that payers can "sell" to providers to offset these losses. Using 2009 to 2010 member-level total cost of care data from a large commercial health plan, we calculated option prices by applying a bootstrap simulation procedure. We repeated these simulations for providers of sizes ranging from 500 to 60,000 patients and for shared savings contracts with and without key design features (minimum savings thresholds,bonus caps, cost outlier truncation, and downside risk) and under assumptions of zero, 1%, and 2% real cost reductions due to the shared savings contracts. Assuming no real cost reduction and a 50% shared savings rate, per patient option prices ranged from $225 (3.1% of overall costs) for 500-patient providers to $23 (0.3%) for 60,000-patient providers. Introducing minimum savings thresholds, bonus caps, cost outlier truncation, and downside risk reduced these option prices. Option prices were highly sensitive to the magnitude of real cost reductions. If shared savings contracts cause 2% reductions in total costs, option prices fall to zero for all but the smallest providers. Calculating the prices of financial options that protect payers and providers from downside risk can inject flexibility into shared savings contracts, extend such contracts to smaller providers, and clarify the tradeoffs between different contract designs, potentially speeding the dissemination of shared savings.

In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

Science.gov (United States)

2014-01-01

Background The purpose of this analysis was to determine whether in office diagnostic needle arthroscopy (Visionscope Imaging System [VSI]) can provide for improved diagnostic assessment and; more cost effective care. Methods Data on arthroscopy procedures in the US for deep seated pathology in the knee and shoulder were used (Calendar Year 2012). These procedures represent approximately 25-30% of all arthroscopic procedures performed annually. Sensitivities, specificities, positive predictive, and negative predictive values for MRI analysis of this deep seated pathology from systematic reviews and meta-analyses were used in assessing for false positive and false negative MRI findings. The costs of performing diagnostic and surgical arthroscopy procedures (using 2013 Medicare reimbursement amounts); costs associated with false negative findings; and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were then assessed. Results In patients presenting with medial meniscal pathology (ICD9CM diagnosis 836.0 over 540,000 procedures in CY 2012); use of the VSI system in place of MRI assessment (standard of care) resulted in a net cost savings to the system of $151 million. In patients presenting with rotator cuff pathology (ICD9CM 840.4 over 165,000 procedures in CY2012); use of VSI in place of MRI similarly saved $59 million. These savings were realized along with more appropriate care as; fewer patients were exposed to higher risk surgical arthroscopic procedures. Conclusions The use of an in-office arthroscopy system can: possibly save the US healthcare system money; shorten the diagnostic odyssey for patients; potentially better prepare clinicians for arthroscopic surgery (when needed) and; eliminate unnecessary outpatient arthroscopy procedures, which commonly result in surgical intervention. PMID:24885678

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

Science.gov (United States)

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric J A; Sidibe, Mintou Fall; Boupha, Boungnong

2011-12-13

Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working

Can health promotion programs save Medicare money?

Science.gov (United States)

Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester

2007-01-01

The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program. PMID:18044084

Constant savings rates and quasi-arithmetic population growth under exhaustible resource constraints

NARCIS (Netherlands)

Asheim, G.B.; Buchholz, W.; Hartwick, J.M.; Mitra, T.; Withagen, C.A.A.M.

2007-01-01

In the Dasgupta–Heal–Solow–Stiglitz (DHSS) model of capital accumulation and resource depletion we show the following equivalence: if an efficient path has constant (gross and net of population growth) savings rates, then population growth must be quasi-arithmetic and the path is a maximin or a

ParkinsonNet: A Low-Cost Health Care Innovation With A Systems Approach From The Netherlands.

Science.gov (United States)

Bloem, Bas R; Rompen, Lonneke; Vries, Nienke M de; Klink, Ab; Munneke, Marten; Jeurissen, Patrick

2017-11-01

ParkinsonNet, a low-cost innovation to optimize care for patients with Parkinson disease, was developed in 2004 as a network of physical therapists in several regions in the Netherlands. Since that time, the network has achieved full national reach, with 70 regional networks and around 3,000 specifically trained professionals from 12 disciplines. Key elements include the empowerment of professionals who are highly trained and specialized in Parkinson disease, the empowerment of patients by education and consultation, and the empowerment of integrated multidisciplinary teams to better address and manage the disease. Studies have found that the ParkinsonNet approach leads to outcomes that are at least as good as, if not better than, outcomes from usual care. One study found a 50 percent reduction in hip fractures and fewer inpatient admissions. Other studies suggest that ParkinsonNet leads to modest but important cost savings (at least US$439 per patient annually). These cost savings outweigh the costs of building and maintaining the network. Because of ParkinsonNet's success, the program has now spread to several other countries and serves as a model of a successful and scalable frugal innovation.

Impact of fuel-dependent electricity retail charges on the value of net-metered PV applications in vertically integrated systems

International Nuclear Information System (INIS)

Nikolaidis, Alexandros I.; Milidonis, Andreas; Charalambous, Charalambos A.

2015-01-01

Retail electricity charges inevitably influence the financial rationale of using net-metered photovoltaic (PV) applications since their structure as well as their level may vary significantly over the life-cycle of a customer-sited PV generation system. This subsequently introduces a further uncertainty for a ratepayer considering a net-metered PV investment. To thoroughly comprehend this uncertainty, the paper employs a top-down approach – in vertically integrated environments – to model the volatility of partially hedged electricity charges and its subsequent impact on the value of bill savings from net-metered PV systems. Besides the utility's pricing strategy and rate structures, particular emphasis is given in modeling the fossil fuel mix component that introduces a significant source of uncertainty on electricity charges and thus on the value of bill savings of net-metered, customer-sited, PV applications. - Highlights: • A top-down approach of developing traditional electricity charges is provided. • The combined effect of pricing strategies, rate structures and fuels is examined. • Fossil fuel prices can substantially affect the net metering compensation. • A financial risk assessment for net-metered PV systems is performed

Can children aged 12 years or more refuse life-saving treatment ...

African Journals Online (AJOL)

The best interests of the child are paramount, and should the child unreasonably refuse to consent to life-saving treatment, the Minister of Social Development may give consent for such treatment in terms of the Children's Act. Otherwise, should a parent, guardian, caregiver or healthcare provider believe that such a refusal ...

VA Telemedicine: An Analysis of Cost and Time Savings.

Science.gov (United States)

Russo, Jack E; McCool, Ryan R; Davies, Louise

2016-03-01

The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

THE SAVINGS-TRADE-FISCAL GAP MODEL: APPLICATION IN SELECTED WEST AFRICAN STATES

Directory of Open Access Journals (Sweden)

Efayena Oba Obukohwo

2017-07-01

Full Text Available With most African economies experiencing adverse economic misalignment in recent times, the need of enhancing the growth process cannot be overemphasized. Using a typical Savings-Trade-Fiscal Gap Model, the paper employed panel data estimation method to examine the impact of savings, trade and fiscal gap on economic growth of 15 West African countries. The paper finds a negative relationship between net trade and economic growth, while savings and government expenditure impacts positively on economic performance. The paper thus, among recommended that it is appropriate for all countries to eliminate fiscal dominance from monetary policy-making, reduce public debt and establish institutions that promote and encourage counter-cyclical fiscal policy, develop their financial systems, establish credibility in fiscal and monetary policy-making as well as encourage trade.

Costs and benefits of individuals conceived after IVF: a net tax evaluation in The Netherlands.

Science.gov (United States)

Moolenaar, L M; Connolly, M; Huisman, B; Postma, M J; Hompes, P G A; van der Veen, F; Mol, B W J

2014-02-01

This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative to those naturally conceived. A model based on the method of generational accounting was developed to evaluate investments in IVF. Calculations were based on average investments paid and received from the government by an individual. All costs were discounted to their net present values and adjusted for survival. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive to changes in the growth of healthcare costs, economic growth and the discount rate. Therefore, it is concluded that, similarly to naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits. This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative those naturally conceived. A model based on the method of generational accounting to evaluate investments in IVF was used. Calculations were based on average investments paid and received from the government by an individual. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

Directory of Open Access Journals (Sweden)

Hoffman Steven J

2011-12-01

Full Text Available Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs. Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140, Laos (136, Senegal (100 and Tanzania (121. Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497 across Ghana (107/140, Laos (136/136, Senegal (51/100 and Tanzania (78/121. Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13% or self-reported performing all five clinical practices according to established evidence (2%. Statistically significant factors associated with higher knowledge within each country included: 1 training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73; and 2 ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70. Statistically significant factors associated with better clinical practices within each country include: 1 reading scientific journals from their own country (OR

Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries.

Science.gov (United States)

Heijink, Richard; Koolman, Xander; Westert, Gert P

2013-06-01

Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production functions using avoidable mortality as outcome measure. Avoidable mortality comprises deaths from certain conditions "that should not occur in the presence of timely and effective healthcare". We investigated the relationship between total avoidable mortality and healthcare spending using descriptive analyses and multiple regression models, focussing on within-country variation and growth rates. We aimed to take into account the role of potential confounders and dynamic effects such as time lags. Additionally, we explored a method to estimate macro-level cost-effectiveness. We found an average yearly avoidable mortality decline of 2.6-5.3% across countries. Simultaneously, healthcare spending rose between 1.9 and 5.9% per year. Most countries with above-average spending growth demonstrated above-average reductions in avoidable mortality. The regression models showed a significant association between contemporaneous and lagged healthcare spending and avoidable mortality. The time-trend, representing an exogenous shift of the health production function, reduced the impact of healthcare spending. After controlling for this time-trend and other confounders, i.e. demographic and socioeconomic variables, a statistically significant relationship between healthcare spending and avoidable mortality remained. We tentatively conclude that macro-level healthcare spending increases provided value for money, at least for the disease groups, countries and years included in this study.

Cost-consequence analysis of multimodal interventions with environmental components for pediatric asthma in the state of Maryland.

Science.gov (United States)

Jassal, Mandeep S; Diette, Gregory B; Dowdy, David W

2013-08-01

Applied environmental strategies for asthma control are often expensive, but may save longer-term healthcare costs. Whether these savings outweigh additional costs of implementing these strategies is uncertain. We conducted a systematic review to estimate the expenditures and savings of environmental interventions for asthma in the state of Maryland. Direct costs included hospitalizations, emergency room, and clinic visits. Indirect expenditures included costs of lost work productivity and travel incurred during the usage of healthcare services. We used decision analysis, assuming a hypothetical cohort of the approximated 49,290 pediatric individuals in Maryland with persistent asthma, to compare costs and benefits of environmental asthma interventions against the standard of care (no intervention) from the societal perspective. Three interventions among nine articles met the inclusion criteria for the systematic review: 1) environmental education using medical professionals; 2) education using non-medical personnel; and 3) multi-component strategy involving education with non-medical personnel, allergen-impermeable covers, and pest management. All interventions were found to be cost-saving relative to the standard of care. Home environmental education using non-medical professionals yielded the highest net savings of $14.1 million (95% simulation interval (SI): $-.283 million, $19.4 million), while the multi-component intervention resulted in the lowest net savings of $8.1 million (95% SI: $-4.9 million, $15.9 million). All strategies were most sensitive to the baseline number of hospitalizations in those not receiving targeted interventions for asthma. Limited environmental reduction strategies for asthma are likely to be cost-saving to the healthcare system in Maryland and should be considered for broader scale-up in other economically similar settings.

Barriers to Investment in Energy-Saving Technologies in Small Firms: The Energy-Efficiency Paradox Revisited

NARCIS (Netherlands)

Koetse, M.J.; de Groot, H.L.F.; Nijkamp, P.

2008-01-01

Despite the fact that energy-saving technologies are considered profitable using standard net-present-value calculations, their adoption rates have been low, particularly in small firms. This study reviews the theoretical and empirical literature that explains this phenomenon, generally known as the

Saving billions of dollars--and physicians' time--by streamlining billing practices.

Science.gov (United States)

Blanchfield, Bonnie B; Heffernan, James L; Osgood, Bradford; Sheehan, Rosemary R; Meyer, Gregg S

2010-06-01

The U.S. system of billing third parties for health care services is complex, expensive, and inefficient. Physicians end up using nearly 12 percent of their net patient service revenue to cover the costs of excessive administrative complexity. A single transparent set of payment rules for multiple payers, a single claim form, and standard rules of submission, among other innovations, would reduce the burden on the billing offices of physician organizations. On a national scale, our hypothetical modeling of these changes would translate into $7 billion of savings annually for physician and clinical services. Four hours of professional time per physician and five hours of practice support staff time could be saved each week.

Returns on investments in energy-saving technologies under energy price uncertainty in Dutch greenhouse horticulture

NARCIS (Netherlands)

Diederen, P.J.M.; Tongeren, van F.W.; Veen, van der H.B.

2003-01-01

Conventional net present value calculations evaluating the profitability of investments in energy-saving technologies in Dutch horticultural outlays predict a much higher rate of adoption of these technologies than is actually observed. This paper tries to explain this gap by applying a real options

Assessing the engineering performance of affordable net-zero energy housing

Science.gov (United States)

Wallpe, Jordan P.

The purpose of this research was to evaluate affordable technologies that are capable of providing attractive, cost-effective energy savings to the housing industry. The research did so by investigating the 2011 Solar Decathlon competition, with additional insight from the Purdue INhome. Insight from the Purdue INhome verified the importance of using a three step design process to design a net-zero energy building. In addition, energy consumption values of the INhome were used to compare and contrast different systems used in other houses. Evaluation of unbiased competition contests gave a better understanding of how a house can realistically reach net-zero. Upon comparison, off-the-shelf engineering systems such as super-efficient HVAC units, heat pump hot water heaters, and properly designed photovoltaic arrays can affordably enable a house to become net-zero. These important and applicable technologies realized from the Solar Decathlon will reduce the 22 percent of all energy consumed through the residential sector in the United States. In conclusion, affordable net-zero energy buildings can be built today with commitment from design professionals, manufacturers, and home owners.

Implications of net energy-return-on-investment for a low-carbon energy transition

Science.gov (United States)

King, Lewis C.; van den Bergh, Jeroen C. J. M.

2018-04-01

Low-carbon energy transitions aim to stay within a carbon budget that limits potential climate change to 2 °C—or well below—through a substantial growth in renewable energy sources alongside improved energy efficiency and carbon capture and storage. Current scenarios tend to overlook their low net energy returns compared to the existing fossil fuel infrastructure. Correcting from gross to net energy, we show that a low-carbon transition would probably lead to a 24-31% decline in net energy per capita by 2050, which implies a strong reversal of the recent rising trends of 0.5% per annum. Unless vast end-use efficiency savings can be achieved in the coming decades, current lifestyles might be impaired. To maintain the present net energy returns, solar and wind renewable power sources should grow two to three times faster than in other proposals. We suggest a new indicator, `energy return on carbon', to assist in maximizing the net energy from the remaining carbon budget.

Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program.

Science.gov (United States)

Frost, Jennifer J; Sonfield, Adam; Zolna, Mia R; Finer, Lawrence B

2014-12-01

Policy Points: The US publicly supported family planning effort serves millions of women and men each year, and this analysis provides new estimates of its positive impact on a wide range of health outcomes and its net savings to the government. The public investment in family planning programs and providers not only helps women and couples avoid unintended pregnancy and abortion, but also helps many thousands avoid cervical cancer, HIV and other sexually transmitted infections, infertility, and preterm and low birth weight births. This investment resulted in net government savings of $13.6 billion in 2010, or $7.09 for every public dollar spent. Each year the United States' publicly supported family planning program serves millions of low-income women. Although the health impact and public-sector savings associated with this program's services extend well beyond preventing unintended pregnancy, they never have been fully quantified. Drawing on an array of survey data and published parameters, we estimated the direct national-level and state-level health benefits that accrued from providing contraceptives, tests for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), Pap tests and tests for human papillomavirus (HPV), and HPV vaccinations at publicly supported family planning settings in 2010. We estimated the public cost savings attributable to these services and compared those with the cost of publicly funded family planning services in 2010 to find the net public-sector savings. We adjusted our estimates of the cost savings for unplanned births to exclude some mistimed births that would remain publicly funded if they had occurred later and to include the medical costs for births through age 5 of the child. In 2010, care provided during publicly supported family planning visits averted an estimated 2.2 million unintended pregnancies, including 287,500 closely spaced and 164,190 preterm or low birth weight (LBW) births, 99

Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

Science.gov (United States)

Taylor, Donald H; Bhavsar, Nrupen A; Bull, Janet H; Kassner, Cordt T; Olson, Andrew; Boucher, Nathan A

2018-05-01

On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis. All age-eligible Medicare decedents who received care and died in North Carolina in calendar years 2009 and 2010. Costs to Medicare for hospice and other healthcare services. Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

Net4Care

DEFF Research Database (Denmark)

Christensen, Henrik Bærbak; Hansen, Klaus Marius

2012-01-01

, health centers are getting larger and more distributed, and the number of healthcare professionals does not follow the trend in chronic diseases. All of this leads to a need for telemedical and mobile health applications. In a Danish context, these applications are often developed through local...... (innovative) initiatives with little regards for national and global (standardization) initiatives. A reason for this discrepancy is that the software architecture for national (and global) systems and standards are hard to understand, hard to develop systems based on, and hard to deploy. To counter this, we...... propose a software ecosystem approach for telemedicine applications, providing a framework, Net4Care, encapsulating national/global design decisions with respect to standardization while allowing for local innovation. This paper presents an analysis of existing systems, of requirements for a software...

Data mining in healthcare: decision making and precision

Directory of Open Access Journals (Sweden)

Ionuţ ŢĂRANU

2016-05-01

Full Text Available The trend of application of data mining in healthcare today is increased because the health sector is rich with information and data mining has become a necessity. Healthcare organizations generate and collect large volumes of information to a daily basis. Use of information technology enables automation of data mining and knowledge that help bring some interesting patterns which means eliminating manual tasks and easy data extraction directly from electronic records, electronic transfer system that will secure medical records, save lives and reduce the cost of medical services as well as enabling early detection of infectious diseases on the basis of advanced data collection. Data mining can enable healthcare organizations to anticipate trends in the patient's medical condition and behaviour proved by analysis of prospects different and by making connections between seemingly unrelated information. The raw data from healthcare organizations are voluminous and heterogeneous. It needs to be collected and stored in organized form and their integration allows the formation unite medical information system. Data mining in health offers unlimited possibilities for analyzing different data models less visible or hidden to common analysis techniques. These patterns can be used by healthcare practitioners to make forecasts, put diagnoses, and set treatments for patients in healthcare organizations.

Outsourcing in private healthcare organisations: a Greek perspective.

Science.gov (United States)

Moschuris, Socrates J; Kondylis, Michael N

2007-01-01

The purpose of this paper is to present a study carried out to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in private healthcare organisations in Greece. A survey instrument was designed and mailed to a random sample of 100 private healthcare organisations in Greece. A total of 25 usable questionnaires were received, representing a response rate of 25 percent. The survey instrument focused on the extent to which private healthcare organisations outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing. Private healthcare organisations in Greece outsource a variety of activities. Cost savings, customisation, and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to an improvement in customer satisfaction and to a cost reduction. Most users are highly satisfied with the performance of these companies and believe that there will be a future increase in the usage of these services. The paper provides a framework regarding outsourcing in private healthcare organisations. This research fills the gap in the area of outsourcing in private healthcare organisations in Greece.

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

Science.gov (United States)

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

Is the United States in the middle of a healthcare bubble?

Science.gov (United States)

Chen, Wen-Yi; Liang, Yia-Wun; Lin, Yu-Hui

2016-01-01

This study investigates the possibility of multiple healthcare bubbles in the US healthcare market. We first applied the newly developed Generalized Sup ADF test to locate multiple healthcare bubble episodes and then estimated the switching regression model specifying multiple healthcare bubble periods to evaluate to what extent macroeconomic variables (such as the interest rate, public debt, and fiscal deficit) and public financing healthcare programs influence the magnitude of healthcare bubbles in terms of the deviation of the medical care price inflation from either the overall price inflation or the money wage growth. Our results show that expansionary monetary and fiscal policies play important roles in determining the deviation of the medical care price inflation from the overall price inflation and that the net government debt has a positive impact on the deviation of the medical care price inflation from the money wage growth. The US healthcare market is now in the middle of a healthcare bubble, and this healthcare bubble has developed slowly and has lasted for approximately 3 decades, mirroring an increased societal preference for healthcare. Policymakers in the US should cautiously consider the fact that healthcare bubbles must imply a misallocation of resources into healthcare, leading to negative consequences on the sustainability of the healthcare system.

Optimising building net energy demand with dynamic BIPV shading

International Nuclear Information System (INIS)

Jayathissa, P.; Luzzatto, M.; Schmidli, J.; Hofer, J.; Nagy, Z.; Schlueter, A.

2017-01-01

Highlights: •Coupled analysis of PV generation and building energy using adaptive BIPV shading. •20–80% net energy saving compared to an equivalent static system. •The system can in some cases compensate for the entire heating/cooling/lighting load. •High resolution radiation simulation including impacts of module self shading. -- Abstract: The utilisation of a dynamic photovoltaic system for adaptive shading can improve building energy performance by controlling solar heat gains and natural lighting, while simultaneously generating electricity on site. This paper firstly presents an integrated simulation framework to couple photovoltaic electricity generation to building energy savings through adaptive shading. A high-resolution radiance and photovoltaic model calculates the photovoltaic electricity yield while taking into account partial shading between modules. The remaining solar irradiation that penetrates the window is used in a resistance-capacitance building thermal model. A simulation of all possible dynamic configurations is conducted for each hourly time step, of which the most energy efficient configuration is chosen. We then utilise this framework to determine the optimal orientation of the photovoltaic panels to maximise the electricity generation while minimising the building’s heating, lighting and cooling demand. An existing adaptive photovoltaic facade was used as a case study for evaluation. Our results report a 20–80% net energy saving compared to an equivalent static photovoltaic shading system depending on the efficiency of the heating and cooling system. In some cases the Adaptive Solar Facade can almost compensate for the entire energy demand of the office space behind it. The control of photovoltaic production on the facade, simultaneously with the building energy demand, opens up new methods of building management as the facade can control both the production and consumption of electricity.

Energy Use Consequences of Ventilating a Net-Zero Energy House

Science.gov (United States)

Ng, Lisa C.; Payne, W. Vance

2016-01-01

A Net-Zero Energy Residential Test Facility (NZERTF) has been constructed at the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland to demonstrate that a home similar in size, aesthetics, and amenities to those in the surrounding communities can achieve net-zero energy use over the course of a year while meeting the average electricity and water use needs of a family of four in the United States. The facility incorporates renewable energy and energy efficient technologies, including an air-to-air heat pump system, a solar photovoltaic system, a solar thermal domestic hot water system, and a heat recovery ventilation system sized to meet American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE) Standard 62.2-2010 ventilation requirements. The largest energy end use within the home was space conditioning, which included heat loss through the building envelope, ventilation air supplied by the heat recovery ventilator (HRV), and internal loads. While HRVs are often described as being able to save energy when compared to ventilating without heat recovery, there have been no studies using a full year of measured data that determine the thermal load and energy impacts of HRV-based ventilation on the central heating and cooling system. Over the course of a year, continuous operation of the HRV at the NZERTF resulted in an annual savings of 7 % in heat pump energy use compared with the hypothetical case of ventilating without heat recovery. The heat pump electrical use varied from an increase of 5 % in the cooling months to 36 % savings in the heating months compared with ventilation without heat recovery. The increase in the cooling months occurred when the outdoor temperature was lower than the indoor temperature, during which the availability of an economizer mode would have been beneficial. Nevertheless, the fan energy required to operate the selected HRV at the NZERTF paid for itself in the heat pump energy saved

Energy Use Consequences of Ventilating a Net-Zero Energy House.

Science.gov (United States)

Ng, Lisa C; Payne, W Vance

2016-03-05

A Net-Zero Energy Residential Test Facility (NZERTF) has been constructed at the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland to demonstrate that a home similar in size, aesthetics, and amenities to those in the surrounding communities can achieve net-zero energy use over the course of a year while meeting the average electricity and water use needs of a family of four in the United States. The facility incorporates renewable energy and energy efficient technologies, including an air-to-air heat pump system, a solar photovoltaic system, a solar thermal domestic hot water system, and a heat recovery ventilation system sized to meet American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE) Standard 62.2-2010 ventilation requirements. The largest energy end use within the home was space conditioning, which included heat loss through the building envelope, ventilation air supplied by the heat recovery ventilator (HRV), and internal loads. While HRVs are often described as being able to save energy when compared to ventilating without heat recovery, there have been no studies using a full year of measured data that determine the thermal load and energy impacts of HRV-based ventilation on the central heating and cooling system. Over the course of a year, continuous operation of the HRV at the NZERTF resulted in an annual savings of 7 % in heat pump energy use compared with the hypothetical case of ventilating without heat recovery. The heat pump electrical use varied from an increase of 5 % in the cooling months to 36 % savings in the heating months compared with ventilation without heat recovery. The increase in the cooling months occurred when the outdoor temperature was lower than the indoor temperature, during which the availability of an economizer mode would have been beneficial. Nevertheless, the fan energy required to operate the selected HRV at the NZERTF paid for itself in the heat pump energy saved

The effect of major adverse renal cardiovascular event (MARCE) incidence, procedure volume, and unit cost on the hospital savings resulting from contrast media use in inpatient angioplasty.

Science.gov (United States)

Keuffel, Eric; McCullough, Peter A; Todoran, Thomas M; Brilakis, Emmanouil S; Palli, Swetha R; Ryan, Michael P; Gunnarsson, Candace

2018-04-01

To determine the net economic impact of switching from low-osmolar contrast media (LOCM) to iso-osmolar contrast media (IOCM; iodixanol) in patients undergoing inpatient coronary or peripheral angioplasty in the United States (US). A budget impact model (BIM) was developed from a hospital perspective. Nationally representative procedural and contrast media prevalence rates, along with MARCE (major adverse renal cardiovascular event) incidence and episode-related cost data were derived from Premier Hospital Data (October 2014 to September 2015). A previously estimated relative risk reduction in MARCE associated with IOCM usage (9.3%) was applied. The higher cost of IOCM was included when calculating the net impact estimates at the aggregate, hospital type, and per hospital levels. One-way (±25%) and probabilistic sensitivity analyses identified the model's most important inputs. Based on weighted analysis, 513,882 US inpatient angioplasties and 35,610 MARCE cases were estimated annually. Switching to an "IOCM only" strategy from a "LOCM only" strategy increases contrast media cost, but prevents 2,900 MARCE events. The annual budget impact was an estimated saving of $30.71 million, aggregated across all US hospitals, $6,316 per hospital, or $60 per procedure. Net savings were maintained across all univariate sensitivity analyses. While MARCE/event-free cost differential was the most important factor driving total net savings for hospitals in the Northeast and West, procedural volume was important in the Midwest and rural locations. Switching to an "IOCM only" strategy from a "LOCM only" approach yields substantial net global savings to hospitals, both at the national level and within hospital sub-groups. Hospital administrators should maintain awareness of the factors that are likely to be more influential for their hospital and recognize that purchasing on the basis of lower contrast media cost may result in higher overall costs for patients undergoing inpatient

Conscientious objection to deceased organ donation by healthcare professionals.

Science.gov (United States)

Shaw, David; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; Georgieva, Denie; Ploeg, Rutger; Broderick, Andrew

2018-02-01

In this article, we analyse the potential benefits and disadvantages of permitting healthcare professionals to invoke conscientious objection to deceased organ donation. There is some evidence that permitting doctors and nurses to register objections can ultimately lead to attitudinal change and acceptance of organ donation. However, while there may be grounds for conscientious objection in other cases such as abortion and euthanasia, the life-saving nature of donation and transplantation renders objection in this context more difficult to justify. In general, dialogue between healthcare professionals is a more appropriate solution, and any objections must be justified with a strong rationale in hospitals where such policies are put in place.

Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries

NARCIS (Netherlands)

Heijink, R.; Koolman, X.; Westert, G.P.

2013-01-01

Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production

Household Savings

DEFF Research Database (Denmark)

Browning, Martin; Lusardi, Annamaria

suggested in the informal saving literature can be captured in the standard optimizing model. Particular attention is given to recent work on the precautionary motive and its implications for saving and consumption behavior. We also discuss the "behavioral" or "psychological" approach that eschews the use......In this survey, we review the recent theoretical and empirical literature on household saving and consumption. The discussion is structured around a list of motives for saving and how well the standard theory captures these motives. We show that almost all of the motives for saving that have been...

Heat Mismatch of future Net Zero Energy Buildings within district heating areas in Denmark

DEFF Research Database (Denmark)

Nielsen, Steffen; Möller, Bernd

The long-term goal for Denmark is to develop an energy system solely based on renewable energy sources (RES) in 2050. To reach this goal energy savings in buildings are essential. Therefore, a focus on energy efficient measures in buildings and net zero energy buildings (NZEBs) have increased...... systems enables them to send or receive energy from these systems. This is beneficial for NZEBs because even though they have an annual net exchange of zero, there is a temporal mismatch in regard to the energy consumption of buildings and the production from the renewable energy units added to them...

Saving in cycles: how to get people to save more money.

Science.gov (United States)

Tam, Leona; Dholakia, Utpal

2014-02-01

Low personal savings rates are an important social issue in the United States. We propose and test one particular method to get people to save more money that is based on the cyclical time orientation. In contrast to conventional, popular methods that encourage individuals to ignore past mistakes, focus on the future, and set goals to save money, our proposed method frames the savings task in cyclical terms, emphasizing the present. Across the studies, individuals who used our proposed cyclical savings method, compared with individuals who used a linear savings method, provided an average of 74% higher savings estimates and saved an average of 78% more money. We also found that the cyclical savings method was more efficacious because it increased implementation planning and lowered future optimism regarding saving money.

Trump proposes initial healthcare agenda

Directory of Open Access Journals (Sweden)

Robbins RA

2016-11-01

Full Text Available No abstract available. Article truncated at 150 words. On Friday, November 11, President-elect Trump proposed a healthcare agenda on his website greatagain.gov (1. Yesterday, November 12, he gave an interview on 60 Minutes clarifying his positions (2. Trump said that he wanted to focus on healthcare and has proposed to: •Repeal all of the Affordable Care Act; •Allow the sale of health insurance across state lines; •Make the purchase of health insurance fully tax deductible; •Expand access to the health savings accounts;•Increase price transparency; •Block grant Medicaid; •Lower entrance barriers to new producers of drugs. In his 60 Minutes interview Trump reiterated that two provisions of the ACA – prohibition of pre-existing conditions exclusion and ability for adult children to stay on parents insurance plans until age 26 – have his support (2. Other aspects of the ACA that might receive his support were not discussed. On the Department of Veterans’ Affairs ...

The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

Energy Technology Data Exchange (ETDEWEB)

Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth; Schiller, Steven R.; Goldman, Charles A.; LaCommare, Kristina

2014-03-19

construction, commercial/industrial custom rebate programs). In this report, the focus is on gross energy savings and the costs borne by the program administrator—including administration, payments to implementation contractors, marketing, incentives to program participants (end users) and both midstream and upstream trade allies, and evaluation costs. We collected data on net savings and costs incurred by program participants. However, there were insufficient data on participant cost contributions, and uncertainty and variability in the ways in which net savings were reported and defined across states (and program administrators).

Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

Science.gov (United States)

Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

2009-01-01

More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.

Relations between decision indicators for implementing technology in healthcare logistics – a bed logistics case study

DEFF Research Database (Denmark)

Feibert, Diana Cordes; Jacobsen, Peter

2015-01-01

The cost of healthcare is rising and reforms have been introduced across Europe to address the cost issue in healthcare. There is potential to improve logistical processes within healthcare to save costs and at the same time provide services that support high quality patient care. Re......-designing processes and implementing technology can improve the efficiency of processes and reduce costs. A relations diagram has been developed that identifies the effects between the constructs Logistics, Technology, Procedure and Structure. Knowledge about how these constructs affect each other is important when...

Evaluation of DementiaNet, a network-based primary care innovation for community-dwelling patients with dementia: protocol for a longitudinal mixed methods multiple case study

NARCIS (Netherlands)

Richters, A.; Nieuwboer, M.S.; Perry, M.; Olde Rikkert, M.G.M.; Melis, R.J.F.; Marck, M.A. van der

2017-01-01

INTRODUCTION: Primary healthcare professionals will increasingly be required to manage and optimise their treatment for patients with dementia. With DementiaNet, we aim to reduce the burden of dementia on healthcare services and society through implementation and facilitation of integrated

Estimating customer electricity savings from projects installed by the U.S. ESCO industry

Energy Technology Data Exchange (ETDEWEB)

Carvallo, Juan Pablo [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Larsen, Peter H. [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

2014-11-25

The U.S. energy service company (ESCO) industry has a well-established track record of delivering substantial energy and dollar savings in the public and institutional facilities sector, typically through the use of energy savings performance contracts (ESPC) (Larsen et al. 2012; Goldman et al. 2005; Hopper et al. 2005, Stuart et al. 2013). This ~$6.4 billion industry, which is expected to grow significantly over the next five years, may play an important role in achieving demand-side energy efficiency under local/state/federal environmental policy goals. To date, there has been little or no research in the public domain to estimate electricity savings for the entire U.S. ESCO industry. Estimating these savings levels is a foundational step in order to determine total avoided greenhouse gas (GHG) emissions from demand-side energy efficiency measures installed by U.S. ESCOs. We introduce a method to estimate the total amount of electricity saved by projects implemented by the U.S. ESCO industry using the Lawrence Berkeley National Laboratory (LBNL) /National Association of Energy Service Companies (NAESCO) database of projects and LBNL’s biennial industry survey. We report two metrics: incremental electricity savings and savings from ESCO projects that are active in a given year (e.g., 2012). Overall, we estimate that in 2012 active U.S. ESCO industry projects generated about 34 TWh of electricity savings—15 TWh of these electricity savings were for MUSH market customers who did not rely on utility customer-funded energy efficiency programs (see Figure 1). This analysis shows that almost two-thirds of 2012 electricity savings in municipal, local and state government facilities, universities/colleges, K-12 schools, and healthcare facilities (i.e., the so-called “MUSH” market) were not supported by a utility customer-funded energy efficiency program.

Research and realization of info-net security controlling system

Science.gov (United States)

Xu, Tao; Zhang, Wei; Li, Xuhong; Wang, Xia; Pan, Wenwen

2017-03-01

The thesis introduces some relative concepts about Network Cybernetics, and we design and realize a new info-net security controlling system based on Network Cybernetics. The system can control the endpoints, safely save files, encrypt communication, supervise actions of users and show security conditions, in order to realize full-scale security management. At last, we simulate the functions of the system. The results show, the system can ensure the controllability of users and devices, and supervise them real-time. The system can maximize the security of the network and users.

The impact of rotavirus vaccination on discounted net tax revenue in Egypt: a government perspective analysis.

Science.gov (United States)

Connolly, Mark P; Topachevskyi, Oleksandr; Standaert, Baudouin; Ortega, Omayra; Postma, Maarten

2012-08-01

We evaluated national rotavirus (RV) immunization programme costs to estimate how resulting changes in morbidity and mortality will influence government fiscal accounts over time. The assumption was that increased childhood survival in vaccinated cohorts leads to increased numbers of children consuming government resource, and an increased number of future tax payers. Our objective was to evaluate the difference in lifetime discounted net tax revenue generated by RV vaccinated and unvaccinated cohorts from the Egyptian government perspective. The model framework adopts the Egyptian government perspective for RV immunization costs (year 2009 values) and all government transfers (e.g. education costs, health costs, pensions). To reflect the government tax revenue, we applied a fixed income tax burden to earnings over the lifetime of vaccinated and unvaccinated cohorts. At each year of the model, we derive net taxes (gross taxes less transfers) discounted to the immunization year to reflect the present value of RV vaccination investment costs. Projected incremental net present values of the vaccinated cohort versus the unvaccinated cohort are $US6.1 million, $US58.1 million and $US55.7 million at 25-, 50- and 72-year time horizons, respectively. The internal rate of return for the government based on RV vaccination at years 25, 50 and 72 was 10.8%, 15.1% and 14.9, respectively. Within the first 5 years of vaccination, 76% of vaccine acquisition costs were offset due to direct and indirect cost savings attributed to a reduction in RV-related disease burden. Investments in RV vaccination in a single year are entirely offset when the vaccinated cohort of newborns reach 22 years of age. The government perspective is useful for evaluating investments in RV vaccination because of ongoing government transfers and tax receipts attributed to changes in RV-attributed morbidity and mortality. The analysis described here illustrates that investing in RV offers tangible long

Cost escalation in health - care technology possible solutions | Járos ...

African Journals Online (AJOL)

Solutions to cost escalation due to health-care technology are proposed. It is argued that proper systems analysis, technology assessment, and planning would result in net savings and itnproved cost-benefits. Identification of needs early in the technological life cycle can positively influence the final form of the chosen ...

Modelling of electricity savings in the Danish households sector: from the energy system to the end-user

DEFF Research Database (Denmark)

Baldini, Mattia; Trivella, Alessio

2017-01-01

sectors, has been extended in order to endogenously determine the best possible investments in more efficient home appliances. Second, we propose a method to relate the optimal energy system solution to the end-user choices by incorporating consumer behaviour and electricity price addition due to taxes...... of support to become profitable. The analysis quantifies energy and economic savings from the consumer side and reveals the impacts on the Danish power system and surrounding countries. Compared to a business-as-usual energy scenario, the end-user attains net economic savings in the range of 30–40 EUR per...

Technical Support Document: Development of the Advanced Energy Design Guide for K-12 Schools--30% Energy Savings

Energy Technology Data Exchange (ETDEWEB)

Pless, S.; Torcellini, P.; Long, N.

2007-09-01

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for K-12 School Buildings (K-12 AEDG), a design guidance document intended to provide recommendations for achieving 30% energy savings in K-12 Schools over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The 30% energy savings target is the first step toward achieving net-zero energy schools; schools that, on an annual basis, draw from outside sources less or equal energy than they generate on site from renewable energy sources.

Potential savings from redetermining disability among children receiving supplemental security income benefits.

Science.gov (United States)

Pulcini, Christian D; Kotelchuck, Milton; Kuhlthau, Karen A; Nozzolillo, Alixandra A; Perrin, James M

2012-01-01

To compare the costs of redetermining disability to potential savings in Supplemental Security Income payments associated with different strategies for implementing Continuing Disability Reviews (CDRs) among children potentially enrolled in SSI from 2012 to 2021. We reviewed publicly available reports from the Social Security Administration and Government Accountability Office to estimate costs and savings. We considered CDRs for children ages 1-17 years, excluding mandated low-birth weight and age 18 redeterminations that SSA routinely has performed. If in 2012 the Social Security Administration performs the same number of CDRs for children as in 2010 (16,677, 1% of eligibles) at a cessation rate of 15%, the agency would experience net savings of approximately $145 million in benefit payments. If CDR numbers increased to the greatest level ever (183,211, 22% of eligibles, in 1999) at the same cessation rate, the agency would save approximately $1.6 billion in benefit payments. Increasing the numbers of CDRs for children represents a considerable opportunity for savings. Recognizing the dynamic nature of disability, the agency could reassess the persistence of disability systematically; doing so could free up resources from children who are no longer eligible and help the agency better direct its benefits to recipients with ongoing disability and whose families need support to meet the extra costs associated with raising a child with a major disability. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A quantitative assessment of the determinants of the net energy value of biofuels

International Nuclear Information System (INIS)

Bureau, Jean-Christophe; Disdier, Anne-Celia; Gauroy, Christine; Treguer, David

2010-01-01

Many studies have investigated the net energy balance of biofuel products (in terms of savings on fossil fuels) and assessed the reductions in greenhouse gas emissions from substituting biofuels for fossil fuel. These studies provide very different results, with net balance ranging from highly positive to negative. Our study analyses a large sample of these studies by retrieving the main parameters used and converting them into units of measurement that are comparable. This information is used to unravel the main determinants of the differences in net energy value across studies. Our approach relies on descriptive statistics and econometric estimates based on a meta-analysis methodology. Our results suggest that the large variability across studies can be explained by the degree to which particular inputs (i.e. nitrogen, farm labor) are controlled for, and the way fossil energy consumption is allocated to the various co-products.

Conscientious objection to deceased organ donation by healthcare professionals

OpenAIRE

Shaw, David; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; Georgieva, Denie; Ploeg, Rutger; Broderick, Andrew

2017-01-01

In this article, we analyse the potential benefits and disadvantages of permitting healthcare professionals to invoke conscientious objection to deceased organ donation. There is some evidence that permitting doctors and nurses to register objections can ultimately lead to attitudinal change and acceptance of organ donation. However, while there may be grounds for conscientious objection in other cases such as abortion and euthanasia, the life-saving nature of donation and transplantation ren...

Improving diabetic foot care in a nurse-managed safety-net clinic.

Science.gov (United States)

Peterson, Joann M; Virden, Mary D

2013-05-01

This article is a description of the development and implementation of a Comprehensive Diabetic Foot Care Program and assessment tool in an academically affiliated nurse-managed, multidisciplinary, safety-net clinic. The assessment tool parallels parameters identified in the Task Force Foot Care Interest Group of the American Diabetes Association's report published in 2008, "Comprehensive Foot Examination and Risk Assessment." Review of literature, Silver City Health Center's (SCHC) 2009 Annual Report, retrospective chart review. Since the full implementation of SCHC's Comprehensive Diabetic Foot Care Program, there have been no hospitalizations of clinic patients for foot-related complications. The development of the Comprehensive Diabetic Foot Assessment tool and the implementation of the Comprehensive Diabetic Foot Care Program have resulted in positive outcomes for the patients in a nurse-managed safety-net clinic. This article demonstrates that quality healthcare services can successfully be developed and implemented in a safety-net clinic setting. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

Assessing the value of pulp mill biomass savings in a climate change conscious economy

International Nuclear Information System (INIS)

Adahl, Anders; Harvey, Simon; Berntsson, Thore

2006-01-01

Pulp mills use significant amounts of biofuels, both internal and purchased. Biofuels could contribute to reach greenhouse gas emission targets at competitive costs. Implementing process integration measures at a pulp mill in order to achieve pulp production with less use of energy (biofuels) has not only on-site consequences but also off-site consequences, such as substitution of fossil fuels elsewhere by the saved pulp mill biofuels, and less on-site electric power generation. In this paper a method, a linking model, is suggested to analyse pulp mill biofuel saving measures when carbon dioxide (CO 2 ) external costs are internalised. The linking model is based on equilibrium economics and links information from CO 2 constrained energy market future scenarios with process integration measures. Pulp mill economics and marginal energy market CO 2 response are identified. In an applied study, four process integration measures at a Swedish pulp mill were analysed using five energy market future scenarios emanating from a Nordic energy model. The investigated investment alternatives for biofuel savings all result in positive net annual savings, irrespectively of the scenario used. However, CO 2 emissions may increase or decrease depending on the future development of the Nordic energy market

Healthcare not-for-profits: FASB exposure draft highlights flexibility in financial statement presentation.

Science.gov (United States)

Conner, Brian

2016-03-01

A new version of the FASB accounting standard covering not-for-profit healthcare organizations contains potentially significant changes to the statement of operations and changes in net assets, statement of cash flows, and notes to the financial statements. Healthcare organizations already have tremendous flexibility with disclosures around all aspects of their business. Although auditors prefer to see only information that can be effectively audited, this preference does not prevent organizations from expanding on certain activities or transactions covered by GAAP in their footnotes.

How does retiree health insurance influence public sector employee saving?

Science.gov (United States)

Clark, Robert L; Mitchell, Olivia S

2014-12-01

Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

Tax-Assisted Approaches for Helping Canadians Meet Out-of-Pocket Health-Care Costs

Directory of Open Access Journals (Sweden)

J.C. Herbert Emery

2016-06-01

Full Text Available Canadians are not saving for the inevitable costs of drugs and long-term care which they will have to pay for out of pocket in their old age, and these costs could potentially be financially devastating for them. Later in life, when out-of-pocket health-care costs mount, those who previously enjoyed the security of a workplace insurance plan to cover such expenses will face a grim financial reality. Many aspects of care for older Canadians aren’t covered by this country’s single-payer health-care system. Besides prescription drugs, these include management of chronic conditions by ancillary health professionals, home care, long-term care, and dental and vision care. Statistics show that in 2012, Canadians’ private spending on health care totaled $60 billion, with private health insurance covering $24.5 billion of that amount. Coverage of health-care costs that don’t fall under Medicare’s purview is at present rather piecemeal. The non-refundable federal Medical Expense Tax Credit covers expenses only after the three-per-cent minimum, or first $2,171, of out-of-pocket costs have been paid by the individual. The Disability Tax Credit is available to those with a certified chronic disability, and these individuals are eligible for further support via the Registered Disability Savings Plan. A Caregiver Tax Credit is also available. The federal government has a golden opportunity to provide an incentive for Canadians to set aside money to pay not only for the often catastrophic medical and drug costs that can come with aging, but also to save so they can afford long-term care, or purchase private health insurance. Too many Canadians, unfortunately, believe that the federal government picks up the tab for long-term care. In fact, provincial subsidies are provided on a means-testing basis, thus leaving many better-off Canadians in the lurch when they can no longer live alone and must make the transition to long-term care. Providing more

Private Sector Savings

Directory of Open Access Journals (Sweden)

Pitonáková Renáta

2018-03-01

Full Text Available The majority of household savings are in the form of bank deposits. It is therefore of interest for credit institutions to tailor their deposit policy for getting finances from non-banking entities and to provide the private sector with the loans that are necessary for investment activities and consumption. This paper deals with the determinants of the saving rate of the private sector of Slovakia. Economic, financial and demographic variables influence savings. Growth of income per capita, private disposable income, elderly dependency ratio, real interest rate and inflation have a positive impact on savings, while increases in public savings indicate a crowding out effect. The inflation rate implies precautionary savings, and dependency ratio savings for bequest. There are also implications for governing institutions deciding on the implementation of appropriate fiscal and monetary operations.

Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money.

Science.gov (United States)

Davis, Jennifer J J

2008-09-01

Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, "Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense." This promising approach to improving health and reducing healthcare costs could potentially be applied to other employer groups.

Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money

Science.gov (United States)

Davis, Jennifer “J. J.”

2008-01-01

Background Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. Objectives As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. Methods The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. Results In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Conclusions Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, “Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense.” This promising approach to improving health and reducing healthcare costs could potentially be applied to other

Does Daylight Saving Save Energy? A Meta-Analysis

OpenAIRE

Havránek, Tomáš; Herman, Dominik; Irsova, Zuzana

2016-01-01

The original rationale for adopting daylight saving time (DST) was energy savings. Modern research studies, however, question the magnitude and even direction of the effect of DST on energy consumption. Representing the first meta-analysis in this literature, we collect 162 estimates from 44 studies and find that the mean reported estimate indicates modest energy savings: 0.34% during the days when DST applies. The literature is not affected by publication bias, but the results vary systemati...

Savings in acute care costs if all older adults treated for fall-related injuries completed matter of balance.

Science.gov (United States)

Howland, Jonathan; Shankar, Kalpana Narayan; Peterson, Elizabeth W; Taylor, Alyssa A

Falls among older adults are a common and serious public health problem. Evidence-based fall prevention programs delivered in community settings and targeting older adults living independently are increasingly deployed throughout the nation. These programs tend to be offered by public and private organizations that serve older adults, and recruitment usually occurs through direct marketing to the target population, rather than through referrals from healthcare providers. Matter of Balance , a program developed to reduce fear of falling and associated activity restriction in community-dwelling older adults, is currently being delivered in 38 of the 50 United States. In this study, we estimate the one-year medical care cost savings if older adults treated at Massachusetts hospitals for fall-related injuries were referred by healthcare providers to participate in Matter of Balance . Data from several sources were used for this study. We estimated annual cost savings in older adult falls recidivism for a hypothetical 100 patients presenting at an emergency department for a fall-related injury, assuming that all were referred to, and 50 % completed, Matter of Balance . This cost-saving estimate was subsequently expanded based on the actual number (43,931) of older adult patients presenting at, and discharged from Massachusetts emergency departments for all fall-related injuries in 2012. Cost savings were calculated for two additional participation rates: 25 % and 75 %. The return on investment (ROI), was calculated based on the percentage of return per each dollar invested. The calculated ROI for Matter of Balance was 144 %. Statewide savings ranged from $2.79 million assuming a 25 % participation rate to $8.37 million, assuming a 75 % participation rate. Referral to evidence-based falls prevention programs of older adult patients presenting at EDs with a fall-related injury could reduce subsequent falls and associated treatment costs.

Do water-saving technologies improve environmental flows?

Science.gov (United States)

Batchelor, Charles; Reddy, V. Ratna; Linstead, Conor; Dhar, Murli; Roy, Sumit; May, Rebecca

2014-10-01

Water saving and conservation technologies (WCTs) have been promoted widely in India as a practical means of improving the water use efficiency and freeing up water for other uses (e.g. for maintaining environmental flows in river systems). However, there is increasing evidence that, somewhat paradoxically, WCTs often contribute to intensification of water use by irrigated and rainfed farming systems. This occurs when: (1) Increased crop yields are coupled with increased consumptive water use and/or (2) Improved efficiency, productivity and profitability encourages farmers to increase the area cropped and/or to adopt multiple cropping systems. In both cases, the net effect is an increase in annual evapotranspiration that, particularly in areas of increasing water scarcity, can have the trade-off of reduced environmental flows. Recognition is also increasing that the claimed water savings of many WCTs may have been overstated. The root cause of this problem lies in confusion over what constitutes real water saving at the system or basin scales. The simple fact is that some of the water that is claimed to be ‘saved’ by WCTs would have percolated into the groundwater from where it can be and often is accessed and reused. Similarly, some of the “saved” runoff can be used downstream by, for example, farmers or freshwater ecosystems. This paper concludes that, particularly in areas facing increasing water scarcity, environmental flows will only be restored and maintained if they are given explicit (rather than theoretical or notional) attention. With this in mind, a simple methodology is proposed for deciding when and where WCTs may have detrimental impacts on environmental flows.

Balance and saving of GHG emissions in thermochemical biorefineries

International Nuclear Information System (INIS)

Haro, Pedro; Aracil, Cristina; Vidal-Barrero, Fernando; Ollero, Pedro

2015-01-01

Highlights: • A simplified methodology for the balance and saving of GHG emissions is provided. • The GHG balance has a physical meaning and does not depend on the fossil reference. • The GHG saving depends on regulation of energy carriers. • The impact of Bio-CCS incorporation and multiproduction is analyzed. • The co-production of chemicals needs to be included in future regulation. - Abstract: In this study, a simplified methodology for the calculation of the balance of greenhouse gas (GHG) emissions and corresponding saving compared with the fossil reference is presented. The proposed methodology allows the estimation of the anthropogenic GHG emissions of thermochemical biorefineries (net emitted to the atmosphere). In the calculation of the GHG balance, all relevant factors have been identified and analyzed including multiproduction, emissions from biogenic carbon capture and storage (Bio-CCS), co-feeding of fossil fuels (secondary feedstock) and possible carbon storage in biomass-derived products (chemicals). Therefore, it is possible to calculate the balance of GHG emissions of a hypothetical thermochemical biorefinery considering different alternatives of land-use, biomass feedstock, co-feeding of fossil fuels, Bio-CCS incorporation and final use of the products. The comparison of the estimated GHG balance with the corresponding fossil reference for each product is of special relevance in the methodology since it is the parameter used in European regulation for the fulfillment of sustainability criteria in biomass-derived fuels and liquids. The proposed methodology is tested using a previously assessed set of different process concepts of thermochemical biorefineries (techno-economic analysis). The resulting GHG balance and saving are analyzed to identify uncertainties and provide recommendations for future regulation. In all process concepts, the GHG savings are above the minimum requirement of GHG emissions for 2018. In the case of incorporating

The use of mosquito nets in fisheries: A global perspective.

Directory of Open Access Journals (Sweden)

Rebecca Short

Full Text Available Free or subsidised mosquito net (MN distribution has been an increasingly important tool in efforts to combat malaria in recent decades throughout the developing world, making great strides towards eradicating this hugely detrimental disease. However, there has been increasing concern in the natural resource management and healthcare communities over alternative use of MNs, particularly in artisanal fisheries where it has been suggested they pose a threat to sustainability of fish stocks. So far, little evidence has been presented as to the global prevalence and characteristics of MN fishing, limiting global management initiatives and incentives for action across disciplines. We conducted a rapid global assessment of mosquito net fishing (MNF observations from expert witnesses living and/or working in malarial zones using an internet survey. MNF was found to be a broadly pan-tropical activity, particularly prevalent in sub-Saharan Africa. MNF is conducted using a variety of deployment methods and scales including seine nets, scoop/dip nets, set nets and traps. MNF was witnessed in a broad range of marine and freshwater habitats and was seen to exploit a wide range of taxa, with capture of juvenile fish reported in more than half of responses. Perceived drivers of MNF were closely related to poverty, revealing potentially complex and arguably detrimental livelihood and food security implications which we discuss in light of current literature and management paradigms. The key policies likely to influence future impacts of MNF are in health, regarding net distribution, and natural resource management regarding restrictions on use. We outline critical directions for research and highlight the need for a collaborative, interdisciplinary approach to development of both localised and broad-scale policy.

Methodology for Outdoor Water Savings Model and Spreadsheet Tool for U.S. and Selected States

Energy Technology Data Exchange (ETDEWEB)

Williams, Alison A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Chen, Yuting [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dunham, Camilla [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fuchs, Heidi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Price, Sarah [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Stratton, Hannah [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-07-31

Green lawns and landscaping are archetypical of the populated American landscape, and typically require irrigation, which corresponds to a significant fraction of residential, commercial, and institutional water use. In North American cities, the estimated portion of residential water used for outdoor purposes ranges from 22-38% in cooler climates up to 59-67% in dry and hot environments, while turfgrass coverage within the United States spans 11.1-20.2 million hectares (Milesi et al. 2009). One national estimate uses satellite and aerial photography data to develop a relationship between impervious surface and lawn surface area, yielding a conservative estimate of 16.4 (± 3.6) million hectares of lawn surface area in the United States—an area three times larger than that devoted to any irrigated crop (Milesi et al. 2005). One approach that holds promise for cutting unnecessary outdoor water use is the increased deployment of “smart” irrigation controllers to increase the water efficiency of irrigation systems. This report describes the methodology and inputs employed in a mathematical model that quantifies the effects of the U.S. Environmental Protection Agency’s WaterSense labeling program for one such type of controller, weather-based irrigation controllers (WBIC). This model builds off that described in “Methodology for National Water Savings Model and Spreadsheet Tool–Outdoor Water Use” and uses a two-tiered approach to quantify outdoor water savings attributable to the WaterSense program for WBIC, as well as net present value (NPV) of that savings. While the first iteration of the model assessed national impacts using averaged national values, this version begins by evaluating impacts in three key large states that make up a sizable portion of the irrigation market: California, Florida, and Texas. These states are considered to be the principal market of “smart” irrigation controllers that may result in the bulk of national savings. Modeled

Horizontal ichthyoplankton tow-net system with unobstructed net opening

Science.gov (United States)

Nester, Robert T.

1987-01-01

The larval fish sampler described here consists of a modified bridle, frame, and net system with an obstruction-free net opening and is small enough for use on boats 10 m or less in length. The tow net features a square net frame attached to a 0.5-m-diameter cylinder-on-cone plankton net with a bridle designed to eliminate all obstructions forward of the net opening, significantly reducing currents and vibrations in the water directly preceding the net. This system was effective in collecting larvae representing more than 25 species of fish at sampling depths ranging from surface to 10 m and could easily be used at greater depths.

Deployment of Analytics into the Healthcare Safety Net: Lessons Learned.

Science.gov (United States)

Hartzband, David; Jacobs, Feygele

2016-01-01

As payment reforms shift healthcare reimbursement toward value-based payment programs, providers need the capability to work with data of greater complexity, scope and scale. This will in many instances necessitate a change in understanding of the value of data, and the types of data needed for analysis to support operations and clinical practice. It will also require the deployment of different infrastructure and analytic tools. Community health centers, which serve more than 25 million people and together form the nation's largest single source of primary care for medically underserved communities and populations, are expanding and will need to optimize their capacity to leverage data as new payer and organizational models emerge. To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA) with an affiliated data warehouse supporting health centers across the state. An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis deploying the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration. 1 In addition, interviews with health center leadership and staff were completed to understand the context for the findings. The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting

Higher-moment measurements of net-kaon, net-charge and net-proton multiplicity distributions at STAR

International Nuclear Information System (INIS)

Sarkar, Amal

2014-01-01

In this paper, we report the measurements of the various moments, such as mean, standard deviation (σ), skewness (S) and kurtosis (κ) of the net-kaon, net-charge and net-proton multiplicity distributions at mid-rapidity in Au + Au collisions from √(s NN )=7.7 to 200 GeV with the STAR experiment at RHIC. This work has been done with the aim to locate the critical point on the QCD phase diagram. These moments and their products are related to the thermodynamic susceptibilities of conserved quantities such as net baryon number, net charge, and net strangeness as well as to the correlation length of the system which diverges in an ideal infinite thermodynamic system at the critical point. For a finite system, existing for a finite time, a non-monotonic behavior of these variables would indicate the presence of the critical point. Furthermore, we also present the moment products Sσ, κσ 2 of net-kaon, net-charge and net-proton multiplicity distributions as a function of collision centrality and energy. The energy and the centrality dependence of higher moments and their products have been compared with different models

Commercial Smartphone-Based Devices and Smart Applications for Personalized Healthcare Monitoring and Management.

Science.gov (United States)

Vashist, Sandeep Kumar; Schneider, E Marion; Luong, John H T

2014-08-18

Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.

Saving can save from death anxiety: mortality salience and financial decision-making.

Science.gov (United States)

Zaleskiewicz, Tomasz; Gasiorowska, Agata; Kesebir, Pelin

2013-01-01

Four studies tested the idea that saving money can buffer death anxiety and constitute a more effective buffer than spending money. Saving can relieve future-related anxiety and provide people with a sense of control over their fate, thereby rendering death thoughts less threatening. Study 1 found that participants primed with both saving and spending reported lower death fear than controls. Saving primes, however, were associated with significantly lower death fear than spending primes. Study 2 demonstrated that mortality primes increase the attractiveness of more frugal behaviors in save-or-spend dilemmas. Studies 3 and 4 found, in two different cultures (Polish and American), that the activation of death thoughts prompts people to allocate money to saving as opposed to spending. Overall, these studies provided evidence that saving protects from existential anxiety, and probably more so than spending.

Saving can save from death anxiety: mortality salience and financial decision-making.

Directory of Open Access Journals (Sweden)

Tomasz Zaleskiewicz

Full Text Available Four studies tested the idea that saving money can buffer death anxiety and constitute a more effective buffer than spending money. Saving can relieve future-related anxiety and provide people with a sense of control over their fate, thereby rendering death thoughts less threatening. Study 1 found that participants primed with both saving and spending reported lower death fear than controls. Saving primes, however, were associated with significantly lower death fear than spending primes. Study 2 demonstrated that mortality primes increase the attractiveness of more frugal behaviors in save-or-spend dilemmas. Studies 3 and 4 found, in two different cultures (Polish and American, that the activation of death thoughts prompts people to allocate money to saving as opposed to spending. Overall, these studies provided evidence that saving protects from existential anxiety, and probably more so than spending.

TVA reaps big savings by letting powerplant work to outside firms

International Nuclear Information System (INIS)

Anon.

1992-01-01

This abstract is the entire text of the article. In a report to Congress, the Tennessee Valley Authority says its shift to full reliance on outside contractors for powerplant construction and modification work saved a net $54M in the first half of 1992. TVA says that total savings from lower overhead and increased efficiency were $75M, but that was partially offset by $21M in one-time mobilization/de-mobilization charges. TVA has a budget of $1.7B this year for new plant and equipment. That will rise to over $2B in the next two years. About 70% of the work involves nuclear plant work. Several members of Congress from the area criticized TVA in mid-1991 when it cut more than 5,000 hourly construction jobs and several hundred salaried construction jobs. The agency said the cuts let it concentrate on power production and promised to make semi-annual reports to Congress detailing the results of contracting out. In the agency's first report, TVA Chairman John Waters says that it saved $19.2M in personnel costs and staff overhead over the six-month period ending June 30, 1992. At the same time, $21.8M was saved through increased construction efficiency and productivity. Waters also says that the switch caused minimal impact on the local work force. Contractors employed 6,166 craft workers on their TVA projects at mid-year, compared with the 5,200 dropped by the agency in mid-1991

A case study: The economic cost of net metering in Maryland: Who bears the economic burden?

International Nuclear Information System (INIS)

Cook, C.; Cross, J.

1999-01-01

The Maryland legislature approved net-metering legislation for residential consumer generators with photovoltaic systems during 1997. Before the legislation passed, the Maryland Energy Administration (MEA) examined its potential economic impact on both the affected utilities and consumer ratepayers--with and without net-metered PV systems. The MEA discovered that the impact on the affected utility is minimal when the net-metered PV capacity is limited to a small percentage of utility peak load. The analysis also determined that the cost burden on other customers under a net-metered scenario is likewise limited. For Maryland's largest investor-owned utility, the maximum amount of any cross-subsidy (or cost) on a per customer basis is 46 cents annually. Furthermore, their analysis showed that when distribution system savings and environmental externalities are incorporated, net-metered customers may actually subsidize other utility customers. The MEA analysis also determined that about 50% of the value of the energy produced is lost if net metering is not available to those customers with grid tied PV systems. Over the long term, most if not all of any potential cost is borne by other residential customers, not utility shareholders. Finally, the additional cost burden to the utility under net metering--compensating the consumer at the retail rate versus the avoided cost rate--is less than expected when one considers the administrative costs associated with a dual-metered billing approach

First Virtual Live Conference in Healthcare.

Science.gov (United States)

Parthasarathi, Ramakrishnan; Gomes, Rachel M; Palanivelu, Praveen Raj; Senthilnathan, Palanisamy; Rajapandian, Subbiah; Venkatachalam, Ramasamy; Palanivelu, Chinnusamy

2017-07-01

Conferences and meetings bring together thousands of doctors from diverse locations. However, the traveling, accommodation, and arrangement of venues for conferences and meetings are expensive and a lot of time needs to be devoted to these logistics. The purpose of this article was to present our own virtual live conference experience using web conferencing and to briefly outline the basics and advantages of this technology in organization of healthcare conferences. Web conferencing technology was used to organize an international bariatric surgery conference, allowing a large number of attendees to participate and interact from wherever they were, using merely an Internet connection with a video player on their personal computers, laptops, or smartphones. A virtual live conference saves a lot of time and cost and simplifies the logistics needed to organize a learning conference with worldwide participation. As far as we know, this is the first report of a virtual live conference in healthcare. We see it as the future of organizing experts as well as medical teaching conferences.

Energy Savings Lifetimes and Persistence

Energy Technology Data Exchange (ETDEWEB)

Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steven R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-02-01

This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from a national collection of costs and savings for electric efficiency programs and portfolios.

Optimizing Existing Multistory Building Designs towards Net-Zero Energy

Directory of Open Access Journals (Sweden)

Mohammad Y. AbuGrain

2017-03-01

Full Text Available Recent global developments in awareness and concerns about environmental problems have led to reconsidering built environment approaches and construction techniques. One of the alternatives is the principle of low/zero-energy buildings. This study investigates the potentials of energy savings in an existing multi-story building in the Mediterranean region in order to achieve net-zero energy as a solution to increasing fossil fuel prices. The Colored building at the Faculty of Architecture, Eastern Mediterranean University, Cyprus was chosen as a target of this study to be investigated and analyzed in order to know how energy efficiency strategies could be applied to the building to reduce annual energy consumption. Since this research objective is to develop a strategy to achieve net-zero energy in existing buildings, case study and problem solving methodologies were applied in this research in order to evaluate the building design in a qualitative manner through observations, in addition to a quantitative method through an energy modeling simulation to achieve desirable results which address the problems. After optimizing the building energy performance, an alternative energy simulation was made of the building in order to make an energy comparison analysis, which leads to reliable conclusions. These methodologies and the strategies used in this research can be applied to similar buildings in order to achieve net-zero energy goals.

Towards a Usability and Error "Safety Net": A Multi-Phased Multi-Method Approach to Ensuring System Usability and Safety.

Science.gov (United States)

Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth

2017-01-01

The usability and safety of health information systems have become major issues in the design and implementation of useful healthcare IT. In this paper we describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. The approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net" that catches different types of usability and safety problems prior to releasing systems widely in healthcare settings.

Consumer directed healthcare: except for the healthy and wealthy it's unwise.

Science.gov (United States)

Woolhandler, Steffie; Himmelstein, David U

2007-06-01

Many politicians and business leaders are advocating high deductible health insurance plans linked with health savings accounts--so-called consumer-directed healthcare. These policies penalize the sick, discourage needed care (especially primary and preventive care), and direct tax subsidies towards the wealthiest Americans. They offer little hope of slowing the growth of health care costs and add further bureaucratic costs and complexity to our health care financing system.

Development of the Advanced Energy Design Guide for K-12 Schools -- 50% Energy Savings

Energy Technology Data Exchange (ETDEWEB)

Bonnema, E.; Leach, M.; Pless, S.; Torcellini, P.

2013-02-01

This Technical Support Document (TSD) describes the process and methodology for the development of the Advanced Energy Design Guide for K-12 School Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-K12) (ASHRAE et al. 2011a). The AEDG-K12 provides recommendations for achieving 50% whole-building energy savings in K-12 schools over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-K12 was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy (DOE).

Managing soil organic carbon in agriculture: the net effect on greenhouse gas emissions

International Nuclear Information System (INIS)

Marland, Gregg; West, Tristram O.; Schlamadinger, Bernhard; Canella, Lorenza

2003-01-01

A change in agricultural practice can increase carbon sequestration in agricultural soils. To know the net effect on greenhouse gas emissions to the atmosphere, however, we consider associated changes in CO 2 emissions resulting from the consumption of fossil fuels, emissions of other greenhouse gases and effects on land productivity and crop yield. We also consider how these factors will evolve over time. A change from conventional tillage to no-till agriculture, based on data for average practice in the U.S.; will result in net carbon sequestration in the soil that averages 337 kg C/ha/yr for the initial 20 yr with a decline to near zero in the following 20 yr, and continuing savings in CO 2 emissions because of reduced use of fossil fuels. The long-term results, considering all factors, can generally be expected to show decreased net greenhouse gas emissions. The quantitative details, however, depend on the site-specific impact of the conversion from conventional to no-till agriculture on agricultural yield and N 2 O emissions from nitrogen fertilizer

Exploring the time-saving bias: How drivers misestimate time saved when increasing speed

Directory of Open Access Journals (Sweden)

Eyal Peer

2010-12-01

Full Text Available According to the time-saving bias, drivers underestimate the time saved when increasing from a low speed and overestimate the time saved when increasing from a relatively high speed. Previous research used a specific type of task --- drivers were asked to estimate time saved when increasing speed and to give a numeric response --- to show this. The present research conducted two studies with multiple questions to show that the time-saving bias occurs in other tasks. Study 1 found that drivers committed the time-saving bias when asked to estimate (a the time saved when increasing speed or (b the distance that can be completed at a given time when increasing speed or (c the speed required to complete a given distance in decreasing times. Study 2 showed no major differences in estimations of time saved compared to estimations of the remaining journey time and also between responses given on a numeric scale versus a visual analog scale. Study 3 tested two possible explanations for the time-saving bias: a Proportion heuristic and a Differences heuristic. Some evidence was found for use of the latter.

Leadership and transformational change in healthcare organisations: a qualitative analysis of the North East Transformation System.

Science.gov (United States)

Erskine, Jonathan; Hunter, David J; Small, Adrian; Hicks, Chris; McGovern, Tom; Lugsden, Ed; Whitty, Paula; Steen, Nick; Eccles, Martin Paul

2013-02-01

The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

NPC Based Design Optimization for a Net Zero Office Building in Hot Climates with PV Panels as Shading Device

Directory of Open Access Journals (Sweden)

Muhammad Zubair

2018-05-01

Full Text Available Hot areas of the world receive a high amount of solar radiation. As a result, buildings in those areas consume more energy to maintain a comfortable climate for their inhabitants. In an effort to design net-zero energy building in hot climates, PV possesses the unique advantage of generating electrical energy while protecting the building from solar irradiance. In this work, to form a net-zero energy building (NZEB, renewable resources such as solar and wind available onsite for an existing building have been analyzed in a hot climate location. PV and wind turbines in various configurations are studied to form a NZEB, where PV-only systems offer better performance than Hybrid PV Wind systems, based on net present cost (NPC. The self-shading losses in PV placed on rooftop areas are analyzed by placing parallel arrays of PV modules at various distances in between them. The effect on building cooling load by rooftop PV panels as shading devices is investigated. Furthermore, self-shading losses of PV are compared by the savings in cooling loads using PV as shading. In the case study, 12.3% saving in the cooling load of the building is observed when the building rooftop is completed shaded by PV panels; annual cooling load decreased from 3.417 GWh to 2.996 GWh, while only 1.04% shaded losses are observed for fully shaded (FS buildings compared to those with no shading (NS, as PV generation decreases from 594.39 kWh/m2 to 588.21 kWh/m2. The net present cost of the project has been decreased from US$4.77 million to US$4.41 million by simply covering the rooftop completely with PV panels, for a net-zero energy building.

Net private benefits of purchasing eco-labeled air conditioners and subsidization policies in China

International Nuclear Information System (INIS)

Sun, Junxiu; Yin, Haitao; Wang, Feng

2014-01-01

Built on a data set of 527 air conditioner models collected from an online retailer, this study investigates whether the savings that consumers realize on their private electricity bills from purchasing energy-efficient appliances compensate for the additional cost of the appliances on the market, and if not, the size of the gap between the savings and the cost. Our findings show that, except for the most energy-efficient category, the cost savings from using energy-efficient air conditioners does compensate for their higher price. Therefore, any government subsidy should be reserved for the most efficient products. For less energy-efficient appliances, the best policy may be to provide more effective information instead of a subsidy because the subsidy might attract consumers away from more energy-efficient air conditioners and result in an unwanted effect. - Highlights: • This paper analyses the net private benefits of purchasing eco-labeled air conditioners in China. • There is no need to subsidize less energy-efficient air conditioners. • The most recently proposed policy development in China is a reform headed in the right direction

Healthcare and healthcare systems: inspiring progress and future prospects.

Science.gov (United States)

Durrani, Hammad

2016-01-01

Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population

Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis.

Directory of Open Access Journals (Sweden)

Toni Meier

Full Text Available Non-communicable diseases (NCDs represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany--in particular the effects of an excessive consumption of fat, salt and sugar--and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA, salt and sugar (mono- & disaccharides, MDS were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002-2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3-24.1 billion EUR in the year 2008, which represents 7% (CI95% 2%-10% of the total treatment costs in Germany (254 billion EUR. This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0-12.1; salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2-7.3 and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million-4.7 billion. Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.

Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis.

Science.gov (United States)

Meier, Toni; Senftleben, Karolin; Deumelandt, Peter; Christen, Olaf; Riedel, Katja; Langer, Martin

2015-01-01

Non-communicable diseases (NCDs) represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany--in particular the effects of an excessive consumption of fat, salt and sugar--and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA), salt and sugar (mono- & disaccharides, MDS) were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002-2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3-24.1 billion EUR) in the year 2008, which represents 7% (CI95% 2%-10%) of the total treatment costs in Germany (254 billion EUR). This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0-12.1); salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2-7.3) and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million-4.7 billion). Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.

Net-baryon-, net-proton-, and net-charge kurtosis in heavy-ion collisions within a relativistic transport approach

International Nuclear Information System (INIS)

Nahrgang, Marlene; Schuster, Tim; Stock, Reinhard; Mitrovski, Michael; Bleicher, Marcus

2012-01-01

We explore the potential of net-baryon, net-proton and net-charge kurtosis measurements to investigate the properties of hot and dense matter created in relativistic heavy-ion collisions. Contrary to calculations in a grand-canonical ensemble we explicitly take into account exact electric and baryon charge conservation on an event-by-event basis. This drastically limits the width of baryon fluctuations. A simple model to account for this is to assume a grand-canonical distribution with a sharp cut-off at the tails. We present baseline predictions of the energy dependence of the net-baryon, net-proton and net-charge kurtosis for central (b≤2.75 fm) Pb+Pb/Au+Au collisions from E lab =2A GeV to √(s NN )=200 GeV from the UrQMD model. While the net-charge kurtosis is compatible with values around zero, the net-baryon number decreases to large negative values with decreasing beam energy. The net-proton kurtosis becomes only slightly negative for low √(s NN ). (orig.)

Energy saving certificates

International Nuclear Information System (INIS)

2005-11-01

The French ministry of economy, finances and industry and the French agency of environment and energy mastery (Ademe) have organized on November 8, 2005, a colloquium for the presentation of the energy saving certificates, a new tool to oblige the energy suppliers to encourage their clients to make energy savings. This document gathers the transparencies presented at this colloquium about the following topics: state-of-the-art and presentation of the energy saving certificates system: presentation of the EEC system, presentation of the EEC standard operations; the energy saving certificates in Europe today: energy efficiency commitment in UK, Italian white certificate scheme, perspectives of the different European systems. (J.S.)

eHealth: Towards a Healthcare Service-Oriented Boundary-Less Infrastructure

Directory of Open Access Journals (Sweden)

Cristian LELUTIU

2010-09-01

Full Text Available The current paper presents several interoperability features applied to a local distributed information system, CardioNET, meant to improve quality of healthcare services, through the use of the latest medical and IT&C technologies. Modern healthcare systems require a patient-centric vision, where patients must receive medical attention or treatment anytime, regardless of their physical location. The eHealth distributed system we present – CardioNET is based on a SOA producer-consumer model taking a patient centric approach where every hardware, software and medical activities become “services”. The system offers tools for remote interactions between patients, doctors, medical entities (e.g. hospitals, labs and authorities. Based on international standards (IDC10, LOINC, HL7, the system assures interoperability and data exchange in widely accepted XML formats. A logical domain bus, called Pervasive Health Service Bus-pHSB, exchanges HL7 compliant data messages between the integrated elements of the platform, through high level protocols (SOAP/HL7. The paper addresses interoperability problems between medical informational platforms proposing an eHealth architecture composed of: - production systems (nodes: General Practitioner, Analysis Laboratories, Clinics, Hospitals, Home Health Care Units (H-HCU;- portal with specialized web services, registries and shared data repositories – distributed, boundary-less environment for decision support, research and educational activities.

Commercial Smartphone-Based Devices and Smart Applications for Personalized Healthcare Monitoring and Management

Directory of Open Access Journals (Sweden)

Sandeep Kumar Vashist

2014-08-01

Full Text Available Smartphone-based devices and applications (SBDAs with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare. Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.

REMINDER Saved Leave Scheme (SLS) : Transfer of leave to saved leave accounts

CERN Multimedia

HR Division

2002-01-01

Under the provisions of the voluntary saved leave scheme (SLS), a maximum total of 10 days'*) annual and compensatory leave (excluding saved leave accumulated in accordance with the provisions of Administrative Circular No. 22B) can be transferred to the saved leave account at the end of the leave year (30 September). We remind you that, since last year, unused leave of all those taking part in the saved leave scheme at the closure of the leave-year accounts is transferred automatically to the saved leave account on that date. Therefore, staff members have no administrative steps to take. In addition, the transfer, which eliminates the risk of omitting to request leave transfers and rules out calculation errors in transfer requests, will be clearly shown in the list of leave transactions that can be consulted in EDH from October 2002 onwards. Furthermore, this automatic leave transfer optimizes staff members' chances of benefiting from a saved leave bonus provided that they are still participants in the schem...

Can health promotion programs save Medicare money?

Directory of Open Access Journals (Sweden)

Ron Z Goetzel

2007-04-01

Full Text Available Ron Z Goetzel1, David Shechter2, Ronald J Ozminkowski1, David C Stapleton3, Pauline J Lapin4, J Michael McGinnis5, Catherine R Gordon6, Lester Breslow71Institute for Health and Productivity Studies, Cornell University, Washington, DC; 2Health and Productivity Research, Thomson Medstat, Santa Barbara, CA; 3Cornell Institute for Policy Research, Cornell University, Washington, DC; 4Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, MD; 5National Academy of Sciences, Institute of Medicine, The National Academies, Washington, DC; 6Office of the Director, Centers for Disease Control and Prevention, Washington, DC; 7UCLA School of Public Health, Dept. of Health Services, Los Angeles, CA, USAAbstract: The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program.Keywords: health promotion, return on investment, Medicare, financial

U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization?

Science.gov (United States)

Bustamante, Arturo Vargas

2016-01-01

For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. PMID:27694684

Economic burden of mucormycosis in the United States: can a vaccine be cost-effective?

Science.gov (United States)

Ibrahim, Ashraf S; Edwards, John E; Bryant, Richard; Spellberg, Brad

2009-01-01

Mucormycosis is a life-threatening infection which causes unacceptably high morbidity and mortality despite treatment. Therefore, a vaccine to prevent mucormycosis is desirable. A major barrier to developing an anti-mucormycosis vaccine is the perception that such a vaccine would not be cost-effective to deploy because the disease is rare. We used data from a recent retrospective study to calculate the annual cost to the US healthcare system caused by mucormycosis infections. We created a model to estimate the cost-efficacy of a niche, anti-mucormycosis vaccine deployed in a targeted manner to high-risk patients. We found that each case of mucormycosis results in an average direct cost to the US healthcare system of $97,743, for an overall cost of mucormycosis of $50 million per year. In the base case scenario, targeted deployment of an anti-mucormycosis vaccine would result in a net cost per quality adjusted life year saved (QUALY) of $17,249. Variations in the price of the vaccine, its market penetration, or the cost of infection could dramatically decrease the net cost, and could even result in net savings per QUALY. In conclusion, mucormycosis causes considerable cost to the US health care system. Targeted deployment of a niche vaccine could decrease infection rates and mortality from mucormycosis in a cost-effective manner.

Petri Nets

Indian Academy of Sciences (India)

In a computer system, for example, typical discrete events ... This project brought out a series of influential reports on Petri net theory in the mid and late ... Technology became a leading centre for Petri net research and from then on, Petri nets ...

Measuring industrial energy savings

International Nuclear Information System (INIS)

Kelly Kissock, J.; Eger, Carl

2008-01-01

Accurate measurement of energy savings from industrial energy efficiency projects can reduce uncertainty about the efficacy of the projects, guide the selection of future projects, improve future estimates of expected savings, promote financing of energy efficiency projects through shared-savings agreements, and improve utilization of capital resources. Many efforts to measure industrial energy savings, or simply track progress toward efficiency goals, have had difficulty incorporating changing weather and production, which are frequently major drivers of plant energy use. This paper presents a general method for measuring plant-wide industrial energy savings that takes into account changing weather and production between the pre and post-retrofit periods. In addition, the method can disaggregate savings into components, which provides additional resolution for understanding the effectiveness of individual projects when several projects are implemented together. The method uses multivariable piece-wise regression models to characterize baseline energy use, and disaggregates savings by taking the total derivative of the energy use equation. Although the method incorporates search techniques, multi-variable least-squares regression and calculus, it is easily implemented using data analysis software, and can use readily available temperature, production and utility billing data. This is important, since more complicated methods may be too complex for widespread use. The method is demonstrated using case studies of actual energy assessments. The case studies demonstrate the importance of adjusting for weather and production between the pre- and post-retrofit periods, how plant-wide savings can be disaggregated to evaluate the effectiveness of individual retrofits, how the method can identify the time-dependence of savings, and limitations of engineering models when used to estimate future savings

76 FR 16477 - General Reporting and Recordkeeping by Savings Associations and Savings and Loan Holding Companies

Science.gov (United States)

2011-03-23

... Savings Associations and Savings and Loan Holding Companies AGENCY: Office of Thrift Supervision (OTS...), 12 CFR 562.4 (audit of savings association, savings and loan holding company, or affiliate), 12 CFR... the savings association), 12 CFR 584.1(f) (books and records of each savings and loan holding company...

Healthcare payments under the budget deal: mostly good news for physicians

Directory of Open Access Journals (Sweden)

Robbins RA

2018-02-01

Full Text Available No abstract available. Article truncated after 150 words. In the early morning hours last Friday (2/9/18 Congress passed and President Trump signed a massive budget agreement (1. The spending package will cost about $320 billion over 10 years, according to the Congressional Budget Office. Payments for healthcare substantially increase under the deal. Most praised the agreement. "Congress made the right choice this morning for patients and communities by voting to halt damaging cuts to hospitals that care for low-income working families and others who face financial challenges," said Dr. Bruce Siegel, CEO of America's Essential Hospitals, which represents the nation's safety-net facilities. Marc Goldwein of the Center for a Responsible Federal Budget called the healthcare provisions the one "beacon of light" in what otherwise is an exorbitantly costly budget bill. Goldwein praised its mix of structural reforms with "reasonable policy” and liked that the bill pays for the increased healthcare spending. The bill extends Medicare physician fee cuts ….

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

Directory of Open Access Journals (Sweden)

Korenromp Eline L

2012-03-01

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

USE OF MIRROR PATTERN CUTTING OF NETTING MATERIALS FOR CONSTRUCTION OF LAKE BEACH SEINES

Directory of Open Access Journals (Sweden)

A. Nazarov

2014-12-01

Full Text Available Purpose. Justification and calculation of a new methodological approach to the construction of a standard beach seine (502 / 302 х 3.75 with the use of the properties of mirror netting ensuring the saving of the netting material, reduction of weight, price and drag resistance. Methodology. The carp age group selectivity of the constructed seine was assessed within fish fauna monitoring based on the catch analysis of monitoring gill nets with mesh sizes of 30-130 mm according to generally accepted methods [9, 10]. Calculation of netting materials and ropes was carried out according to generally accepted methods [12-14]. Seine resistance was calculated according to N. T. Senin formula for different netting materials and the angles of the movement of different seine parts in water [2]. The gear reliability and data processing were carried out according to standard methods [11, 14, 15]. Findings. A variant of the construction of the maximum lightweight beach lake seines made of mirror pattern netting taking into account the properties of the mirror pattern netting material, reduction of weight, price and drag resistance has been proposed. The provided recalculation of the properties of a serial seine made of rhombic mesh for the mirror netting seine taking into account netting properties allowed: 1 reducing the seine drag resistance value by 1,4 times; 2 reducing the weight of netting materials by 16.3% compared to the prototype; 3 increasing the seine selectivity when fishing older age groups of carp in non-drainable ponds. Originality. We presented the method of the calculation and construction of lake beach seines made of mirror netting, analyzed the technological stages of the construction of mirror netting, determined main qualitative and technological parameters, which had effect on the conditions of the construction and reliability of such fishing gears. A new method of the use of an insert of the combined netting material cutting ensuring

Solidarity, justice and unconditional access to healthcare.

Science.gov (United States)

Gheaus, Anca

2017-03-01

Luck egalitarianism provides a reason to object to conditionality in health incentive programmes in some cases when conditionality undermines political values such as solidarity or inclusiveness. This is the case with incentive programmes that aim to restrict access to essential healthcare services. Such programmes undermine solidarity. Yet, most people's lives are objectively worse, in one respect, in non-solidary societies, because solidarity contributes both instrumentally and directly to individuals' well-being. Because solidarity is non-excludable, undermining it will deprive both the prudent and the imprudent citizens of its goods. Thereby, undermining solidarity can make prudent citizens worse off than they would have otherwise been, out of no fault or choice of their own, but rather as a result of somebody else's imprudent choice. This goes against the spirit of luck egalitarianism. Therefore (luck egalitarian) justice can require us to save the imprudent and avoid conditionality in access to essential healthcare services. 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/.

Advertising energy saving programs: The potential environmental cost of emphasizing monetary savings.

Science.gov (United States)

Schwartz, Daniel; Bruine de Bruin, Wändi; Fischhoff, Baruch; Lave, Lester

2015-06-01

Many consumers have monetary or environmental motivations for saving energy. Indeed, saving energy produces both monetary benefits, by reducing energy bills, and environmental benefits, by reducing carbon footprints. We examined how consumers' willingness and reasons to enroll in energy-savings programs are affected by whether advertisements emphasize monetary benefits, environmental benefits, or both. From a normative perspective, having 2 noteworthy kinds of benefit should not decrease a program's attractiveness. In contrast, psychological research suggests that adding external incentives to an intrinsically motivating task may backfire. To date, however, it remains unclear whether this is the case when both extrinsic and intrinsic motivations are inherent to the task, as with energy savings, and whether removing explicit mention of extrinsic motivation will reduce its importance. We found that emphasizing a program's monetary benefits reduced participants' willingness to enroll. In addition, participants' explanations about enrollment revealed less attention to environmental concerns when programs emphasized monetary savings, even when environmental savings were also emphasized. We found equal attention to monetary motivations in all conditions, revealing an asymmetric attention to monetary and environmental motives. These results also provide practical guidance regarding the positioning of energy-saving programs: emphasize intrinsic benefits; the extrinsic ones may speak for themselves. (c) 2015 APA, all rights reserved).

Targeting Net Zero Energy at Marine Corps Base Hawaii, Kaneohe Bay: Preprint

Energy Technology Data Exchange (ETDEWEB)

Burman, K.; Kandt, A.; Lisell, L.; Booth, S.

2012-05-01

This paper summarizes the results of an NREL assessment of Marine Corps Base Hawaii (MCBH), Kaneohe Bay to appraise the potential of achieving net zero energy status through energy efficiency, renewable energy, and hydrogen vehicle integration. In 2008, the U.S. Department of Defense's U.S. Pacific Command partnered with the U.S. Department of Energy's (DOE's) National Renewable Energy Laboratory (NREL) to assess opportunities for increasing energy security through renewable energy and energy efficiency at Hawaii military installations. DOE selected Marine Corps Base Hawaii (MCBH), Kaneohe Bay, to receive technical support for net zero energy assessment and planning funded through the Hawaii Clean Energy Initiative (HCEI). NREL performed a comprehensive assessment to appraise the potential of MCBH Kaneohe Bay to achieve net zero energy status through energy efficiency, renewable energy, and hydrogen vehicle integration. This paper summarizes the results of the assessment and provides energy recommendations. The analysis shows that MCBH Kaneohe Bay has the potential to make significant progress toward becoming a net zero installation. Wind, solar photovoltaics, solar hot water, and hydrogen production were assessed, as well as energy efficiency technologies. Deploying wind turbines is the most cost-effective energy production measure. If the identified energy projects and savings measures are implemented, the base will achieve a 96% site Btu reduction and a 99% source Btu reduction. Using excess wind and solar energy to produce hydrogen for a fleet and fuel cells could significantly reduce energy use and potentially bring MCBH Kaneohe Bay to net zero. Further analysis with an environmental impact and interconnection study will need to be completed. By achieving net zero status, the base will set an example for other military installations, provide environmental benefits, reduce costs, increase energy security, and exceed its energy goals and mandates.

Economic Impact of a Peritoneal Dialysis Continuous Quality Improvement Program in Colombia.

Science.gov (United States)

Makhija, Dilip U; Walton, Surrey M; Mora, Juan P; Sanabria, Rafael M

2017-01-01

♦ BACKGROUND: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ METHODS: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013. Propensity score matching and regression analysis were performed to estimate the incremental cost of peritonitis. Patient months at risk, episodes of peritonitis pre- and post-CQI, and costs of CQI were obtained. Annual net savings of the CQI program were estimated based on the number of peritonitis events prevented. ♦ RESULTS: The incremental cost of a peritonitis episode was $250. In an 8-year period, peritonitis decreased from 1,837 episodes per 38,596 patient-months in 2006 to 841 episodes per 50,910 patient-months in 2014. Overall, the CQI program prevented an estimated 10,409 episodes of peritonitis. The cost of implementing the CQI program was $147,000 in the first year and $119,000 annually thereafter. Using a five percent discount rate, the net present value of the program was $1,346,431, with an average annual net savings of $207,027. The return on investment (i.e. total savings-program cost/program cost) of CQI was 169%. ♦ CONCLUSION: Continuous quality improvement initiatives designed to reduce rates of peritonitis have a strong potential to generate cost savings. Copyright © 2017 International Society for Peritoneal Dialysis.

The equivalency between logic Petri workflow nets and workflow nets.

Science.gov (United States)

Wang, Jing; Yu, ShuXia; Du, YuYue

2015-01-01

Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented.

The Equivalency between Logic Petri Workflow Nets and Workflow Nets

Science.gov (United States)

Wang, Jing; Yu, ShuXia; Du, YuYue

2015-01-01

Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented. PMID:25821845

The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis.

Science.gov (United States)

Aladul, Mohammed I; Fitzpatrick, Raymond W; Chapman, Stephen R

2018-05-15

The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. This study aimed to estimate the budget impact of the introduction of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in rheumatology and gastroenterology specialities in the UK. A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of £44 million on biologics over the next three years. With the entry of Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® the model estimates cumulative savings of £285 million by 2020. The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings. Copyright © 2018 Elsevier Inc. All rights reserved.

Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

Science.gov (United States)

Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

2017-01-01

Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold

Final Technical Report - Autothermal Styrene Manufacturing Process with Net Export of Energy

Energy Technology Data Exchange (ETDEWEB)

Trubac, Robert , E.; Lin, Feng; Ghosh, Ruma: Greene, Marvin

2011-11-29

The overall objectives of the project were to: (a) develop an economically competitive processing technology for styrene monomer (SM) that would reduce process energy requirements by a minimum 25% relative to those of conventional technology while achieving a minimum 10% ROI; and (b) advance the technology towards commercial readiness. This technology is referred to as OMT (Oxymethylation of Toluene). The unique energy savings feature of the OMT technology would be replacement of the conventional benzene and ethylene feedstocks with toluene, methane in natural gas and air or oxygen, the latter of which have much lower specific energy of production values. As an oxidative technology, OMT is a net energy exporter rather than a net energy consumer like the conventional ethylbenzene/styrene (EB/SM) process. OMT plants would ultimately reduce the cost of styrene monomer which in turn will decrease the costs of polystyrene making it perhaps more cost competitive with competing polymers such as polypropylene.

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

Energy Technology Data Exchange (ETDEWEB)

Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2012-07-01

This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

Science.gov (United States)

van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W; Pols, Huibert A P; van der Cammen, Tischa J M

2008-01-01

Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.

76 FR 31680 - General Reporting and Recordkeeping by Savings Associations and Savings and Loan Holding Companies

Science.gov (United States)

2011-06-01

... Savings Associations and Savings and Loan Holding Companies AGENCY: Office of Thrift Supervision (OTS... Savings and Loan Holding Companies. OMB Number: 1550-0011. Form Number: N/A. Description: This information...), 12 CFR 562.4 (audit of savings association, savings and loan holding company, or affiliate), 12 CFR...

12 CFR 583.21 - Savings association.

Science.gov (United States)

2010-01-01

... AFFECTING SAVINGS AND LOAN HOLDING COMPANIES § 583.21 Savings association. The term savings association means a Federal savings and loan association or a Federal savings bank chartered under section 5 of the Home Owners' Loan Act, a building and loan, savings and loan or homestead association or a cooperative...

Coloured Petri Nets

DEFF Research Database (Denmark)

Jensen, Kurt

1987-01-01

The author describes a Petri net model, called coloured Petri nets (CP-nets), by means of which it is possible to describe large systems without having to cope with unnecessary details. The author introduces CP-nets and provide a first impression of their modeling power and the suitability...

Effects of librarian-provided services in healthcare settings: a systematic review.

Science.gov (United States)

Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

2014-01-01

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

Energy Technology Data Exchange (ETDEWEB)

Bonnema, E.; Leach, M.; Pless, S.

2013-06-01

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

Lead-time reduction utilizing lean tools applied to healthcare: the inpatient pharmacy at a local hospital.

Science.gov (United States)

Al-Araidah, Omar; Momani, Amer; Khasawneh, Mohammad; Momani, Mohammed

2010-01-01

The healthcare arena, much like the manufacturing industry, benefits from many aspects of the Toyota lean principles. Lean thinking contributes to reducing or eliminating nonvalue-added time, money, and energy in healthcare. In this paper, we apply selected principles of lean management aiming at reducing the wasted time associated with drug dispensing at an inpatient pharmacy at a local hospital. Thorough investigation of the drug dispensing process revealed unnecessary complexities that contribute to delays in delivering medications to patients. We utilize DMAIC (Define, Measure, Analyze, Improve, Control) and 5S (Sort, Set-in-order, Shine, Standardize, Sustain) principles to identify and reduce wastes that contribute to increasing the lead-time in healthcare operations at the pharmacy understudy. The results obtained from the study revealed potential savings of > 45% in the drug dispensing cycle time.

The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study

Directory of Open Access Journals (Sweden)

Glenn Flores

2017-05-01

Full Text Available Abstract Background Of the 4.8 million uninsured children in America, 62–72% are eligible for but not enrolled in Medicaid or CHIP. Not enough is known, however, about the impact of health insurance on outcomes and costs for previously uninsured children, which has never been examined prospectively. Methods This prospective observational study of uninsured Medicaid/CHIP-eligible minority children compared children obtaining coverage vs. those remaining uninsured. Subjects were recruited at 97 community sites, and 11 outcomes monitored monthly for 1 year. Results In this sample of 237 children, those obtaining coverage were significantly (P 6 months at baseline were associated with remaining uninsured for the entire year. In multivariable analysis, children who had been uninsured for >6 months at baseline (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.4–10.3 and African-American children (OR, 2.8; 95% CI, 1.1–7.3 had significantly higher odds of remaining uninsured for the entire year. Insurance saved $2886/insured child/year, with mean healthcare costs = $5155/uninsured vs. $2269/insured child (P = .04. Conclusions Providing health insurance to Medicaid/CHIP-eligible uninsured children improves health, healthcare access and quality, and parental satisfaction; reduces unmet needs and out-of-pocket costs; and saves $2886/insured child/year. African-American children and those who have been uninsured for >6 months are at greatest risk for remaining uninsured. Extrapolation of the savings realized by insuring uninsured, Medicaid/CHIP-eligible children suggests that America potentially could save $8.7–$10.1 billion annually by providing health insurance to all Medicaid/CHIP-eligible uninsured children.

Geology of Woman Saving Concept

Directory of Open Access Journals (Sweden)

Shayesteh Madani

2014-09-01

Full Text Available Money is lubricant and an instrument for economic transaction. Money social dimension has increased over time, transforming it from a sole economic instrument to a device for various transactions. Money economic value in society is indicated through different forms, one of which is saving, in the sense of money accumulation and its use under specific future circumstances. Women, who form half of the society, take specific approaches to money and savings. The current research aims to investigate the perspectives and changing attitude strategy to money and saving among married women. The participants of this study include 20 to 70 year-old employed household married women who were observed phenomenologically and interviewed qualitatively on saving through.   The findings of this study demonstrated women perspectives on various types of saving, ways of saving, transfer methods, saving consumption forms and their mechanism. It also revealed that while money is an economic instrument and possess the economic material; attitudes and acts related to money are influenced by social conditions that has consequently turned saving into a social phenomenon.

Save Energy: Save Money!

Science.gov (United States)

Eccli, Eugene; And Others

This publication is a collection of inexpensive energy saving tips and home improvements for home owners, particularly in low-income areas or in older homes. Section titles are: (1) Keeping Warm; (2) Getting Heat Where You Need It; (3) Using the Sun; (4) Furnaces, Stoves, and Fireplaces; (5) Insulation and Other Energy Needs; (6) Do-It-Yourself…

Contract saving schemes

NARCIS (Netherlands)

Ronald, R.; Smith, S.J.; Elsinga, M.; Eng, O.S.; Fox O'Mahony, L.; Wachter, S.

2012-01-01

Contractual saving schemes for housing are institutionalised savings programmes normally linked to rights to loans for home purchase. They are diverse types as they have been developed differently in each national context, but normally fall into categories of open, closed, compulsory, and ‘free

REMINDER: Saved Leave Scheme (SLS)

CERN Multimedia

2003-01-01

Transfer of leave to saved leave accounts Under the provisions of the voluntary saved leave scheme (SLS), a maximum total of 10 days'* annual and compensatory leave (excluding saved leave accumulated in accordance with the provisions of Administrative Circular No 22B) can be transferred to the saved leave account at the end of the leave year (30 September). We remind you that unused leave of all those taking part in the saved leave scheme at the closure of the leave year accounts is transferred automatically to the saved leave account on that date. Therefore, staff members have no administrative steps to take. In addition, the transfer, which eliminates the risk of omitting to request leave transfers and rules out calculation errors in transfer requests, will be clearly shown in the list of leave transactions that can be consulted in EDH from October 2003 onwards. Furthermore, this automatic leave transfer optimizes staff members' chances of benefiting from a saved leave bonus provided that they ar...

Forecasting the demand on solar water heating systems and their energy savings potential during the period 2001-2005 in Jordan

International Nuclear Information System (INIS)

Kablan, M.M.

2003-01-01

Jordan is an example of a developing country that depends almost exclusively on imported oil. Luckily, Jordan is blessed with good solar energy resources. However, only 24% of Jordanian families are installing solar water heating systems (SWHS). The objective of this research is to forecast the yearly demand on SWHS by the household sector during the period 2001-2005 and to compute the potential energy savings throughout the investigated period due to the use of SWHS. It is found that the net energy collected over the entire investigated period is about 1454.4 million kW h. In addition, the capital savings over the entire investigated period is estimated to be 46.28 million US$ if SWHS are used to heat water instead of the commonly used LPG gas cookers. The results of the research may assist decision makers in the energy sector to implement more comprehensive plans that encourage more families to install SWHS and save on imported oil

31 CFR 351.47 - May I purchase definitive Series EE savings bonds through a payroll savings plan?

Science.gov (United States)

2010-07-01

... savings bonds through a payroll savings plan? 351.47 Section 351.47 Money and Finance: Treasury....47 May I purchase definitive Series EE savings bonds through a payroll savings plan? You may purchase... maintains a payroll savings plan. An authorized issuing agent must issue the bonds. ...

12 CFR 561.43 - Savings association.

Science.gov (United States)

2010-01-01

..., chartered under section 5 of the Act, or a building and loan, savings and loan, or homestead association, or... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Savings association. 561.43 Section 561.43... AFFECTING ALL SAVINGS ASSOCIATIONS § 561.43 Savings association. The term savings association means a...

Savings Behavior and Satisfaction with Savings: A Comparison of Low- and High-Income Groups.

Science.gov (United States)

Davis, Elizabeth P.; Schumm, Walter R.

1987-01-01

Data on 1,739 married couples from 13 states were analyzed. Associations between satisfaction with savings and level of savings with measures of motivation to save, motivations to spend, and family resources were found to differ substantially between low- and high-income couples. (Author/CH)

31 CFR 359.35 - May I purchase definitive Series I savings bonds through a payroll savings plan?

Science.gov (United States)

2010-07-01

... savings bonds through a payroll savings plan? 359.35 Section 359.35 Money and Finance: Treasury... May I purchase definitive Series I savings bonds through a payroll savings plan? You may purchase definitive bonds through deductions from your pay if your employer maintains a payroll savings plan. An...

Do healthcare tax credits help poor-health individuals on low incomes?

Science.gov (United States)

Di Novi, Cinzia; Marenzi, Anna; Rizzi, Dino

2018-03-01

In several countries, personal income tax permits tax credits for out-of-pocket healthcare expenditure. Tax credits benefit taxpayers at all income levels by reducing their net tax liability and modify the price of out-of-pocket expenditure. To the extent that consumer demand is price elastic, they may influence the amount of eligible healthcare expenditure for which taxpayers may claim a credit. These effects influence, in turn, income distributions and taxpayers' health status and therefore income-related inequality in health. Redistributive consequences of tax credits have been widely investigated. However, little is known about the ability of tax credits to alleviate health inequality. In this paper, we study the potential effects that tax credits for health expenses may have on income-related inequality in health status with reference to the Italian institutional setting. The analysis is performed using a tax-benefit microsimulation model that reproduces the personal income tax and incorporates taxpayers' behavioral responses to changes in tax credit rate. Our results suggest that the current healthcare tax credit design tends to favor the richest part of the population.

The future of UK healthcare: problems and potential solutions to a system in crisis.

Science.gov (United States)

Montgomery, H E; Haines, A; Marlow, N; Pearson, G; Mythen, M G; Grocott, M P W; Swanton, C

2017-08-01

The UK's Health System is in crisis, central funding no longer keeping pace with demand. Traditional responses-spending more, seeking efficiency savings or invoking market forces-are not solutions. The health of our nation demands urgent delivery of a radical new model, negotiated openly between public, policymakers and healthcare professionals. Such a model could focus on disease prevention, modifying health behaviour and implementing change in public policy in fields traditionally considered unrelated to health such as transport, food and advertising. The true cost-effectiveness of healthcare interventions must be balanced against the opportunity cost of their implementation, bolstering the central role of NICE in such decisions. Without such action, the prognosis for our healthcare system-and for the health of the individuals it serves-may be poor. Here, we explore such a new prescription for our national health. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

Directory of Open Access Journals (Sweden)

Pulkki-Brännström Anni-Maria

2012-04-01

Full Text Available Abstract Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs. LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan, but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years, LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price

12 CFR 575.10 - Acquisition and disposition of savings associations, savings and loan holding companies, and...

Science.gov (United States)

2010-01-01

... associations, savings and loan holding companies, and other corporations by mutual holding companies. 575.10... COMPANIES § 575.10 Acquisition and disposition of savings associations, savings and loan holding companies... savings and loan holding company in the stock form that is not a subsidiary holding company, provided the...

Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

Science.gov (United States)

Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

2010-04-01

Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

Application of deconvolution interferometry with both Hi-net and KiK-net data

Science.gov (United States)

Nakata, N.

2013-12-01

Application of deconvolution interferometry to wavefields observed by KiK-net, a strong-motion recording network in Japan, is useful for estimating wave velocities and S-wave splitting in the near surface. Using this technique, for example, Nakata and Snieder (2011, 2012) found changed in velocities caused by Tohoku-Oki earthquake in Japan. At the location of the borehole accelerometer of each KiK-net station, a velocity sensor is also installed as a part of a high-sensitivity seismograph network (Hi-net). I present a technique that uses both Hi-net and KiK-net records for computing deconvolution interferometry. The deconvolved waveform obtained from the combination of Hi-net and KiK-net data is similar to the waveform computed from KiK-net data only, which indicates that one can use Hi-net wavefields for deconvolution interferometry. Because Hi-net records have a high signal-to-noise ratio (S/N) and high dynamic resolution, the S/N and the quality of amplitude and phase of deconvolved waveforms can be improved with Hi-net data. These advantages are especially important for short-time moving-window seismic interferometry and deconvolution interferometry using later coda waves.

The Cost and Cost-Effectiveness of Scaling up Screening and Treatment of Syphilis in Pregnancy: A Model

Science.gov (United States)

Kahn, James G.; Jiwani, Aliya; Gomez, Gabriela B.; Hawkes, Sarah J.; Chesson, Harrell W.; Broutet, Nathalie; Kamb, Mary L.; Newman, Lori M.

2014-01-01

Background Syphilis in pregnancy imposes a significant global health and economic burden. More than half of cases result in serious adverse events, including infant mortality and infection. The annual global burden from mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million disability-adjusted life years (DALYs) and $309 million in medical costs. Syphilis screening and treatment is simple, effective, and affordable, yet, worldwide, most pregnant women do not receive these services. We assessed cost-effectiveness of scaling-up syphilis screening and treatment in existing antenatal care (ANC) programs in various programmatic, epidemiologic, and economic contexts. Methods and Findings We modeled the cost, health impact, and cost-effectiveness of expanded syphilis screening and treatment in ANC, compared to current services, for 1,000,000 pregnancies per year over four years. We defined eight generic country scenarios by systematically varying three factors: current maternal syphilis testing and treatment coverage, syphilis prevalence in pregnant women, and the cost of healthcare. We calculated program and net costs, DALYs averted, and net costs per DALY averted over four years in each scenario. Program costs are estimated at $4,142,287 – $8,235,796 per million pregnant women (2010 USD). Net costs, adjusted for averted medical care and current services, range from net savings of $12,261,250 to net costs of $1,736,807. The program averts an estimated 5,754 – 93,484 DALYs, yielding net savings in four scenarios, and a cost per DALY averted of $24 – $111 in the four scenarios with net costs. Results were robust in sensitivity analyses. Conclusions Eliminating MTCT of syphilis through expanded screening and treatment in ANC is likely to be highly cost-effective by WHO-defined thresholds in a wide range of settings. Countries with high prevalence, low current service coverage, and high healthcare cost would benefit most. Future analyses can be

A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.

Science.gov (United States)

Makombe, Simon D; Jahn, Andreas; Tweya, Hannock; Chuka, Stuart; Yu, Joseph Kwong-Leung; Hochgesang, Mindy; Aberle-Grasse, John; Pasulani, Olesi; Schouten, Erik J; Kamoto, Kelita; Harries, Anthony D

2007-11-01

To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.

Entrepreneurial Saving Practices and Reinvestment

NARCIS (Netherlands)

Beck, Thorsten; Pamuk, Haki; Uras, Burak R.

2017-01-01

We use a novel enterprise survey to gauge the relationship between saving instruments and entrepreneurial reinvestment. We show that while most informal saving practices are not associated with a lower likelihood of reinvestment when compared with formal saving practices, there is a significantly

Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

Science.gov (United States)

Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

2016-12-01

This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.

Navigation API Route Fuel Saving Opportunity Assessment on Large-Scale Real-World Travel Data for Conventional Vehicles and Hybrid Electric Vehicles: Preprint

Energy Technology Data Exchange (ETDEWEB)

Zhu, Lei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holden, Jacob [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gonder, Jeffrey D [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-12-06

The green routing strategy instructing a vehicle to select a fuel-efficient route benefits the current transportation system with fuel-saving opportunities. This paper introduces a navigation API route fuel-saving evaluation framework for estimating fuel advantages of alternative API routes based on large-scale, real-world travel data for conventional vehicles (CVs) and hybrid electric vehicles (HEVs). The navigation APIs, such Google Directions API, integrate traffic conditions and provide feasible alternative routes for origin-destination pairs. This paper develops two link-based fuel-consumption models stratified by link-level speed, road grade, and functional class (local/non-local), one for CVs and the other for HEVs. The link-based fuel-consumption models are built by assigning travel from a large number of GPS driving traces to the links in TomTom MultiNet as the underlying road network layer and road grade data from a U.S. Geological Survey elevation data set. Fuel consumption on a link is calculated by the proposed fuel consumption model. This paper envisions two kinds of applications: 1) identifying alternate routes that save fuel, and 2) quantifying the potential fuel savings for large amounts of travel. An experiment based on a large-scale California Household Travel Survey GPS trajectory data set is conducted. The fuel consumption and savings of CVs and HEVs are investigated. At the same time, the trade-off between fuel saving and time saving for choosing different routes is also examined for both powertrains.

Estimating healthcare costs of acute gastroenteritis and human campylobacteriosis in Switzerland.

Science.gov (United States)

Schmutz, C; Mäusezahl, D; Bless, P J; Hatz, C; Schwenkglenks, M; Urbinello, D

2017-03-01

Rising numbers of campylobacteriosis case notifications in Switzerland resulted in an increased attention to acute gastroenteritis (AG) in general. Patients with a laboratory-confirmed Campylobacter infection perceive their disease as severe and around 15% of these patients are hospitalized. This study aimed at estimating healthcare costs due to AG and campylobacteriosis in Switzerland. We used official health statistics, data from different studies and expert opinion for estimating individual treatment costs for patients with different illness severity and for extrapolating overall costs due to AG and campylobacteriosis. We estimated that total Swiss healthcare costs resulting from these diseases amount to €29-45 million annually. Data suggest that patients with AG consulting a physician without a stool diagnostic test account for €9·0-24·2 million, patients with a negative stool test result for Campylobacter spp. for €12·3 million, patients testing positive for Campylobacter spp. for €1·8 million and hospitalized campylobacteriosis patients for €6·5 million/year. Healthcare costs of campylobacteriosis are high and most likely increasing in Switzerland considering that campylobacteriosis case notifications steadily increased in the past decade. Costs and potential cost savings for the healthcare system should be considered when designing sectorial and cross-sectorial interventions to reduce the burden of human campylobacteriosis in Switzerland.

A Game Theoretic Framework for Green HetNets Using D2D Traffic Offload and Renewable Energy Powered Base Stations

KAUST Repository

Yaacoub, Elias

2015-08-26

This chapter investigates the interplay between cooperative device-to-device (D2D) communications and green communications in LTE heterogeneous networks (HetNets). Two game theoretic concepts are studied and analyzed in order to perform dynamic HetNet base station (BS) on/off switching. The first approach is a coalition-based method whereas the second is based on the Nash bargaining solution. Afterwards, a method for coupling the BS on/off switching approach with D2D collaborative communications is presented and shown to lead to increased energy efficiency. The savings are additionally increased when a portion of the small cell BSs in a HetNet are powered by renewable energy sources. Different utility functions, modeling the game theoretic framework governing the energy consumption balance between the cellular network and the mobile terminals (MTs), are proposed and compared, and their impact on MT quality of service (QoS) is analyzed.

A Game Theoretic Framework for Green HetNets Using D2D Traffic Offload and Renewable Energy Powered Base Stations

KAUST Repository

Yaacoub, Elias; Ghazzai, Hakim; Alouini, Mohamed-Slim

2015-01-01

This chapter investigates the interplay between cooperative device-to-device (D2D) communications and green communications in LTE heterogeneous networks (HetNets). Two game theoretic concepts are studied and analyzed in order to perform dynamic HetNet base station (BS) on/off switching. The first approach is a coalition-based method whereas the second is based on the Nash bargaining solution. Afterwards, a method for coupling the BS on/off switching approach with D2D collaborative communications is presented and shown to lead to increased energy efficiency. The savings are additionally increased when a portion of the small cell BSs in a HetNet are powered by renewable energy sources. Different utility functions, modeling the game theoretic framework governing the energy consumption balance between the cellular network and the mobile terminals (MTs), are proposed and compared, and their impact on MT quality of service (QoS) is analyzed.

Studies of lower-hybrid-assisted current rampup in NET/ITER

International Nuclear Information System (INIS)

Litaudon, X.; Moreau, D.; Bizarro, J.P.; Hoang, G.T.; Kupfer, K.; Peysson, Y.; Bonoli, P.

1992-01-01

Plasma current rampup, from 3.5 MA to the full operating value of 22 MA, is examined in NET/ITER at a density n = 6x10 19 m -3 and a rampup rate 0.35 MA/s. At these conditions, purely ohmic rampup requires about 250 Vs of transformer flux. With 30 MW of lower hybrid (LH) assist, we find that about 20-30 Vs can be saved depending on details of the incident power spectrum, fast electron trapping, etc. The principal constraint is to maintain monotonic (and thus stable) q profiles. The results indicate that a good overall strategy is to add the LH power slowly. Results are then quite insensitive to the incident power spectrum and deposition profiles

The influence of multiple goals on driving behavior: the case of safety, time saving, and fuel saving.

Science.gov (United States)

Dogan, Ebru; Steg, Linda; Delhomme, Patricia

2011-09-01

Due to the innate complexity of the task drivers have to manage multiple goals while driving and the importance of certain goals may vary over time leading to priority being given to different goals depending on the circumstances. This study aimed to investigate drivers' behavioral regulation while managing multiple goals during driving. To do so participants drove on urban and rural roads in a driving simulator while trying to manage fuel saving and time saving goals, besides the safety goals that are always present during driving. A between-subjects design was used with one group of drivers managing two goals (safety and fuel saving) and another group managing three goals (safety, fuel saving, and time saving) while driving. Participants were provided continuous feedback on the fuel saving goal via a meter on the dashboard. The results indicate that even when a fuel saving or time saving goal is salient, safety goals are still given highest priority when interactions with other road users take place and when interacting with a traffic light. Additionally, performance on the fuel saving goal diminished for the group that had to manage fuel saving and time saving together. The theoretical implications for a goal hierarchy in driving tasks and practical implications for eco-driving are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part III--Nonprofits, Ethics, Practice Implications, and Conclusions.

Science.gov (United States)

Nithman, Robert W

2015-01-01

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

Business entity selection: why it matters to healthcare practitioners--part I--Conceptual framework, sole proprietorships, and partnerships.

Science.gov (United States)

Nithman, Robert W

2015-01-01

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvan- tages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with the organizational mission or vision statement, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

Saving-enhanced memory: the benefits of saving on the learning and remembering of new information.

Science.gov (United States)

Storm, Benjamin C; Stone, Sean M

2015-02-01

With the continued integration of technology into people's lives, saving digital information has become an everyday facet of human behavior. In the present research, we examined the consequences of saving certain information on the ability to learn and remember other information. Results from three experiments showed that saving one file before studying a new file significantly improved memory for the contents of the new file. Notably, this effect was not observed when the saving process was deemed unreliable or when the contents of the to-be-saved file were not substantial enough to interfere with memory for the new file. These results suggest that saving provides a means to strategically off-load memory onto the environment in order to reduce the extent to which currently unneeded to-be-remembered information interferes with the learning and remembering of other information. © The Author(s) 2014.

Convex Programming and Bootstrap Sensitivity for Optimized Electricity Bill in Healthcare Buildings under a Time-Of-Use Pricing Scheme

Directory of Open Access Journals (Sweden)

Rodolfo Gordillo-Orquera

2018-06-01

Full Text Available Efficient energy management is strongly dependent on determining the adequate power contracts among the ones offered by different electricity suppliers. This topic takes special relevance in healthcare buildings, where noticeable amounts of energy are required to generate an adequate health environment for patients and staff. In this paper, a convex optimization method is scrutinized to give a straightforward analysis of the optimal power levels to be contracted while minimizing the electricity bill cost in a time-of-use pricing scheme. In addition, a sensitivity analysis is carried out on the constraints in the optimization problems, which are analyzed in terms of both their empirical distribution and their bootstrap-estimated statistical distributions to create a simple-to-use tool for this purpose, the so-called mosaic-distribution. The evaluation of the proposed method was carried out with five-year consumption data on two different kinds of healthcare buildings, a large one given by Hospital Universitario de Fuenlabrada, and a primary care center, Centro de Especialidades el Arroyo, both located at Fuenlabrada (Madrid, Spain. The analysis of the resulting optimization shows that the annual savings achieved vary moderately, ranging from −0.22 % to +27.39%, depending on the analyzed year profile and the healthcare building type. The analysis introducing mosaic-distribution to represent the sensitivity score also provides operative information to evaluate the convenience of implementing energy saving measures. All this information is useful for managers to determine the appropriate power levels for next year contract renewal and to consider whether to implement demand response mechanisms in healthcare buildings.

BMI and Healthcare Cost Impact of Eliminating Tax Subsidy for Advertising Unhealthy Food to Youth.

Science.gov (United States)

Sonneville, Kendrin R; Long, Michael W; Ward, Zachary J; Resch, Stephen C; Wang, Y Claire; Pomeranz, Jennifer L; Moodie, Marj L; Carter, Rob; Sacks, Gary; Swinburn, Boyd A; Gortmaker, Steven L

2015-07-01

Food and beverage TV advertising contributes to childhood obesity. The current tax treatment of advertising as an ordinary business expense in the U.S. subsidizes marketing of nutritionally poor foods and beverages to children. This study models the effect of a national intervention that eliminates the tax subsidy of advertising nutritionally poor foods and beverages on TV to children aged 2-19 years. We adapted and modified the Assessing Cost Effectiveness framework and methods to create the Childhood Obesity Intervention Cost Effectiveness Study model to simulate the impact of the intervention over the 2015-2025 period for the U.S. population, including short-term effects on BMI and 10-year healthcare expenditures. We simulated uncertainty intervals (UIs) using probabilistic sensitivity analysis and discounted outcomes at 3% annually. Data were analyzed in 2014. We estimated the intervention would reduce an aggregate 2.13 million (95% UI=0.83 million, 3.52 million) BMI units in the population and would cost $1.16 per BMI unit reduced (95% UI=$0.51, $2.63). From 2015 to 2025, the intervention would result in $352 million (95% UI=$138 million, $581 million) in healthcare cost savings and gain 4,538 (95% UI=1,752, 7,489) quality-adjusted life-years. Eliminating the tax subsidy of TV advertising costs for nutritionally poor foods and beverages advertised to children and adolescents would likely be a cost-saving strategy to reduce childhood obesity and related healthcare expenditures. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Cost-benefit analysis of retrofit of high-intensity discharge factory lighting with energy-saving alternatives

Energy Technology Data Exchange (ETDEWEB)

Preston, D.J. [Alabama Industrial Assessment Center, The University of Alabama, 1530 W. Tremont St, Allentown, PA 18102 (United States); Woodbury, K.A. [Alabama Industrial Assessment Center, The University of Alabama, 290 Hardaway Hall, Box 870276, Tuscaloosa, AL 35487-0276 (United States)

2013-05-15

Due to increased concern about overall energy costs and the appearance of efficient and inexpensive lighting system alternatives, factories and plants with high-intensity discharge (HID) lighting are forced to consider retrofit with more modern, energy-efficient lighting. The decision is complicated from an economic perspective, and there is a lack of information readily available on the topic. This study provides an analysis of the replacement by retrofit of common probe-start metal halide and high-pressure sodium industrial lighting systems. Retrofit options considered include the more recent pulse-start metal halide lamps and a range of T5 high output and T8 fluorescent lamp configurations. Recent data on lighting system pricing, labor and energy costs, and time required for tasks are reported. The results generated include savings, payback period, and net present value for many retrofit options, as well as the change in energy consumption, carbon footprint, and lumen output for each retrofit. Effects of varying rate of return and daily duration of operation are considered. Based on change in lumen output, payback period, net present value, and comparison of lighting quality, one or two options are recommended from the overall retrofit options considered. A fluorescent retrofit is recommended for each of the HID initial scenarios considered. The payback period is no more than 3 years in any recommended case. The focus of this study is on the potential energy and cost savings, and some proposed solutions may, or may not, be acceptable due to lack of illuminance uniformity.

Social Capital and Savings Behavior

DEFF Research Database (Denmark)

Newman, Carol; Tarp, Finn; Khai, Luu Duc

In this paper, we analyze household savings in rural Vietnam paying particular attention to the factors that determine the proportion of savings held as formal deposits. Our aim is to explore the extent to which social capital can play a role in promoting formal savings behavior. Social capital...

Saving water through global trade

NARCIS (Netherlands)

Chapagain, Ashok; Hoekstra, Arjen Ysbert; Savenije, H.H.G.

2005-01-01

Many nations save domestic water resources by importing water-intensive products and exporting commodities that are less water intensive. National water saving through the import of a product can imply saving water at a global level if the flow is from sites with high to sites with low water

Cost-savings accruable to removing value added tax from antiretrovirals in the South African private health sector

Directory of Open Access Journals (Sweden)

Varsha Bangalee

2017-10-01

Full Text Available Background: Despite the important and essential role that medicines play in any society, all medicines, including those identified as essential, are uniformly subjected to 14% value added tax (VAT, regardless of their therapeutic value in the private healthcare sector of South Africa. The aim of this article is to demonstrate the potential cost-saving attained from the removal of VAT from the private sector pricing of essential medicines, using antiretroviral treatment as an example. Methods: An empirical analysis was undertaken to illustrate the potential cost-saving achieved by removing VAT from the Single Exit Price and the dispensing fee of essential medicines. This outcome was demonstrated by applying the methodology to an adult fixed dose combination 1st line antiretroviral regimen as well as to a group of 3rd line antiretroviral medicines. Results: The potential saving for the lowest priced generic and originator 1st line antiviral regimen accrued to ZAR 693.84 and ZAR 1085.04 over a year respectively. Regarding the 3rd line antiretroviral drugs, results yielded an annual saving of ZAR 1678.68 (darunavir, ZAR5741.04 (maraviroc and ZAR 159.48 (rilpivirine. Conclusions: Lobbying for the removal of VAT from the supply chain of medicines should be intensified. Policy development to monitor and recover lost government revenue through the removal of taxes should be explored.

A strategic approach to developing e-learning capability for healthcare.

Science.gov (United States)

Clarke, Angie; Lewis, Dina; Cole, Ian; Ringrose, Liz

2005-12-01

This article examines a strategic approach to developing e-learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e-learning developments are considered. The 2-year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e-learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented. The MLE has been piloted and on-line learning packages have been acquired. There has been a phased take-up of e-learning opportunities and e-tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning. The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e-learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints-the MLE's benefits are widely recognized.

Energy savings in CSFR - building sector

International Nuclear Information System (INIS)

Jacobsen, F.R.

1993-01-01

The Czechoslovak/Danish project on energy savings in buildings proves that it is possible to save up to 30% of the energy in buildings. 10% can be saved at an investment of 27 bill KCS. The total investment that is needed to save 30% is 140 bill KCS. Further energy savings can be obtained through more energy efficient supply systems. Information dissemination is important for the energy saving programme as are economic incentives. Investments in energy savings should be profitable for the investor, but this is not the case in the Czech and Slovak republics today. Changes are needed. Energy prices are still to low, compared to investment costs. Financial possibilities are not satisfactory for private investors. Price systems are not favourable to investment in energy savings. Training is needed for boiler men and energy consultants. Legislation is essential for the support of the full range of activities in the energy sector. Research and Development activities must back up the development of the sector. Pilot projects can illuminate the savings potential. The production of technical equipment for control and metering and production of insulation materials must be promoted. (AB)

Net Neutrality

DEFF Research Database (Denmark)

Savin, Andrej

2017-01-01

Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else.......Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else....

Annotating Coloured Petri Nets

DEFF Research Database (Denmark)

Lindstrøm, Bo; Wells, Lisa Marie

2002-01-01

Coloured Petri nets (CP-nets) can be used for several fundamentally different purposes like functional analysis, performance analysis, and visualisation. To be able to use the corresponding tool extensions and libraries it is sometimes necessary to include extra auxiliary information in the CP......-net. An example of such auxiliary information is a counter which is associated with a token to be able to do performance analysis. Modifying colour sets and arc inscriptions in a CP-net to support a specific use may lead to creation of several slightly different CP-nets – only to support the different uses...... of the same basic CP-net. One solution to this problem is that the auxiliary information is not integrated into colour sets and arc inscriptions of a CP-net, but is kept separately. This makes it easy to disable this auxiliary information if a CP-net is to be used for another purpose. This paper proposes...

Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Cold Climates

Energy Technology Data Exchange (ETDEWEB)

Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Florida Solar Energy Center (FSEC); IBACOS; National Renewable Energy Laboratory (NREL)

2006-08-01

The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in Cold Climates on a cost-neutral basis.

Strategy to Support Improvement of Healthcare Quality.

Directory of Open Access Journals (Sweden)

Ing. Andrea Zejdlova

2013-01-01

Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

NetSig

DEFF Research Database (Denmark)

Horn, Heiko; Lawrence, Michael S; Chouinard, Candace R

2018-01-01

Methods that integrate molecular network information and tumor genome data could complement gene-based statistical tests to identify likely new cancer genes; but such approaches are challenging to validate at scale, and their predictive value remains unclear. We developed a robust statistic (Net......Sig) that integrates protein interaction networks with data from 4,742 tumor exomes. NetSig can accurately classify known driver genes in 60% of tested tumor types and predicts 62 new driver candidates. Using a quantitative experimental framework to determine in vivo tumorigenic potential in mice, we found that Net......Sig candidates induce tumors at rates that are comparable to those of known oncogenes and are ten-fold higher than those of random genes. By reanalyzing nine tumor-inducing NetSig candidates in 242 patients with oncogene-negative lung adenocarcinomas, we find that two (AKT2 and TFDP2) are significantly amplified...

Critical success factors in implementing an e-rostering system in a healthcare organisation.

Science.gov (United States)

Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

2017-01-01

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

A Science Cloud: OneSpaceNet

Science.gov (United States)

Morikawa, Y.; Murata, K. T.; Watari, S.; Kato, H.; Yamamoto, K.; Inoue, S.; Tsubouchi, K.; Fukazawa, K.; Kimura, E.; Tatebe, O.; Shimojo, S.

2010-12-01

system performs as one disk). There are three supercomputers allocated on the cloud, one from Tokyo, one from Osaka and the other from Nagoya. One's simulation job data on any supercomputers are saved on the cloud data storage (same directory); it is a kind of virtual computing environment. The tiled display wall has 36 panels acting as one display; the pixel (resolution) size of it is as large as 18000x4300. This size is enough to preview or analyze the large-scale computer simulation data. It also allows us to take a look of multiple (e.g., 100 pictures) on one screen together with many researchers. In our talk we also present a brief report of the initial results using the OneSpaceNet for Global MHD simulations as an example of successful use of our science cloud; (i) Ultra-high time resolution visualization of Global MHD simulations on the large-scale storage and parallel processing system on the cloud, (ii) Database of real-time Global MHD simulation and statistic analyses of the data, and (iii) 3D Web service of Global MHD simulations.

Energy Savings Measure Packages. Existing Homes

Energy Technology Data Exchange (ETDEWEB)

Casey, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2011-11-01

This document presents the most cost effective Energy Savings Measure Packages (ESMP) for existing mixed-fuel and all electric homes to achieve 15% and 30% savings for each BetterBuildings grantee location across the United States. These packages are optimized for minimum cost to homeowners for source energy savings given the local climate and prevalent building characteristics (i.e. foundation types). Maximum cost savings are typically found between 30% and 50% energy savings over the reference home; this typically amounts to $300 - $700/year.

Learning Visual Basic NET

CERN Document Server

Liberty, Jesse

2009-01-01

Learning Visual Basic .NET is a complete introduction to VB.NET and object-oriented programming. By using hundreds of examples, this book demonstrates how to develop various kinds of applications--including those that work with databases--and web services. Learning Visual Basic .NET will help you build a solid foundation in .NET.

Energy Saving Melting and Revert Reduction Technology (E-SMARRT): Design Support for Tooling Optimization

Energy Technology Data Exchange (ETDEWEB)

Wang, Dongtao

2011-09-23

High pressure die casting is an intrinsically efficient net shape process and improvements in energy efficiency are strongly dependent on design and process improvements that reduce scrap rates so that more of the total consumed energy goes into acceptable, usable castings. Computer simulation has become widely used within the industry but use is not universal. Further, many key design decisions must be made before the simulation can be run and expense in terms of money and time often limits the number of decision iterations that can be explored. This work continues several years of work creating simple, very fast, design tools that can assist with the early stage design decisions so that the benefits of simulation can be maximized and, more importantly, so that the chances of first shot success are maximized. First shot success and better running processes contributes to less scrap and significantly better energy utilization by the process. This new technology was predicted to result in an average energy savings of 1.83 trillion BTUs/year over a 10 year period. Current (2011) annual energy saving estimates over a ten year period, based on commercial introduction in 2012, a market penetration of 30% by 2015 is 1.89 trillion BTUs/year by 2022. Along with these energy savings, reduction of scrap and improvement in yield will result in a reduction of the environmental emissions associated with the melting and pouring of the metal which will be saved as a result of this technology. The average annual estimate of CO2 reduction per year through 2022 is 0.037 Million Metric Tons of Carbon Equivalent (MM TCE).

SAVING BEHAVIOUR AND DETERMINANTS OF SAVING MOBILIZATION BY RURAL FINANCIAL CO-OPERATORS IN TIGRAI REGION, ETHIOPIA

Directory of Open Access Journals (Sweden)

Sebhatu Kifle Tesfamariam

2012-01-01

Full Text Available This paper identified and examined saving behaviour and determinants of saving mobiliza-tion by the rural co-operators in Southern Tigrai Ethiopia. The input for the study was ob-tained from randomly selected 120 rural household savers from six purposively selected ru-ral savings and credit cooperatives. The result of the study using least squares method showed that savings mobilized is determined by household annual income, amount of loan borrowed and year of member stay in the cooperative. These factors therefore have to be considered in designing strategies aimed at improving the saving mobilization of coopera-tive members in the study area. Besides, economically feasible cooperative societies in the region should be encouraged among the rural households by supporting them with revolv-ing funds as they are more effective and efficient in mobilizing rural savings and provide collateral plus guarantor-based loans with low default rate. This will enable them to boost up their production output and increase their savings thereby stimulating the rural economy.

Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

Energy Technology Data Exchange (ETDEWEB)

Bonnema, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Leach, Matt [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pless, Shanti [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2013-06-05

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

Energy Technology Data Exchange (ETDEWEB)

Bonnema, E.; Leach, M.; Pless, S.

2013-06-01

This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

Connecting possibilistic prudence and optimal saving

Directory of Open Access Journals (Sweden)

Ana María Lucia Casademunt

2013-12-01

Full Text Available In this paper we study the optimal saving problem in the framework of possibility theory. The notion of possibilistic precautionary saving is introduced as a measure of the way the presence of possibilistic risk (represented by a fuzzy number influences a consumer in establishing the level of optimal saving. The notion of prudence of an agent in the face of possibilistic risk is defined and the equivalence between the prudence condition and a positive possibilistic precautionary saving is proved. Some relations between possibilistic risk aversion, prudence and possibilistic precautionary saving were established.

An energy-efficient metro speed profiles for energy savings: application to the Valencia metro

Energy Technology Data Exchange (ETDEWEB)

Villalba Sanchis, I.; Salvador Zuriaga, P.

2016-07-01

Nowadays one of the main priorities for metro line operators is the reduction of energy consumption, due to the environmental impact and economic cost. In order to achieve this objective different strategies can be applied, normally focused into rolling stock, infrastructure and/or operation. Considering short-term measures and related to the traffic operation strategies, different approaches are being researched. One of the most effective strategy which reduce net energy consumption is the use of efficient driving techniques. These techniques produces a speed profile between two stations that requires the minimum net energy consumption, without degrading commercial running times or passenger comfort. In this paper, a computer model for calculating the metro vehicles speed profiles minimizing the energy consumption was developed. The equations considered in the model represent the behavior of a single vehicle operated under manual driving, subject to different constraints such as the headway, cycle time, distances and acceleration limits. The proposed model calculates different commands to be systematically executed by the driver. The resulting simulator has been tuned by means of on board measurements of speed, accelerations and energy consumption obtained along different lines in Metro de Valencia network. For this purpose, different scenarios are analyzed to assess the achievable energy savings. In general terms and comparing with the actual energy consumption, the solutions proposed can reduce the net energy consumption around 19%. (Author)

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part II--Corporations, Limited Liability Companies, and Professional Entities.

Science.gov (United States)

Nithman, Robert W

2015-01-01

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

Moonlight project promotes energy-saving technology

Science.gov (United States)

Ishihara, A.

1986-01-01

In promoting energy saving, development of energy conservation technologies aimed at raising energy efficiency in the fields of energy conversion, its transportation, its storage, and its consumption is considered, along with enactment of legal actions urging rational use of energies and implementation of an enlightenment campaign for energy conservation to play a crucial role. Under the Moonlight Project, technical development is at present being centered around the following six pillars: (1) large scale energy saving technology; (2) pioneering and fundamental energy saving technology; (3) international cooperative research project; (4) research and survey of energy saving technology; (5) energy saving technology development by private industry; and (6) promotion of energy saving through standardization. Heat pumps, magnetohydrodynamic generators and fuel cells are discussed.

Saved Leave Scheme (SLS) : Simplified procedure for the transfer of leave to saved leave accounts

CERN Multimedia

HR Division

2001-01-01

As part of the process of streamlining procedures, the HR and AS Divisions have jointly developed a system whereby annual and compensatory leave will henceforth be automatically transferred1) to saved leave accounts. Under the provisions of the voluntary saved leave scheme (SLS), a maximum total of 10 days'2) annual and compensatory leave (excluding saved leave accumulated in accordance with the provisions of Administrative Circular No. 22 B) can be transferred to the saved leave account at the end of the leave year (30 September). Previously, every person taking part in the scheme has been individually issued with a form for the purposes of requesting the transfer of leave to the leave account and the transfer has then had to be done manually by HR Division. To streamline the procedure, unused leave of all those taking part in the saved leave scheme at the closure of of the leave-year accounts will henceforth be transferred automatically to the saved leave account on that date. This simplification is in the ...

Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.

Science.gov (United States)

George, Sheba M; Hayes, Erin Moran; Fish, Allison; Daskivich, Lauren Patty; Ogunyemi, Omolola I

2016-01-01

Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.

Healthcare marketing on the web: moving forward toward more interactive practices.

Science.gov (United States)

Erdem, S

2007-01-01

It is hard to deny the notion that the Internet has been very efficient in distributing health information to millions of individuals and has become one of the best marketing tools in healthcare. We have been witnessing so many very creative and interactive practices in this field that we can safely assume that it is now the time for e-commerce in healthcare industry. While this is true for many participants, there are also some who are concerned about using some of these new online options in the field of healthcare. Most of these concerns are derived from the questionable accuracy of the "health" information on the net. Considering the fact that the subject matter of the field is "health" we can realize that these concerns are serious and deserve an in-depth look. This paper reviews some of the most current practices in the field and provides some examples of these online options. It is hoped that the review of these examples will result in similar inquiries in the future and as those questionable options are exposed more and more, they will eventually be eliminated and replaced with the better ones.

Innovative use of the integrative review to evaluate evidence of technology transformation in healthcare.

Science.gov (United States)

Phillips, Andrew B; Merrill, Jacqueline A

2015-12-01

Healthcare is in a period significant transformational activity through the accelerated adoption of healthcare technologies, new reimbursement systems that emphasize shared savings and care coordination, and the common place use of mobile technologies by patients, providers, and others. The complexity of healthcare creates barriers to transformational activity and has the potential to inhibit the desired paths toward change envisioned by policymakers. Methods for understanding how change is occurring within this complex environment are important to the evaluation of delivery system reform and the role of technology in healthcare transformation. This study examines the use on an integrative review methodology to evaluate the healthcare literature for evidence of technology transformation in healthcare. The methodology integrates the evaluation of a broad set of literature with an established evaluative framework to develop a more complete understanding of a particular topic. We applied this methodology and the framework of punctuated equilibrium (PEq) to the analysis of the healthcare literature from 2004 to 2012 for evidence of technology transformation, a time during which technology was at the forefront of healthcare policy. The analysis demonstrated that the established PEq framework applied to the literature showed considerable potential for evaluating the progress of policies that encourage healthcare transformation. Significant inhibitors to change were identified through the integrative review and categorized into ten themes that describe the resistant structure of healthcare delivery: variations in the environment; market complexity; regulations; flawed risks and rewards; change theories; barriers; ethical considerations; competition and sustainability; environmental elements, and internal elements. We hypothesize that the resistant nature of the healthcare system described by this study creates barriers to the direct consumer involvement and engagement

Pro-Nets versus No-Nets: Differences in Urban Older Adults' Predilections for Internet Use

Science.gov (United States)

Cresci, M. Kay; Yarandi, Hossein N.; Morrell, Roger W.

2010-01-01

Enthusiasm for information technology (IT) is growing among older adults. Many older adults enjoy IT and the Internet (Pro-Nets), but others have no desire to use it (No-Nets). This study found that Pro-Nets and No-Nets were different on a number of variables that might predict IT use. No-Nets were older, had less education and income, were…

Preferred drug lists: Potential impact on healthcare economics

Directory of Open Access Journals (Sweden)

Kimberly Ovsag

2008-04-01

Full Text Available Kimberly Ovsag, Sabrina Hydery, Shaker A MousaPharmaceutical Research Institute at Albany College of Pharmacy, Albany, New York, USAObjectives: To analyze the implementation of Medicaid preferred drug lists (PDLs in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare.Methods: We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included “drug lists,” “prior authorization,” “prior approval,” and “Medicaid.” We added terms such as “influence use of other healthcare services,” “quality of care,” and “overall economic impact.” We mainly used primary sources.Results: Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a the potential for PDLs to influence the utilization of other healthcare services, (b criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c the effect of PDL implementation on compliance to new regimens, (d the potential effects of restricting medication availability on quality of care, (e administrative costs associated with PDLs, and (f satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact.Conclusions: The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.Keywords: preferred drug lists, medicaid, healthcare costs, managed care

Experiments and simulation of a net closing mechanism for tether-net capture of space debris

Science.gov (United States)

Sharf, Inna; Thomsen, Benjamin; Botta, Eleonora M.; Misra, Arun K.

2017-10-01

This research addresses the design and testing of a debris containment system for use in a tether-net approach to space debris removal. The tether-net active debris removal involves the ejection of a net from a spacecraft by applying impulses to masses on the net, subsequent expansion of the net, the envelopment and capture of the debris target, and the de-orbiting of the debris via a tether to the chaser spacecraft. To ensure a debris removal mission's success, it is important that the debris be successfully captured and then, secured within the net. To this end, we present a concept for a net closing mechanism, which we believe will permit consistently successful debris capture via a simple and unobtrusive design. This net closing system functions by extending the main tether connecting the chaser spacecraft and the net vertex to the perimeter and around the perimeter of the net, allowing the tether to actuate closure of the net in a manner similar to a cinch cord. A particular embodiment of the design in a laboratory test-bed is described: the test-bed itself is comprised of a scaled-down tether-net, a supporting frame and a mock-up debris. Experiments conducted with the facility demonstrate the practicality of the net closing system. A model of the net closure concept has been integrated into the previously developed dynamics simulator of the chaser/tether-net/debris system. Simulations under tether tensioning conditions demonstrate the effectiveness of the closure concept for debris containment, in the gravity-free environment of space, for a realistic debris target. The on-ground experimental test-bed is also used to showcase its utility for validating the dynamics simulation of the net deployment, and a full-scale automated setup would make possible a range of validation studies of other aspects of a tether-net debris capture mission.

Energy usage and technical potential for energy saving measures in the Swedish residential building stock

International Nuclear Information System (INIS)

Mata, Érika; Sasic Kalagasidis, Angela; Johnsson, Filip

2013-01-01

This paper provides an analysis of the current energy usage (net energy and final energy by fuels) and associated carbon dioxide (CO 2 ) emissions of the Swedish residential building stock, which includes single-family dwellings and multi-family dwellings. Twelve energy saving measures (ESMs) are assessed using a bottom–up modeling methodology, in which the Swedish residential stock is represented by a sample of 1400 buildings (based on data from the year 2005). Application of the ESMs studied gives a maximum technical reduction potential in energy demand of 53%, corresponding to a 63% reduction in CO 2 emissions. Although application of the investigated ESMs would reduce CO 2 emissions, the measures that reduce electricity consumption for lighting and appliances (LA) will increase CO 2 emissions, since the saved electricity production is less CO 2 -intensive than the fuel mix used for the increased space heating required to make up for the loss in indirect heating obtained from LA. - Highlights: ► Analysis of year 2005energy use and CO2 emissions of Swedish residential buildings. ► Includes all single-family dwellings and multi-family dwellings. ► Bottom–up modeling of building stock represented by 1400 buildings. ► Technical effects of 12 energy saving measures are assessed. ► Energy demand can be reduced by53% and associated CO 2 emissions by 63%

Reinforcement Learning and Savings Behavior.

Science.gov (United States)

Choi, James J; Laibson, David; Madrian, Brigitte C; Metrick, Andrew

2009-12-01

We show that individual investors over-extrapolate from their personal experience when making savings decisions. Investors who experience particularly rewarding outcomes from saving in their 401(k)-a high average and/or low variance return-increase their 401(k) savings rate more than investors who have less rewarding experiences with saving. This finding is not driven by aggregate time-series shocks, income effects, rational learning about investing skill, investor fixed effects, or time-varying investor-level heterogeneity that is correlated with portfolio allocations to stock, bond, and cash asset classes. We discuss implications for the equity premium puzzle and interventions aimed at improving household financial outcomes.

Reinforcement Learning and Savings Behavior*

Science.gov (United States)

Choi, James J.; Laibson, David; Madrian, Brigitte C.; Metrick, Andrew

2009-01-01

We show that individual investors over-extrapolate from their personal experience when making savings decisions. Investors who experience particularly rewarding outcomes from saving in their 401(k)—a high average and/or low variance return—increase their 401(k) savings rate more than investors who have less rewarding experiences with saving. This finding is not driven by aggregate time-series shocks, income effects, rational learning about investing skill, investor fixed effects, or time-varying investor-level heterogeneity that is correlated with portfolio allocations to stock, bond, and cash asset classes. We discuss implications for the equity premium puzzle and interventions aimed at improving household financial outcomes. PMID:20352013

Electric energy savings from new technologies

Energy Technology Data Exchange (ETDEWEB)

Moe, R.J.; Harrer, B.J.; Kellogg, M.A.; Lyke, A.J.; Imhoff, K.L.; Fisher, Z.J.

1986-01-01

Purpose of the report is to provide information about the electricity-saving potential of new technologies to OCEP that it can use in developing alternative long-term projections of US electricity consumption. Low-, base-, and high-case scenarios of the electricity savings for ten technologies were prepared. The total projected annual savings for the year 2000 for all ten technologies were 137 billion kilowatt hours (BkWh), 279 BkWh, and 470 BkWh, respectively, for the three cases. The magnitude of these savings projections can be gauged by comparing them to the Department's reference case projection for the 1985 National Energy Policy Plan. In the Department's reference case, total consumption in 2000 is projected to be 3319 BkWh. Thus, the savings projected here represent between 4% and 14% of total consumption projected for 2000. Because approximately 75% of the base-case estimate of savings are already incorporated into the reference forecast, reducing projected electricity consumption from what it otherwise would have been, the savings estimated here should not be directly subtracted from the reference forecast.

Saving for Success: Financial Education and Savings Goal Achievement in Individual Development Accounts

Science.gov (United States)

Grinstead, Mary L.; Mauldin, Teresa; Sabia, Joseph J.; Koonce, Joan; Palmer, Lance

2011-01-01

Using microdata from the American Dream Demonstration, the current study examines factors associated with savings and savings goal achievement (indicated by a matched withdrawal) among participants of individual development account (IDA) programs. Multinomial logit results show that hours of participation in financial education programs, higher…

Short-Term Saved Leave Scheme

CERN Multimedia

2007-01-01

As announced at the meeting of the Standing Concertation Committee (SCC) on 26 June 2007 and in http://Bulletin No. 28/2007, the existing Saved Leave Scheme will be discontinued as of 31 December 2007. Staff participating in the Scheme will shortly receive a contract amendment stipulating the end of financial contributions compensated by save leave. Leave already accumulated on saved leave accounts can continue to be taken in accordance with the rules applicable to the current scheme. A new system of saved leave will enter into force on 1 January 2008 and will be the subject of a new implementation procedure entitled "Short-term saved leave scheme" dated 1 January 2008. At its meeting on 4 December 2007, the SCC agreed to recommend the Director-General to approve this procedure, which can be consulted on the HR Department’s website at the following address: https://cern.ch/hr-services/services-Ben/sls_shortterm.asp All staff wishing to participate in the new scheme a...

Short-Term Saved Leave Scheme

CERN Multimedia

HR Department

2007-01-01

As announced at the meeting of the Standing Concertation Committee (SCC) on 26 June 2007 and in http://Bulletin No. 28/2007, the existing Saved Leave Scheme will be discontinued as of 31 December 2007. Staff participating in the Scheme will shortly receive a contract amendment stipulating the end of financial contributions compensated by save leave. Leave already accumulated on saved leave accounts can continue to be taken in accordance with the rules applicable to the current scheme. A new system of saved leave will enter into force on 1 January 2008 and will be the subject of a new im-plementation procedure entitled "Short-term saved leave scheme" dated 1 January 2008. At its meeting on 4 December 2007, the SCC agreed to recommend the Director-General to approve this procedure, which can be consulted on the HR Department’s website at the following address: https://cern.ch/hr-services/services-Ben/sls_shortterm.asp All staff wishing to participate in the new scheme ...

ROOT.NET: Using ROOT from .NET languages like C# and F#

Science.gov (United States)

Watts, G.

2012-12-01

ROOT.NET provides an interface between Microsoft's Common Language Runtime (CLR) and .NET technology and the ubiquitous particle physics analysis tool, ROOT. ROOT.NET automatically generates a series of efficient wrappers around the ROOT API. Unlike pyROOT, these wrappers are statically typed and so are highly efficient as compared to the Python wrappers. The connection to .NET means that one gains access to the full series of languages developed for the CLR including functional languages like F# (based on OCaml). Many features that make ROOT objects work well in the .NET world are added (properties, IEnumerable interface, LINQ compatibility, etc.). Dynamic languages based on the CLR can be used as well, of course (Python, for example). Additionally it is now possible to access ROOT objects that are unknown to the translation tool. This poster will describe the techniques used to effect this translation, along with performance comparisons, and examples. All described source code is posted on the open source site CodePlex.

ROOT.NET: Using ROOT from .NET languages like C and F

International Nuclear Information System (INIS)

Watts, G

2012-01-01

ROOT.NET provides an interface between Microsoft's Common Language Runtime (CLR) and .NET technology and the ubiquitous particle physics analysis tool, ROOT. ROOT.NET automatically generates a series of efficient wrappers around the ROOT API. Unlike pyROOT, these wrappers are statically typed and so are highly efficient as compared to the Python wrappers. The connection to .NET means that one gains access to the full series of languages developed for the CLR including functional languages like F (based on OCaml). Many features that make ROOT objects work well in the .NET world are added (properties, IEnumerable interface, LINQ compatibility, etc.). Dynamic languages based on the CLR can be used as well, of course (Python, for example). Additionally it is now possible to access ROOT objects that are unknown to the translation tool. This poster will describe the techniques used to effect this translation, along with performance comparisons, and examples. All described source code is posted on the open source site CodePlex.

The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

Directory of Open Access Journals (Sweden)

Nhung Nghiem

2016-05-01

Full Text Available Abstract Background A “diet high in sodium” is the second most important dietary risk factor for health loss identified in the Global Burden of Disease Study 2013. We therefore aimed to model health gains and costs (savings of salt reduction interventions related to salt substitution and maximum levels in bread, including by ethnicity and age. We also ranked these four interventions compared to eight other modelled interventions. Methods A Markov macro-simulation model was used to estimate QALYs gained and net health system costs for four dietary sodium reduction interventions, discounted at 3 % per annum. The setting was New Zealand (NZ (2.3 million adults, aged 35+ years which has detailed individual-level administrative cost data. Results The health gain was greatest for an intervention where most (59 % of the sodium in processed foods was replaced by potassium and magnesium salts. This intervention gained 294,000 QALYs over the remaining lifetime of the cohort (95 % UI: 238,000 to 359,000; 0.13 QALY per 35+ year old. Such salt substitution also produced the highest net cost-savings of NZ$ 1.5 billion (US$ 1.0 billion (95 % UI: NZ$ 1.1 to 2.0 billion. All interventions generated relatively larger per capita QALYs for men vs women and for the indigenous Māori population vs non-Māori (e.g., 0.16 vs 0.12 QALYs per adult for the 59 % salt substitution intervention. Of relevance to workforce productivity, in the first 10 years post-intervention, 22 % of the QALY gain was among those aged <65 years (and 37 % for those aged <70. Conclusions The benefits are consistent with the international literature, with large health gains and cost savings possible from some, but not all, sodium reduction interventions. Health gain appears likely to occur among working-age adults and all interventions contributed to reducing health inequalities.

Energy savings: persuasion and persistence

Energy Technology Data Exchange (ETDEWEB)

Eijadi, David; McDougall, Tom; Leaf, Kris; Douglas, Jim; Steinbock, Jason; Reimer, Paul [The Weidt Group, Minnetonka, MN (United States); Gauthier, Julia [Xcel Energy, Minneapolis, MN (United States); Wild, Doug; Richards McDaniel, Stephanie [BWBR Architects, Inc., Saint Paul, MN (United States)

2005-07-01

In this study, the architects, sponsoring utility and energy simulation specialist joined together to investigate the persistence of energy savings in three completed projects: a college library; a municipal transportation facility; and a hospital. The primary question being 'How well did the design decisions made with the help of simulation analysis translate into building operations over several years?' Design simulation and metered performance data are compared for specific energy-saving strategies. The paper provides a brief overview of the basis of selection of the three projects, the energy design assistance methods employed and the decisions made, along with their savings expectations. For each case, design characteristics, modelling assumptions, selected strategies and actual metered performance are outlined. We find evidence of appropriate levels of energy conservation, but they are not the absolute values predicted. In each case, the discrepancies between modelling assumptions and final construction or operating procedures are identified, examined and rectified. The paper illustrates that while owners are saving energy, they are not always getting the full savings potential for what they install. The paper concludes with a re-examination of the overall process. It evaluates the potential for additional savings of individual technologies and related larger utility incentives to design teams and building owners.

Saving-Based Asset Pricing

DEFF Research Database (Denmark)

Dreyer, Johannes Kabderian; Schneider, Johannes; T. Smith, William

2013-01-01

This paper explores the implications of a novel class of preferences for the behavior of asset prices. Following a suggestion by Marshall (1920), we entertain the possibility that people derive utility not only from consumption, but also from the very act of saving. These ‘‘saving-based’’ prefere...

Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data.

Science.gov (United States)

Visscher, Simeon J A; van Stel, Henk F

2017-12-01

This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes), resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch) and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH) are provided as well. This data-in-brief article accompanies the paper "Variation in prevention of child maltreatment by Dutch child healthcare professionals" by Simeon Visscher and Henk van Stel [1].

Constipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation.

Science.gov (United States)

Neri, Luca; Basilisco, Guido; Corazziari, Enrico; Stanghellini, Vincenzo; Bassotti, Gabrio; Bellini, Massimo; Perelli, Ilaria; Cuomo, Rosario

2014-04-01

We sought to evaluate the association between constipation severity, productivity losses and healthcare utilization in a national sample of Italian patients with chronic non-organic constipation (CC). We enrolled 878 outpatients with CC. Clinical and demographic data were collected by physicians during clinical examinations. Patients completed a self-administered questionnaire (Patient Assessment of Constipation-Symptoms, PAC-SYM; Work Productivity and Activity Impairment; healthcare utilization, and Symptoms Checklist 90 Revised - Somatization Scale, SCL-90 R). Mean PAC-SYM score was 1.62 ± 0.69. Mean weekly sick time due to constipation was 2.7 ± 8.6 h and productivity losses due to presenteeism was 19.7% ± 22.3%. Adjusted productivity losses in patients with severe CC (PAC-SYM score 2.3-4.0) compared to patients with mild symptoms (PAC-SYM score 0.0-1.0) was Italian Purchase Power Parity US$ 6160. Constipation severity (PAC-SYM quintiles) was associated with higher healthcare utilization (RRPAC-SYM 4/01.84; p-value for linear trend <0.01). After adjustment for somatization scores, the association of constipation severity with productivity losses and healthcare utilization rates was attenuated yet statistically significant. We observed a graded increase in productivity losses and healthcare utilization with increasing constipation severity. Further studies should evaluate whether significant savings might be achieved with regimens aimed at reducing the constipation severity.

Freshwater savings from marine protein consumption

International Nuclear Information System (INIS)

Gephart, Jessica A; Pace, Michael L; D’Odorico, Paolo

2014-01-01

Marine fisheries provide an essential source of protein for many people around the world. Unlike alternative terrestrial sources of protein, marine fish production requires little to no freshwater inputs. Consuming marine fish protein instead of terrestrial protein therefore represents freshwater savings (equivalent to an avoided water cost) and contributes to a low water footprint diet. These water savings are realized by the producers of alternative protein sources, rather than the consumers of marine protein. This study quantifies freshwater savings from marine fish consumption around the world by estimating the water footprint of replacing marine fish with terrestrial protein based on current consumption patterns. An estimated 7 600 km 3  yr −1 of water is used for human food production. Replacing marine protein with terrestrial protein would require an additional 350 km 3  yr −1 of water, meaning that marine protein provides current water savings of 4.6%. The importance of these freshwater savings is highly uneven around the globe, with savings ranging from as little as 0 to as much as 50%. The largest savings as a per cent of current water footprints occur in Asia, Oceania, and several coastal African nations. The greatest national water savings from marine fish protein occur in Southeast Asia and the United States. As the human population increases, future water savings from marine fish consumption will be increasingly important to food and water security and depend on sustainable harvest of capture fisheries and low water footprint growth of marine aquaculture. (paper)

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

NARCIS (Netherlands)

I.M.C.M. de Kok (Inge); J.J. Polder (Johan); J.D.F. Habbema (Dik); L.M. Berkers (Louise Maria); W.J. Meerding (Willem Jan); M. Rebolj (Matejka); M. van Ballegooijen (Marjolein)

2009-01-01

textabstractIt is under debate whether healthcare costs related to death and in life years gained (LysG) due to life saving interventions should be included in economic evaluations. We estimated the impact of including these costs on cost-effectiveness of cancer screening. We obtained health

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

Directory of Open Access Journals (Sweden)

Jose Manuel Trujillo Gómez

Full Text Available The use of information and communication technologies (ICTs in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking.To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose.A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme.Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers.Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

Science.gov (United States)

Trujillo Gómez, Jose Manuel; Díaz-Gete, Laura; Martín-Cantera, Carlos; Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

2015-01-01

The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme. Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not substitute personal

Energy Savings in a Market Economy

DEFF Research Database (Denmark)

Nørgaard, Jørgen

1998-01-01

The paper outlines the concept of energy savings as opposed to energy efficency. Afterwards are described briefly the up and down role of energy savings in recent Danish energy policy. It discusses the failure of leaving electricity savings and Integrated Resource Planning to the electricity...

Improved methods to evaluate realised energy savings

NARCIS (Netherlands)

Boonekamp, P.G.M.

2005-01-01

This thesis regards the calculation of realised energy savings at national and sectoral level, and the policy contribution to total savings. It is observed that the results of monitoring and evaluation studies on realised energy savings are hardly applied in energy saving policy. Causes are the lack

49 CFR 173.219 - Life-saving appliances.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Life-saving appliances. 173.219 Section 173.219... Life-saving appliances. (a) A life-saving appliance, self-inflating or non-self-inflating, containing small quantities of hazardous materials that are required as part of the life-saving appliance must...

INMARSAT-C SafetyNET

Science.gov (United States)

Tsunamis 406 EPIRB's National Weather Service Marine Forecasts INMARSAT-C SafetyNET Marine Forecast Offices greater danger near shore or any shallow waters? NATIONAL WEATHER SERVICE PRODUCTS VIA INMARSAT-C SafetyNET Inmarsat-C SafetyNET is an internationally adopted, automated satellite system for promulgating

Saving in Sub-Saharan Africa

OpenAIRE

Ernest Aryeetey; Christopher Udry

2000-01-01

Gross domestic savings in Africa averaged only 8 percent of GDP in the 1980s, compared to 23 percent for Southeast Asia and 35 percent in the Newly Industrialized Economies. Aside from being generally low, saving rates in most of Africa have shown consistent decline over the last thirty years. These savings figures must be considered tentative, because they are derived as a residual in the national accounts from expenditure and production data that are themselves quite unreliable. Notwithstan...

Quantum net dynamics

International Nuclear Information System (INIS)

Finkelstein, D.

1989-01-01

The quantum net unifies the basic principles of quantum theory and relativity in a quantum spacetime having no ultraviolet infinities, supporting the Dirac equation, and having the usual vacuum as a quantum condensation. A correspondence principle connects nets to Schwinger sources and further unifies the vertical structure of the theory, so that the functions of the many hierarchic levels of quantum field theory (predicate algebra, set theory, topology,hor-ellipsis, quantum dynamics) are served by one in quantum net dynamics

High-level Petri Nets

DEFF Research Database (Denmark)

various journals and collections. As a result, much of this knowledge is not readily available to people who may be interested in using high-level nets. Within the Petri net community this problem has been discussed many times, and as an outcome this book has been compiled. The book contains reprints...... of some of the most important papers on the application and theory of high-level Petri nets. In this way it makes the relevant literature more available. It is our hope that the book will be a useful source of information and that, e.g., it can be used in the organization of Petri net courses. To make......High-level Petri nets are now widely used in both theoretical analysis and practical modelling of concurrent systems. The main reason for the success of this class of net models is that they make it possible to obtain much more succinct and manageable descriptions than can be obtained by means...

Influence of Components of Net Working Capital on Costs of Companies Manufacturing Machinery and Equipment in the Czech Republic

Directory of Open Access Journals (Sweden)

Zdeněk Motlíček

2015-01-01

Full Text Available The approach to working capital management significantly affects the performance of companies. Nevertheless, this effect varies depending on the observed industry and company’s size and it may be assumed that it is also dependent on territory differences. The paper presents an empirical research aiming to identify particular links between net working capital and costs of the company. The outcomes indicate a relatively strong positive correlation between the variables, especially in case of inventory. Furthermore he ratio of financial costs to ordinary costs is low, as well as the impact of net working capital components on financial costs. It follows that a focus on collection period would not lead to significant savings. The findings appropriately complement Czech and foreign literature focused more on impact of net working capital or working capital on profitability indicators. Further studies concerning a more detailed analysis of the influence of net working capital on corporate costs are difficult to be found. The present research has been conducted on medium-sized companies located in the Czech Republic and manufacturing machinery and equipment. The obtained results suggest the most suitable area of focus for optimization of working capital in relation to costs for the types of companies defined above.

Energy saving synergies in national energy systems

DEFF Research Database (Denmark)

Thellufsen, Jakob Zinck; Lund, Henrik

2015-01-01

In the transition towards a 100% renewable energy system, energy savings are essential. The possibility of energy savings through conservation or efficiency increases can be identified in, for instance, the heating and electricity sectors, in industry, and in transport. Several studies point...... to various optimal levels of savings in the different sectors of the energy system. However, these studies do not investigate the idea of energy savings being system dependent. This paper argues that such system dependency is critical to understand, as it does not make sense to analyse an energy saving...... without taking into account the actual benefit of the saving in relation to the energy system. The study therefore identifies a need to understand how saving methods may interact with each other and the system in which they are conducted. By using energy system analysis to do hourly simulation...

24 CFR 221.1 - Savings clause.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Savings clause. 221.1 Section 221.1... MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES LOW COST AND MODERATE INCOME MORTGAGE INSURANCE-SAVINGS CLAUSE Eligibility Requirements-Low Cost Homes-Savings Clause § 221.1...

Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

Science.gov (United States)

Peters, Ray DeV; Petrunka, Kelly; Khan, Shahriar; Howell-Moneta, Angela; Nelson, Geoffrey; Pancer, S Mark; Loomis, Colleen

2016-02-01

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

Energy saving and cost saving cooling; Energie und Kosten sparende Kuehlung

Energy Technology Data Exchange (ETDEWEB)

Koenig, Klaus W. [Architektur- und Fachpressebuero Klaus W. Koenig, Ueberlingen (Germany)

2012-07-01

In the case of cost reduction, energy conservation and resource savings, rain water is an ideal medium offering more advantages in comparison to the cooling with drinking water. There are no fees for the drinking water and drainage of rain water. It is not necessary to soften rain water so that further operational costs for the treatment and drainage of waste water can be saved. The avoidance of the related material flows and necessary energy is a practiced environmental protection and climate protection.

Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

Science.gov (United States)

Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

2015-12-01

Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

Science.gov (United States)

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Climate protection with rapid payback. Energy and CO2 savings potential of industrial insulation in EU27

Energy Technology Data Exchange (ETDEWEB)

Neelis, M.; Blinde, P.; Overgaag, M.; Deng, Y. [Ecofys Netherlands, Utrecht (Netherlands)

2012-06-15

This study aims to answer the following four questions: (1) What is the energy savings and CO2 emissions mitigation potential resulting from insulating currently uninsulated parts and from better maintenance of insulation systems?; (2) What are the energy savings and CO2 mitigation potential from improving current insulation to cost-effective levels? Cost-effective insulation in this study is defined as the insulation that minimises the sum of the costs of heat loss and the costs of insulation; (3) What is the energy savings and CO2 mitigation potential from improving current insulation beyond cost-effective levels to even more energy-efficient levels? Energy-efficient insulation in this study is defined as the insulation at which the sum of the costs of heat loss and the annualised insulation investments are equal to the costs of typical current insulation while offering an additional energy savings and CO2 mitigation potential; and (4) How can these potentials best be realised? This study investigates savings potentials from improved insulation in EU industry and the power sector under realistic market conditions. Nuclear power plants and power production by renewable sources were left outside the scope of this study as well as insulations of cold applications. Case studies of insulation projects have been used to compare energy loss and investments related to different levels of insulation. The analysis was performed for three temperature levels: <100C; 100-300C and >300C. Results at the level of the case studies were extrapolated to European level using data on current energy use. Other assumptions have been made where needed on the basis of literature and expert input. All potentials are based on a 9% discount rate, an average insulation lifetime of 15 years and a 2-3% per year increase of the price of energy net of inflation.

The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Fine-grained Database Field Search Using Attribute-Based Encryption for E-Healthcare Clouds.

Science.gov (United States)

Guo, Cheng; Zhuang, Ruhan; Jie, Yingmo; Ren, Yizhi; Wu, Ting; Choo, Kim-Kwang Raymond

2016-11-01

An effectively designed e-healthcare system can significantly enhance the quality of access and experience of healthcare users, including facilitating medical and healthcare providers in ensuring a smooth delivery of services. Ensuring the security of patients' electronic health records (EHRs) in the e-healthcare system is an active research area. EHRs may be outsourced to a third-party, such as a community healthcare cloud service provider for storage due to cost-saving measures. Generally, encrypting the EHRs when they are stored in the system (i.e. data-at-rest) or prior to outsourcing the data is used to ensure data confidentiality. Searchable encryption (SE) scheme is a promising technique that can ensure the protection of private information without compromising on performance. In this paper, we propose a novel framework for controlling access to EHRs stored in semi-trusted cloud servers (e.g. a private cloud or a community cloud). To achieve fine-grained access control for EHRs, we leverage the ciphertext-policy attribute-based encryption (CP-ABE) technique to encrypt tables published by hospitals, including patients' EHRs, and the table is stored in the database with the primary key being the patient's unique identity. Our framework can enable different users with different privileges to search on different database fields. Differ from previous attempts to secure outsourcing of data, we emphasize the control of the searches of the fields within the database. We demonstrate the utility of the scheme by evaluating the scheme using datasets from the University of California, Irvine.

Planning of nets

International Nuclear Information System (INIS)

Carberry, M

1996-01-01

The paper is about the planning of nets in areas of low density like it is the case of the rural areas. The author includes economic and technological aspects, planning of nets, demands and management among others

Using electronic health records to save money.

Science.gov (United States)

Bar-Dayan, Yosefa; Saed, Halil; Boaz, Mona; Misch, Yehudith; Shahar, Talia; Husiascky, Ilan; Blumenfeld, Oren

2013-06-01

Health information technology, especially electronic health records (EHRs), can be used to improve the efficiency and effectiveness of healthcare providers. This study assessed the cost-savings of incorporating a list of preferred specialty care providers into the EHRs used by all primary care physicians (PCPs), accompanied by a comprehensive implementation plan. On January 1, 2005, all specialty clinic providers at the Israeli Defense Forces were divided into one of four financial classes based on their charges, class 1, the least expensive, being the most preferred, followed by classes 2-4. This list was incorporated into the EHRs used by all PCPs in primary care clinics. PCPs received comprehensive training. Target referral goals were determined for each class and measured for 4 years, together with the total cost of all specialist visits in the first year compared to the following years. Quality assessment (QA) scores were used as a measure of the program's effect on the quality of patient care. During 2005-2008, a marginally significant decline in referrals to class 1 was observed (r=-0.254, p=0.078), however a significant increase in referral rates to class 2 was observed (r=0.957, p=0.042), concurrent with a decrease in referral rates to classes 3 and 4 (r=-0.312, p=0.024). An inverse correlation was observed between year and total costs for all visits to specialists (2008 prices; r=-0.96, p=0.04), and between the mean cost of one specialist visit over the 4 years, indicating a significant reduction in real costs (2008 prices; r=-0.995, p=0.005). QA was not affected by these changes (r=0.94, p=0.016). From a policy perspective, our data suggest that EHR can facilitate effective utilization of healthcare providers and decrease costs.

The value of reducing hospital-acquired pressure ulcer prevalence: an illustrative analysis.

Science.gov (United States)

Spetz, Joanne; Brown, Diane S; Aydin, Carolyn; Donaldson, Nancy

2013-04-01

The aim of this study was to assess the cost savings associated with implementing nursing approaches to prevent hospital-acquired pressure ulcers (HAPU). Hospitals face substantial costs associated with the treatment of HAPUs. Interventions have been demonstrated as effective for HAPU prevention and management, but it is widely perceived that preventative measures are expensive and, thus, may not be a good use of resources. A return-on-investment (ROI) framework from the Agency for Healthcare Research and Quality (AHRQ) Quality Indicators Toolkit was used for this study. The researchers identified achievable improvements in HAPU rates from data from the Collaborative Alliance for Nursing Outcomes and measured costs and savings associated with HAPU reduction from published literature. The analysis produced a baseline ROI ratio of 1.61 and net savings of $127.51 per patient. Hospital-acquired pressure ulcer surveillance and prevention can be cost saving for hospitals and should be considered by nurse executives as a strategy to support quality outcomes.

Programming NET Web Services

CERN Document Server

Ferrara, Alex

2007-01-01

Web services are poised to become a key technology for a wide range of Internet-enabled applications, spanning everything from straight B2B systems to mobile devices and proprietary in-house software. While there are several tools and platforms that can be used for building web services, developers are finding a powerful tool in Microsoft's .NET Framework and Visual Studio .NET. Designed from scratch to support the development of web services, the .NET Framework simplifies the process--programmers find that tasks that took an hour using the SOAP Toolkit take just minutes. Programming .NET

Problems experienced by role players within the managed healthcare context in Gauteng

Directory of Open Access Journals (Sweden)

S Mahlo

2000-09-01

Full Text Available Role players within the context of managed healthcare in Gauteng experience problems in the delivery of healthcare, which negatively affect their working relationships. This in turn, affects the quality of care provided to patients. The purpose of this study is to explore and describe the problem experienced by different role players within the context of managed healthcare in Gauteng, as well as the suggested solutions to counteract these problems. These results will be utilised as the basis of a conceptual framework to formulate a strategy to enhance the working relationships amongst these role players. The strategy will not be discussed in this article as the focus is on the problems experienced by the role players in the delivery of healthcare, as well as suggested solutions in the counteraction thereof. A qualitative, exploratory, descriptive and contextual study was followed to explore and describe the problems, as well as the suggested solutions to counteract these problems. Focus group interviews were conducted to collect data from three private hospitals, three managed care organisations and four general medical practitioners in Gauteng. The participants were purposively and conveniently selected. Content analysis as described by Tesch (1990 was followed to analyse the data. The main problems experienced were related to inadequate communication, inadequate staff competence, cost saving versus quality care, procedural complexity, perceived loss of power by doctors and patients and the system of accounts payment. The suggested solutions focused mainly on empowerment and standardisation of procedures. It is recommended that replication studies of this nature be conducted in other provinces and that ethical standards are formulated within the managed healthcare context.

Public assessment of key performance indicators of healthcare in a Canadian province: the effect of age and chronic health problems.

Science.gov (United States)

Nurullah, Abu Sadat; Northcott, Herbert C; Harvey, Michael D

2014-01-15

This study explores the effect of age and chronic conditions on public perceptions of the health system, as measured by the Key Performance Indicators (KPIs) of healthcare, in the province of Alberta in Canada. Drawing from data collected by Government of Alberta's Department of Health and Wellness, this research examines two key questions: (1) Do people in the 65+ age group rate the KPIs of healthcare (i.e., availability, accessibility, quality, outcome, and satisfaction) more favorably compared to people in younger age groups in Alberta? (2) Does the rating of KPIs of healthcare in Alberta vary with different chronic conditions (i.e., no chronic problem, chronic illnesses without pain, and chronic pain)? The findings indicate that people in the older age group tend to rate the KPIs of healthcare more favorably compared to younger age groups in Alberta, net of socio-demographic factors, self-reported health status, and knowledge and utilization of health services. However, people experiencing chronic pain are less likely to rate the KPIs of healthcare favorably compared to people with no chronic health problem in Alberta. Discussion includes implications of the findings for the healthcare system in the province.

Federal Aviation Administration retained savings program proposal

International Nuclear Information System (INIS)

Hostick, D.J.; Larson, L.L.; Hostick, C.J.

1998-03-01

Federal legislation allows federal agencies to retain up to 50% of the savings associated with implementing energy efficiency and water conservation measures and practices. Given budget pressures to reduce expenditures, the use of retained savings to fund additional projects represents a source of funds outside of the traditional budget cycle. The Southwest Region Federal Aviation Administration (FAA) has tasked Pacific Northwest National Laboratory (PNNL) to develop a model retained savings program for Southwest Region FAA use and as a prototype for consideration by the FAA. PNNL recommends the following steps be taken in developing a Southwest Region FAA retained savings program: Establish a retained savings mechanism. Determine the level at which the retained savings should be consolidated into a fund. The preliminary recommendation is to establish a revolving efficiency loan fund at the regional level. Such a mechanism allows some consolidation of savings to fund larger projects, while maintaining a sense of facility ownership in that the funds will remain within the region

Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data

Directory of Open Access Journals (Sweden)

Simeon J.A. Visscher

2017-12-01

Full Text Available This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes, resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH are provided as well. This data-in-brief article accompanies the paper “Variation in prevention of child maltreatment by Dutch child healthcare professionals” by Simeon Visscher and Henk van Stel [1].

Values and Technologies in Energy Savings

DEFF Research Database (Denmark)

Nørgård, Jørgen Stig

2000-01-01

of this saving can cause what is called the rebound effect, which reduces the savings obtained from the technology. Ways to avoid this effect are suggested, and they require value changes, primarly around frugality, consumption, and hard-working. There are indications that some of the necessary changes are well......The chapter is based on the assumption, that technology improvement is not sufficient to achieve a sustainable world community. Changes in people´s values are necessary. A simple model suggest how values, together with basic needs and with the environmental and societal frames, determine people......´s behavioural pattern and lifestyles. Deliberate changes in social values are illustrated by a historical example. From the side of technology the basic principles in the economy of energy savings are briefly described. The marginally profitable energy savings provides an economic saving. The application...

"We are supposed to take care of it": a qualitative examination of care and repair behaviour of long-lasting, insecticide-treated nets in Nasarawa State, Nigeria.

Science.gov (United States)

Hunter, Gabrielle C; Scandurra, Leah; Acosta, Angela; Koenker, Hannah; Obi, Emmanuel; Weber, Rachel

2014-08-14

The longevity of long-lasting insecticidal nets (LLIN) under field conditions has important implications for malaria vector control. The behaviour of bed net users, including net care and repair, may protect or damage bed nets and impact the physical integrity of nets. However, this behaviour, and the motivating and inhibiting factors, is not well understood. Qualitative research methods were used to examine behaviour, attitudes and norms around damage, care and repair of LLINs. Eighteen in-depth interviews (IDI) and six focus group discussions (FGD) were conducted with LLIN users in two local government areas of Nasarawa State, Nigeria. A brief background questionnaire with the 73 participants prior to IDIs or FGDs collected additional data on demographics, net use, and care and repair behaviour. Respondents cited that the major causes of damage to bed nets are primarily children, followed by rodents, everyday handling that is not gentle, and characteristics of sleeping spaces. Caring for nets was perceived as both preventing damage by careful handling and keeping the net clean, which may lead to over-washing of LLINs. Repairing a damaged net was considered something that net users should do and the responsibility of adults in the household. Despite this, reported frequency of net repair was low (18%). Motivations for taking care of and repairing nets centred around caring for one's family, avoiding mosquito bites, saving money, and maintaining the positive opinion of others by keeping a clean and intact net. Barriers to net care and repair related to time availability and low perceived value of bed nets or of one's health. This study provides novel and valuable insights on the perceptions and attitudes of LLIN users in Nasarawa, Nigeria on the durability of bed nets, how to care for and repair nets, and for what reasons. Communication around net care should stress proper daily storage of nets, regular net inspections, prompt repairs, and clarify misconceptions

Game Coloured Petri Nets

DEFF Research Database (Denmark)

Westergaard, Michael

2006-01-01

This paper introduces the notion of game coloured Petri nets. This allows the modeler to explicitly model what parts of the model comprise the modeled system and what parts are the environment of the modeled system. We give the formal definition of game coloured Petri nets, a means of reachability...... analysis of this net class, and an application of game coloured Petri nets to automatically generate easy-to-understand visualizations of the model by exploiting the knowledge that some parts of the model are not interesting from a visualization perspective (i.e. they are part of the environment...

The health of healthcare, Part II: patient healthcare has cancer.

Science.gov (United States)

Waldman, Deane

2013-01-01

In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare.

Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals.

Science.gov (United States)

Handberg, Charlotte; Voss, Anna Katarina

2018-01-01

To describe the perspectives of healthcare professionals caring for intubated patients on implementing augmentative and alternative communication (AAC) in critical care settings. Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalisation and rehabilitation. Little is known about the use of AAC in critical care settings. The design was informed by interpretive descriptive methodology along with the theoretical framework symbolic interactionism, which guided the study of healthcare professionals (n = 48) in five different intensive care units. Data were generated through participant observations and 10 focus group interviews. The findings represent an understanding of the healthcare professionals' perspectives on implementing AAC in critical care settings and revealed three themes. Caring Ontology was the foundation of the healthcare professionals' profession. Cultural Belief represented the actual premise in the interactions during the healthcare professionals' work, saving lives in a biomedical setting whilst appearing competent and efficient, leading to Triggered Conduct and giving low priority to psychosocial issues like communication. Lack of the ability to communicate puts patients at greater risk of receiving poorer treatment, which supports the pressuring need to implement and use AAC in critical care. It is documented that culture in biomedical paradigms can have consequences that are the opposite of the staffs' ideals. The findings may guide staff in implementing AAC strategies in their communication with patients and at the same time preserve their caring ontology and professional pride. Improving communication strategies may improve patient safety and make a difference in patient outcomes. Increased knowledge of and familiarity with AAC strategies may provide healthcare professionals

Year-round daylight saving time will save more energy in India than corresponding DST or time zones

International Nuclear Information System (INIS)

Ahuja, Dilip R.; SenGupta, D.P.

2012-01-01

Many countries have experimented with daylight saving time (DST) to save energy and to align human activities more closely to the daily cycle of light and darkness. Using a novel methodology, we estimate the year-round energy savings to be obtained from advancing Indian Standard Time (IST), from the introduction of DST, and from dividing the country into two time zones. We find that the option of advancing IST consistently saves more energy than the corresponding DST option, which in turn saves more energy than the corresponding time zones option. This is because the energy benefits of advancing IST accrue for the entire year throughout the country, whereas the benefits of DST are confined to summer months and the benefits of two time zones are largely in the lower energy consuming eastern region. We recommend advancing IST by half-hour to being six hours ahead of UTC. This confers the advantages of DST and time zones without their disadvantages and is forecast to save more than 2 billion kWh of electricity every year during evening peaks that are difficult to supply. While these results are India-specific, similar exercises would be useful to many other countries. - Highlights: ► Advancing IST (YRDST) consistently saves more energy than the corresponding DST. ► DST consistently saves more energy than dividing India into two time zones. ► There are also many non-energy benefits of advancing IST. ► Results are for India; countries with DST may find it useful to consider YRDST.

Implementation of energy-saving policies in China: How local governments assisted industrial enterprises in achieving energy-saving targets

International Nuclear Information System (INIS)

Zhao, Xiaofan; Li, Huimin; Wu, Liang; Qi, Ye

2014-01-01

Local governments have replaced the national ministries that are in charge of various industries to become the primary implementer of energy-saving policies in China since 2000. This paper employs a case study-based approach to demonstrate the significance of local governments’ policy measures in assisting industrial enterprises with energy-saving activities in China. Based on the longitudinal case of the Jasmine Thermal Electric Power Company, this paper hypothesizes that sub-national governments have played a major role in implementing energy-saving policies in China since the 11th Five-year-plan period. A wide range of provincial and municipal agencies collaborated in implementing five types of policy measures – informational policy, skill building, improved enforcement of central directives, price adjustment, and funding – that reduced barriers to energy saving and motivated active pursuit of energy-saving activities at industrial enterprises. The case study demonstrates how an enterprise and local governments work together to achieve the enterprise's energy-saving target. The authors will investigate the hypothesis of this paper in the context of multiple case studies that they plan to undertake in the future. - Highlights: • We employ a case study-based approach to study policy implementation in China. • Local governments have played a major role in implementing energy-saving policies. • Local public agencies collaborated in implementing five types of policy measures. • Local policy measures reduced barriers to energy saving at industrial enterprises. • Enterprises and local governments work together to achieve energy-saving targets

Reform Proposals for Replenishing Retirement Savings

Directory of Open Access Journals (Sweden)

Jack M. Mintz

2013-02-01

Full Text Available The 2008-2009 economic crisis dealt a serious blow to Canadians’ retirement savings. While markets have since partially recovered, the ratio of Canadians’ household net-worth relative to disposable income still remains below where it was in 2007. So much wealth that workers had accumulated to prepare for retirement has been wiped away, while the years since 2008 that might have otherwise been spent compounding retirement savings have been spent, instead, on trying to recover losses in a low-interest-rate environment that has limited returns. With large waves of older workers approaching retirement age, and these future retirees projected to live longer than previous cohorts, Canada now faces the very realistic scenario that a significant number of people will reach retirement age without the funds they will need to provide a comfortable post-working-life income. Canadian policy-makers may not have the ability to restore that destroyed wealth. And with most governments already struggling to resolve serious deficits, the situation is not likely to be ameliorated with anything that requires additional spending, or that could reduce tax revenues. But there are policy reforms available that can help at least in better preparing the coming waves of retirees for a financially secure retirement. The reforms need not be far-reaching to have a meaningful impact. And they need not be costly, either. They can include a modest expansion of the Canada Pension Plan (CPP to allow larger contributions — shared by employers and employees, or covered entirely by employees — that would, in turn, allow retiring workers to draw a larger maximum pension, rather than having to rely on the guaranteed income supplement (GIS. CPP contributions could also be made deductible from taxable income, like RRSP investments, to encourage workers to maximize contributions. To minimize an increase in payroll taxes, the eligibility age for CPP benefits could be increased to

Coloured Petri Nets

DEFF Research Database (Denmark)

Jensen, Kurt

1991-01-01

This paper describes how Coloured Petri Nets (CP-nets) have been developed — from being a promising theoretical model to being a full-fledged language for the design, specification, simulation, validation and implementation of large software systems (and other systems in which human beings and...

Net zero water

CSIR Research Space (South Africa)

Lindeque, M

2013-01-01

Full Text Available the national grid. The unfortunate situation with water is that there is no replacement technology for water. Water can be supplied from many different sources. A net zero energy development will move closer to a net zero water development by reducing...

Design and evaluation of modified screen net house for off-season vegetable raising in composite climate

International Nuclear Information System (INIS)

Sethi, V.P.; Dubey, R.K.; Dhath, A.S.

2009-01-01

Currently the use of conventional screen net houses for off-season vegetable raising in north India composite climate is not so effective and has many constructional and operational limitations like poor structural design, higher constructional cost, no greenhouse effect in winter and higher plant temperatures in summer. Similarly, the use of polyethylene sheet covered greenhouses also has problems like much higher constructional and operational costs and higher inside air temperatures in summers. In this study, modified designs of 500 m 2 (one kanal) and 250 m 2 (half kanal) screen net house have been presented particularly suitable for composite climate (where both winters as well as summers are harsh) as a replacement for conventional net house and polyethylene sheet covered greenhouse design. To make these designs low cost and more effective, low tunnels (covered with low density polyethylene sheet) have been designed and used in winter over the plant rows to generate localized greenhouse effect for faster plant growth. By doing so, average daily air temperature under the tunnels was raised about 9-10 deg. C above the open field air temperature. In this way, huge cost of covering the net house or greenhouse during winter with costly polyethylene sheet could be saved. Similarly, in extreme summer when the ambient air temperature exceeded 40 deg. C (during the fruiting stage of the crop) a 50% shade net was used inside the modified net house at 2.5 m height (instead of using active cooling system) resulting in 4-6 deg. C drop in the plant temperature. Experimental evaluation of the modified net house was conducted during winter and summer months of year 2007-08 (December to June) by growing brinjal crop and compared with conventional net house, polyethylene sheet greenhouse and in open field condition. It was observed that due to the combined effect of low tunnels (in winter) and shade net (in summer), the micro-climatic parameters like air temperature, plant

Future Costs, Fixed Healthcare Budgets, and the Decision Rules of Cost-Effectiveness Analysis.

Science.gov (United States)

van Baal, Pieter; Meltzer, David; Brouwer, Werner

2016-02-01

Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs that may result from this additional demand in health care and include only future costs of related illnesses. Although there has been much debate regarding the question to which extent future costs should be included from a societal perspective, the appropriate role of future medical costs in the widely adopted but more narrow healthcare perspective has been neglected. Using a theoretical model, we demonstrate that optimal decision rules for cost-effectiveness analyses assuming fixed healthcare budgets dictate that future costs of both related and unrelated medical care should be included. Practical relevance of including the costs of future unrelated medical care is illustrated using the example of transcatheter aortic valve implantation. Our findings suggest that guidelines should prescribe inclusion of these costs. Copyright © 2014 John Wiley & Sons, Ltd.

Towards new information resources for public health--from WordNet to MedicalWordNet.

Science.gov (United States)

Fellbaum, Christiane; Hahn, Udo; Smith, Barry

2006-06-01

In the last two decades, WordNet has evolved as the most comprehensive computational lexicon of general English. In this article, we discuss its potential for supporting the creation of an entirely new kind of information resource for public health, viz. MedicalWordNet. This resource is not to be conceived merely as a lexical extension of the original WordNet to medical terminology; indeed, there is already a considerable degree of overlap between WordNet and the vocabulary of medicine. Instead, we propose a new type of repository, consisting of three large collections of (1) medically relevant word forms, structured along the lines of the existing Princeton WordNet; (2) medically validated propositions, referred to here as medical facts, which will constitute what we shall call MedicalFactNet; and (3) propositions reflecting laypersons' medical beliefs, which will constitute what we shall call the MedicalBeliefNet. We introduce a methodology for setting up the MedicalWordNet. We then turn to the discussion of research challenges that have to be met to build this new type of information resource. We build a database of sentences relevant to the medical domain. The sentences are generated from WordNet via its relations as well as from medical statements broken down into elementary propositions. Two subcorpora of sentences are distinguished, MedicalBeliefNet and MedicalFactNet. The former is rated for assent by laypersons; the latter for correctness by medical experts. The sentence corpora will be valuable for a variety of applications in information retrieval as well as in research in linguistics and psychology with respect to the study of expert and non-expert beliefs and their linguistic expressions. Our work has to meet several considerable challenges. These include accounting for the distinction between medical experts and laypersons, the social issues of expert-layperson communication in different media, the linguistic aspects of encoding medical knowledge, and

Multiflavor string-net models

Science.gov (United States)

Lin, Chien-Hung

2017-05-01

We generalize the string-net construction to multiple flavors of strings, each of which is labeled by the elements of an Abelian group Gi. The same flavor of strings can branch, while different flavors of strings can cross one another and thus they form intersecting string nets. We systematically construct the exactly soluble lattice Hamiltonians and the ground-state wave functions for the intersecting string-net condensed phases. We analyze the braiding statistics of the low-energy quasiparticle excitations and find that our model can realize all the topological phases as the string-net model with group G =∏iGi . In this respect, our construction provides various ways of building lattice models which realize topological order G , corresponding to different partitions of G and thus different flavors of string nets. In fact, our construction concretely demonstrates the Künneth formula by constructing various lattice models with the same topological order. As an example, we construct the G =Z2×Z2×Z2 string-net model which realizes a non-Abelian topological phase by properly intersecting three copies of toric codes.

A ‘Carbon Saving Multiplier’ as an alternative to rebound in considering reduced energy supply chain requirements from energy efficiency?

International Nuclear Information System (INIS)

Turner, Karen; Katris, Antonios

2017-01-01

A growing area of research into rebound effects from increased energy efficiency involves application of demand-driven input-output models to consider indirect energy consumption effects associated with re-spending decisions by households with reduced energy spending requirements. However, there is often a lack of clarity in applied studies as to how indirect effects involving energy use and/or carbon emissions in supply chains of both energy and non-energy goods and services have been calculated. We propose that more transparency for policymakers may be introduced by replacing consideration of what are often referred to as ‘indirect rebound’ effects with a simple Carbon Saving Multiplier metric. We illustrate using results from a demand-driven input-output model that tracks supply chain activity at national and/or global level. We argue that this captures and conveys the same information on quantity adjustments in energy used in supply chain activity but does so in a manner that is more positive, transparent, understandable and useful for a policy audience. This is achieved by focusing (here via carbon emissions) on the net benefits of changes in different types of energy use at both household and supply chain levels when energy efficiency improves in households. - Highlights: • Considers energy supply adjustments when household energy efficiency improves. • Focuses on energy supply chain impacts that may offset direct rebound effects. • Carbon Saving Multiplier proposed as a useful indicator of net energy use benefits.

Energy savings in Danish residential building stock

DEFF Research Database (Denmark)

Tommerup, Henrik M.; Svendsen, Svend

2006-01-01

a short account of the technical energy-saving possibilities that are present in existing dwellings and presents a financial methodology used for assessing energy-saving measures. In order to estimate the total savings potential detailed calculations have been performed in a case with two typical...... buildings representing the residential building stock and based on these calculations an assessment of the energy-saving potential is performed. A profitable savings potential of energy used for space heating of about 80% is identified over 45 years (until 2050) within the residential building stock......A large potential for energy savings exists in the Danish residential building stock due to the fact that 75% of the buildings were constructed before 1979 when the first important demands for energy performance of building were introduced. It is also a fact that many buildings in Denmark face...

Rare, but challenging tumors: NET

International Nuclear Information System (INIS)

Ivanova, D.; Balev, B.

2013-01-01

Full text: Introduction: Gastroenteropancreatic Neuroendocrine Tumors (GEP - NET) are a heterogeneous group of tumors with different locations and many different clinical, histological, and imaging performance. In a part of them a secretion of various organic substances is present. The morbidity of GEP - NET in the EU is growing, and this leads to increase the attention to them. What you will learn: Imaging methods used for localization and staging of GEP - NET, characteristics of the study’s protocols; Classification of GEP - NET; Demonstration of typical and atypical imaging features of GEP - NET in patients registered at the NET Center at University Hospital ‘St. Marina’, Varna; Features of metastatic NET, The role of imaging in the evaluation of treatment response and follow-up of the patients. Discussion: The image semiotics analysis is based on 19 cases of GEP - NET registered NET Center at University Hospital ‘St. Marina’. The main imaging method is multidetector CT (MDCT), and magnetic resonance imaging (MRI ) has advantages in the evaluation of liver lesions and the local prevalence of anorectal tumors. In patients with advanced disease and liver lesions the assessment of skeletal involvement (MRI/ nuclear medical method) is mandatory. The majority of GEP - NET have not any specific imaging findings. Therefore it is extremely important proper planning and conducting of the study (MDCT and MR enterography; accurate assessment phase of scanning, positive and negative contrast). Conclusion: GEP - NET is a major diagnostic challenge due to the absence of typical imaging characteristics and often an overlap with those of the tumors of different origin can be observed. Therefore, a good knowledge of clinical and imaging changes occurring at different locations is needed. MDCT is the basis for the diagnosis, staging and follow-up of these neoplasms

[Healthcare value chain: a model for the Brazilian healthcare system].

Science.gov (United States)

Pedroso, Marcelo Caldeira; Malik, Ana Maria

2012-10-01

This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

Limitations of shallow nets approximation.

Science.gov (United States)

Lin, Shao-Bo

2017-10-01

In this paper, we aim at analyzing the approximation abilities of shallow networks in reproducing kernel Hilbert spaces (RKHSs). We prove that there is a probability measure such that the achievable lower bound for approximating by shallow nets can be realized for all functions in balls of reproducing kernel Hilbert space with high probability, which is different with the classical minimax approximation error estimates. This result together with the existing approximation results for deep nets shows the limitations for shallow nets and provides a theoretical explanation on why deep nets perform better than shallow nets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Consumer behaviours: Teaching children to save energy

Science.gov (United States)

Grønhøj, Alice

2016-08-01

Energy-saving programmes are increasingly targeted at children to encourage household energy conservation. A study involving the assignment of energy-saving interventions to Girl Scouts shows that a child-focused intervention can improve energy-saving behaviours among children and their parents.

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

Science.gov (United States)

Graves, Nicholas; Page, Katie; Martin, Elizabeth; Brain, David; Hall, Lisa; Campbell, Megan; Fulop, Naomi; Jimmeison, Nerina; White, Katherine; Paterson, David; Barnett, Adrian G.

2016-01-01

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia.

Directory of Open Access Journals (Sweden)

Nicholas Graves

Full Text Available The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011-2012.No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.The Australian National Hand Hygiene Initiative was cost

The effect of netting solidity ratio and inclined angle on the hydrodynamic characteristics of knotless polyethylene netting

Science.gov (United States)

Tang, Hao; Hu, Fuxiang; Xu, Liuxiong; Dong, Shuchuang; Zhou, Cheng; Wang, Xuefang

2017-10-01

Knotless polyethylene (PE) netting has been widely used in aquaculture cages and fishing gears, especially in Japan. In this study, the hydrodynamic coefficient of six knotless PE netting panels with different solidity ratios were assessed in a flume tank under various attack angles of netting from 0° (parallel to flow) to 90° (perpendicular to flow) and current speeds from 40 cm s-1 to 130 cm s-1. It was found that the drag coefficient was related to Reynolds number, solidity ratio and attack angle of netting. The solidity ratio was positively related with drag coefficient for netting panel perpendicular to flow, whereas when setting the netting panel parallel to the flow the opposite result was obtained. For netting panels placed at an angle to the flow, the lift coefficient reached the maximum at an attack angle of 50° and then decreased as the attack angle further increased. The solidity ratio had a dual influence on drag coefficient of inclined netting panels. Compared to result in the literature, the normal drag coefficient of knotless PE netting measured in this study is larger than that of nylon netting or Dyneema netting.

Lean healthcare.

Science.gov (United States)

Weinstock, Donna

2008-01-01

As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

Use of bed nets and factors that influence bed net use among Jinuo Ethnic Minority in southern China.

Science.gov (United States)

Xu, Jian-wei; Liao, Yuan-mei; Liu, Hui; Nie, Ren-hua; Havumaki, Joshua

2014-01-01

Insecticide-treated nets (ITNs) are an integral part of vector control recommendations for malaria elimination in China. This study investigated the extent to which bed nets were used and which factors influence bed net use among Jinuo Ethnic Minority in China-Myanmar-Laos border areas. This study combined a quantitative household questionnaire survey and qualitative semi-structured in-depth interviews (SDI). Questionnaires were administered to 352 heads of households. SDIs were given to 20 key informants. The bed net to person ratio was 1∶2.1 (i.e., nearly one net for every two people), however only 169 (48.0%) households owned at least one net and 623 (47.2%) residents slept under bed nets the prior night. The percentages of residents who regularly slept under nets (RSUN) and slept under nets the prior night (SUNPN) were similar (48.0% vs. 47.2%, P>0.05), however the percentage correct use of nets (CUN) was significantly lower (34.5%, Pcash income per person (ACIP) was an independent factor that influenced bed net use (PHigh bed net availability does not necessarily mean higher coverage or bed net use. Household income, house type and knowledge of the ability of bed nets to prevent malaria are all independent factors that influence bed net use among Jinuo Ethnic Minority.

Fusion through the NET

International Nuclear Information System (INIS)

Spears, B.

1987-01-01

The paper concerns the next generation of fusion machines which are intended to demonstrate the technical viability of fusion. In Europe, the device that will follow on from JET is known as NET - the Next European Torus. If the design programme for NET proceeds, Europe could start to build the machine in 1994. The present JET programme hopes to achieve breakeven in the early 1990's. NET hopes to reach ignition in the next century, and so lay the foundation for a demonstration reactor. A description is given of the technical specifications of the components of NET, including: the first wall, the divertors to protect the wall, the array of magnets that provide the fields containing the plasma, the superconducting magnets, and the shield of the machine. NET's research programme is briefly outlined, including the testing programme to optimise conditions in the machine to achieve ignition, and its safety work. (U.K.)

NetView technical research

Science.gov (United States)

1993-01-01

This is the Final Technical Report for the NetView Technical Research task. This report is prepared in accordance with Contract Data Requirements List (CDRL) item A002. NetView assistance was provided and details are presented under the following headings: NetView Management Systems (NMS) project tasks; WBAFB IBM 3090; WPAFB AMDAHL; WPAFB IBM 3084; Hill AFB; McClellan AFB AMDAHL; McClellan AFB IBM 3090; and Warner-Robins AFB.

Efficacy of PermaNet® 3.0 and PermaNet® 2.0 nets against laboratory-reared and wild Anopheles gambiae sensu lato populations in northern Tanzania.

Science.gov (United States)

Kweka, Eliningaya J; Lyaruu, Lucile J; Mahande, Aneth M

2017-01-18

Mosquitoes have developed resistance against pyrethroids, the only class of insecticides approved for use on long-lasting insecticidal nets (LLINs). The present study sought to evaluate the efficacy of the pyrethroid synergist PermaNet® 3.0 LLIN versus the pyrethroid-only PermaNet® 2.0 LLIN, in an East African hut design in Lower Moshi, northern Tanzania. In this setting, resistance to pyrethroid insecticides has been identified in Anopheles gambiae mosquitoes. Standard World Health Organization bioefficacy evaluations were conducted in both laboratory and experimental huts. Experimental hut evaluations were conducted in an area where there was presence of a population of highly pyrethroid-resistant An. arabiensis mosquitoes. All nets used were subjected to cone bioassays and then to experimental hut trials. Mosquito mortality, blood-feeding inhibition and personal protection rate were compared between untreated nets, unwashed LLINs and LLINs that were washed 20 times. Both washed and unwashed PermaNet® 2.0 and PermaNet® 3.0 LLINs had knockdown and mortality rates of 100% against a susceptible strain of An. gambiae sensu stricto. The adjusted mortality rate of the wild mosquito population after use of the unwashed PermaNet® 3.0 and PermaNet® 2.0 nets was found to be higher than after use of the washed PermaNet® 2.0 and PermaNet® 3.0 nets. Given the increasing incidence of pyrethroid resistance in An. gambiae mosquitoes in Tanzania, we recommend that consideration is given to its distribution in areas with pyrethroid-resistant malaria vectors within the framework of a national insecticide-resistance management plan.

PODATKOVNE STORITVE ADO.NET IN ADO.NET ENTITY FRAMEWORK

OpenAIRE

Volavc, Franc

2012-01-01

V diplomskem delu smo predstavili Microsoftovi ogrodji ADO.NET in ADO.NET Entity Framework. Preučili in analizirali smo metode za dostop do podatkovnih virov, ki jih ponujata ogrodji, ter nato te ugotovitve preslikati v odločitveno drevo, katero bo programerjem in razvijalcem informacijskih sistemov pomagalo pri odločanju glede pristopa za dostop do podatkovnih virov. Ker bomo v diplomskem delu predstavili Microsoftovi ogrodji, bomo posledično omejeni zgolj na Microsoftovo tehnologijo, se pra...

ONU Power Saving Scheme for EPON System

Science.gov (United States)

Mukai, Hiroaki; Tano, Fumihiko; Tanaka, Masaki; Kozaki, Seiji; Yamanaka, Hideaki

PON (Passive Optical Network) achieves FTTH (Fiber To The Home) economically, by sharing an optical fiber among plural subscribers. Recently, global climate change has been recognized as a serious near term problem. Power saving techniques for electronic devices are important. In PON system, the ONU (Optical Network Unit) power saving scheme has been studied and defined in XG-PON. In this paper, we propose an ONU power saving scheme for EPON. Then, we present an analysis of the power reduction effect and the data transmission delay caused by the ONU power saving scheme. According to the analysis, we propose an efficient provisioning method for the ONU power saving scheme which is applicable to both of XG-PON and EPON.

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up.

Science.gov (United States)

Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos

2017-01-01

Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

Blanket testing in NET

International Nuclear Information System (INIS)

Chazalon, M.; Daenner, W.; Libin, B.

1989-01-01

The testing stages in NET for the performance assessment of the various breeding blanket concepts developed at the present time in Europe for DEMO (LiPb and ceramic blankets) and the requirements upon NET to perform these tests are reviewed. Typical locations available in NET for blanket testing are the central outboard segments and the horizontal ports of in-vessel sectors. These test positions will be connectable with external test loops. The number of test loops (helium, water, liquid metal) will be such that each major class of blankets can be tested in NET. The test positions, the boundary conditions and the external test loops are identified and the requirements for test blankets are summarized (author). 6

12 CFR 541.18 - Interim Federal savings association.

Science.gov (United States)

2010-01-01

... an existing savings and loan holding company or to facilitate any other transaction the Office may... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Interim Federal savings association. 541.18... REGULATIONS AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.18 Interim Federal savings association. The term...

E-health and healthcare enterprise information system leveraging service-oriented architecture.

Science.gov (United States)

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

2012-04-01

To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

Architecture of personal healthcare information system in ubiquitous healthcare

NARCIS (Netherlands)

Bhardwaj, S.; Sain, M.; Lee, H.-J.; Chung, W.Y.; Slezak, D.; et al., xx

2009-01-01

Due to recent development in Ubiquitous Healthcare now it’s time to build such application which can work independently and with less interference of Physician. In this paper we are try to build the whole architecture of personal Healthcare information system for ubiquitous healthcare which also

Feasibility of Achieving a Zero-Net-Energy, Zero-Net-Cost Homes

Energy Technology Data Exchange (ETDEWEB)

Al-Beaini, S.; Borgeson, S.; Coffery, B.; Gregory, D.; Konis, K.; Scown, C.; Simjanovic, J.; Stanley, J.; Strogen, B.; Walker, I.

2009-09-01

A green building competition, to be known as the Energy Free Home Challenge (EFHC), is scheduled to be opened to teams around the world in 2010. This competition will encourage both design innovation and cost reduction, by requiring design entries to meet 'zero net energy' and 'zero net cost' criteria. For the purposes of this competition, a 'zero net energy' home produces at least as much energy as it purchases over the course of a year, regardless of the time and form of the energy (e.g., electricity, heat, or fuel) consumed or produced. A 'zero net cost' home is no more expensive than a traditional home of comparable size and comfort, when evaluated over the course of a 30-year mortgage. In other words, the 'green premium' must have a payback period less than 30 years, based on the value of energy saved. The overarching goal of the competition is to develop affordable, high-performance homes that can be mass-produced at a large scale, and are able to meet occupant needs in harsh climates (as can be found where the competition will be held in Illinois). This report outlines the goals of the competition, and gauges their feasibility using both modeling results and published data. To ensure that the established rules are challenging, yet reasonable, this report seeks to refine the competition goals after exploring their feasibility through case studies, cost projections, and energy modeling. The authors of this report conducted a survey of the most progressive home energy-efficiency practices expected to appear in competition design submittals. In Appendix A, a summary can be found of recent projects throughout the United States, Canada, Germany, Switzerland, Sweden and Japan, where some of the most progressive technologies have been implemented. As with past energy efficient home projects, EFHC competitors will incorporate a multitude of energy efficiency measures into their home designs. The authors believe that

Current Status and Future Prospect of K-NET and KiK-net

Science.gov (United States)

Aoi, S.; Kunugi, T.; Suzuki, W.; Nakamura, H.; Fujiwara, H.

2014-12-01

During 18 years since the deployment of K-NET following the Kobe earthquake, our attention has mainly focused on rapidity of the data collection and an unfailing and reliable observation. In this presentation, we review three generations of the instruments employed by K-NET and KiK-net from these two points of view.At beginning of the 2000's, we newly developed the second generation instruments (K-NET02, K-NET02A, KiK-net06) to replace the first generation instruments (K-NET95, SMAC-MDK) employed when the networks were constructed in the 1990's. These instruments have an automatic dial-out function. It takes typically 2-5 s to establish communication and a few seconds to send the pre-trigger data. After that, data is available typically within a 1.5 s delay. Not only waveform data but also strong motion indexes such as real-time intensity, PGA, PGV, PGD, and response spectra are continuously sent once a second.After the 2011 Tohoku earthquake, we have developed the third generation instruments (K-NET11, KiK-net11) and have replaced almost half of the all stations country wide. Main improvement of this instrument is more unfailing and reliable observation. Because we have often experienced very large ground motions (e.g. 45 records exceeding gravity), the maximum measureable range was expanded from 2000 gal to 4000 gal for the second generation instrument, and to 8000 gal for the third. For the third generation instrument, in case of power failure, observation (including transmission of data) works for seven days thanks to the backup battery, while for the second generation instruments it works only for one day. By adding an oblique component to the three-component accelerometers, we could automatically distinguish shaking data from noise such as electric pulses which may cause a false alarm in EEW. Implementation to guarantee the continuity of observation under severe conditions such as during the Tohoku earthquake is very important, as well as a highly efficient

Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Marine Climates; January 2006 - December 2006

Energy Technology Data Exchange (ETDEWEB)

Building America Industrialized Housing Partnership (BAIHP); Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

2006-12-01

The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Marine Climate Region on a cost neutral basis.

Work life and patient safety culture in Canadian healthcare: connecting the quality dots using national accreditation results.

Science.gov (United States)

Mitchell, Jonathan I

2012-01-01

Fostering quality work life is paramount to building a strong patient safety culture in healthcare organizations. Data from two patient safety culture and work-life questionnaires used for Accreditation Canada's national program were analyzed. Strong team leadership was reported in that units were doing a good job of identifying, assessing and managing risks to patients. Seventy-one percent of respondents gave their unit a positive overall grade on patient safety, and 79% of respondents felt that they could often do their best-quality work in their job. However, healthcare workers felt that they did not have enough time to do their jobs adequately and indicated that co-workers were cutting corners in patient care in order to save time. This article discusses engaging both senior leadership and the entire organization in the change process, ensuring supervisory support, and using performance measures to focus organizational efforts on key priorities all as improvement strategies relevant to these findings. These strategies can be used by organizations across sectors and jurisdictions and by healthcare leaders to positively affect work life and patient safety.

Discrimination in Healthcare Settings is Associated with Disability in Older Adults: Health and Retirement Study, 2008-2012.

Science.gov (United States)

Rogers, Stephanie E; Thrasher, Angela D; Miao, Yinghui; Boscardin, W John; Smith, Alexander K

2015-10-01

As our society ages, improving medical care for an older population will be crucial. Discrimination in healthcare may contribute to substandard experiences with the healthcare system, increasing the burden of poor health in older adults. Few studies have focused on the presence of healthcare discrimination and its effects on older adults. We aimed to examine the relationship between healthcare discrimination and new or worsened disability. This was a longitudinal analysis of data from the nationally representative Health and Retirement Study administered in 2008 with follow-up through 2012. Six thousand and seventeen adults over the age of 50 years (mean age 67 years, 56.3 % female, 83.1 % white) were included in this study. Healthcare discrimination assessed by a 2008 report of receiving poorer service or treatment than other people by doctors or hospitals (never, less than a year=infrequent; more than once a year=frequent). Outcome was self-report of new or worsened disability by 2012 (difficulty or dependence in any of six activities of daily living). We used a Cox proportional hazards model adjusting for age, race/ethnicity, gender, net worth, education, depression, high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, and healthcare utilization in the past 2 years. In all, 12.6 % experienced discrimination infrequently and 5.9 % frequently. Almost one-third of participants (29 %) reporting frequent healthcare discrimination developed new or worsened disability over 4 years, compared to 16.8 % of those who infrequently and 14.7 % of those who never experienced healthcare discrimination (p discrimination, frequent healthcare discrimination was associated with new or worsened disability over 4 years (aHR = 1.63, 95 % CI 1.16-2.27). One out of five adults over the age of 50 years experiences discrimination in healthcare settings. One in 17 experience frequent healthcare discrimination, and this is associated with new or worsened

Uncertainties in the Value of Bill Savings from Behind-the-Meter, Residential Photovoltaic Systems: The Roles of Electricity Market Conditions, Retail Rate Design, and Net Metering

OpenAIRE

Darghouth, Naim Richard

2013-01-01

Net metering has become a widespread policy mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), allowing customers with PV systems to reduce their electric bills by offsetting their consumption with PV generation, independent of the timing of the generation relative to consumption. Although net metering is one of the principal drivers for the residential PV market in the U.S., the academic literature on this policy has been sparse and this dissertation co...

Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania

Directory of Open Access Journals (Sweden)

Gerrets Rene PM

2008-06-01

Full Text Available Abstract Background Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Methods Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Findings Net use was 62.7% overall, 87.2% amongst infants (0 to1 year, 81.8% amongst young children (>1 to 5 years, 54.5% amongst older children (6 to 15 years and 59.6% amongst adults (>15 years. 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%. Half of nets used by young children (50.0% and over a third of those used by older children (37.2% were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use and was the primary means for protecting adults (60.2% use. All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily

Prescription Program Provides Significant Savings

Science.gov (United States)

Rowan, James M.

2010-01-01

Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

12 CFR 583.20 - Savings and loan holding company.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Savings and loan holding company. 583.20... REGULATIONS AFFECTING SAVINGS AND LOAN HOLDING COMPANIES § 583.20 Savings and loan holding company. The term savings and loan holding company means any company that directly or indirectly controls a savings...

Initial CAD investigations for NET

International Nuclear Information System (INIS)

Katz, F.; Leinemann, K.; Ludwig, A.; Marek, U.; Olbrich, W.; Schlechtendahl, E.G.

1985-11-01

This report summarizes the work done under contract no. 164/84-7/FU-D-/NET between the Commission of the European Communities and KfK during the period from June 1, 1984, through May 31, 1985. The following topics are covered in this report: Initial modelling of NET version NET2A, CAD system extension for remote handling studies, analysis of the CAD information structure, work related to the transfer of CAD information between KfK and the NET team. (orig.) [de

Macroeconomic determinants of savings in Egypt "Statistical Model"

Directory of Open Access Journals (Sweden)

Hanaa Abdelaty Hasan Esmail

2014-07-01

Full Text Available Like lot of countries, aggregate consumption constitutes a major portion of Gross Domestic Product (GDP in Egypt. Consumption decisions determine savings decisions. In long term growth literature, differences in long term growth had been explained to a large extent by differences in the rates of savings which also determine a country’s investment in productive capacity, human capital and socio-economic infrastructure. In this study, we analyse macroeconomic determinants of savings in Egypt using Ordinary multiple regression. Our results indicate that national savings rate is positively related with real GDP growth rate. This suggests that saving is a positive function of income. The evidence suggests that national savings rate is negatively related with federal debt growth and inflation. This hints towards crowding out of private sector investment through decline in savings rate as a result of government’s indebtedness. Finally, negative association between savings rate and inflation implies that the consumer is rational and makes decisions based on his perceptions when it comes to allocating the lifetime resources over the period of his life. Increase in inflation dampens the incentive to save and people respond rationally which is made evident by the negative sign on inflation coefficient in our model.

Cogeneration an opportunity for industrial energy saving

International Nuclear Information System (INIS)

Pasha, R.A.; Butt, Z.S.

2011-01-01

This paper is about the cogeneration from industrial energy savings opportunities perspective. The energy crisis in these days forces industry to find ways to cope with critical situation. There are several energy savings options which if properly planned and implemented would be beneficial both for industry and community. One way of energy saving is Cogeneration i.e. Combined Heat and Power. The paper will review the basic methods, types and then discuss the suitability of these options for specific industry. It has been identified that generally process industry can get benefits of energy savings. (author)

NetBeans IDE 8 cookbook

CERN Document Server

Salter, David

2014-01-01

If you're a Java developer of any level using NetBeans and want to learn how to get the most out of NetBeans, then this book is for you. Learning how to utilize NetBeans will provide a firm foundation for your Java application development.

The Net Advance of Physics

Science.gov (United States)

THE NET ADVANCE OF PHYSICS Review Articles and Tutorials in an Encyclopædic Format Established 1995 [Link to MIT] Computer support for The Net Advance of Physics is furnished by The Massachusetts Newest Additions SPECIAL FEATURES: Net Advance RETRO: Nineteenth Century Physics History of Science

Are Women Empowered to Save?

Directory of Open Access Journals (Sweden)

Frances Woolley

2013-12-01

Full Text Available Female economic empowerment – rising earnings, increased opportunities, greater labour force participation – has given many women the means to save. The shifting of responsibility for retirement security from employers and governments onto individuals has given women a reason to save. But are women actually saving? In this paper, we explore the relationship between the gender dynamics within a family and the accumulation of wealth. We find that little evidence in support of the conventional wisdom that families with a female financial manager save more and repay their debts more often. We find some evidence that male financial management leads to greater savings, and other evidence suggesting that savings patterns have a complex relationship with intra-family gender dynamics. El empoderamiento económico de la mujer – el aumento de los ingresos, mayores oportunidades, mayor participación laboral – ha dado a muchas mujeres los medios para ahorrar. Al pasar la responsabilidad de los ingresos de la jubilación de los empleadores y el gobierno a los individuos ha dado a las mujeres un motivo para ahorrar. ¿Pero realmente ahorran las mujeres? En este artículo se analizan las relaciones entre las dinámicas de género en una familia, y la acumulación de riqueza. Se ha llegado a la conclusión de que hay poca evidencia que apoye la creencia convencional de que las familias en las que una mujer gestiona las financias ahorran más y devuelven sus créditos más frecuentemente. Se ha encontrado alguna evidencia de que la gestión financiera por varones acarrea mayores ahorros, y otras evidencias que sugieren que los patrones de ahorro tienen una relación compleja con las dinámicas de género dentro de la familia.

Improved netting

International Nuclear Information System (INIS)

Bramley, A.; Clabburn, R.J.T.

1976-01-01

A method is described for producing netting composed of longitudinal and transverse threads of irradiation cross linked thermoplastic material, the threads being joined together at their crossings by moulded masses of cross linked thermoplastic material. The thread may be formed of polyethylene filaments, subjected to a radiation dose of 15 to 25 MR. The moulding can be conducted at 245 0 to 260 0 C or higher. The product is claimed to be an improved quality of netting, with bonds of increased strength between crossing threads. (U.K.)

Energy conservation. Federal shared energy savings contracting

International Nuclear Information System (INIS)

Fultz, Keith O.; Milans, Flora H.; Kirk, Roy J.; Welker, Robert A.; Sparling, William J.; Butler, Sharon E.; Irwin, Susan W.

1989-04-01

A number of impediments have discouraged federal agencies from using shared energy savings contracts. As of November 30, 1988, only two federal agencies - the U.S. Postal Service (USPS) and the Department of the Army -had awarded such contracts even though they can yield significant energy and cost savings. The three major impediments we identified were uncertainty about the applicability of a particular procurement policy and practice, lack of management incentives, and difficulty in measuring energy and cost savings. To address the first impediment, the Department of Energy (DOE) developed a manual on shared energy savings contracting. The second impediment was addressed when the 100th Congress authorized incentives for federal agencies to enter into shared savings contracts. DOE addressed the third impediment by developing a methodology for calculating energy consumption and cost savings. However, because of differing methodological preferences, this issue will need to be addressed on a contract-by-contract basis. Some state governments and private sector firms are using performance contracts to reduce energy costs in their buildings and facilities. We were able to identify six states that were using performance contracts. Five have established programs, and all six states have projects under contract. The seven energy service companies we contacted indicated interest in federal shared energy savings contracting

Hospital treatment, mortality and healthcare costs in relation to socioeconomic status among people with bipolar affective disorder

Science.gov (United States)

Yeh, Ling-Ling; Chen, Yu-Chun; Kuo, Kuei-Hong; Chang, Chin-Kuo

2016-01-01

Background Evidence regarding the relationships between the socioeconomic status and long-term outcomes of individuals with bipolar affective disorder (BPD) is lacking. Aims We aimed to estimate the effects of baseline socioeconomic status on longitudinal outcomes. Method A national cohort of adult participants with newly diagnosed BPD was identified in 2008. The effects of personal and household socioeconomic status were explored on outcomes of hospital treatment, mortality and healthcare costs, over a 3-year follow-up period (2008–2011). Results A total of 7987 participants were recruited. The relative risks of hospital treatment and mortality were found elevated for the ones from low-income households who also had higher healthcare costs. Low premium levels did not correlate with future healthcare costs. Conclusions Socioeconomic deprivation is associated with poorer outcome and higher healthcare costs in BPD patients. Special care should be given to those with lower socioeconomic status to improve outcomes with potential benefits of cost savings in the following years. Declaration of interest None. Copyright and usage © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703748

Redefining the Core Competencies of Future Healthcare Executives under Healthcare Reform

Science.gov (United States)

Love, Dianne B.; Ayadi, M. Femi

2015-01-01

As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a…

Household water saving: Evidence from Spain

Science.gov (United States)

Aisa, Rosa; Larramona, Gemma

2012-12-01

This article focuses on household water use in Spain by analyzing the influence of a detailed set of factors. We find that, although the presence of both water-saving equipment and water-conservation habits leads to water savings, the factors that influence each are not the same. In particular, our results show that those individuals most committed to the adoption of water-saving equipment and, at the same time, less committed to water-conservation habits tend to have higher incomes.

Net alkalinity and net acidity 1: Theoretical considerations

International Nuclear Information System (INIS)

Kirby, Carl S.; Cravotta, Charles A.

2005-01-01

Net acidity and net alkalinity are widely used, poorly defined, and commonly misunderstood parameters for the characterization of mine drainage. The authors explain theoretical expressions of 3 types of alkalinity (caustic, phenolphthalein, and total) and acidity (mineral, CO 2 , and total). Except for rarely-invoked negative alkalinity, theoretically defined total alkalinity is closely analogous to measured alkalinity and presents few practical interpretation problems. Theoretically defined 'CO 2 -acidity' is closely related to most standard titration methods with an endpoint pH of 8.3 used for determining acidity in mine drainage, but it is unfortunately named because CO 2 is intentionally driven off during titration of mine-drainage samples. Using the proton condition/mass-action approach and employing graphs to illustrate speciation with changes in pH, the authors explore the concept of principal components and how to assign acidity contributions to aqueous species commonly present in mine drainage. Acidity is defined in mine drainage based on aqueous speciation at the sample pH and on the capacity of these species to undergo hydrolysis to pH 8.3. Application of this definition shows that the computed acidity in mgL -1 as CaCO 3 (based on pH and analytical concentrations of dissolved Fe II , Fe III , Mn, and Al in mgL -1 ):acidity calculated =50{1000(10 -pH )+[2(Fe II )+3(Fe III )]/56+2(Mn) /55+3(Al)/27}underestimates contributions from HSO 4 - and H + , but overestimates the acidity due to Fe 3+ and Al 3+ . However, these errors tend to approximately cancel each other. It is demonstrated that 'net alkalinity' is a valid mathematical construction based on theoretical definitions of alkalinity and acidity. Further, it is shown that, for most mine-drainage solutions, a useful net alkalinity value can be derived from: (1) alkalinity and acidity values based on aqueous speciation (2) measured alkalinity minus calculated acidity, or (3) taking the negative of the

Net alkalinity and net acidity 1: Theoretical considerations

Science.gov (United States)

Kirby, C.S.; Cravotta, C.A.

2005-01-01

Net acidity and net alkalinity are widely used, poorly defined, and commonly misunderstood parameters for the characterization of mine drainage. The authors explain theoretical expressions of 3 types of alkalinity (caustic, phenolphthalein, and total) and acidity (mineral, CO2, and total). Except for rarely-invoked negative alkalinity, theoretically defined total alkalinity is closely analogous to measured alkalinity and presents few practical interpretation problems. Theoretically defined "CO 2-acidity" is closely related to most standard titration methods with an endpoint pH of 8.3 used for determining acidity in mine drainage, but it is unfortunately named because CO2 is intentionally driven off during titration of mine-drainage samples. Using the proton condition/mass- action approach and employing graphs to illustrate speciation with changes in pH, the authors explore the concept of principal components and how to assign acidity contributions to aqueous species commonly present in mine drainage. Acidity is defined in mine drainage based on aqueous speciation at the sample pH and on the capacity of these species to undergo hydrolysis to pH 8.3. Application of this definition shows that the computed acidity in mg L -1 as CaCO3 (based on pH and analytical concentrations of dissolved FeII, FeIII, Mn, and Al in mg L -1):aciditycalculated=50{1000(10-pH)+[2(FeII)+3(FeIII)]/56+2(Mn)/ 55+3(Al)/27}underestimates contributions from HSO4- and H+, but overestimates the acidity due to Fe3+ and Al3+. However, these errors tend to approximately cancel each other. It is demonstrated that "net alkalinity" is a valid mathematical construction based on theoretical definitions of alkalinity and acidity. Further, it is shown that, for most mine-drainage solutions, a useful net alkalinity value can be derived from: (1) alkalinity and acidity values based on aqueous speciation, (2) measured alkalinity minus calculated acidity, or (3) taking the negative of the value obtained in a

Feeding your piggy bank with intentions : A study on saving behaviour, saving strategies, and happiness

NARCIS (Netherlands)

De Francisco Vela, S.; Desmet, P.M.A.; Casais, M.

2014-01-01

The act of saving money can connect one’s present state to a meaningful future state, especially if we consider money not as a direct source of happiness, but as a resource for engaging in meaningful activities. To explore how design can contribute to making the act of saving more meaningful, we

Saving electricity in a hurry - update 2011

Energy Technology Data Exchange (ETDEWEB)

Pasquier, Sara Bryan

2011-06-15

As demonstrated by the March 2011 earthquake and tsunami-triggered blackouts in Japan, electricity shortfalls can happen anytime and anywhere. Countries can minimise the negative economic, social and environmental impacts of such electricity shortfalls by developing emergency energy-saving strategies before a crisis occurs. This new IEA report highlights preliminary findings and conclusions from electricity shortfalls in Japan, the United States, New Zealand, South Africa and Chile. It draws on recent analysis to: reinforce well-established guidelines on diagnosing electricity shortfalls, identifying energy-saving opportunities and selecting a package of energy-saving measures; and highlight proven practice for implementing emergency energy-saving programmes. This paper will be valuable to government, academic, private-sector and civil-society stakeholders who inform, develop and implement electricity policy in general, and emergency energy-saving programmes in particular.

Proof Nets for Lambek Calculus

NARCIS (Netherlands)

Roorda, Dirk

1992-01-01

The proof nets of linear logic are adapted to the non-commutative Lambek calculus. A different criterion for soundness of proof nets is given, which gives rise to new algorithms for proof search. The order sensitiveness of the Lambek calculus is reflected by the planarity condition on proof nets;

Properties of porous netted materials

International Nuclear Information System (INIS)

Daragan, V.D.; Drozdov, B.G.; Kotov, A.Yu.; Mel'nikov, G.N.; Pustogarov, A.V.

1987-01-01

Hydraulic and strength characteristics, efficient heat conduction and inner heat exchange coefficient are experimentally studied for porous netted materials on the base of the brass nets as dependent on porosity, cell size and method of net laying. Results of the studies are presented. It is shown that due to anisotropy of the material properties the hydraulic resistance in the direction parallel to the nets plane is 1.3-1.6 times higher than in the perpendicular one. Values of the effective heat conduction in the direction perpendicular to the nets plane at Π>0.45 agree with the data from literature, at Π<0.45 a deviation from the calculated values is marked in the direction of the heat conduction decrease

System effectiveness of a targeted free mass distribution of long lasting insecticidal nets in Zanzibar, Tanzania

Directory of Open Access Journals (Sweden)

Abass Ali K

2010-06-01

Full Text Available Abstract Background Insecticide-treated nets (ITN and long-lasting insecticidal treated nets (LLIN are important means of malaria prevention. Although there is consensus regarding their importance, there is uncertainty as to which delivery strategies are optimal for dispensing these life saving interventions. A targeted mass distribution of free LLINs to children under five and pregnant women was implemented in Zanzibar between August 2005 and January 2006. The outcomes of this distribution among children under five were evaluated, four to nine months after implementation. Methods Two cross-sectional surveys were conducted in May 2006 in two districts of Zanzibar: Micheweni (MI on Pemba Island and North A (NA on Unguja Island. Household interviews were conducted with 509 caretakers of under-five children, who were surveyed for socio-economic status, the net distribution process, perceptions and use of bed nets. Each step in the distribution process was assessed in all children one to five years of age for unconditional and conditional proportion of success. System effectiveness (the accumulated proportion of success and equity effectiveness were calculated, and predictors for LLIN use were identified. Results The overall proportion of children under five sleeping under any type of treated net was 83.7% (318/380 in MI and 91.8% (357/389 in NA. The LLIN usage was 56.8% (216/380 in MI and 86.9% (338/389 in NA. Overall system effectiveness was 49% in MI and 87% in NA, and equity was found in the distribution scale-up in NA. In both districts, the predicting factor of a child sleeping under an LLIN was caretakers thinking that LLINs are better than conventional nets (OR = 2.8, p = 0.005 in MI and 2.5, p = 0.041 in NA, in addition to receiving an LLIN (OR = 4.9, p Conclusions Targeted free mass distribution of LLINs can result in high and equitable bed net coverage among children under five. However, in order to sustain high effective coverage, there

RECRUITMENT FINANCED BY SAVED LEAVE (RSL PROGRAMME)

CERN Multimedia

Division du Personnel; Tel. 73903

1999-01-01

Transfer to the saved leave account and saved leave bonusStaff members participating in the RSL programme may opt to transfer up to 10 days of unused annual leave or unused compensatory leave into their saved leave account, at the end of the leave year, i.e. 30 September (as set out in the implementation procedure dated 27 August 1997).A leave transfer request form, which you should complete, sign and return, if you wish to use this possibility, has been addressed you. To allow the necessary time for the processing of your request, you should return it without delay.As foreseen in the implementation procedure, an additional day of saved leave will be granted for each full period of 20 days remaining in the saved leave account on 31 December 1999, for any staff member participating in the RSL programme until that date.For part-time staff members participating in the RSL programme, the above-mentioned days of leave (annual, compensatory and saved) are adjusted proportionally to their contractual working week as...

Chinese hotel general managers' perspectives on energy-saving practices

Science.gov (United States)

Zhu, Yidan

As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

Understanding Net Zero Energy Buildings

DEFF Research Database (Denmark)

Salom, Jaume; Widén, Joakim; Candanedo, José

2011-01-01

Although several alternative definitions exist, a Net-Zero Energy Building (Net ZEB) can be succinctly described as a grid-connected building that generates as much energy as it uses over a year. The “net-zero” balance is attained by applying energy conservation and efficiency measures...... and by incorporating renewable energy systems. While based on annual balances, a complete description of a Net ZEB requires examining the system at smaller time-scales. This assessment should address: (a) the relationship between power generation and building loads and (b) the resulting interaction with the power grid...

Healthcare

Science.gov (United States)

Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

2012-01-01

This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

History-dependent stochastic Petri nets

NARCIS (Netherlands)

Schonenberg, H.; Sidorova, N.; Aalst, van der W.M.P.; Hee, van K.M.; Pnueli, A.; Virbitskaite, I.; Voronkov, A.

2010-01-01

Stochastic Petri Nets are a useful and well-known tool for performance analysis. However, an implicit assumption in the different types of Stochastic Petri Nets is the Markov property. It is assumed that a choice in the Petri net only depends on the current state and not on earlier choices. For many

Poor Families Striving to Save in Matched Children's Savings Accounts: Findings from a Randomized Experimental Design in Uganda.

Science.gov (United States)

Karimli, Leyla; Ssewamala, Fred M; Neilands, Torsten B

2014-12-01

This study examines participants' savings in children's savings accounts (CSAs) set up for AIDS-orphaned children ages 10-15 in Uganda. Using a cluster randomized experimental design, we examine the extent to which families participating in a CSA program report more savings than their counterparts not participating in the program, explore the extent to which families who participate in the CSA program report using formal financial institutions compared with families who do not have a CSA, and consider whether families participating in the CSA program bring new money into the CSA or whether they reshuffle existing household assets. We find that participating in a CSA increased families' likelihood to report having saved money. However, our results show no intervention effect either on the amount of self-reported savings or on the likelihood of using formal financial institutions. Further research is needed to understand whether use of a CSA helps families generate new wealth.

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

Pro ASP.NET 4 in VB 2010

CERN Document Server

MacDonald, Matthew; Freeman, Adam; Szpuszta, Mario; Agarwal, Vidya Vrat

2010-01-01

ASP.NET 4 is the latest version of Microsoft's revolutionary ASP.NET technology. It is the principal standard for creating dynamic web pages on the Windows platform. Pro ASP.NET 4 in VB 2010 raises the bar for high-quality, practical advice on learning and deploying Microsoft's dynamic web solution. This new edition is updated with everything you need to come to grips with the latest version of ASP.NET, including coverage of ASP.NET MVC, ASP.NET AJAX 4, ASP.NET Dynamic Data, and Silverlight 3. Seasoned .NET professionals Matthew MacDonald and Mario Szpuszta explain how you can get the most fro

Healthcare technology: physician collaboration in reducing the surgical cost.

Science.gov (United States)

Olson, Steven A; Obremskey, William T; Bozic, Kevin J

2013-06-01

The increasing cost of providing health care is a national concern. Healthcare spending related to providing hospital care is one of the primary drivers of healthcare spending in the United States. Adoption of advanced medical technologies accounts for the largest percentage of growth in healthcare spending in the United States when compared with other developed countries. Within the specialty of orthopaedic surgery, a variety of implants can result in similar outcomes for patients in several areas of clinical care. However, surgeons often do not know the cost of implants used in a specific procedure or how the use of an implant or technology affects the overall cost of the episode of care. The purposes of this study were (1) to describe physician-led processes for introduction of new surgical products and technologies; and (2) to inform physicians of potential cost savings of physician-led product contract negotiations and approval of new technology. We performed a detailed review of the steps taken by two centers that have implemented surgeon-led programs to demonstrate responsibility in technology acquisition and product procurement decision-making. Each program has developed a physician peer review process in technology and new product acquisition that has resulted in a substantial reduction in spending for the respective hospitals in regard to surgical implants. Implant costs have decreased between 3% and 38% using different negotiating strategies. At the same time, new product requests by physicians have been approved in greater than 90% of instances. Hospitals need physicians to be engaged and informed in discussions concerning current and new technology and products. Surgeons can provide leadership for these efforts to reduce the cost of high-quality care.

Does extending daylight saving time save energy? Evidence from an Australian experiment

Energy Technology Data Exchange (ETDEWEB)

Kellogg, R. [California Univ., Berkeley, CA (United States). Dept. of Agricultural and Resource Economics; Wolff, H. [California Univ., Berkeley, CA (United States). Dept. of Agricultural and Resource Economics]|[Forschungsinstitut zur Zukunft der Arbeit (IZA), Bonn (Germany)

2007-03-15

Several countries are considering extending Daylight Saving Time (DST) in order to conserve energy, and the U.S. will extend DST by one month beginning in 2007. However, projections that these extensions will reduce electricity consumption rely on extrapolations and simulations rather than empirical evidence. This paper, in contrast, examines a quasiexperiment in which parts of Australia extended DST in 2000 to facilitate the Sydney Olympics. Using detailed panel data and a triple differences specification, we show that the extension did not conserve electricity, and that a prominent simulation model overstates electricity savings when it is applied to Australia. (orig.)

The costs and potential savings of a novel telepaediatric service in Queensland

Directory of Open Access Journals (Sweden)

Scuffham Paul

2007-03-01

Full Text Available Abstract Background There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. Methods In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry. Results During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider. Conclusion Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.

[Saving motives in young, middle-aged, and older adults. Preliminary results of a new inventory for exploring lifespan saving motives].

Science.gov (United States)

Rager, B; Lang, F R; Wagner, G G

2012-12-01

There is some research on personal reasons for saving money in the economic sciences. However, not much is known about the age differences of saving motives. In this vein, the future time perspective (FTP) is known to play a critical role for motivation across the life span. In this study, we introduce a new Saving Motive Inventory (SMI), which also covers saving goals after retirement. Furthermore, it is argued that additional saving motives that are not based on economic models of life-cycle saving also exist. In accordance with the socio-emotional selectivity theory, we explored age differences in an online survey with 496 participants from young (19-44 years), middle-aged (45-64 years), and older (65-86 years) adulthood, who completed a questionnaire on saving motives, personality, and future-related thinking (e.g., Future Time Perspective Scale, Life Orientation Test). Results of the explorative Factor Analysis (EFA) are consistent with the theoretical expectations. The factors are generativity, educational investment, consumption, indifference, and provision for death and dying. Together these five factors account for 67% of the variance. In general, the inventory is reliable and valid with respect to the expected internal and external criteria. It contributes to better understanding of saving motives over the lifespan, especially with respect to effects of the future time perspective.

Control Evaluation Information System Savings

Directory of Open Access Journals (Sweden)

Eddy Sutedjo

2011-05-01

Full Text Available The purpose of this research is to evaluate the control of information system savings in the banking and to identify the weaknesses and problem happened in those saving systems. Research method used are book studies by collecting data and information needed and field studies by interview, observation, questioner, and checklist using COBIT method as a standard to assess the information system control of the company. The expected result about the evaluation result that show in the problem happened and recommendation given as the evaluation report and to give a view about the control done by the company. Conclusion took from this research that this banking company has met standards although some weaknesses still exists in the system.Index Terms - Control Information System, Savings

Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Mixed-Humid Climates; January 2006 - December 2006

Energy Technology Data Exchange (ETDEWEB)

Building America Industrialized Housing Partnership (BAIHP); Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

2006-12-01

The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Mixed-Humid Climate Region on a cost-neutral basis.

Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in the Hot-Dry and Mixed-Dry Climates

Energy Technology Data Exchange (ETDEWEB)

Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); Florida Solar Energy Center (FSEC); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

2006-01-01

The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Hot-Dry/Mixed-Dry Climate Region on a cost neutral basis.

NASA Net Zero Energy Buildings Roadmap

Energy Technology Data Exchange (ETDEWEB)

Pless, S.; Scheib, J.; Torcellini, P.; Hendron, B.; Slovensky, M.

2014-10-01

In preparation for the time-phased net zero energy requirement for new federal buildings starting in 2020, set forth in Executive Order 13514, NASA requested that the National Renewable Energy Laboratory (NREL) to develop a roadmap for NASA's compliance. NASA detailed a Statement of Work that requested information on strategic, organizational, and tactical aspects of net zero energy buildings. In response, this document presents a high-level approach to net zero energy planning, design, construction, and operations, based on NREL's first-hand experience procuring net zero energy construction, and based on NREL and other industry research on net zero energy feasibility. The strategic approach to net zero energy starts with an interpretation of the executive order language relating to net zero energy. Specifically, this roadmap defines a net zero energy acquisition process as one that sets an aggressive energy use intensity goal for the building in project planning, meets the reduced demand goal through energy efficiency strategies and technologies, then adds renewable energy in a prioritized manner, using building-associated, emission- free sources first, to offset the annual energy use required at the building; the net zero energy process extends through the life of the building, requiring a balance of energy use and production in each calendar year.

RESTful NET

CERN Document Server

Flanders, Jon

2008-01-01

RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

Getting to Net Zero

Energy Technology Data Exchange (ETDEWEB)

2016-09-01

The technology necessary to build net zero energy buildings (NZEBs) is ready and available today, however, building to net zero energy performance levels can be challenging. Energy efficiency measures, onsite energy generation resources, load matching and grid interaction, climatic factors, and local policies vary from location to location and require unique methods of constructing NZEBs. It is recommended that Components start looking into how to construct and operate NZEBs now as there is a learning curve to net zero construction and FY 2020 is just around the corner.

Net Zero Energy Buildings

DEFF Research Database (Denmark)

Marszal, Anna Joanna; Bourrelle, Julien S.; Gustavsen, Arild

2010-01-01

and identify possible renewable energy supply options which may be considered in calculations. Finally, the gap between the methodology proposed by each organisation and their respective national building code is assessed; providing an overview of the possible changes building codes will need to undergo......The international cooperation project IEA SHC Task 40 / ECBCS Annex 52 “Towards Net Zero Energy Solar Buildings”, attempts to develop a common understanding and to set up the basis for an international definition framework of Net Zero Energy Buildings (Net ZEBs). The understanding of such buildings...

Pro NET Best Practices

CERN Document Server

Ritchie, Stephen D

2011-01-01

Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

Prooxidant/Antioxidant Ratio (ProAntidex as a Better Index of Net Free Radical Scavenging Potential

Directory of Open Access Journals (Sweden)

Hwee Ming Cheng

2010-11-01

Full Text Available The antioxidant activity of several Malaysian plant extracts was analyzed simultaneously with their pro-oxidant capacity. This ratio represents an index (ProAntidex of the net free radical scavenging ability of whole plant extracts. We observed that ethanolic extracts of Nephelium lappaceum peel, Fragaria x ananassa leaf, Lawsonia inermis leaf, Syzygium aqueum leaf and grape seed had a lower Pro-Antidex than the commercially available Emblica™ extract which is an antioxidant agent with very low pro-oxidant activity. Among the aqueous extracts, Lawsonia inermis leaf, Nephelium mutobile leaf and grape seed had lower pro-oxidant activity compared to the Emblica™ extract. Among these extracts, aqueous extract of Nephelium mutobile leaf had a very low index of 0.05 compared to 0.69 for Emblica™. Most of the extracts had a far lower ProAntidex compared to the Vitamin C. The index enables us to identify extracts with high net free radical scavenging activity potential. The ProAntidex is beneficial as a screening parameter to the food industries and healthcare.

ASP.NET web API build RESTful web applications and services on the .NET framework

CERN Document Server

Kanjilal, Joydip

2013-01-01

This book is a step-by-step, practical tutorial with a simple approach to help you build RESTful web applications and services on the .NET framework quickly and efficiently.This book is for ASP.NET web developers who want to explore REST-based services with C# 5. This book contains many real-world code examples with explanations whenever necessary. Some experience with C# and ASP.NET 4 is expected.

Housing-related lifestyle and energy saving

DEFF Research Database (Denmark)

Thøgersen, John

2017-01-01

of relevant background characteristics. A multivariate GLM analysis reveals that when differences in housing-related lifestyles are controlled, neither country of residence nor the interaction between lifestyle and country of residence influence energy saving innovativeness or everyday energy-saving efforts...

Electronic healthcare information security

CERN Document Server

Dube, Kudakwashe; Shoniregun, Charles A

2010-01-01

The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

Translating Colored Control Flow Nets into Readable Java via Annotated Java Workflow Nets

DEFF Research Database (Denmark)

Lassen, Kristian Bisgaard; Tjell, Simon

2007-01-01

In this paper, we present a method for developing Java applications from Colored Control Flow Nets (CCFNs), which is a special kind of Colored Petri Nets (CPNs) that we introduce. CCFN makes an explicit distinction between the representation of: The system, the environment of the system, and the ......In this paper, we present a method for developing Java applications from Colored Control Flow Nets (CCFNs), which is a special kind of Colored Petri Nets (CPNs) that we introduce. CCFN makes an explicit distinction between the representation of: The system, the environment of the system......, and the interface between the system and the environment. Our translation maps CCFNs into Anno- tated Java Workflow Nets (AJWNs) as an intermediate step, and these AJWNs are finally mapped to Java. CCFN is intended to enforce the modeler to describe the system in an imperative manner which makes the subsequent...... translation to Java easier to define. The translation to Java preserves data dependencies and control-flow aspects of the source CCFN. This paper contributes to the model-driven software development paradigm, by showing how to model a system, environment, and their interface, as a CCFN and presenting a fully...

Entrepreneurial Saving Practices and Reinvestment : Theory and Evidence

NARCIS (Netherlands)

Beck, T.H.L.; Pamuk, H.; Uras, R.B.

2014-01-01

We use a novel enterprise survey from Tanzania to gauge the relationship between saving instruments and entrepreneurial reinvestment. While most informal savings practices do not imply a lower likelihood of entrepreneurial reinvestment when compared with formal savings practices, we find a

Programming NET 35

CERN Document Server

Liberty, Jesse

2009-01-01

Bestselling author Jesse Liberty and industry expert Alex Horovitz uncover the common threads that unite the .NET 3.5 technologies, so you can benefit from the best practices and architectural patterns baked into the new Microsoft frameworks. The book offers a Grand Tour" of .NET 3.5 that describes how the principal technologies can be used together, with Ajax, to build modern n-tier and service-oriented applications. "

NETS - A NEURAL NETWORK DEVELOPMENT TOOL, VERSION 3.0 (MACINTOSH VERSION)

Science.gov (United States)

Phillips, T. A.

1994-01-01

NETS, A Tool for the Development and Evaluation of Neural Networks, provides a simulation of Neural Network algorithms plus an environment for developing such algorithms. Neural Networks are a class of systems modeled after the human brain. Artificial Neural Networks are formed from hundreds or thousands of simulated neurons, connected to each other in a manner similar to brain neurons. Problems which involve pattern matching readily fit the class of problems which NETS is designed to solve. NETS uses the back propagation learning method for all of the networks which it creates. The nodes of a network are usually grouped together into clumps called layers. Generally, a network will have an input layer through which the various environment stimuli are presented to the network, and an output layer for determining the network's response. The number of nodes in these two layers is usually tied to some features of the problem being solved. Other layers, which form intermediate stops between the input and output layers, are called hidden layers. NETS allows the user to customize the patterns of connections between layers of a network. NETS also provides features for saving the weight values of a network during the learning process, which allows for more precise control over the learning process. NETS is an interpreter. Its method of execution is the familiar "read-evaluate-print" loop found in interpreted languages such as BASIC and LISP. The user is presented with a prompt which is the simulator's way of asking for input. After a command is issued, NETS will attempt to evaluate the command, which may produce more prompts requesting specific information or an error if the command is not understood. The typical process involved when using NETS consists of translating the problem into a format which uses input/output pairs, designing a network configuration for the problem, and finally training the network with input/output pairs until an acceptable error is reached. NETS

Net metering: zero electricity bill

International Nuclear Information System (INIS)

Mangi, A.; Khan, Z.

2011-01-01

Worldwide move towards renewable energy sources, environmental concerns and decentralization of the power sector have made net metering an attractive option for power generation at small scale. This paper discusses the net metering, economical issues of renewable sources in Pakistan, technical aspects, installation suitability according to varying terrain, existing utility rules and formulation of legislation for net metering making it economically attractive. (author)

Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

Science.gov (United States)

Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

2016-10-01

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

Entrepreneurial saving practices and reinvestment : Theory and evidence

NARCIS (Netherlands)

Beck, T.H.L.; Pamuk, Haki; Uras, Burak

2017-01-01

We use a novel enterprise survey to gauge the relationship between saving instruments and entrepreneurial reinvestment. We show that while most informal saving practices are not associated with a lower likelihood of reinvestment when compared with formal saving practices, there is a significantly

Healthcare Robotics

OpenAIRE

Riek, Laurel D.

2017-01-01

Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key sta...

Scale Effects of Water Saving on Irrigation Efficiency: Case Study of a Rice-Based Groundwater Irrigation System on the Sanjiang Plain, Northeast China

Directory of Open Access Journals (Sweden)

Haorui Chen

2017-12-01

Full Text Available This research analyzed the scale effect of water saving in Bielahonghe (BLH Basin, a rice-cultivating district on the Sanjiang Plain, Northeast China. Water budgets with different surface irrigation water supply ratios and water-saving measures were simulated with a semi-distributed water balance model. PFnws, representing the ratio of rice evapotranspiration to net water supply (the total amount of irrigation and precipitation minus the amount of water reused, was employed to assess the water use efficiency. Seven spatial scales (noted from S1 to S7, ranging from a single field (317.87 ha to the whole basin (about 100,800 ha were determined. PFnws values were quantified across scales and several water-saving measures, including water-saving irrigation regimes, canal lining, and a reduction of the surface water supply ratio (SWSR. The results indicated that PFnws increased with scale and could be calculated by a fitted power function (PFnws = 0.736Area0.033, R2 = 0.58. Furthermore, PFnws increased most prominently when the scale increased from S1 to S2. The water-saving irrigation regime (WSIR had the most substantial water-saving effect (WSE at S1. Specifically, PFnws improved by 21.2% at S1 when high-intensity WSIR was applied. Additionally, the WSE values of S3 and S5 were slightly higher than at other scales when the branch canal water delivery coefficient increased from 0.65 to 0.80 through canal lining. Furthermore, the PFnws at each scale varied with SWSR. Specifically, PFnws from S3 to S7 improved as SWSR decreased from 0.4 to 0.3 but remained approximately constant when SWSR decreased from 0.3 to 0.

Net Locality

DEFF Research Database (Denmark)

de Souza e Silva, Adriana Araujo; Gordon, Eric

Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps......, to location-based social networks and games, such as Foursquare and facebook. Warns of the threats these technologies, such as data surveillance, present to our sense of privacy, while also outlining the opportunities for pro-social developments. Provides a theory of the web in the context of the history...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

Factors Influencing Healthcare Service Quality

Directory of Open Access Journals (Sweden)

Ali Mohammad Mosadeghrad

2014-07-01

Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

Overview of contractual savings institutions

OpenAIRE

Vittas, Dimitri; Skully, Michael

1991-01-01

Contractual savings institutions include national provident funds, life insurance companies, private pension funds, and funded social pension insurance systems. They have long-term liabilities and stable cash flows and are therefore ideal providers of term finance, not only to government and industry, but also to municipal authorities and the housing sector. Except for Singapore, Malaysia, and a few other countries, most developing countries have small and insignificant contractual savings in...

China energy-water nexus: Assessing the water-saving synergy effects of energy-saving policies during the eleventh Five-year Plan

International Nuclear Information System (INIS)

Gu, Alun; Teng, Fei; Wang, Yu

2014-01-01

Highlights: • Energy and water limit China’s sustainable development. • Current energy policies fail to address water saving issues. • The energy-water coefficient is estimated for both direct use and indirect use. • Water saving effects associated with energy-saving policies is calculated. • Water-energy nexus should be enhanced in key industrial sectors. - Abstract: Energy and water have become major factors limiting sustainable development in China. Energy efficiency and optimization of water management are critical for the healthy growth of the Chinese economy. Current national energy policies fail to adequately address water use issues. Similarly, current water policies do not consider the impact of energy consumption and greenhouse gas emissions. Consequently, few studies have investigated the relationship between energy consumption and water use. The present study analyzes the energy-water nexus in Chinese industries using input–output tables. Coefficients that characterize the relationship between energy consumption and water are used to describe the supply-consumption relationship between the water supply and primary energy sectors. Next, we calculate the water-saving effects associated with the enforcement of energy-saving policies in selected industrial sectors during the eleventh Five-year Plan, from 2005 to 2010. These calculations address the ferrous metals, non-ferrous metals, petrochemical engineering, building materials, and electricity industries as well as key light industries. Our findings indicate that energy-saving efforts in these industries will result in savings in water consumption. This study suggests that a cooperative relationship between water and energy conservation efforts should be an important factor in creating policies that encourage simultaneous savings of both resources. Additionally, the study indicates that government should promote water- and energy-saving techniques in key industrial sectors to encourage

37 CFR 11.61 - Savings clause.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Savings clause. 11.61 Section... Disciplinary Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings § 11.61 Savings clause. (a... subsequent to such effective date, if such conduct would continue to justify suspension or exclusion under...

Refrigeration: Introducing energy saving opportunities for business

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-04-15

In some industries, most notably food and drink and chemicals, refrigeration accounts for a significant proportion of overall site energy costs. For instance, in the industrial handling of meat, poultry and fish, it often accounts for 50% of total energy costs. In ice-cream production the proportion is 70%. In a number of commercial sectors, refrigeration also represents a significant proportion of overall energy costs. For example: Cold storage 90%; Food supermarkets 50%; Small shops with refrigerated cabinets 70% or over; Pubs and clubs 30%. Against these high costs, even a small reduction in refrigeration energy use can offer significant cost savings, resulting in increased profits. Energy saving need not be expensive. Energy savings of up to 20% can be realised in many refrigeration plant through actions that require little or no investment. In addition, improving the efficiency and reducing the load on a refrigeration plant can improve reliability and reduce the likelihood of a breakdown. Most organisations can save energy and money on refrigeration by: More efficient equipment; Good maintenance; Housekeeping and control. This publication provides an understanding of the operation of refrigeration systems, identifies where savings can be realised and will enable readers to present an informed case on energy savings to key decision makers within their organisation. (GB)

REMINDER Saved Leave Scheme (SLS) : Simplified procedure for the transfer of leave to saved leave accounts

CERN Multimedia

HR Division

2001-01-01

As part of the process of streamlining procedures, the HR and AS Divisions have jointly developed a system whereby annual and compensatory leave will henceforth be automatically transferred1) to saved leave accounts. Under the provisions of the voluntary saved leave scheme (SLS), a maximum total of 10 days'2)Previously, every person taking part in the scheme has been individually issued with a form for the purposes of requesting the transfer of leave to the leave account and the transfer has then had to be done manually by HR Division. To streamline the procedure, unused leave of all those taking part in the saved leave scheme at the closure of the leave-year accounts will henceforth be transferred automatically to the saved leave account on that date. This simplification is in the interest of all parties concerned. This automatic transfer procedure has a number of advantages for participants in the SLS scheme. First, staff members will no longer have to take any administrative steps. Secondly, the new proced...

48 CFR 48.104-3 - Sharing collateral savings.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Sharing collateral savings... CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.104-3 Sharing collateral savings. (a) The Government shares collateral savings with the contractor, unless the head of the contracting activity has...

48 CFR 2448.104-3 - Sharing collateral savings.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Sharing collateral savings... DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of the HCA to determine that the cost of calculating and tracking collateral savings will exceed the...

Poor Families Striving to Save in Matched Children’s Savings Accounts: Findings from a Randomized Experimental Design in Uganda

Science.gov (United States)

Karimli, Leyla; Ssewamala, Fred M.; Neilands, Torsten B.

2014-01-01

This study examines participants’ savings in children’s savings accounts (CSAs) set up for AIDS-orphaned children ages 10–15 in Uganda. Using a cluster randomized experimental design, we examine the extent to which families participating in a CSA program report more savings than their counterparts not participating in the program, explore the extent to which families who participate in the CSA program report using formal financial institutions compared with families who do not have a CSA, and consider whether families participating in the CSA program bring new money into the CSA or whether they reshuffle existing household assets. We find that participating in a CSA increased families’ likelihood to report having saved money. However, our results show no intervention effect either on the amount of self-reported savings or on the likelihood of using formal financial institutions. Further research is needed to understand whether use of a CSA helps families generate new wealth. PMID:25525282

Caught in the Net: Perineuronal Nets and Addiction

Directory of Open Access Journals (Sweden)

Megan Slaker

2016-01-01

Full Text Available Exposure to drugs of abuse induces plasticity in the brain and creates persistent drug-related memories. These changes in plasticity and persistent drug memories are believed to produce aberrant motivation and reinforcement contributing to addiction. Most studies have explored the effect drugs of abuse have on pre- and postsynaptic cells and astrocytes; however, more recently, attention has shifted to explore the effect these drugs have on the extracellular matrix (ECM. Within the ECM are unique structures arranged in a net-like manner, surrounding a subset of neurons called perineuronal nets (PNNs. This review focuses on drug-induced changes in PNNs, the molecules that regulate PNNs, and the expression of PNNs within brain circuitry mediating motivation, reward, and reinforcement as it pertains to addiction.

Electric energy savings from new technologies. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Harrer, B.J.; Kellogg, M.A.; Lyke, A.J.; Imhoff, K.L.; Fisher, Z.J.

1986-09-01

Purpose of the report is to provide information about the electricity-saving potential of new technologies to OCEP that it can use in developing alternative long-term projections of US electricity consumption. Low-, base-, and high-case scenarios of the electricity savings for 10 technologies were prepared. The total projected annual savings for the year 2000 for all 10 technologies were 137 billion kilowatt hours (BkWh), 279 BkWh, and 470 BkWh, respectively, for the three cases. The magnitude of these savings projections can be gauged by comparing them to the Department's reference case projection for the 1985 National Energy Policy Plan. In the Department's reference case, total consumption in 2000 is projected to be 3319 BkWh. Because approximately 75% of the base-case estimate of savings are already incorporated into the reference projection, only 25% of the savings estimated here should be subtracted from the reference projection for analysis purposes.

Energy saving analysis and management modeling based on index decomposition analysis integrated energy saving potential method: Application to complex chemical processes

International Nuclear Information System (INIS)

Geng, Zhiqiang; Gao, Huachao; Wang, Yanqing; Han, Yongming; Zhu, Qunxiong

2017-01-01

Highlights: • The integrated framework that combines IDA with energy-saving potential method is proposed. • Energy saving analysis and management framework of complex chemical processes is obtained. • This proposed method is efficient in energy optimization and carbon emissions of complex chemical processes. - Abstract: Energy saving and management of complex chemical processes play a crucial role in the sustainable development procedure. In order to analyze the effect of the technology, management level, and production structure having on energy efficiency and energy saving potential, this paper proposed a novel integrated framework that combines index decomposition analysis (IDA) with energy saving potential method. The IDA method can obtain the level of energy activity, energy hierarchy and energy intensity effectively based on data-drive to reflect the impact of energy usage. The energy saving potential method can verify the correctness of the improvement direction proposed by the IDA method. Meanwhile, energy efficiency improvement, energy consumption reduction and energy savings can be visually discovered by the proposed framework. The demonstration analysis of ethylene production has verified the practicality of the proposed method. Moreover, we can obtain the corresponding improvement for the ethylene production based on the demonstration analysis. The energy efficiency index and the energy saving potential of these worst months can be increased by 6.7% and 7.4%, respectively. And the carbon emissions can be reduced by 7.4–8.2%.

Why healthcare providers merge.

Science.gov (United States)

Postma, Jeroen; Roos, Anne-Fleur

2016-04-01

In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

12 CFR 583.12 - Multiple savings and loan holding company.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Multiple savings and loan holding company. 583... DEFINITIONS FOR REGULATIONS AFFECTING SAVINGS AND LOAN HOLDING COMPANIES § 583.12 Multiple savings and loan holding company. The term multiple savings and loan holding company means any savings and loan holding...

12 CFR 583.11 - Diversified savings and loan holding company.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Diversified savings and loan holding company... DEFINITIONS FOR REGULATIONS AFFECTING SAVINGS AND LOAN HOLDING COMPANIES § 583.11 Diversified savings and loan holding company. The term diversified savings and loan holding company means any savings and loan holding...

Revolving fund for energy saving

International Nuclear Information System (INIS)

Prebensen, K.

1993-01-01

A key issue in Eastern Europe is the adjustment of prices from the former COMECON level to a level conforming with free market conditions. In the case of household heating, this issue involves the removal of government subsidies leading to sharply increasing prices, metering of individual consumption, improving the efficiency of energy production, distribution and use - where savings of 30-50% in each link are technically feasible - thereby providing a potential for a adapting consumption patterns to higher energy prices, provided that funds are available. Currently, investment in commercial heat production and distribution systems have received substantial international support - whereas investment in reduction of demand has been little exploited. The Revolving Fund for Energy Savings in Polish Households is a concept for efficient financing of small-scale projects. It aims at financing, on the level of housing cooperatives, on the basis of a simplified lending and project evaluation procedure, well suited to current Polish conditions or an organizationally and financially weak banking system and little developed technical knowledge in the field of energy saving. A general introduction to the issue is given and technical problems are elaborated. The implementation of Energy Savings in Housing seen from the banking point of view, and a current pilot scheme for financing, are described. (AB)

Advances in Biological Water-saving Research: Challenge and Perspectives

Institute of Scientific and Technical Information of China (English)

Lun Shan; Xiping Deng; Suiqi Zhang

2006-01-01

Increasing the efficiency of water use by crops continues to escalate as a topic of concern because drought is a restrictive environmental factor for crop productivity worldwide. Greater yield per unit rainfall is one of the most important challenges in water-saving agriculture. Besides water-saving by irrigation engineering and conservation tillage, a good understanding of factors limiting and/or regulating yield now provides us with an opportunity to identify and then precisely select for physiological and breeding traits that increase the efficiency of water use and drought tolerance under water-limited conditions, biological water-saving is one means of achieving this goat. A definition of biological water-saving measures is proposed which embraces improvements in water-use efficiency (WUE) and drought tolerance, by genetic improvement and physiological regulation. The preponderance of biological water-saving measures is discussed and strategies identified for working within natural resource constraints. The technology and future perspectives of biological water saving could provide not only new water-saving techniques but also a scientific base for application of water-saving irrigation and conservation tillage.

Concepts. Environmental care through energy saving

Energy Technology Data Exchange (ETDEWEB)

Wagner, G.

1987-04-01

Energy saving is an important ingredient of a preventive energy policy. It helps to reduce pollutants which are one essential source of damage done to air, water and soil. But even the environmentally damaging side effects of energy production, storage and distribution can be cut down through energy saving.

Mozambican Aggregate Consumption and Domestic Saving ...

African Journals Online (AJOL)

It was an unprecedented decade for its break with the previous trend; but so far, the new trend does not correspond to a substantial change in growth strategy to ensure that foreign savings become complementary rather than a substitute for domestic savings. Keywords: consumption, economic growth strategy, domestic ...

Casual relationship between gross domestic saving and economic ...

African Journals Online (AJOL)

The empirical study confirmed that a significant relationship between domestic savings and ... and, which ultimately increases the country domestic saving level. ... which increase saving and investment into the country due to its dual effect. ... South Africa (96); South Sudan (1); Sudan (3); Swaziland (3); Tanzania (19); Togo ...

Building Savings and Investments Culture among Nigerians | Imegi ...

African Journals Online (AJOL)

It is therefore necessary to build among Nigerians savings and investments culture. A review of extant literature revealed that people save and invest for several reasons among which are to enhance the standard of living, take advantage of rare business opportunities, and meet unforeseen circumstances. Savings can be ...

Water saving through international trade of agricultural products

NARCIS (Netherlands)

Chapagain, Ashok; Hoekstra, Arjen Ysbert; Savenije, H.H.G.

2006-01-01

Many nations save domestic water resources by importing water-intensive products and exporting commodities that are less water intensive. National water saving through the import of a product can imply saving water at a global level if the flow is from sites with high to sites with low water

The K-NET - A year after

International Nuclear Information System (INIS)

Kinoshita, S.; Ohtani, K.; Katayama, T.

2001-01-01

We started to release the K-NET strong-motion data from June 1996 and about one year passed. In this article, we report the development of K-NET and some applications using the K-NET information released on the Internet. (author)

Mars MetNet Mission Status

Science.gov (United States)

Harri, A.-M.; Aleksashkin, S.; Arruego, I.; Schmidt, W.; Genzer, M.; Vazquez, L.; Haukka, H.; Palin, M.; Nikkanen, T.

2015-10-01

New kind of planetary exploration mission for Mars is under development in collaboration between the Finnish Meteorological Institute (FMI), Lavochkin Association (LA), Space Research Institute (IKI) and Institutio Nacional de Tecnica Aerospacial (INTA). The Mars MetNet mission is based on a new semihard landing vehicle called MetNet Lander (MNL). The scientific payload of the Mars MetNet Precursor [1] mission is divided into three categories: Atmospheric instruments, Optical devices and Composition and structure devices. Each of the payload instruments will provide significant insights in to the Martian atmospheric behavior. The key technologies of the MetNet Lander have been qualified and the electrical qualification model (EQM) of the payload bay has been built and successfully tested.

NET SALARY ADJUSTMENT

CERN Multimedia

Finance Division

2001-01-01

On 15 June 2001 the Council approved the correction of the discrepancy identified in the net salary adjustment implemented on 1st January 2001 by retroactively increasing the scale of basic salaries to achieve the 2.8% average net salary adjustment approved in December 2000. We should like to inform you that the corresponding adjustment will be made to your July salary. Full details of the retroactive adjustments will consequently be shown on your pay slip.

The distribution over time of costs and social net benefits for pertussis immunization programs.

Science.gov (United States)

Girard, Dorota Zdanowska

2010-03-01

The cost of a six-dose pertussis immunization programs for children and adolescents is investigated in relation to estimators of the price of acellular vaccine, the value of a child's life, levels of vaccination rate and discount rates. We compare the cost of the program maintained over time at 90% with three alternative strategies, each involving a decrease in vaccination coverage. Data from England and Wales, 1966-2005, is used to formalize a delay in occurrence of pertussis cases as a result of a fall in coverage. We first apply the criterion of minimization of the total social cost of pertussis to identify the best cost saving immunization strategy. The results are also discussed in form of the discounted present value of the total social net benefits. We find that the discounted present value of the total social net benefit is maximized when a stable vaccination program at 90% is compared to a gradual decrease in vaccination coverage leading to the lowest vaccination rate. The benefits to society of providing sustained immunization strategy, vaccinating the highest proportion of children and adolescents, are systematically proved on the basis of the second optimisation criterion, independently of the level of estimators applied during economic evaluation for the cost variables.

The efficiency frontier approach to economic evaluation of health-care interventions.

Science.gov (United States)

Caro, J Jaime; Nord, Erik; Siebert, Uwe; McGuire, Alistair; McGregor, Maurice; Henry, David; de Pouvourville, Gérard; Atella, Vincenzo; Kolominsky-Rabas, Peter

2010-10-01

IQWiG commissioned an international panel of experts to develop methods for the assessment of the relation of benefits to costs in the German statutory health-care system. The panel recommended that IQWiG inform German decision makers of the net costs and value of additional benefits of an intervention in the context of relevant other interventions in that indication. To facilitate guidance regarding maximum reimbursement, this information is presented in an efficiency plot with costs on the horizontal axis and value of benefits on the vertical. The efficiency frontier links the interventions that are not dominated and provides guidance. A technology that places on the frontier or to the left is reasonably efficient, while one falling to the right requires further justification for reimbursement at that price. This information does not automatically give the maximum reimbursement, as other considerations may be relevant. Given that the estimates are for a specific indication, they do not address priority setting across the health-care system. This approach informs decision makers about efficiency of interventions, conforms to the mandate and is consistent with basic economic principles. Empirical testing of its feasibility and usefulness is required.

Technical energy savings versus changes in human behaviour

DEFF Research Database (Denmark)

Nørgaard, Jørgen

1996-01-01

Energy savings seems to be the most environmentally benign element in an energy policy. The paper is a reflection on the work on saving energy both by improving technology and by adapting human daily behaviour. A simple model is suggested for the energy chain which converts the primary energy all...... the way into human satisfaction via energy services. Results of various analyses and field experiments show saving potentials for electricity of 50 - 80 per cents. Barriers for implementing these technical saving options are discussed. Also the necessity and potentials for changing behavioural or life...

Net energy gain from DT fusion

International Nuclear Information System (INIS)

Buende, R.

1985-01-01

The net energy which can be gained from an energy raw material by means of a certain conversion system is deduced as the figure-of-merit which adequately characterizes the net energy balance of utilizing an energy source. This potential net energy gain is determined for DT fusion power plants. It is represented as a function of the degree of exploitation of the energy raw material lithium ore and is compared with the net energy which can be gained with LW and FBR power plants by exploiting uranium ore. The comparison clearly demonstrates the net energetic advantage of DT fusion. A sensitivity study shows that this holds even if the energy expenditure for constructing and operating is drastically increased

A multifunctional energy-saving magnetic field generator

Science.gov (United States)

Xiong, Hui; Sun, Wanpeng; Liu, Jinzhen; Shi, Jinhua

2018-03-01

To improve the energy utilization of magnetic field generators for biological applications, a multifunctional energy-saving magnetic field generator (ESMFG) is presented. It is capable of producing both an alternating magnetic field (AMF) and a bipolar pulse magnetic field (BPMF) with high energy-saving and energy-reuse rates. Based on a theoretical analysis of an RLC second-order circuit, the energy-saving and energy-reuse rates of both types of magnetic fields can be calculated and are found to have acceptable values. The results of an experimental study using the proposed generator show that for the BPMF, the peak current reaches 130 A and the intensity reaches 70.3 mT. For the AMF, the intensity is 11.0 mT and the RMS current is 20 A. The energy-saving and energy-reuse rates for the AMF generator are 61.3% and 63.5%, respectively, while for the BPMF generator, the energy-saving rate is 33.6%. Thus, the proposed ESMFG has excellent potential for use in biomedical applications.

Causal Links among Saving, Investment and Growth and ...

African Journals Online (AJOL)

The relationship between saving, investment and GDP still remains an empirical issue. In their aspiration to catch up the rest of the world, developing countries provides a special place on this matter. This paper tried to investigate the main determinants of saving and the connection among saving, investment and GDP in the ...

Canada Education Savings Program: Annual Statistical Review--2009

Science.gov (United States)

Human Resources and Skills Development Canada, 2009

2009-01-01

The Canada Education Savings Program is an initiative of the Government of Canada. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in Registered…

Net alkalinity and net acidity 2: Practical considerations

Science.gov (United States)

Kirby, C.S.; Cravotta, C.A.

2005-01-01

The pH, alkalinity, and acidity of mine drainage and associated waters can be misinterpreted because of the chemical instability of samples and possible misunderstandings of standard analytical method results. Synthetic and field samples of mine drainage having various initial pH values and concentrations of dissolved metals and alkalinity were titrated by several methods, and the results were compared to alkalinity and acidity calculated based on dissolved solutes. The pH, alkalinity, and acidity were compared between fresh, unoxidized and aged, oxidized samples. Data for Pennsylvania coal mine drainage indicates that the pH of fresh samples was predominantly acidic (pH 2.5-4) or near neutral (pH 6-7); ??? 25% of the samples had pH values between 5 and 6. Following oxidation, no samples had pH values between 5 and 6. The Standard Method Alkalinity titration is constrained to yield values >0. Most calculated and measured alkalinities for samples with positive alkalinities were in close agreement. However, for low-pH samples, the calculated alkalinity can be negative due to negative contributions by dissolved metals that may oxidize and hydrolyze. The Standard Method hot peroxide treatment titration for acidity determination (Hot Acidity) accurately indicates the potential for pH to decrease to acidic values after complete degassing of CO2 and oxidation of Fe and Mn, and it indicates either the excess alkalinity or that required for neutralization of the sample. The Hot Acidity directly measures net acidity (= -net alkalinity). Samples that had near-neutral pH after oxidation had negative Hot Acidity; samples that had pH mine drainage treatment can lead to systems with insufficient Alkalinity to neutralize metal and H+ acidity and is not recommended. The use of net alkalinity = -Hot Acidity titration is recommended for the planning of mine drainage treatment. The use of net alkalinity = (Alkalinitymeasured - Aciditycalculated) is recommended with some cautions

Reducing healthcare costs facilitated by surgical auditing: a systematic review.

Science.gov (United States)

Govaert, Johannes Arthuur; van Bommel, Anne Charlotte Madeline; van Dijk, Wouter Antonie; van Leersum, Nicoline Johanneke; Tollenaar, Robertus Alexandre Eduard Mattheus; Wouters, Michael Wilhemus Jacobus Maria

2015-07-01

Surgical auditing has been developed in order to benchmark and to facilitate quality improvement. The aim of this review is to determine if auditing combined with systematic feedback of information on process and outcomes of care results in lower costs of surgical care. A systematic search of published literature before 21-08-2013 was conducted in Pubmed, Embase, Web of Science, and Cochrane Library. Articles were selected if they met the inclusion criteria of describing a surgical audit with cost-evaluation. The systematic search resulted in 3608 papers. Six studies were identified as relevant, all showing a positive effect of surgical auditing on quality of healthcare and therefore cost savings was reported. Cost reductions ranging from $16 to $356 per patient were seen in audits evaluating general or vascular procedures. The highest potential cost reduction was described in a colorectal surgical audit (up to $1,986 per patient). All six identified articles in this review describe a reduction in complications and thereby a reduction in costs due to surgical auditing. Surgical auditing may be of greater value when high-risk procedures are evaluated, since prevention of adverse events in these procedures might be of greater clinical and therefore of greater financial impact. This systematic review shows that surgical auditing can function as a quality instrument and therefore as a tool to reduce costs. Since evidence is scarce so far, further studies should be performed to investigate if surgical auditing has positive effects to turn the rising healthcare costs around. In the future, incorporating (actual) cost analyses and patient-related outcome measures would increase the audits' value and provide a complete overview of the value of healthcare.

Creation of Carbon Credits by Water Saving

Directory of Open Access Journals (Sweden)

Yasutoshi Shimizu

2012-07-01

Full Text Available Until now, as a way of reducing greenhouse gas emissions from Japanese homes, the emphasis has been on reduction of energy consumption for air-conditioning and lighting. In recent years, there has been progress in CO₂ emission reduction through research into the water-saving performance of bathroom fixtures such as toilets and showers. Simulations have shown that CO₂ emissions associated with water consumption in Japanese homes can be reduced by 25% (1% of Japan’s total CO₂ emissions by 2020 through the adoption of the use of water-saving fixtures. In response to this finding, a program to promote the replacement of current fixtures with water-saving toilet bowls and thermally insulated bathtubs has been added to the Government of Japan’s energy-saving policy. Furthermore, CO₂ emission reduction through widespread use of water-saving fixtures has been adopted by the domestic credit system promoted by the Government of Japan as a way of achieving CO₂ emission-reduction targets; application of this credit system has also begun. As part of a bilateral offset credit mechanism promoted by the Government of Japan, research to evaluate the CO₂ reduction potential of the adoption of water-saving fixtures has been done in the city of Dalian, in China.

Save Energy Now Assessments Results 2008 Detailed Report

Energy Technology Data Exchange (ETDEWEB)

Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Nimbalkar, Sachin U [ORNL; Quinn, James [U.S. Department of Energy; Glatt, Ms. Sandy [DOE Industrial Technologies Program; Orthwein, Mr. Bill [U.S. Department of Energy

2010-09-01

In October 2005, U.S. Department of Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy savings assessment. The approach for these assessments drew heavily on the existing resources of ITP's technology delivery component. Over the years, ITP Technology Delivery has worked with industry partners to assemble a suite of respected software tools, proven assessment protocols, training curricula, certified energy experts, and strong partnerships for deployment. The Save Energy Now assessments conducted in calendar year 2006 focused on natural gas savings and targeted many of the nation's largest manufacturing plants - those that consume at least 1 TBtu of energy annually. The 2006 Save Energy Now assessments focused primarily on assessments of steam and process heating systems, which account for an estimated 74% of all natural gas use by U.S. manufacturing plants. Because of the success of the Save Energy Now assessments conducted in 2006 and 2007, the program was expanded and enhanced in two major ways in 2008: (1) a new goal was set to perform at least 260 assessments; and (2) the assessment focus was expanded to include pumping, compressed air, and fan systems in addition to steam and process heating. DOE ITP also has developed software tools to assess energy efficiency improvement opportunities in pumping, compressed air, and fan systems. The Save Energy Now assessments integrate a strong training component designed to teach industrial plant personnel how to use DOE's opportunity assessment software tools. This approach has the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to

Bed net ownership in Kenya: the impact of 3.4 million free bed nets

Directory of Open Access Journals (Sweden)

Vulule John

2010-06-01

Full Text Available Abstract Background In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs were distributed free in a campaign targeting children 0-59 months old (CU5s in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. Methods A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs with attached global positioning systems (GPS were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. Results In targeted areas, 67.5% (95% CI: 64.6, 70.3% of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0% of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7% slept under an ITN during the previous evening. Nearly forty percent (39.1% of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%. Conclusions The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.

Cost-saving production technologies and partial ownership

OpenAIRE

Juan Carlos Barcena-Ruiz; Norma Olaizola

2007-01-01

This work analyzes the incentives to acquire cost-saving production technologies when cross-participation exists at ownership level. We show that cross-participation reduces the incentives to adopt the cost-saving production technology.

A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.

Science.gov (United States)

Klatt, Maryanna D; Sieck, Cynthia; Gascon, Gregg; Malarkey, William; Huerta, Timothy

2016-08-01

To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group. We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n=84) and the diet/exercise intervention (n=86) to a retrospectively matched control group (n=258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study. Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention. Significantly fewer primary care visits (porganization health cost savings that such programs can generate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Canada Education Savings Program: Annual Statistical Review 2011

Science.gov (United States)

Human Resources and Skills Development Canada, 2011

2011-01-01

The Canada Education Savings Program has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in…

Canada Education Savings Program: Annual Statistical Review 2012

Science.gov (United States)

Human Resources and Skills Development Canada, 2012

2012-01-01

The Canada Education Savings Program (CESP) has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development Canada, the program administers the Canada Education Savings Grant (CESG) and the Canada Learning Bond (CLB). These two initiatives help Canadian families save for a child's…

Annuity payments can increase patient access to innovative cell and gene therapies under England's net budget impact test.

Science.gov (United States)

Jørgensen, Jesper; Kefalas, Panos

2017-01-01

Background: Cell and gene therapies have the potential to provide therapeutic breakthroughs, but the high costs of researching, developing, manufacturing and delivering them translate into prices that may challenge healthcare budgets. Various measures exist that aim to address the affordability challenge, including reducing price, limiting patient numbers and/or linking remuneration to product performance. Objective: To explore how the net budget impact test recently introduced in England can affect patient access to high-value, one-off cell and gene therapies, and how managed entry agreements can improve access. Methods: We use a hypothetical example where a new high-value, one-off therapy launches in an indication where it displaces a relatively low cost chronic treatment. We calculate the number of patients that can be treated without exceeding the £20 million net budget impact threshold, and compare results for scenarios where a full upfront payment is used, and where annuity-based payments are used. Results : Charging a full upfront payment at the time of treatment can lead to suboptimal patient access. Conclusion: Annuity-based payments in combination with an outcomes-based remuneration scheme reduce consequences of decision uncertainty and can increase patient access, without exceeding the net budget impact test.

Advanced Energy Retrofit Guide (AERG): Practical Ways to Improve Energy Performance; Healthcare Facilities (Book)

Energy Technology Data Exchange (ETDEWEB)

Hendron, R.; Leach, M.; Bonnema, E.; Shekhar, D.; Pless, S.

2013-09-01

The Advanced Energy Retrofit Guide for Healthcare Facilities is part of a series of retrofit guides commissioned by the U.S. Department of Energy. By presenting general project planning guidance as well as detailed descriptions and financial payback metrics for the most important and relevant energy efficiency measures (EEMs), the guides provide a practical roadmap for effectively planning and implementing performance improvements in existing buildings. The Advanced Energy Retrofit Guides (AERGs) are intended to address key segments of the U.S. commercial building stock: retail stores, office buildings, K-12 schools, grocery stores, and healthcare facilities. The guides' general project planning considerations are applicable nationwide; the energy and cost savings estimates for recommended EEMs were developed based on energy simulations and cost estimates for an example hospital tailored to five distinct climate regions. These results can be extrapolated to other U.S. climate zones. Analysis is presented for individual EEMs, and for packages of recommended EEMs for two project types: existing building commissioning projects that apply low-cost and no-cost measures, and whole-building retrofits involving more capital-intensive measures.

47 CFR 65.450 - Net income.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net income. 65.450 Section 65.450... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Exchange Carriers § 65.450 Net income. (a) Net income shall consist of all revenues derived from the provision of interstate telecommunications services...

Check a Box. Save a Life: How student leadership is shaking up health care and driving a revolution in patient safety.

Science.gov (United States)

Henderson, Daniel; Carson-Stevens, Andrew; Bohnen, Jordan; Gutnik, Lily; Hafiz, Shabnam; Mills, Shannon

2010-03-01

The objective was to engage health professions students as leaders in spreading the World Health Organization Surgical Checklist. The published impact of the checklist in reducing surgical complications and deaths, combined with its ease of use, offers an ideal target for students to save lives and prevent suffering. As members of the "Check a Box. Save a Life." campaign, students can speed the pace of patient safety improvement. The campaign was developed around an online Webcast event, designated its launch. Outreach was conducted mainly through social media, especially the popular networking Web site, Facebook. The Institute for Healthcare Improvement's Open School for Health Professions and the American Medical Student Association provided a source of potential campaign members. One hundred eighty-two registrants, representing 122 distinct hosting institutions, signed up for the launch event. Based on hosts' projected event sizes, assessed in a registration questionnaire, approximately 1400 students are believed to have participated in the event. After the launch, these students joined the campaign and were invited to carry out projects in their home institutions. Six weeks after the launch, the campaign reconvened at the Institute for Healthcare Improvement's 21st Annual National Forum, and attendees presented case reports of 15 projects they had undertaken since the launch. As an independent, self-organized, decentralized effort and an application of student social organizing to the cause of patient safety, "Check a Box." is a landmark achievement. Leveraging social media and disrupting the traditional model of safety leadership, the campaign offers hope for the future of patient safety.

Business Profile of Boat Lift Net and Stationary Lift Net Fishing Gear in Morodemak Waters Central Java

Science.gov (United States)

Hapsari, Trisnani D.; Jayanto, Bogi B.; Fitri, Aristi D. P.; Triarso, I.

2018-02-01

Lift net is one of the fishing gears that is used widely in the Morodemak coastal fishing port (PPP) for catching pelagic fish. The yield of fish captured by these fishing gear has high economic value, such as fish belt (Trichiurus sp), squids (Loligo sp) and anchovies (Stelophorus sp). The aims of this research were to determine the technical aspects of boat lift net and stationary lift net fishing gear in Morodemak Waters Demak Regency; to find out the financial aspect of those fishing gears and to analyze the financial feasibility by counting PP, NPV, IRR, and B/C ratio criteria. This research used case study method with descriptive analysis. The sampling method was purposive sampling with 22 fishermen as respondents. The result of the research showed that the average of boat lift net acceptance was Rp 388,580,000. The financial analysis of fisheries boat lift net with the result of NPV Rp 836,149,272, PP 2.44 years, IRR value 54%, and B/C ratio 1.73. The average of stationary lift net acceptance was Rp 27,750,000. The financial analysis lift net with the result of NPV Rp 37,937,601; PP 1.96 years, IRR value 86%, and B/C ratio 1.32. This research had a positive NPV value, B/C ratio >1, and IRR > discount rate (12 %). This study concluded that the fishery business of boat lift net and stationary lift net in Morodemak coastal fishing port (PPP) was worth running.

Humanitarian response: improving logistics to save lives.

Science.gov (United States)

McCoy, Jessica

2008-01-01

Each year, millions of people worldwide are affected by disasters, underscoring the importance of effective relief efforts. Many highly visible disaster responses have been inefficient and ineffective. Humanitarian agencies typically play a key role in disaster response (eg, procuring and distributing relief items to an affected population, assisting with evacuation, providing healthcare, assisting in the development of long-term shelter), and thus their efficiency is critical for a successful disaster response. The field of disaster and emergency response modeling is well established, but the application of such techniques to humanitarian logistics is relatively recent. This article surveys models of humanitarian response logistics and identifies promising opportunities for future work. Existing models analyze a variety of preparation and response decisions (eg, warehouse location and the distribution of relief supplies), consider both natural and manmade disasters, and typically seek to minimize cost or unmet demand. Opportunities to enhance the logistics of humanitarian response include the adaptation of models developed for general disaster response; the use of existing models, techniques, and insights from the literature on commercial supply chain management; the development of working partnerships between humanitarian aid organizations and private companies with expertise in logistics; and the consideration of behavioral factors relevant to a response. Implementable, realistic models that support the logistics of humanitarian relief can improve the preparation for and the response to disasters, which in turn can save lives.

Net neutrality and audiovisual services

OpenAIRE

van Eijk, N.; Nikoltchev, S.

2011-01-01

Net neutrality is high on the European agenda. New regulations for the communication sector provide a legal framework for net neutrality and need to be implemented on both a European and a national level. The key element is not just about blocking or slowing down traffic across communication networks: the control over the distribution of audiovisual services constitutes a vital part of the problem. In this contribution, the phenomenon of net neutrality is described first. Next, the European a...

Caustic saving potentile in textile processing mills

International Nuclear Information System (INIS)

Latif, M.; Rehman, A.; Ghafar, A.; Hafeez, N.M.

2010-01-01

The textile processing industry of pakistan has great potential of improvement in resource consumption in various production processes. One major concern is the heavy usage of caustic soda (sodium hydroxide) especially during the mercerization process which incurs a significant cost to a textile processing mill. To reduce the unit fabric production cost and stay competitive, the industry need to minimize the caustic wastage and explore the caustic saving potential. This paper describe the detailed caustic consumption practices and saving potentials in woven textile sector based on the data base of 100 industries. Region wise caustic saving potential is also investigated . Three caustic conservation option including process improvement, reuse and recycling, and caustic recovery plants are discussed. Detailed technical and and financial requirements. saving potentials and paybacks of these options are provided. (author)