WorldWideScience

Sample records for reducing support cost

  1. The Logistics Management Decision Support System (LMDSS) : an effective tool to reduce life cycle support costs of aviation systems

    OpenAIRE

    Moore, Ellen E.; Snyder, Carolynn M.

    1998-01-01

    Approved for public release; distribution is unlimited This thesis assesses the capability of the Logistics Management Decision Support System (LMDSS) to meet the information needs of Naval Air Systems Command (NAVAIR) logistics managers based on surveys of logistics managers and interviews with LMDSS program representatives. The LMDSS is being introduced as a tool to facilitate action by NAVAIR logistics managers to reduce the life cycle support costs of aviation systems while protecting ...

  2. The Bottom supported fast breeder reactor vessel - an alternative approach to seismic accommodation and reduced cost

    International Nuclear Information System (INIS)

    Nakagawa, H.; Golan, S.; Petrozelli, J.; Kumaoka, Y.; Kawamura, Y.

    1988-01-01

    Most FBR vessels are supported by hanging from their top portions. A disadvantage of such a top supported reactor vessel (TSRV) structural configuration is that it may generate high reactor core accelerations. This is due to the long path the seismic vibrations must travel from the basemat up through the building and then down through the RV block to the core. To compensate for this disadvantage, TSRV blocks are often strengthened beyond what is required for other considerations, such as pressure, to satisfy seismic response criteria, thus increasing weights and costs. In addition to long load paths, TSRVs also have common load paths. For example, in a TSRV (with the core supported from the bottom of the RV) the sodium and core loads both travel along the RV pressure boundary. Therefore, one of these loads will likely control the RV thickness leaving excess margin for the other loads. It is the premise of this paper that the revision of a large pool FBR from a TSRV configuration to a specific bottom supported reactor vessel (BSRV) configuration can resolve the above TSRV disadvantages related to load path length and diversity, thereby improving seismic performance and simultaneously reducing RV block costs by reducing weights. This paper demonstrates this premise by comparing a reference TSRV block with a specific BSRV block design

  3. Reduced cost of ownership

    International Nuclear Information System (INIS)

    Wyse, W.H.; Newton, J.C.

    1995-01-01

    There is common drive throughout industry towards reduced costs of ownership of plant and equipment. Rolls-Royce and Associates Ltd. has developed the systems and expertise necessary to achieve these objectives. This Paper outlines the methods being used on existing facilities, and describes a new all embracing process called Planned Lifetime Management. This process, based on the military standard Integrated Logistic Support, ensures that all aspects of support are clearly identified at the design stage and that support is monitored to allow through-life support costs to be optimized. (author)

  4. Implementation of Distance Support (DS) to Reduce Total Ownership Cost (R-TOC)

    Science.gov (United States)

    2012-02-01

    Policy of 22 Mar 2007, states that DS combines people, processes and technology into a collaborative infrastructure regardless of geographic location...Tech Assist Data for Submarine Enterprise 120 FTA Events Performed 164 MH Via On-Si te Support Average Cost Per Event (Based on $60.00 Per Hour...CFFC/Command Policy) 16% Success Rate Overa l l On Al l FTA Events 37% Success Rate On Out-Of-Area Events Average MHs Per Event 19 MH Via DS

  5. Low-cost flexible supercapacitors based on laser reduced graphene oxide supported on polyethylene terephthalate substrate

    Science.gov (United States)

    Ghoniem, Engy; Mori, Shinsuke; Abdel-Moniem, Ahmed

    2016-08-01

    A controlled high powered CO2 laser system is used to reduce and pattern graphene oxide (GO) film supported onto a flexible polyethylene terephthalate (PET) substrate. The laser reduced graphene oxide (rGO) film is characterized and evaluated electrochemically in the absence and presence of an overlying anodicaly deposited thin film of pseuodcapactive MnO2 as electrodes for supercapacitor applications using aqueous electrolyte. The laser treatment of the GO film leads to an overlapped structure of defective multi-layer rGO sheets with an electrical conductivity of 273 S m-1. The rGO and MnO2/rGO electrodes exhibit specific capacitance in the range of 82-107 and 172-368 Fg-1 at applied current range of 0.1-1.0 mA cm-2 and retain 98 and 95% of their initial capacitances after 2000 cycles at a current density of 1.0 mA cm-2, respectively. Also, the rGO is assigned as an electrode material for flexible conventionally stacked and interdigitated in-plane supercapacitor structures using gel electrolyte. Three electrode architectures of 2, 4, and 6 sub-electrodes are studied for the interdigital in-plane design. The device with interdigital 6 sub-electrodes architecture I-PS(6) delivers power density of 537.1 Wcm-3 and an energy density of 0.45 mWh cm-3.

  6. Reducing costs by reducing size

    International Nuclear Information System (INIS)

    Hayns, M.R.; Shepherd, J.

    1991-01-01

    The present paper discusses briefly the many factors, including capital cost, which have to be taken into account in determining whether a series of power stations based on a small nuclear plant can be competitive with a series based on traditional large unit sizes giving the guaranteed level of supply. The 320 MWe UK/US Safe Integral Reactor is described as a good example of how the factors discussed can be beneficially incorporated into a design using proven technology. Finally it goes on to illustrate how the overall costs of a generating system can indeed by reduced by use of the 320 MWe Safe Integral Reactor rather than conventional units of around 1200 MWe. (author). 9 figs

  7. The effectiveness of insurer-supported safety and health engineering controls in reducing workers' compensation claims and costs.

    Science.gov (United States)

    Wurzelbacher, Steven J; Bertke, Stephen J; Lampl, Michael P; Bushnell, P Timothy; Meyers, Alysha R; Robins, David C; Al-Tarawneh, Ibraheem S

    2014-12-01

    This study evaluated the effectiveness of a program in which a workers' compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees. © 2014 Wiley Periodicals, Inc.

  8. Reducing maintenance costs

    International Nuclear Information System (INIS)

    Zaiss, W.; Reuschle, K.; Baier, B.

    2002-01-01

    The increasingly more expensive maintenance measures, cuts in the cost budget, and the loss of know-how on the part of vendors all require a change of policy with respect to maintenance concepts of the part of operators. This also applies to the existing valve concepts, the drives included. Under these aspects, the current drive, which is self-actuated and actuated by outside media, for a parallel-plate valve of a nomial width of 700 was reconsidered. The effort served to reduce maintenance costs and, at the same time, simplify the drive concept as well as cut back on the number of in-service inspections. Moreover, the number of active components were to be minimized and installation conditions in the plant were to be improved. When the boundary conditions to be observed with respect to process technology had been laid down, the competent technical department developed a concept of modification of the drive. A major constituent part was the demonstration of the functioning capability of the new drive under accident conditions. It was achieved mainly by an analytical approach. In the resultant drive concept, the same control valves are employed to actuate a driving cylinder by means of self-actuation or by an outside medium as a function of pressure. (orig.) [de

  9. Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

    Science.gov (United States)

    Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

    2017-08-01

    We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

  10. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    Directory of Open Access Journals (Sweden)

    Naberhuis JK

    2017-08-01

    . Studies have demonstrated that malnutrition can increase the costs of care and length of hospital stay while corresponding studies show that nutrition interventions can help lower the cost of health care by decreasing the incidence of complications and speeding recovery. As populations age, policies that lead to wider adoption of screening, assessment, and treatment of malnutrition will be important to improve health economic outcomes. Keywords: economics of nutrition interventions, reducing health care costs through nutrition

  11. The ITER reduced cost design

    International Nuclear Information System (INIS)

    Aymar, R.

    2000-01-01

    Six years of joint work under the international thermonuclear experimental reactor (ITER) EDA agreement yielded a mature design for ITER which met the objectives set for it (ITER final design report (FDR)), together with a corpus of scientific and technological data, large/full scale models or prototypes of key components/systems and progress in understanding which both validated the specific design and are generally applicable to a next step, reactor-oriented tokamak on the road to the development of fusion as an energy source. In response to requests from the parties to explore the scope for addressing ITER's programmatic objective at reduced cost, the study of options for cost reduction has been the main feature of ITER work since summer 1998, using the advances in physics and technology databases, understandings, and tools arising out of the ITER collaboration to date. A joint concept improvement task force drawn from the joint central team and home teams has overseen and co-ordinated studies of the key issues in physics and technology which control the possibility of reducing the overall investment and simultaneously achieving the required objectives. The aim of this task force is to achieve common understandings of these issues and their consequences so as to inform and to influence the best cost-benefit choice, which will attract consensus between the ITER partners. A report to be submitted to the parties by the end of 1999 will present key elements of a specific design of minimum capital investment, with a target cost saving of about 50% the cost of the ITER FDR design, and a restricted number of design variants. Outline conclusions from the work of the task force are presented in terms of physics, operations, and design of the main tokamak systems. Possible implications for the way forward are discussed

  12. Incorrect predictions reduce switch costs.

    Science.gov (United States)

    Kleinsorge, Thomas; Scheil, Juliane

    2015-07-01

    In three experiments, we combined two sources of conflict within a modified task-switching procedure. The first source of conflict was the one inherent in any task switching situation, namely the conflict between a task set activated by the recent performance of another task and the task set needed to perform the actually relevant task. The second source of conflict was induced by requiring participants to guess aspects of the upcoming task (Exps. 1 & 2: task identity; Exp. 3: position of task precue). In case of an incorrect guess, a conflict accrues between the representation of the guessed task and the actually relevant task. In Experiments 1 and 2, incorrect guesses led to an overall increase of reaction times and error rates, but they reduced task switch costs compared to conditions in which participants predicted the correct task. In Experiment 3, incorrect guesses resulted in faster performance overall and to a selective decrease of reaction times in task switch trials when the cue-target interval was long. We interpret these findings in terms of an enhanced level of controlled processing induced by a combination of two sources of conflict converging upon the same target of cognitive control. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Cost reducing code implementation strategies

    International Nuclear Information System (INIS)

    Kurtz, Randall L.; Griswold, Michael E.; Jones, Gary C.; Daley, Thomas J.

    1995-01-01

    Sargent and Lundy's Code consulting experience reveals a wide variety of approaches toward implementing the requirements of various nuclear Codes Standards. This paper will describe various Code implementation strategies which assure that Code requirements are fully met in a practical and cost-effective manner. Applications to be discussed includes the following: new construction; repair, replacement and modifications; assessments and life extensions. Lessons learned and illustrative examples will be included. Preferred strategies and specific recommendations will also be addressed. Sargent and Lundy appreciates the opportunity provided by the Korea Atomic Industrial Forum and Korean Nuclear Society to share our ideas and enhance global cooperation through the exchange of information and views on relevant topics

  14. Reducing operational costs through MIPS management

    NARCIS (Netherlands)

    Kwiatkowski, L.M.; Verhoef, C.

    2015-01-01

    We focus on an approach to reducing the costs of running applications. MIPS, which is a traditional acronym for millions of instructions per second, have evolved to become a measurement of processing power and CPU resource consumption. The need for controlling MIPS attributed costs is indispensable

  15. Leveraging Technology to Reduce Patient Transaction Costs.

    Science.gov (United States)

    Edlow, Richard C

    2015-01-01

    Medical practices are under significant pressure to provide superior customer service in an environment of declining or flat reimbursement. The solution for many practices involves the integration of a variety of third-party technologies that conveniently interface with one's electronic practice management and medical records systems. Typically, the applications allow the practice to reduce the cost of each patient interaction. Drilling down to quantify the cost of each individual patient interaction helps to determine the practicality of implementation.

  16. Reducing the cost of administrative justice

    International Nuclear Information System (INIS)

    Tourtellotte, J.R.

    1982-01-01

    In virtually every sector of government regulation, the complaint has been lodged that the costs of administrative justice are too high. These costs in time, money, resources, and productivity can have a profound effect on the individual consumer. When applied to an energy technology such as nuclear power, costs of administrative justice can transcent time and money to have even more profound and pervasive soeietal effects. Societal costs can be expressed in terms of their impact on important national concerns, that is, the standard of living, technological superiority, and the national energy equation. Some views are presented on the interests involved in the regulation of nuclear power and what can be done to bring those interests into better balance so as to reduce the cost of administrative justice

  17. Autonomous Droop Scheme With Reduced Generation Cost

    DEFF Research Database (Denmark)

    Nutkani, Inam Ullah; Loh, Poh Chiang; Wang, Peng

    2014-01-01

    ) of the microgrid. To reduce this TGC without relying on fast communication links, an autonomous droop scheme is proposed here, whose resulting power sharing is decided by the individual DG generation costs. Comparing it with the traditional scheme, the proposed scheme retains its simplicity and it is hence more....... This objective might, however, not suit microgrids well since DGs are usually of different types, unlike synchronous generators. Other factors like cost, efficiency, and emission penalty of each DG at different loading must be considered since they contribute directly to the total generation cost (TGC...

  18. Cost reducing investments and spatial competition

    OpenAIRE

    Domenico Scalera; Alberto Zazzaro

    2005-01-01

    In this paper we analyze the relationship between competition and cost reducing investments in the context of a location model. In particular, we derive the symmetric subgame-perfect equilibrium of a three-stage circular city model with closed-loop strategies, and study the effects of changes in competition fundamentals under both a given number of firms and free entry

  19. Costs of emission-reducing manure application

    NARCIS (Netherlands)

    Huijsmans, J.F.M.; Verwijs, B.; Rodhe, L.; Smith, K.

    2004-01-01

    Favourable economics of handling and application of manure are of fundamental importance to encourage the implementation of emission-reducing application techniques. The economics of manure application depend on the costs of the equipment and the time to carry out the field operation. In this study

  20. Methods Reduce Cost, Enhance Quality of Nanotubes

    Science.gov (United States)

    2009-01-01

    For all the challenges posed by the microgravity conditions of space, weight is actually one of the more significant problems NASA faces in the development of the next generation of U.S. space vehicles. For the Agency s Constellation Program, engineers at NASA centers are designing and testing new vessels as safe, practical, and cost-effective means of space travel following the eventual retirement of the space shuttle. Program components like the Orion Crew Exploration Vehicle, intended to carry astronauts to the International Space Station and the Moon, must be designed to specific weight requirements to manage fuel consumption and match launch rocket capabilities; Orion s gross liftoff weight target is about 63,789 pounds. Future space vehicles will require even greater attention to lightweight construction to help conserve fuel for long-range missions to Mars and beyond. In order to reduce spacecraft weight without sacrificing structural integrity, NASA is pursuing the development of materials that promise to revolutionize not only spacecraft construction, but also a host of potential applications on Earth. Single-walled carbon nanotubes are one material of particular interest. These tubular, single-layer carbon molecules - 100,000 of them braided together would be no thicker than a human hair - display a range of remarkable characteristics. Possessing greater tensile strength than steel at a fraction of the weight, the nanotubes are efficient heat conductors with metallic or semiconductor electrical properties depending on their diameter and chirality (the pattern of each nanotube s hexagonal lattice structure). All of these properties make the nanotubes an appealing material for spacecraft construction, with the potential for nanotube composites to reduce spacecraft weight by 50 percent or more. The nanotubes may also feature in a number of other space exploration applications, including life support, energy storage, and sensor technologies. NASA s various

  1. Costs of reducing nutrient losses in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Brian H.; Abildtrup, Jens; Jensen, Jørgen Dejgård

    to the eastern part of Denmark. The final plan for the Aquatic Environment III from 2004 included a 13% reduction of N-leaching until 2015 based on cost effective administrative measures like wetlands and catch crops. Also a tax on mineral phosphorus in feedstuffs was included in order to half the phosphorus......The economic calculations carried out prior to the Plan for the Aquatic Environment III included a comparison of regulation systems aimed at reducing nitrogen leaching, analyses of measures for reducing phosphorus losses and estimation of administrative costs. The conclusions were that taxation...... surplus. The measures in the Plan will have to be supplemented by more measures to meet the targets in the EU's Water Framework Directive....

  2. Hospital Costs Of Extracorporeal Life Support Therapy

    NARCIS (Netherlands)

    Oude Lansink-Hartgring, Annemieke; van den Hengel, Berber; van der Bij, Wim; Erasmus, Michiel E.; Mariani, Massimo A.; Rienstra, Michiel; Cernak, Vladimir; Vermeulen, Karin M.; van den Bergh, Walter M.

    Objectives: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but

  3. New transmission interconnection reduces consumer costs

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2008-09-15

    The Central American electric interconnection system (SIEPAC) project will involve the construction of a 1830 km 230 kV transmission system that will link Guatemala, El Salvador, Honduras, Costa Rica, Nicaragua, and Panama. The system is expected to alleviate the region's power shortages and reduce electricity costs for consumers. Costs for the SIEPAC project have been estimated at $370 million. The system will serve approximately 37 million customers, and will include 15 substations. The contract for building the electrical equipment has been awarded to Schweitzer Engineering Laboratories (SEL) who plan to manufacture components at a plant in Mexico. The equipment will include high speed line protection, automation, and control systems. Line current differential systems and satellite-synchronized clocks will also be used. The new transmission system is expected to be fully operational by 2009. 1 fig.

  4. Reduced cost mission design using surrogate models

    Science.gov (United States)

    Feldhacker, Juliana D.; Jones, Brandon A.; Doostan, Alireza; Hampton, Jerrad

    2016-01-01

    This paper uses surrogate models to reduce the computational cost associated with spacecraft mission design in three-body dynamical systems. Sampling-based least squares regression is used to project the system response onto a set of orthogonal bases, providing a representation of the ΔV required for rendezvous as a reduced-order surrogate model. Models are presented for mid-field rendezvous of spacecraft in orbits in the Earth-Moon circular restricted three-body problem, including a halo orbit about the Earth-Moon L2 libration point (EML-2) and a distant retrograde orbit (DRO) about the Moon. In each case, the initial position of the spacecraft, the time of flight, and the separation between the chaser and the target vehicles are all considered as design inputs. The results show that sample sizes on the order of 102 are sufficient to produce accurate surrogates, with RMS errors reaching 0.2 m/s for the halo orbit and falling below 0.01 m/s for the DRO. A single function call to the resulting surrogate is up to two orders of magnitude faster than computing the same solution using full fidelity propagators. The expansion coefficients solved for in the surrogates are then used to conduct a global sensitivity analysis of the ΔV on each of the input parameters, which identifies the separation between the spacecraft as the primary contributor to the ΔV cost. Finally, the models are demonstrated to be useful for cheap evaluation of the cost function in constrained optimization problems seeking to minimize the ΔV required for rendezvous. These surrogate models show significant advantages for mission design in three-body systems, in terms of both computational cost and capabilities, over traditional Monte Carlo methods.

  5. SIR (Safe Integral Reactor) - reducing size can reduce cost

    International Nuclear Information System (INIS)

    Hayns, M.R.

    1991-01-01

    Traditional engineering economics have favoured the advantages of larger size as a means of reducing specific capital costs and hence unit generating costs. For large and small plants utilising the same concept, e.g. a small four-loop PWR vs a large four-loop PWR with the same number of components, economies of scale are well established. If, however, a smaller plant is sized to take advantage of features which are only feasible at smaller outputs, is of simpler design, with the advantage taken of the simplified design to produce the most cost-effective layout, and incorporates fewer, more easily replaceable components with minimal assembly on site, it is possible to produce a plant which is competitive with larger plant of more traditional design. When 'system' effects, such as better matching of installed capacity to the growth in demand and the fact that a smaller total capacity will be needed to meet a given demand with a specified level of confidence, are taken into account, it can be shown that a utility's overall cash-flow position can be improved with lower associated absolute financial risks. The UK/US Safe Integral Reactor (SIR) is an integral pressurized water reactor in the 300-400 MW(e) range which utilises conventional water reactor technology in a way not feasible at the very large, sizes of recent years. The SIR concept is briefly explained and its technical and economic advantages in terms of simplicity, construction, maintenance, availability, decommissioning, safety and siting described. The results of system analyses which demonstrate the overall financial advantages to a utility are presented. (author)

  6. Operating Costs Reducing in MDF Manufacturing Industries

    Directory of Open Access Journals (Sweden)

    José Augusto Coeve Florino

    2014-05-01

    Full Text Available The sustained efforts by electric motors when subjected to cutting, trimming or finishing are directly related to the material being machined and the angle of attack of the tool. Choosing the right tool for this operation depends on an expected result. So the engines behave differently to each operation. The optimization between strength, speed, power, material and type of operation, can be found to reduce operational costs of production, besides determining the exact time to make the set-up of worn tool. The reduction in operating costs is an item of sustainability that outlines the strategic positioning on companies to become competitive in the global marketplace. With the great technological development present today, this issue goes away with the very latest products on the market for professionals who productivity will be dealt with in these modern maintenance equipment such as power quality analyzer, Imager, profile projector and microscope for research. The result of this work is the optimization of the cutting operation and energy consumption thereby demonstrating an optimum point of operation in a case study presented in this work.

  7. An Evaluation of the WSSC (Weapon System Support Cost) Cost Allocation Algorithms. II. Installation Support.

    Science.gov (United States)

    1983-06-01

    S XX3OXX, or XX37XX is found. As a result, the following two host-financed tenant support accounts currently will be treated as unit operations costs ... Horngren , Cost Accounting : A Managerial Emphasis, Prentice-Hall Inc., Englewood Cliffs, NJ, 1972. 10. D. B. Levine and J. M. Jondrow, "The...WSSC COST ALLOCATION Technical Report ~ALGORITHMS II: INSTALLATION SUPPORT 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOR( S ) 9. CONTRACT OR GRANT NUMBER

  8. States reducing solar's soft costs

    Energy Technology Data Exchange (ETDEWEB)

    Meehan, Chris

    2012-07-01

    In 2012 the costs of modules will drop below the balance of system costs or 'soft costs' of solar in the US. Federal policy that nationalizes permitting processes could reduce some of the soft costs, but is unlikely. That's why states like California, Colorado, Connecticut and Vermont passed own laws to reduce soft costs by speeding solar permitting and reducing fees. (orig.)

  9. Transforming Wartime Contracting: Controlling Costs, Reducing Risks

    Science.gov (United States)

    2011-08-01

    conceptual ambiguity lies nestled in the meaning ascribed to “inherent.” The language of the Instruction also serves as an illustration that...other factors to the composite rate to present a fuller accounting of the cost of military personnel. It adds costs for recruitment and advertising ...Defense Adds to above: Costs for recruitment and advertising , training, subsidized groceries (commissaries), education assistance, child-development

  10. Support to LANL: Cost estimation. Final report

    International Nuclear Information System (INIS)

    1993-01-01

    This report summarizes the activities and progress by ICF Kaiser Engineers conducted on behalf of Los Alamos National Laboratories (LANL) for the US Department of Energy, Office of Waste Management (EM-33) in the area of improving methods for Cost Estimation. This work was conducted between October 1, 1992 and September 30, 1993. ICF Kaiser Engineers supported LANL in providing the Office of Waste Management with planning and document preparation services for a Cost and Schedule Estimating Guide (Guide). The intent of the Guide was to use Activity-Based Cost (ABC) estimation as a basic method in preparing cost estimates for DOE planning and budgeting documents, including Activity Data Sheets (ADSs), which form the basis for the Five Year Plan document. Prior to the initiation of the present contract with LANL, ICF Kaiser Engineers was tasked to initiate planning efforts directed toward a Guide. This work, accomplished from June to September, 1992, included visits to eight DOE field offices and consultation with DOE Headquarters staff to determine the need for a Guide, the desired contents of a Guide, and the types of ABC estimation methods and documentation requirements that would be compatible with current or potential practices and expertise in existence at DOE field offices and their contractors

  11. Postpartum follow-up: can psychosocial support reduce newborn readmissions?

    Science.gov (United States)

    Barilla, Dora; Marshak, Helen Hopp; Anderson, S Eric; Hopp, Joyce W

    2010-01-01

    To determine whether there was a relationship between postpartum psychosocial support from healthcare providers and the rate of normal newborn readmissions (NNRs), and whether there was a cost benefit to justify an intervention. Data were abstracted for all normal newborn births from 1999 to 2006 (N = 14,786) at a community hospital in southern California at three different time periods: (1) at baseline prior to any intervention (1999-2000), (2) the 4 years during the comprehensive psychosocial support intervention (2001-2004), and (3) the 2 years during a limited psychosocial support intervention (2004-2006). A cost-benefit analysis was performed to analyze whether the financial benefits from the intervention matched or exceeded the costs for NNRs. There was a significantly lower readmission rate of 1.0% (p = < .001) during the comprehensive intervention time period compared to baseline (2.3%) or to the limited intervention time period (2.3%). Although there was no significant difference in the average cost per newborn readmitted across the three study time periods, during the comprehensive intervention time period the average costs of a NNR were significantly lower ($4,180, p = .041) for the intervention group compared to those who received no intervention ($5,338). There was a cost benefit of 513,540 dollars due to fewer readmissions during the comprehensive time period, but it did not exceed the cost of the intervention. Providing comprehensive follow-up for new mothers in the postpartum period can reduce NNRs, thus lowering the average newborn readmission costs for those who receive psychosocial support. Followup for new mothers should be an accepted norm rather than the exception in postpartum care, but NNRs should not be considered the sole outcome in such programs.

  12. Offshore windfarm proposal to reduce costs of foundations and installations.

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-09-04

    The principle aim of this project is to develop innovative pile insertion, installation vessel pile handling and pile transfer systems that reduce the installed cost per kW of offshore wind turbine foundation installation. The project was to accomplish this by first developing a novel method of handling foundation piles without the use of craneage thereby allowing long piles of 5-6m diameter to be lifted safely in shallow water. This would extend the operating envelope by allowing work to continue without the weather constraints associated with lifting heavy loads by crane. The method would eventually reduce the size of the pile installation barge resulting in reduced installation costs. This part of the project has been satisfactorily completed, resulting in an innovative pile handling technique. Secondly a nonpercussive pile insertion method would be developed suitable for large diameter piles. The targeted aims of this method are as follows: To reduce or negate the need to handle and dispose of large amounts of spoil. To eliminate the need for piling hammers large enough to drive 6m diameter piles. These would be too heavy for the present generation of offshore cranes to lift, and the rental costs exorbitant. The advantages of these aims are: A reduction in the noise pollution produced by all percussive methods of pile driving and in particular large hammers. These noise levels are unacceptable to present and future environmental constraints. Because of the reduced drill spoil being handled compared to an industry standard full face drill, the energy consumption and therefore cost, is also reduced. Owing to the high cost and risk associated with mobilising and operating the equipment necessary for field trials in a marine environment (the cost for mobilising and operating a construction jack-up barge, all backup marine support craft, pile driving hammers and test piles can be several times the available grant funding), it was decided and agreed at an early stage

  13. Manual for Reducing Educational Unit Costs in Latin American Countries.

    Science.gov (United States)

    Centro Multinacional de Investigacion Educativa, San Jose (Costa Rica).

    Designed for educational administrators, this manual provides suggestions for reducing educational unit costs in Latin America without reducing the quality of the education. Chapter one defines unit cost concepts and compares the costs of the Latin American countries. Chapter two deals with the different policies which could affect the principal…

  14. Reducing Development and Operations Costs using NASA's "GMSEC" Systems Architecture

    Science.gov (United States)

    Smith, Dan; Bristow, John; Crouse, Patrick

    2007-01-01

    This viewgraph presentation reviews the role of Goddard Mission Services Evolution Center (GMSEC) in reducing development and operation costs in handling the massive data from NASA missions. The goals of GMSEC systems architecture development are to (1) Simplify integration and development, (2)Facilitate technology infusion over time, (3) Support evolving operational concepts, and (4) All for mix of heritage, COTS and new components. First 3 missions (i.e., Tropical Rainforest Measuring Mission (TRMM), Small Explorer (SMEX) missions - SWAS, TRACE, SAMPEX, and ST5 3-Satellite Constellation System) each selected a different telemetry and command system. These results show that GMSEC's message-bus component-based framework architecture is well proven and provides significant benefits over traditional flight and ground data system designs. The missions benefit through increased set of product options, enhanced automation, lower cost and new mission-enabling operations concept options .

  15. Identifying Fixed Support Costs in Air Force Visibility and Management of Operating and Support Costs (VAMOSC).

    Science.gov (United States)

    1983-04-01

    Algorithms I: Overview," Technical Report No. 115-2, Desmatics, Inc., 1983. 6. C. T. Horngren , Cost Accounting : A Managerial Emphasis, Prentice-Hall Inc...CHART NATIONA BUREAUJ OF STAf4DARO-I% 3-A S . . . . . . . . . . I.I i ". ’ 1).N’r1F𔃻I."U FmiXE Sc’pioir COSTS IN A VA,(),C * by Robert L. Gardner Dennis...operations and support (O& S ) costs for Air Force aircraft weapon systems and ground communications-electronics (C-E) systems. Included are fuel, materiel, pay

  16. Strategies Used by Adults to Reduce Their Prescription Drug Costs

    Science.gov (United States)

    ... data from the 2011 National Health Interview Survey (NHIS). Keywords: National Health Interview Survey, alternative therapies, medication ... to cost ( 9 ) that are not measured in NHIS. Definitions Strategies for reducing prescription drug costs : Based ...

  17. Reducing health care costs - potential and limitations of local ...

    African Journals Online (AJOL)

    Reducing health care costs - potential and limitations of local authority health services. ... both the quality and the cost-effectiveness of health care would be improved. ... LAs offer an appropriate structure for effective community control over the ...

  18. Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis.

    Science.gov (United States)

    Iglesias, Cynthia; Nixon, Jane; Cranny, Gillian; Nelson, E Andrea; Hawkins, Kim; Phillips, Angela; Torgerson, David; Mason, Su; Cullum, Nicky

    2006-06-17

    To assess the cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital. Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial. 11 hospitals in six UK NHS trusts. Intention to treat population comprising 1971 participants. Kaplan Meier estimates of restricted mean time to development of pressure ulcers and total costs for treatment in hospital. Alternating pressure mattresses were associated with lower overall costs (283.6 pounds sterling per patient on average, 95% confidence interval--377.59 pounds sterling to 976.79 pounds sterling) mainly due to reduced length of stay in hospital, and greater benefits (a delay in time to ulceration of 10.64 days on average,--24.40 to 3.09). The differences in health benefits and total costs for hospital stay between alternating pressure mattresses and alternating pressure overlays were not statistically significant; however, a cost effectiveness acceptability curve indicated that on average alternating pressure mattresses compared with alternating pressure overlays were associated with an 80% probability of being cost saving. Alternating pressure mattresses for the prevention of pressure ulcers are more likely to be cost effective and are more acceptable to patients than alternating pressure overlays.

  19. Autonomous droop scheme with reduced generation cost

    DEFF Research Database (Denmark)

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

    2013-01-01

    Droop scheme has been widely applied to the control of Distributed Generators (DGs) in microgrids for proportional power sharing based on their ratings. For standalone microgrid, where centralized management system is not viable, the proportional power sharing based droop might not suit well since...... DGs are usually of different types unlike synchronous generators. This paper presents an autonomous droop scheme that takes into consideration the operating cost, efficiency and emission penalty of each DG since all these factors directly or indirectly contributes to the Total Generation Cost (TGC......) of the overall microgrid. Comparing it with the traditional scheme, the proposed scheme has retained its simplicity, which certainly is a feature preferred by the industry. The overall performance of the proposed scheme has been verified through simulation and experiment....

  20. Can automation in radiotherapy reduce costs?

    Science.gov (United States)

    Massaccesi, Mariangela; Corti, Michele; Azario, Luigi; Balducci, Mario; Ferro, Milena; Mantini, Giovanna; Mattiucci, Gian Carlo; Valentini, Vincenzo

    2015-01-01

    Computerized automation is likely to play an increasingly important role in radiotherapy. The objective of this study was to report the results of the first part of a program to implement a model for economical evaluation based on micro-costing method. To test the efficacy of the model, the financial impact of the introduction of an automation tool was estimated. A single- and multi-center validation of the model by a prospective collection of data is planned as the second step of the program. The model was implemented by using an interactive spreadsheet (Microsoft Excel, 2010). The variables to be included were identified across three components: productivity, staff, and equipment. To calculate staff requirements, the workflow of Gemelli ART center was mapped out and relevant workload measures were defined. Profit and loss, productivity and staffing were identified as significant outcomes. Results were presented in terms of earnings before interest and taxes (EBIT). Three different scenarios were hypothesized: baseline situation at Gemelli ART (scenario 1); reduction by 2 minutes of the average duration of treatment fractions (scenario 2); and increased incidence of advanced treatment modalities (scenario 3). By using the model, predicted EBIT values for each scenario were calculated across a period of eight years (from 2015 to 2022). For both scenarios 2 and 3 costs are expected to slightly increase as compared to baseline situation that is particularly due to a little increase in clinical personnel costs. However, in both cases EBIT values are more favorable than baseline situation (EBIT values: scenario 1, 27%, scenario 2, 30%, scenario 3, 28% of revenues). A model based on a micro-costing method was able to estimate the financial consequences of the introduction of an automation tool in our radiotherapy department. A prospective collection of data at Gemelli ART and in a consortium of centers is currently under way to prospectively validate the model.

  1. Cost estimates supporting West Valley DEIS

    International Nuclear Information System (INIS)

    Pirro, J.

    1981-01-01

    An Environmental Impact Statement (EIS) is being prepared which considers alternate means for solidifying the high level liquid wastes (HLLW) at the Western New York Nuclear Service Center (WNYNSC). For this purpose three basic scenarios were considered. In the first scenario, the HLLW is converted into terminal waste form of borosilicate glass. Before vitrification, the non-radioactive chemical salts are separated from the radioactive and transuranic (TRU) constituents in the HLLW. In the second scenario, the HLLW is converted into an intermediate form-fused salt. The stored HLLW is dewatered and melted and the solids are transported to a Department of Energy (DOE) site. The fused salt will be processed of the DOE site at a later date where it will be converted to a vitrified form in a facility that will be constructed to treat HLLW stored at that site. The vitrified salt will be eventually removed for permanent disposal at a Federal repository. In the third scenario, the HLLW is solidified in the existing HLLW storage tanks with cement and returned for on-site disposal in the existing tanks or additional tanks as needed to accommodate the volume. To support the EIS, the costs to accomplish each of the alternatives is provided. The purpose of this cost estimate is to provide a common basis to evaluate the expenditures required to immobilize the HLLW presently stored at the WNYNSC

  2. Social Security And Mental Illness: Reducing Disability With Supported Employment

    Science.gov (United States)

    Drake, Robert E.; Skinner, Jonathan S.; Bond, Gary R.; Goldman, Howard H.

    2010-01-01

    Social Security Administration disability programs are expensive, growing, and headed toward bankruptcy. People with psychiatric disabilities now constitute the largest and most rapidly expanding subgroup of program beneficiaries. Evidence-based supported employment is a well-defined, rigorously tested service model that helps people with psychiatric disabilities obtain and succeed in competitive employment. Providing evidence-based supported employment and mental health services to this population could reduce the growing rates of disability and enable those already disabled to contribute positively to the workforce and to their own welfare, at little or no cost (and, depending on assumptions, a possible savings) to the government. PMID:19414885

  3. Using collaborative work groups to reduce O ampersand M costs

    International Nuclear Information System (INIS)

    Francoeur, R.; Jones, J.N.

    1995-01-01

    Commonwealth Edison Company (ComEd) entered the nineties burdened with external distractions from its core business of power generation. Its unresolved 1987 rate case continued to face intervention in the courts. Some of its largest industrial and municipal customers were exploring more economical alternatives. The new convention facility in Chicago actually engaged an independent energy supplier. Retail wheeling was the hot topic, and internal problems were present. Operations and Maintenance (O ampersand M) costs were steadily increasing. Two of their six nuclear stations were on the Nuclear Regulatory Commission's Watch List. Immediate changes had to occur if ComEd was to ensure its future competitiveness. At ComEd Braidwood Nuclear Power Station some untraditional work methodologies were embarked upon to help the parent company reduce its O ampersand M costs. Various types of collaborative work groups were formed, and have succeeded in lowering O ampersand M costs through shorter refueling outages and the use of fewer contracted personnel. These collaborative work groups are listed below and are described in detail in the remainder of this paper: (1) A core group of Maintenance Modification Contractor (MMC) supervision integrated into the Owner's Maintenance Staff, (2) A Corporate Outage Support Group of supervisory personnel which supplements the site's Maintenance Staff, (3) The Integrated Outage and Turbine Overhaul Contractor using a mixture of its own and Maintenance Staff supervisory personnel during outages with the Owner supplementing craft support using a third-party, (4) Six nuclear stations sharing key MMC personnel to insure experienced individuals are used effectively, and (5) Composite teams of maintenance personnel working across defined disciplines Braidwood Station has capitalized on the strategy of positive collaboration to become one of the lowest cost producers of nuclear power. Its use has enabled the Station to successfully complete the

  4. Lean Manufacturing Implementation: an Approach to Reduce Production Cost

    Directory of Open Access Journals (Sweden)

    Iraswari

    2012-04-01

    Full Text Available Abstract: Lean Manufacturing Implementation: An Approach To Reduce Production Cost. Opportunities to improve production processes and reduce production cost through the implementation of lean manufacturing in small medium garment manufacturing are presented in this research. This research shows that there is a possibility of decrease in production cost and increase in return on sales. Lean manufacturing implementation can eliminate waste in the production process. This is a set of techniques for identification and elimination of waste gathered from The Ford Production, Statistical Process Control and other techniques. Improvement of quality could be carried out while time and cost of production are being reduced.

  5. Reducing the Cost of Grid Extension for Rural Electrification

    OpenAIRE

    NRECA International, Ltd.

    2000-01-01

    This study first reviews the cost of grid extension in a number of countries. It then identifies ways to reduce costs by examining how they are affected by a variety of factors. An electricity supply system may be divided into two discrete components: the grid extension and the low-voltage distribution system. This study will focus on the first of these two components, the cost of grid ext...

  6. Cost Decision Support in Product Design

    NARCIS (Netherlands)

    Liebers, A.; Kals, H.J.J.

    1997-01-01

    The constraints addressed in decision making during product design, process planning and production planning determine the admissible solution space for the manufacture of products. The solution space determines largely the costs that are incurred in the production process. In order to be able to

  7. Reducing biosolids disposal costs using land application in forested areas

    International Nuclear Information System (INIS)

    Huffines, R.L.

    1995-01-01

    Switching biosolids land application from a reclamation site to a forested site significantly reduced the cost of biosolids disposal at the Savannah River Site. Previous beneficial reuse programs focused on reclamation of existing borrow pits. While extremely beneficial, this program became very costly due to the regulatory requirements for groundwater monitoring, soil monitoring and frequent biosolids analyses. A new program was developed to reuse biosolids in forested areas where the biosolids could be used as a soil conditioner and fertilizer to enhance timber yield. The forested land application site was designed so that groundwater monitoring and soil monitoring could be eliminated while biosolids monitoring and site maintenance were minimized. Monitoring costs alone were reduced by 80%. Capital costs for site preparation were also significantly reduced since there was no longer a need for expensive groundwater monitoring wells

  8. Reducing Design Cycle Time and Cost Through Process Resequencing

    Science.gov (United States)

    Rogers, James L.

    2004-01-01

    In today's competitive environment, companies are under enormous pressure to reduce the time and cost of their design cycle. One method for reducing both time and cost is to develop an understanding of the flow of the design processes and the effects of the iterative subcycles that are found in complex design projects. Once these aspects are understood, the design manager can make decisions that take advantage of decomposition, concurrent engineering, and parallel processing techniques to reduce the total time and the total cost of the design cycle. One software tool that can aid in this decision-making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). The DeMAID software minimizes the feedback couplings that create iterative subcycles, groups processes into iterative subcycles, and decomposes the subcycles into a hierarchical structure. The real benefits of producing the best design in the least time and at a minimum cost are obtained from sequencing the processes in the subcycles.

  9. Concepts for reducing nuclear utility inventory carrying costs

    International Nuclear Information System (INIS)

    Graybill, R.E.; DiCola, F.E.; Solanas, C.H.

    1985-01-01

    Nuclear utilities are under pressure to reduce their operating and maintenance expenses such that the total cost of generating electricity through nuclear power remains an economically attractive option. One area in which expenses may be reduced is total inventory carrying cost. The total inventory carrying cost consists of financing an inventory, managing the inventory, assuring quality, engineering of acceptable parts specifications, and procuring initial and replenishment stock. Concepts and methodology must be developed to reduce the remaining expenses of a utility's total inventory carrying cost. Currently, two concepts exist: pooled inventory management system (PIMS), originally established by General Electric Company and a group of boiling water reactor owners, and Nuclear Parts Associates' (NUPA) shared inventory management program (SIMP). Both concepts share or pool parts and components among utilities. The SIMP program objectives and technical activities are summarized

  10. Operations and support cost modeling of conceptual space vehicles

    Science.gov (United States)

    Ebeling, Charles

    1994-01-01

    The University of Dayton is pleased to submit this annual report to the National Aeronautics and Space Administration (NASA) Langley Research Center which documents the development of an operations and support (O&S) cost model as part of a larger life cycle cost (LCC) structure. It is intended for use during the conceptual design of new launch vehicles and spacecraft. This research is being conducted under NASA Research Grant NAG-1-1327. This research effort changes the focus from that of the first two years in which a reliability and maintainability model was developed to the initial development of an operations and support life cycle cost model. Cost categories were initially patterned after NASA's three axis work breakdown structure consisting of a configuration axis (vehicle), a function axis, and a cost axis. A revised cost element structure (CES), which is currently under study by NASA, was used to established the basic cost elements used in the model. While the focus of the effort was on operations and maintenance costs and other recurring costs, the computerized model allowed for other cost categories such as RDT&E and production costs to be addressed. Secondary tasks performed concurrent with the development of the costing model included support and upgrades to the reliability and maintainability (R&M) model. The primary result of the current research has been a methodology and a computer implementation of the methodology to provide for timely operations and support cost analysis during the conceptual design activities.

  11. Reducing patient drug acquisition costs can lower diabetes health claims.

    Science.gov (United States)

    Mahoney, John J

    2005-08-01

    Concerned about rising prevalence and costs of diabetes among its employees, Pitney Bowes Inc recently revamped its drug benefit design to synergize with ongoing efforts in its disease management and patient education programs. Specifically, based on a predictive model showing that low medication adherence was linked to subsequent increases in healthcare costs in patients with diabetes, the company shifted all diabetes drugs and devices from tier 2 or 3 formulary status to tier 1. The rationale was that reducing patient out-of-pocket costs would eliminate financial barriers to preventive care, and thereby increase adherence, reduce costly complications, and slow the overall rate of rising healthcare costs. This single change in pharmaceutical benefit design immediately made critical brand-name drugs available to most Pitney Bowes employees and their covered dependents for 10% coinsurance, the same coinsurance level as for generic drugs, versus the previous cost share of 25% to 50%. After 2 to 3 years, preliminary results in plan participants with diabetes indicate that medication possession rates have increased significantly, use of fixed-combination drugs has increased (possibly related to easier adherence), average total pharmacy costs have decreased by 7%, and emergency department visits have decreased by 26%. Hospital admission rates, although increasing slightly, remain below the demographically adjusted Medstat benchmark. Overall direct healthcare costs per plan participant with diabetes decreased by 6%. In addition, the rate of increase in overall per-plan-participant health costs at Pitney Bowes has slowed markedly, with net per-plan-participant costs in 2003 at about 4000 dollars per year versus 6500 dollars for the industry benchmark. This recent moderation in overall corporate health costs may be related to these strategic changes in drug benefit design for diabetes, asthma, and hypertension and also to ongoing enhancements in the company's disease

  12. Reducing Interaction Costs for Self-interested Agents

    Science.gov (United States)

    Zhang, Yunqi; Larson, Kate

    In many multiagent systems, agents are not able to freely interact with each other or with a centralized mechanism. They may be limited in their interactions by cost or by the inherent structure of the system. Using a combinatorial auction application as motivation, we study the impact of interaction costs and structure on the strategic behaviour of self-interested agents. We present a particular model of costly agent-interaction, and argue that self-interested agents may wish to coordinate their actions with their neighbours so as to reduce their individual costs. We highlight the issues that arise in such a setting, propose a cost-sharing mechanism that agents can use, and discuss group coordination procedures. Experimental work validates our model.

  13. Reducing Operating Room Costs Through Real-Time Cost Information Feedback: A Pilot Study.

    Science.gov (United States)

    Tabib, Christian H; Bahler, Clinton D; Hardacker, Thomas J; Ball, Kevin M; Sundaram, Chandru P

    2015-08-01

    To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed. A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of $5243.04 per case. Ten recommended modifiable items were found to have an average per case cost of $1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by $899.67 (17.2%) because of changes directly related to the modifiable items. Therefore, 73.2% of the possible identified savings was realized. The same stepwise approach was applied to laparoscopic donor nephrectomies. The average total cost per case before the washout period was $3530.05 with $457.54 attributed to modifiable items. After the washout period, modifiable items costs were reduced by $289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group. Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes.

  14. Use of commercial grade item dedication to reduce procurement costs

    International Nuclear Information System (INIS)

    Rosch, F.

    1995-01-01

    In the mid-1980s, the Nuclear Regulatory Industry (NRC) began inspecting utility practices of procuring and dedicating commercial grade items intended for plant safety-related applications. As a result of the industry efforts to address NRC concerns, nuclear utilities have enhanced existing programs and procedures for dedication of commercial grade items. Though these programs were originally enhanced to meet NRC concerns, utilities have discovered that the dedication of commercial grade items can also reduce overall procurement costs. This paper will discuss the enhancement of utility dedication programs and demonstrates how utilities have utilized them to reduce procurement costs

  15. Need for Cost Optimization of Space Life Support Systems

    Science.gov (United States)

    Jones, Harry W.; Anderson, Grant

    2017-01-01

    As the nation plans manned missions that go far beyond Earth orbit to Mars, there is an urgent need for a robust, disciplined systems engineering methodology that can identify an optimized Environmental Control and Life Support (ECLSS) architecture for long duration deep space missions. But unlike the previously used Equivalent System Mass (ESM), the method must be inclusive of all driving parameters and emphasize the economic analysis of life support system design. The key parameter for this analysis is Life Cycle Cost (LCC). LCC takes into account the cost for development and qualification of the system, launch costs, operational costs, maintenance costs and all other relevant and associated costs. Additionally, an effective methodology must consider system technical performance, safety, reliability, maintainability, crew time, and other factors that could affect the overall merit of the life support system.

  16. Design meeting on reduced technical objectives/reduced cost ITER options

    International Nuclear Information System (INIS)

    Spears, W.

    1999-01-01

    At this meeting, which took place at Garching, Germany in January 1999, means of reducing the overall cost for ITER to 50% where discussed. It was felt that a smaller plasma of high elongation and high triangularity was a step in the right direction. Further steps would include cheaper magnetic field coils, cheaper in-vessel components and also costly buildings

  17. Reduced cost and improved figure of sapphire optical components

    Science.gov (United States)

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

    2015-10-01

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

  18. Rightsizing HVAC Systems to Reduce Capital Costs and Save Energy

    Science.gov (United States)

    Sebesta, James

    2010-01-01

    Nearly every institution is faced with the situation of having to reduce the cost of a construction project from time to time through a process generally referred to as "value engineering." Just the mention of those words, however, gives rise to all types of connotations, thoughts, and memories (usually negative) for those in the…

  19. Valuing patents on cost-reducing technology: A case study

    NARCIS (Netherlands)

    van Triest, S.P.; van de Vis, Wim

    2007-01-01

    We present an approach for valuing patents on production process improvements. Specifically, we focus on valuing a patent on cost-reducing process improvements from the viewpoint of the patent holding firm. We do this by considering the relevant cash flows that result from owning the patent. The

  20. CANDU 9 - reducing capital costs through advanced construction

    International Nuclear Information System (INIS)

    Hedges, K.; Yu, S.; Hopwood, J.

    1996-01-01

    Reducing costs is a clear priority in nuclear markets where capital reaches billions and financing is hard-won. To address that priority, AECL introduced the use of advanced construction techniques. This has been one of the key thrusts behind its development of CANDU 9. (author)

  1. Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

    Science.gov (United States)

    Martini, Gilbert R., Jr.

    1991-01-01

    A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

  2. Device interactions in reducing the cost of tidal stream energy

    International Nuclear Information System (INIS)

    Vazquez, A.; Iglesias, G.

    2015-01-01

    Highlights: • Numerical modelling is used to estimate the levelised cost of tidal stream energy. • As a case study, a model of Lynmouth (UK) is implemented and successfully validated. • The resolution of the model allows the demarcation of individual devices on the model grid. • Device interactions reduce the available tidal resource and the cost increases significantly. - Abstract: The levelised cost of energy takes into account the lifetime generated energy and the costs associated with a project. The objective of this work is to investigate the effects of device interactions on the energy output and, therefore, on the levelised cost of energy of a tidal stream project, by means of numerical modelling. For this purpose, a case study is considered: Lynmouth (North Devon, UK), an area in the Bristol Channel in which the first tidal stream turbine was installed − a testimony of its potential as a tidal energy site. A state-of-the-art hydrodynamics model is implemented on a high-resolution computational grid, which allows the demarcation of the individual devices. The modification to the energy output resulting from interaction between turbines within the tidal farm is thus resolved for each individual turbine. The results indicate that significant changes in the levelised cost of energy values, of up to £0.221 kW h −1 , occur due to the aforementioned modifications, which should not be disregarded if the cost of tidal stream energy is to be minimised

  3. Cost effectiveness of reducing radon exposure in Spanish dwellings

    International Nuclear Information System (INIS)

    Colgan, P.A.; Gutierrez, J.

    1996-01-01

    Published information on the distribution of radon levels in Spanish single family dwellings is used to evaluate the cost-effectiveness of three different intervention scenarios: remediation of existing dwellings, radon proofing of all future dwellings and the targetting of areas with higher than average indoor radon concentrations. Analysis is carried out on the basis of a Reference Level of 400 Bq m -3 for the existing housing stock and 200 Bq m -3 for new dwellings. Certain assumptions are made about the effectiveness and durability of the measures applied and annualised costs are used to calculate the costs per lung cancer death averted. The results reveal that targetting future housing is a more cost-effective option than remediation of existing dwellings with radon concentrations above the Reference Level -the costs per lung cancer death averted are typically $145000. In high-risk areas, these costs can be considerably less, depending on the percentage of dwellings expected to exceed the Reference Level and the average savings in exposure as a result of the intervention. The costs of intervention to reduce lung cancer deaths following exposure to radon compare favourably with those of other health programmes in other countries. (Author)

  4. 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.

  5. Standardized ultrasound templates for diagnosing appendicitis reduce annual imaging costs.

    Science.gov (United States)

    Nordin, Andrew B; Sales, Stephen; Nielsen, Jason W; Adler, Brent; Bates, David Gregory; Kenney, Brian

    2018-01-01

    Ultrasound is preferred over computed tomography (CT) for diagnosing appendicitis in children to avoid undue radiation exposure. We previously reported our experience in instituting a standardized appendicitis ultrasound template, which decreased CT rates by 67.3%. In this analysis, we demonstrate the ongoing cost savings associated with using this template. Retrospective chart review for the time period preceding template implementation (June 2012-September 2012) was combined with prospective review through December 2015 for all patients in the emergency department receiving diagnostic imaging for appendicitis. The type of imaging was recorded, and imaging rates and ultrasound test statistics were calculated. Estimated annual imaging costs based on pretemplate ultrasound and CT utilization rates were compared with post-template annual costs to calculate annual and cumulative savings. In the pretemplate period, ultrasound and CT rates were 80.2% and 44.3%, respectively, resulting in a combined annual cost of $300,527.70. Similar calculations were performed for each succeeding year, accounting for changes in patient volume. Using pretemplate rates, our projected 2015 imaging cost was $371,402.86; however, our ultrasound rate had increased to 98.3%, whereas the CT rate declined to 9.6%, yielding an annual estimated cost of $224,853.00 and a savings of $146,549.86. Since implementation, annual savings have steadily increased for a cumulative cost savings of $336,683.83. Standardizing ultrasound reports for appendicitis not only reduces the use of CT scans and the associated radiation exposure but also decreases annual imaging costs despite increased numbers of imaging studies. Continued cost reduction may be possible by using diagnostic algorithms. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Development of cost effective fenceline monitoring approaches to support advanced leak detection and repair strategies

    Science.gov (United States)

    Cost-effective fence line and process monitoring systems to support advanced leak detection and repair (LDAR) strategies can enhance protection of public health, facilitate worker safety, and help companies realize cost savings by reducing lost product. The U.S. EPA Office of Re...

  7. The Impact of Medicaid Peer Support Utilization on Cost

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in The Impact of Medicaid Peer Support Utilization on Cost, published in Volume 4, Issue 1 of the Medicare and Medicaid Research...

  8. Cost-effectiveness of pharmacotherapy to reduce obesity.

    Directory of Open Access Journals (Sweden)

    J Lennert Veerman

    Full Text Available AIMS: Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. METHODS: We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs below A$50 000 per Disability Adjusted Life Year (DALY averted are considered good value for money. RESULTS: The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000-180 000 for sibutramine and A$230 000/DALY (170 000-340 000 for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. CONCLUSIONS: Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden.

  9. Consolidating staff augmentation contracts improves teamwork and reduces costs

    International Nuclear Information System (INIS)

    Townsend, J.; Sibilla, L.; Gregovich, J.W.

    1991-01-01

    Nuclear power plants have traditionally used multiple contracting firms to provide temporary staff augmentation personnel primarily because of two perceptions: (1) managers believe they have greater access to a higher quality, readily available pool of applicants. (2) using multiple contractors inherently keeps costs down as a result of several competitors submitting resumes for the same position. This paper provides information, based on the experiences of a leading nuclear power plant, that disproves these perceptions. It explains why consolidating several contracts for professional and technical classifications (excluding craft labor and refueling personnel) and competitively bidding and awarding the contract to a single contracting firm promotes teamwork and reduces costs

  10. Small Habitat Commonality Reduces Cost for Human Mars Missions

    Science.gov (United States)

    Griffin, Brand N.; Lepsch, Roger; Martin, John; Howard, Robert; Rucker, Michelle; Zapata, Edgar; McCleskey, Carey; Howe, Scott; Mary, Natalie; Nerren, Philip (Inventor)

    2015-01-01

    Most view the Apollo Program as expensive. It was. But, a human mission to Mars will be orders of magnitude more difficult and costly. Recently, NASA's Evolvable Mars Campaign (EMC) mapped out a step-wise approach for exploring Mars and the Mars-moon system. It is early in the planning process but because approximately 80% of the total life cycle cost is committed during preliminary design, there is an effort to emphasize cost reduction methods up front. Amongst the options, commonality across small habitat elements shows promise for consolidating the high bow-wave costs of Design, Development, Test and Evaluation (DDT&E) while still accommodating each end-item's functionality. In addition to DDT&E, there are other cost and operations benefits to commonality such as reduced logistics, simplified infrastructure integration and with inter-operability, improved safety and simplified training. These benefits are not without a cost. Some habitats are sub-optimized giving up unique attributes for the benefit of the overall architecture and because the first item sets the course for those to follow, rapidly developing technology may be excluded. The small habitats within the EMC include the pressurized crew cabins for the ascent vehicle,

  11. Reducing Reforestation Costs in Lebanon: Adaptive Field Trials

    Directory of Open Access Journals (Sweden)

    Garabet (Garo Haroutunian

    2017-05-01

    Full Text Available Lebanon’s Ministry of Environment initiated a project in 2009 to determine low-cost reforestation techniques for stone pine (Pinus pinea and Lebanon cedar (Cedrus libani for large-scale land rehabilitation activities in the arid Middle East. Irrigation (several techniques vs. no water, planting (8- to 18-month-old seedlings, seeding, and soil preparation methods were evaluated in three sets of adaptive management field trials. The aim was to reduce reforestation costs while still achieving sufficient regeneration. A key result for management was that non-irrigated seed planting of stone pine and possibly of Lebanon cedar showed promise for cost-effective reforestation and could be competitive with seedlings, given correct seed source and planting conditions. Stone pine seeds collected from nearby mother trees and planted without irrigation on sandy soil showed 35% survival for <600 USD/ha; seedlings planted without irrigation cost about 2500 USD/ha and achieved 50–70% survival (costs based on 800 seedlings/ha. Water supplements increased establishment costs over 2 years without concomitant improvements to survival. Future studies should evaluate how soil texture and soil preparation interact with other factors to affect seed germination and survival for each species.

  12. Operations and support cost modeling using Markov chains

    Science.gov (United States)

    Unal, Resit

    1989-01-01

    Systems for future missions will be selected with life cycle costs (LCC) as a primary evaluation criterion. This reflects the current realization that only systems which are considered affordable will be built in the future due to the national budget constaints. Such an environment calls for innovative cost modeling techniques which address all of the phases a space system goes through during its life cycle, namely: design and development, fabrication, operations and support; and retirement. A significant portion of the LCC for reusable systems are generated during the operations and support phase (OS). Typically, OS costs can account for 60 to 80 percent of the total LCC. Clearly, OS costs are wholly determined or at least strongly influenced by decisions made during the design and development phases of the project. As a result OS costs need to be considered and estimated early in the conceptual phase. To be effective, an OS cost estimating model needs to account for actual instead of ideal processes by associating cost elements with probabilities. One approach that may be suitable for OS cost modeling is the use of the Markov Chain Process. Markov chains are an important method of probabilistic analysis for operations research analysts but they are rarely used for life cycle cost analysis. This research effort evaluates the use of Markov Chains in LCC analysis by developing OS cost model for a hypothetical reusable space transportation vehicle (HSTV) and suggests further uses of the Markov Chain process as a design-aid tool.

  13. Reducing the cost of back-contact module technology

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, I.J.; Eerenstein, W.; Rosca, V. [ECN Solar Energy, P.O. Box 1, 1755 ZG Petten (Netherlands)

    2013-07-01

    Back-contact modules made using a conductive back-sheet foil have a number of advantages over standard H-pattern modules including a higher power output, compatibility with very thin cells and high throughput, high yield manufacturing. For a conductive back-sheet based module the most cost critical components are the conductive back-sheet and the conductive adhesives used to make the contact between the cells and the conductive back-sheet. In this paper a number of methods for reducing the module materials cost will be presented. Climate chamber testing of low cost foils without isolation coating and without silver contacts demonstrated that this type of foil is reliable in damp-heat, reaching 2000 hours at 85%RH and 85{sup o}C with a loss in fill-factor of less than 2%.

  14. Subsea industry implements NORSOK: Happy marriages reduce costs

    International Nuclear Information System (INIS)

    Heggelund, N.

    1995-01-01

    Cost reduction by implementing NORSOK standards and cooperation between subsea suppliers to the Norwegian continental shelf, are discussed in this article. The aim of NORSOK, which is based on US standards, is to achieve standardization of technical requirements for drilling and production facilities, to identify and develop common requirements for equipment and installations, based on functional specifications, interfaces and limited variety for equipment and design, and to take into consideration existing industry standards and use these where possible. The offspring of cooperation is notable cost reductions. Subsea costs at Saga's Vigdis field have been reduced by 50% in two years. More subsea projects could come up soon. Norsk Hydro has short-listed a semi PDQ (Processing, Drilling and living Quarters), a ship or Gullfaks tie-in as runner-up concepts for the Viksund project. 1 fig

  15. Does SDDS Subscription Reduce Borrowing Costs for Emerging Market Economies?

    OpenAIRE

    John Cady

    2005-01-01

    Does macroeconomic data transparency-as signaled by subscription to the IMF's Special Data Dissemination Standard (SDDS)-help reduce borrowing costs in international capital markets? This question is examined using data on new issues of sovereign foreign-currency-denominated (U.S. dollar, yen, and euro) bonds for several emerging market economies. Panel econometric estimates indicate that spreads on new bond issues declined on average by close to 20 percent, or by an average of about 55 basis...

  16. Improving performance and reducing costs of cooling towers

    International Nuclear Information System (INIS)

    Bartz, J.A.

    1992-01-01

    Cooling towers represent a significant capital investment at a steam electric power station. In addition, deficiencies in thermal performance can result in major operating penalties of fuel cost, replacement energy, and capacity addition. This paper summarizes two recent EPRI research projects aimed at reducing thermal performance deficiencies and decreasing installed costs of evaporative cooling towers. First, EPRI Research Project 2113, Cooling Tower Performance Prediction and Improvement, is summarized. This project has resulted in published data sets on the measured thermal performance characteristics of a variety of cooling tower packings, computer codes to predict tower performance, and computer code validation through large-scale tower performance measurements. Principal results are contained in an EPRIGEMS software module, Cooling Tower Advisor. This PC- based software contains a tutorial plus codes to predict tower thermal performance, arranged in a user-friendly format. The second EPRI effort, Research Project 2819-10/11, Fabric Structures for Power Plant Applications, has resulted in designs and costs of large structures with shells constructed of recently-developed fabrics. Primary power plant applications for such structures are the shells of natural draft cooling towers and coal-pile covers. Fabric structures offer low initial cost, acceptable life, and seismic superiority, among other advantages. Detailed conceptual designs and installed cost data are reviewed. 8 refs., 9 figs., 3 tabs

  17. Reducing electrocoagulation harvesting costs for practical microalgal biodiesel production.

    Science.gov (United States)

    Dassey, Adam J; Theegala, Chandra S

    2014-01-01

    Electrocoagulation has shown potential to be a primary microalgae harvesting technique for biodiesel production. However, methods to reduce energy and electrode costs are still necessary for practical application. Electrocoagulation tests were conducted on Nannochloris sp. and Dunaliella sp. using perforated aluminium and iron electrodes under various charge densities. Aluminium electrodes were shown to be more efficient than iron electrodes when harvesting both algal species. Despite the lower harvesting efficiency, however, the iron electrodes were more energy and cost efficient. Operational costs of less than $0.03/L oil were achieved when harvesting Nannochloris sp. with iron electrodes at 35% harvest efficiency, whereas aluminium electrodes cost $0.75/L oil with 42% harvesting efficiency. Increasing the harvesting efficiencies for both aluminium and iron electrodes also increased the overall cost per litre of oil, therefore lower harvesting efficiencies with lower energy inputs was recommended. Also, increasing the culturing salinity to 2 ppt sodium chloride for freshwater Nannochloris sp. was determined practical to improve the electrocoagulation energy efficiency despite a 25% reduction in cell growth.

  18. Radically Reducing the Costs of Panel Critical Reviews According to ISO 14040

    DEFF Research Database (Denmark)

    Weidema, Bo Pedersen; Christiansen, Kim; Wernet, Gregor

    2013-01-01

    We suggest a procedure that radically reduces the critical review costs without compromising their thoroughness and overall quality. This procedure has 3 elements: A fixed panel for all reviews, an already critically reviewed background database, and a software-supported review procedure. The pre....... The presentation discusses these elements in the light of the upcoming ISO 14071 on critical review....

  19. Streamlining: Reducing costs and increasing STS operations effectiveness

    Science.gov (United States)

    Petersburg, R. K.

    1985-01-01

    The development of streamlining as a concept, its inclusion in the space transportation system engineering and operations support (STSEOS) contract, and how it serves as an incentive to management and technical support personnel is discussed. The mechanics of encouraging and processing streamlining suggestions, reviews, feedback to submitters, recognition, and how individual employee performance evaluations are used to motivation are discussed. Several items that were implemented are mentioned. Information reported and the methodology of determining estimated dollar savings are outlined. The overall effect of this activity on the ability of the McDonnell Douglas flight preparation and mission operations team to support a rapidly increasing flight rate without a proportional increase in cost is illustrated.

  20. Much Lower Launch Costs Make Resupply Cheaper than Recycling for Space Life Support

    Science.gov (United States)

    Jones, Harry W.

    2017-01-01

    The development of commercial launch vehicles by SpaceX has greatly reduced the cost of launching mass to Low Earth Orbit (LEO). Reusable launch vehicles may further reduce the launch cost per kilogram. The new low launch cost makes open loop life support much cheaper than before. Open loop systems resupply water and oxygen in tanks for crew use and provide disposable lithium hydroxide (LiOH) in canisters to remove carbon dioxide. Short human space missions such as Apollo and shuttle have used open loop life support, but the long duration International Space Station (ISS) recycles water and oxygen and removes carbon dioxide with a regenerative molecular sieve. These ISS regenerative and recycling life support systems have significantly reduced the total launch mass needed for life support. But, since the development cost of recycling systems is much higher than the cost of tanks and canisters, the relative cost savings have been much less than the launch mass savings. The Life Cycle Cost (LCC) includes development, launch, and operations. If another space station was built in LEO, resupply life support would be much cheaper than the current recycling systems. The mission most favorable to recycling would be a long term lunar base, since the resupply mass would be large, the proximity to Earth would reduce the need for recycling reliability and spares, and the launch cost would be much higher than for LEO due to the need for lunar transit and descent propulsion systems. For a ten-year lunar base, the new low launch costs make resupply cheaper than recycling systems similar to ISS life support.

  1. Interim monitoring of cost dynamics for publicly supported energy technologies

    Energy Technology Data Exchange (ETDEWEB)

    Nemet, Gregory F. [La Follette School of Public Affairs, University of Wisconsin, 1225 Observatory Drive, Madison, WI 53706 (United States)]|[Nelson Institute for Environmental Studies, University of Wisconsin, Madison, WI 53726 (United States)

    2009-03-15

    The combination of substantial public funding of nascent energy technologies and recent increases in the costs of those that have been most heavily supported has raised questions about whether policy makers should sustain, alter, enhance, or terminate such programs. This paper uses experience curves for photovoltaics (PV) and wind to (1) estimate ranges of costs for these public programs and (2) introduce new ways of evaluating recent cost dynamics. For both technology cases, the estimated costs of the subsidies required to reach targets are sensitive to the choice of time period on which cost projections are based. The variation in the discounted social cost of subsidies exceeds an order of magnitude. Vigilance is required to avoid the very expensive outcomes contained within these distributions of social costs. Two measures of the significance of recent deviations are introduced. Both indicate that wind costs are within the expected range of prior forecasts but that PV costs are not. The magnitude of the public funds involved in these programs heightens the need for better analytical tools with which to monitor and evaluate cost dynamics. (author)

  2. 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.

  3. Does a renewable fuel standard for biofuels reduce climate costs?

    Energy Technology Data Exchange (ETDEWEB)

    Greaker, Mads; Hoel, Michael; Rosendahl, Knut Einar

    2012-07-01

    Recent contributions have questioned whether biofuels policies actually lead to emissions reductions, and thus lower climate costs. In this paper we make two contributions to the literature. First, we study the market effects of a renewable fuel standard. Opposed to most previous studies we model the supply of fossil fuels taking into account that fossil fuels is a non-renewable resource. Second, we model emissions from land use change explicitly when we evaluate the climate effects of the renewable fuel standard. We find that extraction of fossil fuels most likely will decline initially as a consequence of the standard. Thus, if emissions from biofuels are sufficiently low, the standard will have beneficial climate effects. Furthermore, we find that the standard tends to reduce total fuel (i.e., oil plus biofuels) consumption initially. Hence, even if emissions from biofuels are substantial, climate costs may be reduced. Finally, if only a subset of countries introduce a renewable fuel standard, there will be carbon leakage to the rest of the world. However, climate costs may decline as global extraction of fossil fuels is postponed.(Author)

  4. Next-generation nozzle check valve significantly reduces operating costs

    Energy Technology Data Exchange (ETDEWEB)

    Roorda, O. [SMX International, Toronto, ON (Canada)

    2009-01-15

    Check valves perform an important function in preventing reverse flow and protecting plant and mechanical equipment. However, the variety of different types of valves and extreme differences in performance even within one type can change maintenance requirements and life cycle costs, amounting to millions of dollars over the typical 15-year design life of piping components. A next-generation non-slam nozzle check valve which prevents return flow has greatly reduced operating costs by protecting the mechanical equipment in a piping system. This article described the check valve varieties such as the swing check valve, a dual-plate check valve, and nozzle check valves. Advancements in optimized design of a non-slam nozzle check valve were also discussed, with particular reference to computer flow modelling such as computational fluid dynamics; computer stress modelling such as finite element analysis; and flow testing (using rapid prototype development and flow loop testing), both to improve dynamic performance and reduce hydraulic losses. The benefits of maximized dynamic performance and minimized pressure loss from the new designed valve were also outlined. It was concluded that this latest non-slam nozzle check valve design has potential applications in natural gas, liquefied natural gas, and oil pipelines, including subsea applications, as well as refineries, and petrochemical plants among others, and is suitable for horizontal and vertical installation. The result of this next-generation nozzle check valve design is not only superior performance, and effective protection of mechanical equipment but also minimized life cycle costs. 1 fig.

  5. Predictive models reduce talent development costs in female gymnastics.

    Science.gov (United States)

    Pion, Johan; Hohmann, Andreas; Liu, Tianbiao; Lenoir, Matthieu; Segers, Veerle

    2017-04-01

    This retrospective study focuses on the comparison of different predictive models based on the results of a talent identification test battery for female gymnasts. We studied to what extent these models have the potential to optimise selection procedures, and at the same time reduce talent development costs in female artistic gymnastics. The dropout rate of 243 female elite gymnasts was investigated, 5 years past talent selection, using linear (discriminant analysis) and non-linear predictive models (Kohonen feature maps and multilayer perceptron). The coaches classified 51.9% of the participants correct. Discriminant analysis improved the correct classification to 71.6% while the non-linear technique of Kohonen feature maps reached 73.7% correctness. Application of the multilayer perceptron even classified 79.8% of the gymnasts correctly. The combination of different predictive models for talent selection can avoid deselection of high-potential female gymnasts. The selection procedure based upon the different statistical analyses results in decrease of 33.3% of cost because the pool of selected athletes can be reduced to 92 instead of 138 gymnasts (as selected by the coaches). Reduction of the costs allows the limited resources to be fully invested in the high-potential athletes.

  6. Reducing Wildlife Damage with Cost-Effective Management Programmes.

    Directory of Open Access Journals (Sweden)

    Cheryl R Krull

    Full Text Available Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control, with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation

  7. Managing concrete bridges: Methods for reducing costs and user inconveniences

    DEFF Research Database (Denmark)

    Goltermann, Per

    2005-01-01

    The paper presents experiences from modern bridge maintenance management, which has been forced to develop new and cost-efficient approaches in order to cope with the increase in overall deterioration of the aging bridge stock, the growing requirements to accessibility and the decreasing budgets...... situations often postpone or reduce the repair and rehabilitation activities required in critical parts of the structure. The paper will present some cases, where these approaches have been used on existing concrete bridges and explain how these experiences can be applied on other types of structures...

  8. Advanced transfer chute reduces dust at lower cost

    Energy Technology Data Exchange (ETDEWEB)

    Blazek, C. [Benetech Inc. (United States)

    2005-10-01

    Dominion Resources' Kincaid Generating Station in Illinois is recognized as a leader in handling and burning PRB coal. Since being named the Powder Plant of the Year in 2001 and 2004 by the PRB Coal Users' Group, Kincaid has improved its coal handling by installing an InteliFlo controlled-flow transfer chute from Benetech. The InteliFlo design eliminates the need for skirt boards, conveyor discharge hoods, and complex load bed designs, and reduces O & M costs. 4 figs.

  9. REDUCING ENVIRONMENTAL IMPACT AND COST OF PRODUCTION FOR DRYING FRUITS

    Directory of Open Access Journals (Sweden)

    Murad Erol

    2013-12-01

    Full Text Available To reduce the production costs for heat used in drying fruit plants was studied using of local biomass from tree branch pruning. The average annual get 3 t / ha biomass whit energy potential of 37 GJ/ha at a cost of up to 60 €/t. biomass at 10 - 50 mm chopped and dried below 20% can be gasefied with TLUD process characterized by high energy conversion efficiency, stability and safety in operation, emissions of CO and PM very low. TLUD process produces on average and 15% biochar that can be used as fuel or as agricultural amendment to increase fertility and for atmospheric carbon sequestration. There have been experiments simulated by model of USCMER 30/60MGB dryer equipped with two thermal modules TLUD FORTE-40 for apple slices drying heat of the apple prinings. Biomass used and biochar resulting chemical and energy were defined as micro-gasification process TLUD. That can dry 205 kg of apple slices in 6 hours with 74 kg of dry biomass to 10% of that remains and 12.2 kg biochar, biochar with or without 52 kg biomass, which costs € 8.55 or € 5.97, ie 4.3 or 6.1 times cheaper than diesel. On dry ton of sliced apple it can produce 59.6 kg biochar with soil seize -174.8 kg. CO2.

  10. Renewable electricity production costs-A framework to assist policy-makers' decisions on price support

    International Nuclear Information System (INIS)

    Dinica, Valentina

    2011-01-01

    Despite recent progress, the production costs for renewable electricity remain above those for conventional power. Expectations of continuous reductions in production costs, typically underpin governments' policies for financial support. They often draw on the technology-focused versions of the Experience Curve model. This paper discusses how national-contextual factors also have a strong influence on production costs, such as geographic, infrastructural, institutional, and resource factors. As technologies mature, and as they reach significant levels of diffusion nationally, sustained increases in production costs might be recorded, due to these nationally contextual factors, poorly accounted for in policy-making decisions for price support. The paper suggests an analytical framework for a more comprehensive understanding of production costs. Based on this, it recommends that the evolution of specific cost levels and factors be monitored to locate 'sources of changes'. The paper also suggests policy instruments that governments may use to facilitate cost decreases, whenever possible. The application of the framework is illustrated for the diffusion of wind power in Spain during the past three decades. - Highlights: → Models, frameworks for policy-making on price support for renewable electricity production costs. → Policy instruments to help reduce production costs. → Limits to the influence of policies of production costs reductions.

  11. Fixed-point image orthorectification algorithms for reduced computational cost

    Science.gov (United States)

    French, Joseph Clinton

    Imaging systems have been applied to many new applications in recent years. With the advent of low-cost, low-power focal planes and more powerful, lower cost computers, remote sensing applications have become more wide spread. Many of these applications require some form of geolocation, especially when relative distances are desired. However, when greater global positional accuracy is needed, orthorectification becomes necessary. Orthorectification is the process of projecting an image onto a Digital Elevation Map (DEM), which removes terrain distortions and corrects the perspective distortion by changing the viewing angle to be perpendicular to the projection plane. Orthorectification is used in disaster tracking, landscape management, wildlife monitoring and many other applications. However, orthorectification is a computationally expensive process due to floating point operations and divisions in the algorithm. To reduce the computational cost of on-board processing, two novel algorithm modifications are proposed. One modification is projection utilizing fixed-point arithmetic. Fixed point arithmetic removes the floating point operations and reduces the processing time by operating only on integers. The second modification is replacement of the division inherent in projection with a multiplication of the inverse. The inverse must operate iteratively. Therefore, the inverse is replaced with a linear approximation. As a result of these modifications, the processing time of projection is reduced by a factor of 1.3x with an average pixel position error of 0.2% of a pixel size for 128-bit integer processing and over 4x with an average pixel position error of less than 13% of a pixel size for a 64-bit integer processing. A secondary inverse function approximation is also developed that replaces the linear approximation with a quadratic. The quadratic approximation produces a more accurate approximation of the inverse, allowing for an integer multiplication calculation

  12. What Do Information Technology Support Services Really Cost?

    Science.gov (United States)

    Leach, Karen; Smallen, David

    1998-01-01

    A study examined the cost of information-technology support services in higher education institutions. The report describes the project's origins and work to date and reports initial results in three areas: network services, desktop repair services, and administrative information systems, looking in each case at economies of scale, outsourcing…

  13. Multifaceted intervention including education, rounding checklist implementation, cost feedback, and financial incentives reduces inpatient laboratory costs.

    Science.gov (United States)

    Yarbrough, Peter M; Kukhareva, Polina V; Horton, Devin; Edholm, Karli; Kawamoto, Kensaku

    2016-05-01

    Inappropriate laboratory testing is a contributor to waste in healthcare. To evaluate the impact of a multifaceted laboratory reduction intervention on laboratory costs. A retrospective, controlled, interrupted time series (ITS) study. University of Utah Health Care, a 500-bed academic medical center in Salt Lake City, Utah. All patients 18 years or older admitted to the hospital to a service other than obstetrics, rehabilitation, or psychiatry. Multifaceted quality-improvement initiative in a hospitalist service including education, process change, cost feedback, and financial incentive. Primary outcomes of lab cost per day and per visit. Secondary outcomes of number of basic metabolic panel (BMP), comprehensive metabolic panel (CMP), complete blood count (CBC), and prothrombin time/international normalized ratio tests per day; length of stay (LOS); and 30-day readmissions. A total of 6310 hospitalist patient visits (intervention group) were compared to 25,586 nonhospitalist visits (control group). Among the intervention group, the unadjusted mean cost per day was reduced from $138 before the intervention to $123 after the intervention (P analysis showed significant reductions in cost per day, cost per visit, and the number of BMP, CMP, and CBC tests per day (P = 0.034, 0.02, <0.001, 0.004, and <0.001). LOS was unchanged and 30-day readmissions decreased in the intervention group. A multifaceted approach to laboratory reduction demonstrated a significant reduction in laboratory cost per day and per visit, as well as common tests per day at a major academic medical center. Journal of Hospital Medicine 2016;11:348-354. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  14. Advanced technology heavy water monitors offering reduced implementation costs

    International Nuclear Information System (INIS)

    Kalechstein, W.; Hippola, K.B.

    1984-10-01

    The development of second generation heavy water monitors for use at CANDU power stations and heavy water plants has been completed and the instruments brought to the stage of commercial availability. Applications of advanced technology and reduced utilization of custom manufactured components have together resulted in instruments that are less expensive to produce than the original monitors and do not require costly station services. The design has been tested on two prototypes and fully documented, including the inspection and test procedures required for manufacture to the CSA Z299.3 quality verfication program standard. Production of the new monitors by a commercial vendor (Barringer Research Ltd.) has begun and the first instrument is scheduled for delivery to CRNL's NRU reactor in late 1984

  15. DEMAND ILLUSION AS A WAY TO REDUCE COSTS

    Directory of Open Access Journals (Sweden)

    Kirill N. Sosnovskij

    2014-01-01

    Full Text Available Article devoted to a technique that reduces costs to retailers, as well as increase the speed of discounted products. This article deals with the laws of visual merchandising that have a significant impact on the implementation of the company’s products. The analysis of the first law, with the subsequent introduction into it of a new additional method. Consider the effect of «Illusion of deficit» arising from the application of the proposed method. The article also defines the basic hypothesis of the existence of methods and effect, and the conditions for their effective implementation. To confirm the effectiveness of the developed method, quantitative surveys are conducted for different age groups creating situational model, which allows respondents to feel as a consumer.

  16. Investing in CenteringPregnancy™ Group Prenatal Care Reduces Newborn Hospitalization Costs.

    Science.gov (United States)

    Crockett, Amy; Heberlein, Emily C; Glasscock, Leah; Covington-Kolb, Sarah; Shea, Karen; Khan, Imtiaz A

    CenteringPregnancy™ group prenatal care is an innovative model with promising evidence of reducing preterm birth. The outpatient costs of offering CenteringPregnancy pose barriers to model adoption. Enhanced provider reimbursement for group prenatal care may improve birth outcomes and generate newborn hospitalization cost savings for insurers. To investigate potential cost savings for investment in CenteringPregnancy, we evaluated the impact on newborn hospital admission costs of a pilot incentive project, where BlueChoice Health Plan South Carolina Medicaid managed care organization paid an obstetric practice offering CenteringPregnancy $175 for each patient who participated in at least five group prenatal care sessions. Using a one to many case-control matching without replacement, each CenteringPregnancy participant was matched retrospectively on propensity score, age, race, and clinical risk factors with five individual care participants. We estimated the odds of newborn hospital admission type (neonatal intensive care unit [NICU] or well-baby admission) for matched CenteringPregnancy and individual care cohorts with four or more visits using multivariate logistic regression. Cost savings were calculated using mean costs per admission type at the delivery hospital. Of the CenteringPregnancy newborns, 3.5% had a NICU admission compared with 12.0% of individual care newborns (p Investing in CenteringPregnancy for 85 patients ($14,875) led to an estimated net savings for the managed care organization of $67,293 in NICU costs. CenteringPregnancy may reduce costs through fewer NICU admissions. Enhanced reimbursement from payers to obstetric practices supporting CenteringPregnancy sustainability may improve birth outcomes and reduce associated NICU costs. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Deep reduced PEDOT films support electrochemical applications: Biomimetic color front.

    Directory of Open Access Journals (Sweden)

    Toribio Fernandez OTERO

    2015-02-01

    Full Text Available Most of the literature accepts, despite many controversial results, that during oxidation/reduction films of conducting polymers move from electronic conductors to insulators. Thus, engineers and device’s designers are forced to use metallic supports to reoxidize the material for reversible device work. Electrochromic front experiments appear as main visual support of the claimed insulating nature of reduced conducting polymers. Here we present a different design of the biomimetic electrochromic front that corroborates the electronic and ionic conducting nature of deep reduced films. The direct contact PEDOT metal/electrolyte and film/electrolyte was prevented from electrolyte contact until 1cm far from the metal contact with protecting Parafilm®. The deep reduced PEDOT film supports the flow of high currents promoting reaction induced electrochromic color changes beginning 1 cm far from the metal-polymer electrical contact and advancing, through the reduced film, towards the metal contact. Reverse color changes during oxidation/reduction always are initiated at the film/electrolyte contact advancing, under the protecting film, towards the film/metal contact. Both reduced and oxidized states of the film demonstrate electronic and ionic conductivities high enough to be used for electronic applications or, as self-supported electrodes, for electrochemical devices. The electrochemically stimulated conformational relaxation (ESCR model explains those results.

  18. Ventilation cost impact of reduced radon-daughter working levels

    International Nuclear Information System (INIS)

    Bates, R.C.

    1981-01-01

    Published information on costs of radon-daughter control in uranium mines was analyzed to develop estimates of the cost per ton for any level of radiation exposure control. All data were converted to 1967 cost of living index to provide a common analysis base. Results of the analysis show that the cost per ton increases exponentially as the radiation level is lowered. A linear relationship with the cost of living index is assumed, and equations and graphs are provided to estimate control cost per ton for any exposure control level and cost of living index

  19. A cost-reducing extracorporeal membrane oxygenation (ECMO) program model: a single institution experience.

    Science.gov (United States)

    Cavarocchi, N C; Wallace, S; Hong, E Y; Tropea, A; Byrne, J; Pitcher, H T; Hirose, H

    2015-03-01

    The worldwide demand for ECMO support has grown. Its provision remains limited due to several factors (high cost, complicated technology, lack of expertise) that increase healthcare cost. Our goal was to assess if an intensive care unit (ICU)-run ECMO model without continuous bedside perfusionists would decrease costs while maintaining patient safety and outcomes. A new ECMO program was implemented in 2010, consisting of dedicated ICU multidisciplinary providers (ICU-registered nurses, mid-level providers and intensivists). In year one, we introduced an education platform, new technology and dedicated space. In year two, continuous bedside monitoring by perfusionists was removed and new management algorithms designating multidisciplinary providers as first responders were established. The patient safety and cost benefit from the removal of the continuous bedside monitoring of the perfusionists of this new ECMO program was retrospectively reviewed and compared. During the study period, 74 patients (28 patients in year 1 and 46 patients in year 2) were placed on ECMO (mean days: 8 ± 5.7). The total annual hospital expenditure for the ECMO program was significantly reduced in the new model ($234,000 in year 2 vs. $600,264 in year 1), showing a 61% decrease in cost. This cost decrease was attributed to a decreased utilization of perfusion services and the introduction of longer lasting and more efficient ECMO technology. We did not find any significant changes in registered nurse ratios or any differences in outcomes related to ICU safety events. We demonstrated that the ICU-run ECMO model managed to lower hospital cost by reducing the cost of continuous bedside perfusion support without a change in outcomes. © The Author(s) 2014.

  20. Reduced computational cost in the calculation of worst case response time for real time systems

    OpenAIRE

    Urriza, José M.; Schorb, Lucas; Orozco, Javier D.; Cayssials, Ricardo

    2009-01-01

    Modern Real Time Operating Systems require reducing computational costs even though the microprocessors become more powerful each day. It is usual that Real Time Operating Systems for embedded systems have advance features to administrate the resources of the applications that they support. In order to guarantee either the schedulability of the system or the schedulability of a new task in a dynamic Real Time System, it is necessary to know the Worst Case Response Time of the Real Time tasks ...

  1. Cyclosporine/ketoconazole reduces treatment costs for nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    A Iyengar

    2013-01-01

    Full Text Available Cyclosporine A (CyA is an effective agent for the treatment of glucocorticoid-dependent idiopathic nephrotic syndrome (GCDNS, but costs are prohibitive in resource-poor societies. The objectives of this study were to evaluate the efficacy and safety of reducing the dose of CyA by co-administering ketoconazole. A prospective study targeting children 2-18 years of age with GCDNS in remission with CyA monotherapy was conducted. CyA dose was reduced by 50% and ketoconazole was added at 25% of the recommended therapeutic dose, and the drug levels and therapeutic and adverse effects (AE were monitored. Continued combined therapy after completion of the 4-week trial period was offered. Ten patients (median age 9.5 years, range 3.0-16.0 years were enrolled in the study. At week 4, the CyA dose was 2.2 ± 0.7 mg/kg/day compared with 5.6 ± 0.9 mg/kg/day at enrolment ( P 50% without increased adverse events or drug monitoring needs. This intervention demonstrates how access of patients with limited resources to needed drugs can be improved by interference with physiological drug elimination.

  2. Green roofs: roof system reducing heating and cooling costs

    Directory of Open Access Journals (Sweden)

    Konasova, Sarka

    2016-06-01

    Full Text Available Green roofs are among the passive building systems that contribute to the thermal stability of the rooms under the roof in both summer and winter. Green roofs can provide a significant contribution to the thermal balance of the protected space. Over the past ten years, many studies have been carried out to investigate the energy benefits of green roofs in terms of the energy performance of buildings. These studies show that the installation of vegetated cover can achieve energy savings for both winter heating and summer cooling. The green roof, as a thermal insulation, reduces the amount of building operating energy costs and reduces heat losses. This article summarizes current literature and points to situations in which green roofs can play an important role in saving energy for heating and cooling due to improved thermal insulating function of the roof, in case of extensive vegetation coverage without significant overloading of the roof structure and associated over-dimensioning. It is important to note that these energy savings always depend on the particular climate, the type of building and the availability and the type of roof structure.

  3. Optimum value engineering and integrated design methods for reducing the cost of R-2000 houses

    Energy Technology Data Exchange (ETDEWEB)

    Proskiw, G. [Proskiw Engineering Ltd., Winnipeg, MB (Canada); Parekh, A. [Natural Resources Canada, Ottawa, ON (Canada)

    2009-07-01

    Opportunities exist to reduce the incremental cost of R-2000 construction by using optimum value engineering (OVE) and integrated design (ID) techniques. OVE is a construction philosophy in which components and systems are designed to meet their intended purposes without excessive or unnecessary use of resources. This paper summarized a study that was designed to identify opportunities for reducing the costs of R-2000 houses while improving their performance. These included detailed energy and cost analysis of various OVE/ID options which were then applied to a sample of 18 representative new home designs from British Columbia, Manitoba, and New Brunswick. The paper described the OVE/ID measures studied, cost analysis, measure utilization and energy analysis. It also included a detailed discussion of individual OVE/ID measures. Examples of some of these measures were the elimination of floor system cross-bridging; support of non-load bearing partition walls; engineered wood beams; drywall clips at corners; and non-load bearing partition walls. It was concluded that significant opportunities exist to reduce the incremental cost of R-2000 houses through careful application of OVE and ID practices. 5 refs., 4 tabs., 1 fig.

  4. A Cost Model for Integrated Logistic Support Activities

    Directory of Open Access Journals (Sweden)

    M. Elena Nenni

    2013-01-01

    Full Text Available An Integrated Logistic Support (ILS service has the objective of improving a system’s efficiency and availability for the life cycle. The system constructor offers the service to the customer, and she becomes the Contractor Logistic Support (CLS. The aim of this paper is to propose an approach to support the CLS in the budget formulation. Specific goals of the model are the provision of the annual cost of ILS activities through a specific cost model and a comprehensive examination of expected benefits, costs and savings under alternative ILS strategies. A simple example derived from an industrial application is also provided to illustrate the idea. Scientific literature is lacking in the topic and documents from the military are just dealing with the issue of performance measurement. Moreover, they are obviously focused on the customer’s perspective. Other scientific papers are general and focused only on maintenance or life cycle management. The model developed in this paper approaches the problem from the perspective of the CLS, and it is specifically tailored on the main issues of an ILS service.

  5. A U.K. cost-benefit analysis of circles of support and accountability interventions.

    Science.gov (United States)

    Elliott, Ian A; Beech, Anthony R

    2013-06-01

    Circles of Support and Accountability (CoSA) aim to augment sex offender risk management at the point of community reentry by facilitating "Circles" of volunteers who provide support, guidance, and advice, while ensuring that the offender remains accountable for their actions. In this study, the authors provide (a) a rapid evidence assessment of the effectiveness of CoSA in reducing reoffending, and (b) a U.K. cost-benefit analysis for CoSA when compared to the criminal justice costs of reoffending. From the study analysis, the average cost of a "Circle" was estimated to be £11,303 per annum and appears to produce a 50% reduction in reoffending (sexual and nonsexual), as the estimated cost of reoffending was estimated to be £147,161 per offender, per annum. Based on a hypothetical cohort of 100 offenders--50 of whom receive CoSA and 50 of whom do not--investment in CoSA appears to provide a cost saving of £23,494 and a benefit-cost ratio of 1.04. Accounting for estimates that the full extent of the cost to society may be 5 to 10 times the tangible costs substantially increases estimated cost savings related to CoSA.

  6. An assessment of monitoring requirements and costs of 'Reduced Emissions from Deforestation and Degradation'

    Directory of Open Access Journals (Sweden)

    McCallum Ian

    2009-08-01

    Full Text Available Abstract Background Negotiations on a future climate policy framework addressing Reduced Emissions from Deforestation and Degradation (REDD are ongoing. Regardless of how such a framework will be designed, many technical solutions of estimating forest cover and forest carbon stock change exist to support policy in monitoring and accounting. These technologies typically combine remotely sensed data with ground-based inventories. In this article we assess the costs of monitoring REDD based on available technologies and requirements associated with key elements of REDD policy. Results We find that the design of a REDD policy framework (and specifically its rules can have a significant impact on monitoring costs. Costs may vary from 0.5 to 550 US$ per square kilometre depending on the required precision of carbon stock and area change detection. Moreover, they follow economies of scale, i.e. single country or project solutions will face relatively higher monitoring costs. Conclusion Although monitoring costs are relatively small compared to other cost items within a REDD system, they should be shared not only among countries but also among sectors, because an integrated monitoring system would have multiple benefits for non-REDD management. Overcoming initialization costs and unequal access to monitoring technologies is crucial for implementation of an integrated monitoring system, and demands for international cooperation.

  7. Contracting and project strategy to reduce the costs

    International Nuclear Information System (INIS)

    Moum, I.O.; Mosbergvik, O.A.

    1995-01-01

    The Norwegian oil industry has developed and grown to a significant size from the 1970's through the 80's, and numerous large fields were developed under a business environment with high oil prices. The technological challenges were significant, but the expectation of high volumes of produced oil and increasing oil prices, secured the funding for development of these large fields. Today this situation is dramatically changed, and the low oil price alone would make it uneconomic to develop the new fields. In addition to low oil prices, people are now also facing smaller reservoirs, deeper water and more sever environmental conditions. The general competitiveness of the Norwegian Continental Shelf is challenged. Many initiatives have been launched in Norway to support the necessary improvements in business performance. The Norwegian oil and gas industry together with the authorities have through 1994 worked together in the NORSOK initiative to identify means to save 40--50% in cost and time for development of new fields. The industry has developed new technology. The authorities have been addressing the fiscal conditions and general framework for the oil companies, and several areas of improvement have been identified and to some degree implemented by the operators. The most important improvements are probably those that are directly implemented in actual development projects, and Statoil/Kvaerner have together some joint experiences that can illustrate how such ideas successfully can be implemented

  8. Autonomous exoskeleton reduces metabolic cost of human walking.

    Science.gov (United States)

    Mooney, Luke M; Rouse, Elliott J; Herr, Hugh M

    2014-11-03

    Passive exoskeletons that assist with human locomotion are often lightweight and compact, but are unable to provide net mechanical power to the exoskeletal wearer. In contrast, powered exoskeletons often provide biologically appropriate levels of mechanical power, but the size and mass of their actuator/power source designs often lead to heavy and unwieldy devices. In this study, we extend the design and evaluation of a lightweight and powerful autonomous exoskeleton evaluated for loaded walking in (J Neuroeng Rehab 11:80, 2014) to the case of unloaded walking conditions. The metabolic energy consumption of seven study participants (85 ± 12 kg body mass) was measured while walking on a level treadmill at 1.4 m/s. Testing conditions included not wearing the exoskeleton and wearing the exoskeleton, in both powered and unpowered modes. When averaged across the gait cycle, the autonomous exoskeleton applied a mean positive mechanical power of 26 ± 1 W (13 W per ankle) with 2.12 kg of added exoskeletal foot-shank mass (1.06 kg per leg). Use of the leg exoskeleton significantly reduced the metabolic cost of walking by 35 ± 13 W, which was an improvement of 10 ± 3% (p = 0.023) relative to the control condition of not wearing the exoskeleton. The results of this study highlight the advantages of developing lightweight and powerful exoskeletons that can comfortably assist the body during walking.

  9. Cost-effectiveness of school support for orphan girls to prevent HIV infection in Zimbabwe.

    Science.gov (United States)

    Miller, Ted; Hallfors, Denise; Cho, Hyunsan; Luseno, Winnie; Waehrer, Geetha

    2013-10-01

    This cost-effectiveness study analyzes the cost per quality-adjusted life year (QALY) gained in a randomized controlled trial that tested school support as a structural intervention to prevent HIV risk factors among Zimbabwe orphan girl adolescents. The intervention significantly reduced early marriage, increased years of schooling completed, and increased health-related quality of life. By reducing early marriage, the literature suggests the intervention reduced HIV infection. The intervention yielded an estimated US$1,472 in societal benefits and an estimated gain of 0.36 QALYs per orphan supported. It cost an estimated US$6/QALY gained, about 1 % of annual per capita income in Zimbabwe. That is well below the maximum price that the World Health Organization (WHO) Commission on Macroeconomics and Health recommends paying for health gains in low and middle income countries. About half the girls in the intervention condition were boarded when they reached high school. For non-boarders, the intervention's financial benefits exceeded its costs, yielding an estimated net cost savings of $502 per pupil. Without boarding, the intervention would yield net savings even if it were 34 % less effective in replication. Boarding was not cost-effective. It cost an additional $1,234 per girl boarded (over the 3 years of the study, discounted to present value at a 3 % discount rate) but had no effect on any of the outcome measures relative to girls in the treatment group who did not board. For girls who did not board, the average cost of approximately 3 years of school support was US$973.

  10. A seismic performance and cost comparison of top and bottom supported liquid metal reactor vessels

    International Nuclear Information System (INIS)

    Carlson, T.M.; Kiciman, O.K.; Petrozelli, J.F.

    1989-01-01

    It is the premise of this paper that the revision of a pool LMR from a TSRV configuration to a specific bottom supported reactor vessel (BSRV) configuration can resolve the above TSRV disadvantages related to load path length and diversity, thereby improving seismic performance and simultaneously reducing RV block costs by reducing weights. This paper demonstrates this premise by comparing a reference TSRV block with a specific BSRV block design. Recent capital cost estimates ($/kWe) for U.S. liquid metal reactor (LMR) plant designs reveal that the balance of plant costs could be reduced below that of the balance of plant costs for a comparable light water reactor plant. However, in regions of high seismicity, non-seismically isolated LMR nuclear steam supply system weights are costs per kWe are two to three times the weights and costs of light water reactor nuclear steam supply systems. While all portions of the LMR nuclear steam supply system require examination for potential cost reductions, the focus of this paper is the reactor vessel (RV) block for a large pool plant

  11. Health care development: integrating transaction cost theory with social support theory.

    Science.gov (United States)

    Hajli, M Nick; Shanmugam, Mohana; Hajli, Ali; Khani, Amir Hossein; Wang, Yichuan

    2014-07-28

    The emergence of Web 2.0 technologies has already been influential in many industries, and Web 2.0 applications are now beginning to have an impact on health care. These new technologies offer a promising approach for shaping the future of modern health care, with the potential for opening up new opportunities for the health care industry as it struggles to deal with challenges including the need to cut costs, the increasing demand for health services and the increasing cost of medical technology. Social media such as social networking sites are attracting more individuals to online health communities, contributing to an increase in the productivity of modern health care and reducing transaction costs. This study therefore examines the potential effect of social technologies, particularly social media, on health care development by adopting a social support/transaction cost perspective. Viewed through the lens of Information Systems, social support and transaction cost theories indicate that social media, particularly online health communities, positively support health care development. The results show that individuals join online health communities to share and receive social support, and these social interactions provide both informational and emotional support.

  12. Increasing Air Compressor Productivity While Reducing Maintenance and Repair Costs

    National Research Council Canada - National Science Library

    Foss, R. S

    1993-01-01

    .... When this vital utility is put into this perspective we can start to deal with the considerations of systems engineering, planning, performance evaluation, cost control and preventive maintenance...

  13. Lean Six Sigma for Reduced Cycle Costs and Improved Readiness

    National Research Council Canada - National Science Library

    Apte, Uday; Kang, Keebom

    2006-01-01

    ... it. Hence, efficient logistics systems, including transportation, inventory management, modifications and maintenance activities, are critically important for containing the lifecycle costs of weapon...

  14. Energy-efficient induction motors designing with application of a modified criterion of reduced costs

    Directory of Open Access Journals (Sweden)

    V.S. Petrushin

    2014-03-01

    Full Text Available The paper introduces a modified criterion of reduced costs that employs coefficients of operation significance and priority of ohmic loss accounting to allow matching maximum efficiency with minimum reduced costs. Impact of the inflation factor on the criterion of reduced costs is analyzed.

  15. Cellulose-Supported Ionic Liquids for Low-Cost Pressure Swing CO{sub 2} Capture

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Daniel G.; Dowson, George R. M.; Styring, Peter, E-mail: p.styring@sheffield.ac.uk [UK Centre for Carbon Dioxide Utilisation, Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield (United Kingdom)

    2017-07-07

    Reducing the cost of capturing CO{sub 2} from point source emitters is a major challenge facing carbon capture, utilization, and storage. While solid ionic liquids (SoILs) have been shown to allow selective and rapid CO{sub 2} capture by pressure swing separation of flue gases, expectations of their high cost hinders their potential application. Cellulose is found to be a reliable, cheap, and sustainable support for a range of SoILs, reducing the total sorbent cost by improving the efficiency of the ionic liquid (IL) through increased ionic surface area that results from coating. It was also found that cellulose support imparts surface characteristics, which increased total sorbent uptake. Combined, these effects allowed a fourfold to eightfold improvement in uptake per gram of IL for SoILs that have previously shown high uptake and a 9- to 39-fold improvement for those with previously poor uptake. This offers the potential to drastically reduce the amount of IL required to separate a given gas volume. Furthermore, the fast kinetics are retained, with adsorb–desorb cycles taking place over a matter of seconds. This means that rapid cycling can be achieved, which results in high cumulative separation capacity relative to a conventional temperature swing process. The supported materials show an optimum at 75% cellulose:25% IL as a result of even coating of the cellulose surface. The projected reduction in plant size and operational costs represents a potentially ground-breaking step forward in carbon dioxide capture technologies.

  16. Using preventive home monitoring to reduce hospital admission rates and reduce costs

    DEFF Research Database (Denmark)

    Dinesen, Birthe Irene; Haesum, Lisa K E; Soerensen, Natascha

    2012-01-01

    We studied whether preventive home monitoring of patients with chronic obstructive pulmonary disease (COPD) could reduce the frequency of hospital admissions and lower the cost of hospitalization. Patients were recruited from a health centre, general practitioner (GP) or the pulmonary hospital ward....... They were randomized to usual care or tele-rehabilitation with a telehealth monitoring device installed in their home for four months. A total of 111 patients were suitable for inclusion and consented to be randomized: 60 patients were allocated to intervention and three were lost to follow...... of admissions was €3461 per patient in the intervention group and €4576 in the control group; this difference was not significant. The Kaplan-Meier estimates for time to hospital admission were longer for the intervention group than the controls, but the difference was not significant. Future work requires...

  17. Reducing costs while maintaining quality in endovascular neurosurgical procedures.

    Science.gov (United States)

    Kashlan, Osama N; Wilson, Thomas J; Chaudhary, Neeraj; Gemmete, Joseph J; Stetler, William R; Dunnick, N Reed; Thompson, B Gregory; Pandey, Aditya S

    2014-11-01

    As medical costs continue to rise during a time of increasing medical resource utilization, both hospitals and physicians must attempt to limit superfluous health care expenses. Neurointerventional treatment has been shown to be costly, but it is often the best treatment available for certain neuropathologies. The authors studied the effects of 3 policy changes designed to limit the costs of performing neurointerventional procedures at the University of Michigan. The authors retrospectively analyzed the costs of performing neurointerventional procedures during the 6-month periods before and after the implementation of 3 cost-saving policies: 1) the use of an alternative, more economical contrast agent, 2) standardization of coil prices through negotiation with industry representatives to receive economies of scale, and 3) institution of a feedback method to show practitioners the costs of unused products per patient procedure. The costs during the 6-month time intervals before and after implementation were also compared with costs during the most recent 6-month time period. The policy requiring use of a more economical contrast agent led to a decrease in the cost of contrast usage of $42.79 per procedure for the first 6 months after implementation, and $137.09 per procedure for the most current 6-month period, resulting in an estimated total savings of $62,924.31 for the most recent 6-month period. The standardized coil pricing system led to savings of $159.21 per coil after the policy change, and $188.07 per coil in the most recent 6-month period. This yielded total estimated savings of $76,732.56 during the most recent 6-month period. The feedback system for unused items decreased the cost of wasted products by approximately $44.36 per procedure in the 6 months directly after the policy change and by $48.20 per procedure in the most recent 6-month period, leading to total estimated savings of $22,123.80 during the most recent 6-month period. According to

  18. iHadoop: Asynchronous Iterations Support for MapReduce

    KAUST Repository

    Elnikety, Eslam

    2011-08-01

    MapReduce is a distributed programming framework designed to ease the development of scalable data-intensive applications for large clusters of commodity machines. Most machine learning and data mining applications involve iterative computations over large datasets, such as the Web hyperlink structures and social network graphs. Yet, the MapReduce model does not efficiently support this important class of applications. The architecture of MapReduce, most critically its dataflow techniques and task scheduling, is completely unaware of the nature of iterative applications; tasks are scheduled according to a policy that optimizes the execution for a single iteration which wastes bandwidth, I/O, and CPU cycles when compared with an optimal execution for a consecutive set of iterations. This work presents iHadoop, a modified MapReduce model, and an associated implementation, optimized for iterative computations. The iHadoop model schedules iterations asynchronously. It connects the output of one iteration to the next, allowing both to process their data concurrently. iHadoop\\'s task scheduler exploits inter- iteration data locality by scheduling tasks that exhibit a producer/consumer relation on the same physical machine allowing a fast local data transfer. For those iterative applications that require satisfying certain criteria before termination, iHadoop runs the check concurrently during the execution of the subsequent iteration to further reduce the application\\'s latency. This thesis also describes our implementation of the iHadoop model, and evaluates its performance against Hadoop, the widely used open source implementation of MapReduce. Experiments using different data analysis applications over real-world and synthetic datasets show that iHadoop performs better than Hadoop for iterative algorithms, reducing execution time of iterative applications by 25% on average. Furthermore, integrating iHadoop with HaLoop, a variant Hadoop implementation that caches

  19. Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing.

    Science.gov (United States)

    Cereda, Emanuele; Klersy, Catherine; Andreola, Manuela; Pisati, Roberto; Schols, Jos M G A; Caccialanza, Riccardo; D'Andrea, Federico

    2017-02-01

    The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric-isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. This economic evaluation - from a local healthcare system perspective - was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Although the experimental formula was more expensive (mean difference: 39.4 Euros; P costs of local PU care (difference, -74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  20. Reduced Cost Composite Hot Structures with Oxidation Protection, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Innovative, low cost high performance technologies are critical to the affordability of future space missions. Carbon/carbon (C/C) composites have significant...

  1. Reducing Operating Costs and Energy Consumption at Water Utilities

    Science.gov (United States)

    Due to their unique combination of high energy usage and potential for significant savings, utilities are turning to energy-efficient technologies to help save money. Learn about cost and energy saving technologies from this brochure.

  2. Reducing Operating Costs by Optimizing Space in Facilities

    Science.gov (United States)

    2012-03-01

    Design: Mapping the High Performance Workscape. Jossey-Bass. San Francisco. Berkman, Elliot. (2012). A Conceptual Guide to Statistics using SPSS. Sage ...Cleaning: Includes labor costs for in-house and contract service, payroll , taxes and fringe benefits, plus salaried supervisors and managers, as well as...Labor costs include payroll , taxes and fringe benefits for employees and contracted workers. Personnel include operating engineers, general

  3. Reducing Inventory System Costs by Using Robust Demand Estimators

    OpenAIRE

    Raymond A. Jacobs; Harvey M. Wagner

    1989-01-01

    Applications of inventory theory typically use historical data to estimate demand distribution parameters. Imprecise knowledge of the demand distribution adds to the usual replenishment costs associated with stochastic demands. Only limited research has been directed at the problem of choosing cost effective statistical procedures for estimating these parameters. Available theoretical findings on estimating the demand parameters for (s, S) inventory replenishment policies are limited by their...

  4. Case drilling - an innovative approach to reducing drilling costs

    Energy Technology Data Exchange (ETDEWEB)

    Madell, G.; Tessari, R. M. [Tesco Corp., Calgary, AB (Canada); Warren, T. [Tesco Drilling Technology, Calgary, AB (Canada)

    1999-11-01

    Casing drilling is introduced as a new drilling technique that uses standard oil field casing to simultaneously drill and case the well. The technology includes both rig and downhole equipment, customized to function effectively as an integrated drilling system. This paper describes the testing program designed to identify and overcome technical challenges. Although not fully optimized, it appears that the system is functional. Test results indicate the need for improvements in the pump down cement float equipment and the tools and procedures for drilling up the cement plugs. The pump down latch and retrieval system also needs to be further developed and tested for high angle directional applications. Cost savings in the range of 10 to 15 per cent are expected for trouble-free wells. By eliminating the cost of unscheduled events encountered in troublesome wells, cost savings may reach as high as 30 per cent. 3 refs., 7 figs.

  5. Early appendectomy reduces costs in children with perforated appendicitis.

    Science.gov (United States)

    Church, Joseph T; Klein, Edwin J; Carr, Benjamin D; Bruch, Steven W

    2017-12-01

    Perforated appendicitis can be managed with early appendectomy, or nonoperative management followed by interval appendectomy. We aimed to identify the strategy with the lowest health care utilization and cost. We retrospectively reviewed the medical records of all children ≤18 years old with perforated appendicitis admitted to a single institution between January 2009 and March 2016. After excluding immunosuppressed patients and transfers from outside hospitals, we grouped the remaining patients by early or interval appendectomy. Cost accounting data were obtained from our institutional database. The primary outcome was total hospital cost over 2 y from initial admission for appendicitis. Other outcomes analyzed included initial admission costs, number of admissions, emergency room and clinic visits, percutaneous procedures, cross-sectional and overall imaging studies, and length of stay. A total of 203 children with perforated appendicitis were identified. After exclusion of immunosuppressed patients and outside hospital transfers, 94 patients were included in the study. Thirty-nine underwent early appendectomy and 55 initial nonoperative management; of these, 54 underwent elective interval appendectomy. Five of 55 patients (9%) failed initial nonoperative management and required earlier-than-planned appendectomy. Total cost over 2 y was significantly lower with early appendectomy than initial nonoperative management ($19,300 ± 14,300 versus $26,000 ± 17,500; P = 0.05). Early appendectomy resulted in fewer hospital admissions, clinic visits, invasive procedures, and imaging studies. Early appendectomy results in lower hospital costs and less health care utilization compared with initial nonoperative management with elective interval appendectomy. A prospective study will shed more light on this question and can assess the role of nonoperative management without interval appendectomy in children with perforated appendicitis. Copyright © 2017 Elsevier

  6. Costs reduced by innovative plastic distribution pipe use

    International Nuclear Information System (INIS)

    Maxwell, F.W.

    1995-01-01

    As part of a strategic corporate cost-reduction initiative, Pacific Gas and Electric Company's Gas Distribution Group has achieved some quick but significant cash savings. System design, construction, and the purchasing function were areas that produced some fast paybacks while maintaining reliability and safety. The primary savings were made by optimizing pipe specifications to match system operating parameters. This allowed the use of smaller diameter pipes and/or thinner wall pipes which conserved the materials cost of the pipeline. Other realized savings in the form of coiled pipe, purchasing changes, and backfilling specifications are also described

  7. A parametric cost model for estimating operating and support costs of US Navy (non-nuclear) surface ships

    OpenAIRE

    Brandt, James M.

    1999-01-01

    Approved for public release; distribution is unlimited With few effective decision-making tools to assess the affordability of major weapon systems, management of total ownership costs is continually misunderstood. Cost analysis provides a quick and reliable assessment of affordability. Because there is no standardized method for calculating reliable estimates of operating and support (O&S) costs (the principal component of total ownership cost), this thesis formulates a parametric cost mo...

  8. Reducing carbon transaction costs in community based forest management

    NARCIS (Netherlands)

    Skutsch, Margaret

    The paper considers the potential for community based forest management (of existing forests) in developing countries, as a future CDM strategy, to sequester carbon and claim credits in future commitment periods. This kind of forestry is cost effective, and should bring many more benefits to local

  9. Management Science/Industrial Engineering Techniques to Reduce Food Costs.

    Science.gov (United States)

    Greenberg, Murray

    This paper examines the contributions of Industrial Engineering and Management Science toward reduction in the cost of production and distribution of food. Food processing firms were requested to respond to a questionnaire which asked for examples of their use of various operations research tools and information on the number of operations…

  10. Target Context Specification Can Reduce Costs in Nonfocal Prospective Memory

    Science.gov (United States)

    Lourenço, Joana S.; White, Katherine; Maylor, Elizabeth A.

    2013-01-01

    Performing a nonfocal prospective memory (PM) task results in a cost to ongoing task processing, but the precise nature of the monitoring processes involved remains unclear. We investigated whether target context specification (i.e., explicitly associating the PM target with a subset of ongoing stimuli) can trigger trial-by-trial changes in task…

  11. Reducing Building HVAC Costs with Site-Recovery Energy

    Science.gov (United States)

    Pargeter, Stephen J.

    2012-01-01

    Building owners are caught between two powerful forces--the need to lower energy costs and the need to meet or exceed outdoor air ventilation regulations for occupant health and comfort. Large amounts of energy are wasted each day from commercial, institutional, and government building sites as heating, ventilation, and air conditioning (HVAC)…

  12. EOS Operations Systems: EDOS Implemented Changes to Reduce Operations Costs

    Science.gov (United States)

    Cordier, Guy R.; Gomez-Rosa, Carlos; McLemore, Bruce D.

    2007-01-01

    The authors describe in this paper the progress achieved to-date with the reengineering of the Earth Observing System (EOS) Data and Operations System (EDOS), the experience gained in the process and the ensuing reduction of ground systems operations costs. The reengineering effort included a major methodology change, applying to an existing schedule driven system, a data-driven system approach.

  13. Cost and cost-effectiveness analysis of a community mobilisation intervention to reduce intimate partner violence in Kampala, Uganda.

    Science.gov (United States)

    Michaels-Igbokwe, Christine; Abramsky, Tanya; Devries, Karen; Michau, Lori; Musuya, Tina; Watts, Charlotte

    2016-02-29

    Intimate partner violence (IPV) poses a major public health concern. To date there are few rigorous economic evaluations of interventions aimed at preventing IPV in low-income settings. This study provides a cost and cost effectiveness analysis of SASA!, a community mobilisation intervention to change social norms and prevent IPV. An economic evaluation alongside a cluster randomised controlled trial. Both financial and economic costs were collected retrospectively from the provider's perspective to generate total and unit cost estimates over four years of intervention programming. Univariate sensitivity analysis is conducted to estimate the impact of uncertainty in cost and outcome measures on results. The total cost of developing the SASA! Activist Kit is estimated as US$138,598. Total intervention costs over four years are estimated as US$553,252. The annual cost of supporting 351 activists to conduct SASA! activities was approximately US$389 per activist and the average cost per person reached in intervention communities was US$21 over the full course of the intervention, or US$5 annually. The primary trial outcome was past year experience of physical IPV with an estimated 1201 cases averted (90% CI: 97-2307 cases averted). The estimated cost per case of past year IPV averted was US$460. This study provides the first economic evaluation of a community mobilisation intervention aimed at preventing IPV. SASA! unit costs compare favourably with gender transformative interventions and support services for survivors of IPV. ClinicalTrials.gov # NCT00790959.

  14. The relative cost of bent-hip bent-knee walking is reduced in water.

    Science.gov (United States)

    Kuliukas, Algis V; Milne, Nick; Fournier, Paul

    2009-01-01

    The debate about how early hominids walked may be characterised as two competing hypotheses: They moved with a fully upright (FU) gait, like modern humans, or with a bent-hip, bent-knee (BK) gait, like apes. Both have assumed that this bipedalism was almost exclusively on land, in trees or a combination of the two. Recent findings favoured the FU hypothesis by showing that the BK gait is 50-60% more energetically costly than a FU human gait on land. We confirm these findings but show that in water this cost differential is markedly reduced, especially in deeper water, at slower speeds and with greater knee flexion. These data suggest that the controversy about australopithecine locomotion may be eased if it is assumed that wading was a component of their locomotor repertoire and supports the idea that shallow water might have been an environment favourable to the evolution of early forms of "non-optimal" hominid bipedalism.

  15. How to Reduce Those Costly School Bus Accidents.

    Science.gov (United States)

    Farmer, Ernest

    1985-01-01

    The deterrent to school bus accidents is preparedness. Training programs for drivers and mechanics, equipment specifications, and a community support base are some of the ways to prevent tragedy. (MLF)

  16. Lean Six Sigma for reduced cycle costs and improved readiness

    OpenAIRE

    Apte, Uday; Kang, Keebom

    2006-01-01

    Sponsored Report (for Acquisition Research Program) In general, during the lifecycle of a weapon system a significantly larger amount of money gets spent in operating and maintaining the system than acquiring it. Hence, efficient logistics systems, including transportation, inventory management, modifications and maintenance activities, are critically important for containing the lifecycle costs of weapon systems and for maintaining the highest level of military readiness given the extant ...

  17. Strategies and costs for reducing CO2 emissions in Finland

    International Nuclear Information System (INIS)

    Lehtilae, A.; Pirilae, P.

    1993-01-01

    In this study cost-efficient measures for the abatement of energy-related CO 2 emissions in Finland are analyzed, and the direct costs of such measures are estimated. The time frame considered is the period up to the year 2010. Furthermore, the probable impacts of an energy/CO 2 -tax on the Finnish energy system are worked out, and an attempt is made to assess the effectiveness of a tax scheme as an economic instrument for achieving CO 2 emission targets. The primary methodological tool in the analyses has been the model of the Finnish energy system developed at the Technical Research Centre of Finland (VTT) within the project. The model facilitates the search for cost-efficient emission control strategies over a period of several decades. Structural and technological changes in the energy system, e.g. fuel and technology substitution, new technologies, efficiency improvements, and energy-saving measures have been allowed for in the model. The results of the analyses show that achieving the target of returning the CO 2 emissions to the 1990 level by the year 2000 would be very difficult and costly in Finland. In the case of a nuclear moratorium it would be reasonable to delay the target by ten years. Even in the delayed cases achieving the target would require extensive structural changes and substantial energy-saving measures in the absence of additional nuclear energy. Coal use would have to be severely restricted, whereas the use of biomass and natural gas should be more than doubled compared to the 1990 levels. According to the results, a CO 2 tax would clearly be a more efficient instrument than a tax based on the energy content of a fuel

  18. Does Prescription Drug Adherence Reduce Hospitalizations and Costs?

    OpenAIRE

    William Encinosa; Didem Bernard; Avi Dor

    2010-01-01

    We estimate the impact of diabetic drug adherence on hospitalizations, ER visits, and hospital costs, using insurance claims from MarketScan® employer data. However, it is often difficult to measure the impact of drug adherence on hospitalizations since both adherence and hospitalizations may be correlated with unobservable patient severity. We control for such unobservables using propensity score methods and instrumental variables for adherence such as drug coinsurance levels and direct-to- ...

  19. Support and Against Historical Cost Accounting: is IT Value Relevance for Decision Making?

    OpenAIRE

    Rahmawati, Evi

    2006-01-01

    This paper reviews the issues on the support and criticism of historical cost accounting (HCA) and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of economic condit...

  20. Support and Against Historical Cost Accounting: is IT Value Relevance for Decision Making?

    OpenAIRE

    Rahmawati, Evi

    2006-01-01

    This paper reviews the issues on the support and criticism of historical cost accounting (HCA) and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of  economic condit...

  1. Cost and cost effectiveness of vaginal progesterone gel in reducing preterm birth: an economic analysis of the PREGNANT trial.

    Science.gov (United States)

    Pizzi, Laura T; Seligman, Neil S; Baxter, Jason K; Jutkowitz, Eric; Berghella, Vincenzo

    2014-05-01

    Preterm birth (PTB) is a costly public health problem in the USA. The PREGNANT trial tested the efficacy of vaginal progesterone (VP) 8 % gel in reducing the likelihood of PTB among women with a short cervix. We calculated the costs and cost effectiveness of VP gel versus placebo using decision analytic models informed by PREGNANT patient-level data. PREGNANT enrolled 459 pregnant women with a cervical length of 10-20 mm and randomized them to either VP 8 % gel or placebo. We used a cost model to estimate the total cost of treatment per mother and a cost-effectiveness model to estimate the cost per PTB averted with VP gel versus placebo. Patient-level trial data informed model inputs and included PTB rates in low- and high-risk women in each study group at <28 weeks gestation, 28-31, 32-36, and ≥37 weeks. Cost assumptions were based on 2010 US healthcare services reimbursements. The cost model was validated against patient-level data. Sensitivity analyses were used to test the robustness of the cost-effectiveness model. The estimated cost per mother was $US23,079 for VP gel and $US36,436 for placebo. The cost-effectiveness model showed savings of $US24,071 per PTB averted with VP gel. VP gel realized cost savings and cost effectiveness in 79 % of simulations. Based on findings from PREGNANT, VP gel was associated with cost savings and cost effectiveness compared with placebo. Future trials designed to include cost metrics are needed to better understand the value of VP.

  2. A crisis management decision support system to reduce ingestion dose

    International Nuclear Information System (INIS)

    Schenker-Wicki, A.; Gibbert, R.

    1993-01-01

    Environmental accidents such as extensive radioactive or chemical contamination can have more serious consequences for a population than any other kind of accidents known before. Owing to the serious consequences and the high number of people who may be affected, the selection of the best countermeasures to ameliorate the imminent impact is very difficult and the political responsibility is enormous. To help overcome such problems the National Emergency Operations Center in Zurich (Switzerland) has developed a decision support system to evaluate acceptable countermeasures for reducing ingestion dose after an accidental release of radioactive material. The system involves all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory as well as the necessary structuring of the decision-making process. The decision-making concept comprehends decision making on two different levels, a technical and a political one. (author)

  3. Cost benchmarking of railway projects in Europe – can it help to reduce costs?

    DEFF Research Database (Denmark)

    Trabo, Inara; Landex, Alex; Nielsen, Otto Anker

    a certain overview of the range of costs in various budget disciplines. The Copenhagen-Ringsted project is shown to be right in the middle of the range in terms of total costs per kilometre, and its values in the discipline comparisons do not significantly differ from the values of the less expensive...... projects. Deeper analysis of project unit costs is still continuing, but the preliminary results show that the cost values for projects located in the same geographical zone are similar. For example, this can be explained by their use of the same construction companies. However, unit prices in southern...

  4. 48 CFR 5152.245-9001 - Government property for installation support services (cost-reimbursement contracts).

    Science.gov (United States)

    2010-10-01

    ... installation support services (cost-reimbursement contracts). 5152.245-9001 Section 5152.245-9001 Federal... CONTRACT CLAUSES 5152.245-9001 Government property for installation support services (cost-reimbursement... Installation Support Services (Cost-Reimbursement Contracts) (OCT 1989) (DEV) (a) Government-furnished property...

  5. A New Remote Communications Link to Reduce Residential PV Solar Costs

    Energy Technology Data Exchange (ETDEWEB)

    King, Randy [Operant Solar Corporation,CA (United States); Sugiyama, Rod [Operant Solar Corporation,CA (United States)

    2017-12-11

    Monitoring of PV/DER site production is expensive to install and unreliable. Among third party systems providers, lost communications links are a growing concern. Nearly 20% of links are failing, provisioning is complex, recovery is expensive, production data is lost, and access is fragmented. FleetLink is a new concept in DER system communications, purpose built for lowering the cost of maintaining active contact with residential end user sites and ensuring that production data is reliably available to third party systems providers. Systems providers require accurate, secure system monitoring and reporting of production data and system faults while driving down overall costs to compete effectively. This plug and play, independently operating communications solution lowers the cost of fleet contact from typically .08 dollars-$.12/W down to .02 dollars -.03/W including installation and maintenance expenses. FleetLink establishes a breakthrough in simplicity that facilitates rapid expansion of residential solar by reducing initial capital outlay and lowering installation labor time and skill levels. The solution also facilitates higher DER installation growth rates by driving down maintenance costs and eliminating communications trouble calls. This is accomplished by the FleetLink’s unique network technology that enables dynamic network configuration for fast changes, and active, self-healing DER site contact for uptime assurance. Using an open source network framework with proprietary, application specific enhancements, FleetLink independently manages connectivity, security, recovery, grid control communications, and fleet expansion while presenting a compliant SunSpec interface to the third party operations centers. The net system cost savings of at least .05 dollars/W supports the SunShot cost goals and the flexibility and scalability of the solution accelerates the velocity and ubiquitous adoption of solar.

  6. Timely Referral to Outpatient Nephrology Care Slows Progression and Reduces Treatment Costs of Chronic Kidney Diseases

    Directory of Open Access Journals (Sweden)

    Gerhard Lonnemann

    2017-03-01

    Discussion: Timely referral to outpatient nephrology care is associated with slowed disease progression, less hospital admissions, reduced total treatment costs, and improved survival in patients with CKD.

  7. A long pulse modulator for reduced size and cost

    International Nuclear Information System (INIS)

    Pfeffer, H.; Bartelson, L.; Bourkland, K.; Jensen, C.; Kerns, Q.; Prieto, P.; Saewert, G.; Wolff, D.

    1994-07-01

    A novel modulator has been designed, built and tested for the TESLA test facility. This e + e - accelerator concept uses superconducting RF cavities and requires 2ms of RF power at 10 pps. As the final accelerator will require several hundred modulators, a cost effective, space saving and high efficiency design is desired. This modulator used a modest size switched capacitor bank that droops approximately 20% during the pulse. This large droop is compensated for by the use of a resonant LC circuit. The capacitor bank is connected to the high side of a pulse transformer primary using a series GTO switch. The resonant circuit is connected to the low side of the pulse transformer primary. The output pulse is flat to within 1% for 1.9 ms during a 2.3 ms base pulse width. Measured efficiency, from breaker to klystron and including energy lost in the rise time, is approximately 85%

  8. Water quality audits can improve availability and reduce costs

    International Nuclear Information System (INIS)

    Dvorin, R.S.; Schlesinger, H.A.

    1984-01-01

    The Water Quality Audit (WQA) is an independent, detailed review and thorough analysis of an operating plant's water technology control systems and operator education (as distinguished from operator training). The need for such an audit and its role in improving the reliability and availability of both nuclear and fossil-fueled power plants is discussed. Instances of how the failure of either system hardware or operational control has caused injection of seawater, acid, caustic, or ion exchange resin into the condensate-feedwater system and steam generator are revealed. The systems to be audited are described, and the stage-wise nature of the audit explained. The potential savings of an audit are outlined and the timing and range of costs of a WQA are given

  9. Development and evaluation of low-cost walker with trunk support for senior citizen.

    Science.gov (United States)

    Poier, Paloma Hohmann; Godke, Francisco; Foggiatto, José Aguiomar; Ulbricht, Leandra

    2017-10-09

    Develop and evaluate a low-cost walker with trunk support for senior citizens. Two-stage descriptive study: development of a walker with trunk support and evaluation with fourth age senior citizens. Twenty-three fourth age senior citizens were selected. The evaluated criteria were the immediate influence of the walker on the static stabilometry with baropodometer and the evaluation of gait with accelerometers monitoring time and amplitude of the hip movement. There was a significant decrease in the body oscillation of senior citizens with the use of the developed walker, and there were changes in the joint amplitudes of the hip, but they were not significant. Using low-cost materials, it was possible to develop and equipment that met resistance and effectiveness requirements. The walker interfered in the balance of the senior citizens, reducing significantly the static body oscillation.

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

    Science.gov (United States)

    Savitz, Lucy A; Savitz, Samuel T

    2016-01-01

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

  11. Soil Segregation Methods for Reducing Transportation and Disposal Costs - 13544

    Energy Technology Data Exchange (ETDEWEB)

    Frothingham, David; Andrews, Shawn; Barker, Michelle; Boyle, James; Buechi, Stephen; Graham, Marc; Houston, Linda; Polek, Michael; Simmington, Robert; Spector, Harold [U.S. Army Corps of Engineers, Buffalo District, 1776 Niagara St., Buffalo, NY 14207 (United States); Elliott, Robert ' Dan' [U.S. Army Reserve, 812A Franklin St.,Worcester, MA 01604 (United States); Durham, Lisa [Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Ave., Argonne, IL 60439 (United States)

    2013-07-01

    At Formerly Utilized Sites Remedial Action Program (FUSRAP) sites where the selected alternative for contaminated soil is excavation and off-site disposal, the most significant budget items of the remedial action are the costs for transportation and disposal of soil at an off-site facility. At these sites, the objective is to excavate and dispose of only those soils that exceed derived concentration guideline levels. In situ soil segregation using gross gamma detectors to guide the excavation is often challenging at sites where the soil contamination is overlain by clean soil or where the contaminated soil is located in isolated, subsurface pockets. In addition, data gaps are often identified during the alternative evaluation and selection process, resulting in increased uncertainty in the extent of subsurface contamination. In response, the U.S. Army Corps of Engineers, Buffalo District is implementing ex situ soil segregation methods. At the remediated Painesville Site, soils were excavated and fed through a conveyor-belt system, which automatically segregated them into above- and below-cleanup criteria discharge piles utilizing gamma spectroscopy. At the Linde Site and the Shallow Land Disposal Area (SLDA) Site, which are both in the remediation phase, soils are initially segregated during the excavation process using gross gamma detectors and then transported to a pad for confirmatory manual surveying and sampling. At the Linde Site, the ex situ soils are analyzed on the basis of a site-specific method, to establish compliance with beneficial reuse criteria that were developed for the Linde remediation. At the SLDA Site, the ex situ soils are surveyed and sampled based on Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM) final status survey guidance to demonstrate compliance with the derived concentration guideline levels. At all three sites, the ex situ soils that meet the site- specific DCGLs are retained on-site and used as backfill

  12. Soil Segregation Methods for Reducing Transportation and Disposal Costs - 13544

    International Nuclear Information System (INIS)

    Frothingham, David; Andrews, Shawn; Barker, Michelle; Boyle, James; Buechi, Stephen; Graham, Marc; Houston, Linda; Polek, Michael; Simmington, Robert; Spector, Harold; Elliott, Robert 'Dan'; Durham, Lisa

    2013-01-01

    At Formerly Utilized Sites Remedial Action Program (FUSRAP) sites where the selected alternative for contaminated soil is excavation and off-site disposal, the most significant budget items of the remedial action are the costs for transportation and disposal of soil at an off-site facility. At these sites, the objective is to excavate and dispose of only those soils that exceed derived concentration guideline levels. In situ soil segregation using gross gamma detectors to guide the excavation is often challenging at sites where the soil contamination is overlain by clean soil or where the contaminated soil is located in isolated, subsurface pockets. In addition, data gaps are often identified during the alternative evaluation and selection process, resulting in increased uncertainty in the extent of subsurface contamination. In response, the U.S. Army Corps of Engineers, Buffalo District is implementing ex situ soil segregation methods. At the remediated Painesville Site, soils were excavated and fed through a conveyor-belt system, which automatically segregated them into above- and below-cleanup criteria discharge piles utilizing gamma spectroscopy. At the Linde Site and the Shallow Land Disposal Area (SLDA) Site, which are both in the remediation phase, soils are initially segregated during the excavation process using gross gamma detectors and then transported to a pad for confirmatory manual surveying and sampling. At the Linde Site, the ex situ soils are analyzed on the basis of a site-specific method, to establish compliance with beneficial reuse criteria that were developed for the Linde remediation. At the SLDA Site, the ex situ soils are surveyed and sampled based on Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM) final status survey guidance to demonstrate compliance with the derived concentration guideline levels. At all three sites, the ex situ soils that meet the site- specific DCGLs are retained on-site and used as backfill

  13. Nisin Production Utilizing Skimmed Milk Aiming to Reduce Process Cost

    Science.gov (United States)

    Jozala, Angela Faustino; de Andrade, Maura Sayuri; de Arauz, Luciana Juncioni; Pessoa, Adalberto; Penna, Thereza Christina Vessoni

    Nisin is a natural additive for conservation of food, pharmaceutical, and dental products and can be used as a therapeutic agent. Nisin inhibits the outgrowth of spores, the growth of a variety of Gram-positive and Gram-negative bacteria. This study was performed to optimize large-scale nisin production in skimmed milk and subproducts aiming at low-costs process and stimulating its utilization. Lactococcus lactis American Type Culture Collection (ATCC) 11454 was developed in a rotary shaker (30°C/36 h/100 rpm) in diluted skimmed milk and nisin activity, growth parameters, and media components were also studied. Nisin activity in growth media was expressed in arbitrary units (AU/mL) and converted to standard nisin concentration (Nisaplin®, 25 mg of pure nisin is 1.0×106 AU/mL). Nisin activity in skimmed milk 2.27 gtotal solids was up to threefold higher than transfers in skimmed milk 4.54 gtotal solids and was up to 85-fold higher than transfers in skimmed milk 1.14 gtotal solids. L. lactis was assayed in a New Brunswick fermentor with 1.5 L of diluted skimmed milk (2.27 gtotal solids) and airflow of 1.5 mL/min (30°C/36/200 rpm), without pH control. In this condition nisin activity was observed after 4 h (45.07 AU/mL) and in the end of 36 h process (3312.07 AU/mL). This work shows the utilization of a low-cost growth medium (diluted skimmed milk) to nisin production with wide applications. Furthermore, milk subproducts (milk whey) can be exploited in nisin production, because in Brazil 50% of milk whey is disposed with no treatment in rivers and because of high organic matter concentrations it is considered an important pollutant. In this particular case an optimized production of an antimicrobial would be lined up with industrial disposal recycling.

  14. Comparing surgical trays with redundant instruments with trays with reduced instruments: a cost analysis.

    Science.gov (United States)

    John-Baptiste, A; Sowerby, L J; Chin, C J; Martin, J; Rotenberg, B W

    2016-01-01

    When prearranged standard surgical trays contain instruments that are repeatedly unused, the redundancy can result in unnecessary health care costs. Our objective was to estimate potential savings by performing an economic evaluation comparing the cost of surgical trays with redundant instruments with surgical trays with reduced instruments ("reduced trays"). We performed a cost-analysis from the hospital perspective over a 1-year period. Using a mathematical model, we compared the direct costs of trays containing redundant instruments to reduced trays for 5 otolaryngology procedures. We incorporated data from several sources including local hospital data on surgical volume, the number of instruments on redundant and reduced trays, wages of personnel and time required to pack instruments. From the literature, we incorporated instrument depreciation costs and the time required to decontaminate an instrument. We performed 1-way sensitivity analyses on all variables, including surgical volume. Costs were estimated in 2013 Canadian dollars. The cost of redundant trays was $21 806 and the cost of reduced trays was $8803, for a 1-year cost saving of $13 003. In sensitivity analyses, cost savings ranged from $3262 to $21 395, based on the surgical volume at the institution. Variation in surgical volume resulted in a wider range of estimates, with a minimum of $3253 for low-volume to a maximum of $52 012 for high-volume institutions. Our study suggests moderate savings may be achieved by reducing surgical tray redundancy and, if applied to other surgical specialties, may result in savings to Canadian health care systems.

  15. 43 CFR 429.26 - When may Reclamation reduce or waive costs or fees?

    Science.gov (United States)

    2010-10-01

    ... Reductions or Waivers of Application Fees, Administrative Costs, and Use Fees § 429.26 When may Reclamation reduce or waive costs or fees? (a) As determined appropriate and approved and documented by the applicable Regional Director, the application fees may be waived, and charges for administrative costs or use...

  16. Preliminary analysis about reducing production costs in uranium mining and metallurgy at Fuzhou uranium mine

    International Nuclear Information System (INIS)

    Wu Sanmao

    1999-01-01

    The production costs in uranium ming and metallurgy have been analyzed quantitatively term by term according to present production situation for The Uranium Mining and Metallurgy Corp, which is part of Fuzhou Uranium Mine. The principal factors influencing on the production costs and the main means reducing the production costs have been found

  17. A Summary of: 25 Ways to Reduce the Cost of College

    Science.gov (United States)

    Center for College Affordability and Productivity (NJ1), 2010

    2010-01-01

    Almost everyone agrees that colleges have become costly to attend and are a growing burden on society to finance. Rising tuition costs threaten the ability and desire of students to attend college. Are there things that can be done to significantly reduce the cost of college? The answer is an emphatic "yes." The Center for College Affordability…

  18. Cost Analysis of the STONE Randomized Trial: Can Health Care Costs be Reduced One Test at a Time?

    Science.gov (United States)

    Melnikow, Joy; Xing, Guibo; Cox, Ginger; Leigh, Paul; Mills, Lisa; Miglioretti, Diana L; Moghadassi, Michelle; Smith-Bindman, Rebecca

    2016-04-01

    Decreasing the use of high-cost tests may reduce health care costs. To compare costs of care for patients presenting to the emergency department (ED) with suspected kidney stones randomized to 1 of 3 initial imaging tests. Patients were randomized to point-of-care ultrasound (POC US, least costly), radiology ultrasound (RAD US), or computed tomography (CT, most costly). Subsequent testing and treatment were the choice of the treating physician. A total of 2759 patients at 15 EDs were randomized to POC US (n=908), RAD US, (n=893), or CT (n=958). Mean age was 40.4 years; 51.8% were male. All medical care documented in the trial database in the 7 days following enrollment was abstracted and coded to estimate costs using national average 2012 Medicare reimbursements. Costs for initial ED care and total 7-day costs were compared using nonparametric bootstrap to account for clustering of patients within medical centers. Initial ED visit costs were modestly lower for patients assigned to RAD US: $423 ($411, $434) compared with patients assigned to CT: $448 ($438, $459) (Pcosts were not significantly different between groups: $1014 ($912, $1129) for POC US, $970 ($878, $1078) for RAD US, and $959 ($870, $1044) for CT. Hospital admissions contributed over 50% of total costs, though only 11% of patients were admitted. Mean total costs (and admission rates) varied substantially by site from $749 to $1239. Assignment to a less costly test had no impact on overall health care costs for ED patients. System-level interventions addressing variation in admission rates from the ED might have greater impact on costs.

  19. Reducing capital and operating costs in gas processing, liquefaction, and storage

    Energy Technology Data Exchange (ETDEWEB)

    Krusen, III, L C [Phillips Petroleum Co., Bartlesville, OK (United States). Research Div.

    1997-06-01

    The LNG industry is unanimous that capital costs must be reduced throughout the chain, and especially at the liquefaction facility including associated gas processing and LNG storage. The Ken ai LNG plant provides an example of how both reduced capital and operating costs were attained. This paper will cover cost production strategies that can be applied to liquefaction processes in general, and will than focus on their realization in the Phillips Optimized Cascade LNG process. The paper concludes that reduced LNG plant costs are attainable. (Author).

  20. Reducing capital and operating costs in gas processing, liquefaction, and storage

    International Nuclear Information System (INIS)

    Krusen, L.C. III

    1997-01-01

    The LNG industry is unanimous that capital costs must be reduced throughout the chain, and especially at the liquefaction facility including associated gas processing and LNG storage. The Ken ai LNG plant provides an example of how both reduced capital and operating costs were attained. This paper will cover cost production strategies that can be applied to liquefaction processes in general, and will than focus on their realization in the Phillips Optimized Cascade LNG process. The paper concludes that reduced LNG plant costs are attainable. (Author)

  1. Sound stabilizes locomotor-respiratory coupling and reduces energy cost.

    Directory of Open Access Journals (Sweden)

    Charles P Hoffmann

    Full Text Available A natural synchronization between locomotor and respiratory systems is known to exist for various species and various forms of locomotion. This Locomotor-Respiratory Coupling (LRC is fundamental for the energy transfer between the two subsystems during long duration exercise and originates from mechanical and neurological interactions. Different methodologies have been used to compute LRC, giving rise to various and often diverging results in terms of synchronization, (de-stabilization via information, and associated energy cost. In this article, the theory of nonlinear-coupled oscillators was adopted to characterize LRC, through the model of the sine circle map, and tested it in the context of cycling. Our specific focus was the sound-induced stabilization of LRC and its associated change in energy consumption. In our experimental study, participants were instructed during a cycling exercise to synchronize either their respiration or their pedaling rate with an external auditory stimulus whose rhythm corresponded to their individual preferential breathing or cycling frequencies. Results showed a significant reduction in energy expenditure with auditory stimulation, accompanied by a stabilization of LRC. The sound-induced effect was asymmetrical, with a better stabilizing influence of the metronome on the locomotor system than on the respiratory system. A modification of the respiratory frequency was indeed observed when participants cycled in synchrony with the tone, leading to a transition toward more stable frequency ratios as predicted by the sine circle map. In addition to the classical mechanical and neurological origins of LRC, here we demonstrated using the sine circle map model that information plays an important modulatory role of the synchronization, and has global energetic consequences.

  2. Reducing the Requirements and Cost of Astronomical Telescopes

    Science.gov (United States)

    Smith, W. Scott; Whitakter, Ann F. (Technical Monitor)

    2002-01-01

    Limits on astronomical telescope apertures are being rapidly approached. These limits result from logistics, increasing complexity, and finally budgetary constraints. In an historical perspective, great strides have been made in the area of aperture, adaptive optics, wavefront sensors, detectors, stellar interferometers and image reconstruction. What will be the next advances? Emerging data analysis techniques based on communication theory holds the promise of yielding more information from observational data based on significant computer post-processing. This paper explores some of the current telescope limitations and ponders the possibilities increasing the yield of scientific data based on the migration computer post-processing techniques to higher dimensions. Some of these processes hold the promise of reducing the requirements on the basic telescope hardware making the next generation of instruments more affordable.

  3. Reducing Anesthesia and Health Care Cost Through Utilization of Child Life Specialists in Pediatric Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Michael T. [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital, Miami, Florida (United States); Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida (United States); Todd, Kimberly E.; Oakley, Heather; Bradley, Julie A.; Rotondo, Ronny L.; Morris, Christopher G.; Klein, Stuart; Mendenhall, Nancy P. [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida (United States)

    2016-10-01

    therapy, where N equals the number of children aged 3 to 12 years treated in 1 year. This formula assumes that the payer subsidizes the cost for the employment of a CCLS, although our institution absorbed this expense for this data cohort. The predicted annualized health care system cost savings from reducing the frequency of anesthesia with radiation therapy when treating 100 children aged 3 to 12 years per year could exceed $775,000. Conclusions: These data suggest that a CCLS significantly reduces the frequency of daily anesthesia for children treated with radiation therapy. Health care system payers may achieve significant cost savings by financially supporting the employment of a CCLS in high-volume pediatric radiation therapy centers.

  4. Reducing Anesthesia and Health Care Cost Through Utilization of Child Life Specialists in Pediatric Radiation Oncology.

    Science.gov (United States)

    Scott, Michael T; Todd, Kimberly E; Oakley, Heather; Bradley, Julie A; Rotondo, Ronny L; Morris, Christopher G; Klein, Stuart; Mendenhall, Nancy P; Indelicato, Daniel J

    2016-10-01

    years treated in 1 year. This formula assumes that the payer subsidizes the cost for the employment of a CCLS, although our institution absorbed this expense for this data cohort. The predicted annualized health care system cost savings from reducing the frequency of anesthesia with radiation therapy when treating 100 children aged 3 to 12 years per year could exceed $775,000. These data suggest that a CCLS significantly reduces the frequency of daily anesthesia for children treated with radiation therapy. Health care system payers may achieve significant cost savings by financially supporting the employment of a CCLS in high-volume pediatric radiation therapy centers. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Reducing Anesthesia and Health Care Cost Through Utilization of Child Life Specialists in Pediatric Radiation Oncology

    International Nuclear Information System (INIS)

    Scott, Michael T.; Todd, Kimberly E.; Oakley, Heather; Bradley, Julie A.; Rotondo, Ronny L.; Morris, Christopher G.; Klein, Stuart; Mendenhall, Nancy P.; Indelicato, Daniel J.

    2016-01-01

    equals the number of children aged 3 to 12 years treated in 1 year. This formula assumes that the payer subsidizes the cost for the employment of a CCLS, although our institution absorbed this expense for this data cohort. The predicted annualized health care system cost savings from reducing the frequency of anesthesia with radiation therapy when treating 100 children aged 3 to 12 years per year could exceed $775,000. Conclusions: These data suggest that a CCLS significantly reduces the frequency of daily anesthesia for children treated with radiation therapy. Health care system payers may achieve significant cost savings by financially supporting the employment of a CCLS in high-volume pediatric radiation therapy centers.

  6. The AskIT Service Desk: A Model for Improving Productivity and Reducing Costs

    Energy Technology Data Exchange (ETDEWEB)

    Ashcraft, Phillip Lynn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Fogle, Blythe G. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Cummings, Susan M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lopez, Leon [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-29

    This was prepared for the business process improvement presentation to the Department of Energy. Los Alamos National Laboratory provides a single point of contact, the AskIT Service Desk, to address issues that impact customer productivity. At the most basic level, what customers want is for their calls to be received, to get a response from a knowledgeable analyst, and to have their issues resolved and their requests fulfilled. Providing a centralized, single point of contact service desk makes initiating technical or business support simple for the customer and improves the odds of immediately resolving the issue or correctly escalating the request to the next support level when necessary. Fulfilling customer requests through automated workflow also improves customer productivity and reduces costs. Finally, customers should be provided the option to solve their own problems through easy access to self-help resources such as frequently asked questions (FAQs) and how-to guides. To accomplish this, everyone who provides and supports services must understand how these processes and functions work together. Service providers and those who support services must “speak the same language” and share common objectives. The Associate Directorate for Business Innovation (ADBI) began the journey to improve services by selecting a known service delivery framework (Information Technology Infrastructure Library, or ITIL). From this framework, components that contribute significant business value were selected.

  7. The System 80+ standard plant design reduces operations and maintenance costs

    International Nuclear Information System (INIS)

    Chari, D.R.; Robertson, J.E.

    1998-01-01

    To be cost-competitive, nuclear power plants must maximize plant availability and minimize operations and maintenance (O and M) costs. A plant whose design supports these goals will generate more power at less cost and thereby have a lower unit generating cost. The ABB Combustion Engineering Nuclear Systems (ABB-CE) System 80+ Standard Nuclear Power Plant, rated at 1400 megawatts electric (MWe), is designed for high availability at reduced cost. To demonstrate that the duration of refueling outages, the major contributor to plant unavailability, can be shortened, ABB-CE developed a detailed plan that shows a System 80+ plant can safely perform a refueling and maintenance outage in 18 days. This is a significant reduction from the average current U.S. plant outages of 45 days, and is possible due to a two-part outage strategy: use System 80+ advanced system design features and relaxed technical specification (TS) time limits to shift some maintenance from outages to operating periods: and, use System 80+ structural, system, and component features, such as the larger operating floor, permanent pool seal, integral reactor head area cable tray system and missile shield, and longer life reactor coolant pump seals, to reduce the scope and duration of outage maintenance activities. Plant staffing level is the major variable, or controllable contributor to operations costs. ABB-CE worked with the Institute of Nuclear Power Operations (INPO) to perform detailed staffing analyses that show a System 80+ plant can be operated reliably with 30 percent less staff than currently operating nuclear plants of similar size. Safety was not sacrificed when ABB-CE developed the System 80+ refueling outage plan and staffing level. The outage plan was developed utilizing a defense-in-depth concept for shutdown safety. The defense in-depth concept is implemented via systematic control of outage risk evaluation (SCORE) cards. The SCORE cards identify primary and alternate means of

  8. Cost-benefit analysis of the Swiss national policy on reducing micropollutants in treated wastewater.

    Science.gov (United States)

    Logar, Ivana; Brouwer, Roy; Maurer, Max; Ort, Christoph

    2014-11-04

    Contamination of freshwater with micropollutants (MPs) is a growing concern worldwide. Even at very low concentrations, MPs can have adverse effects on aquatic ecosystems and possibly also on human health. Switzerland is one of the first countries to start implementing a national policy to reduce MPs in the effluents of municipal sewage treatment plants (STPs). This paper estimates the benefits of upgrading STPs based on public's stated preferences. To assess public demand for the reduction of the environmental and health risks of MPs, we conducted a choice experiment in a national online survey. The results indicate that the average willingness to pay per household is CHF 100 (US$ 73) annually for reducing the potential environmental risk of MPs to a low level. These benefits, aggregated over households in the catchment of the STPs to be upgraded, generate a total annual economic value of CHF 155 million (US$ 113 million). This compares with estimated annual costs for upgrading 123 STPs of CHF 133 million (US$ 97 million) or CHF 86 (US$ 63) per household connected to these STPs. Hence, a cost-benefit analysis justifies the investment decision from an economic point of view and supports the implementation of the national policy in the ongoing political discussion.

  9. The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

    Science.gov (United States)

    Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

    2018-02-23

    To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

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

    Science.gov (United States)

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

    2014-05-01

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

  11. Are the Costs of Reducing Greenhouse Gases from Passenger Vehicles Negative?

    OpenAIRE

    Parry, Ian W.H.

    2006-01-01

    Energy models suggest that the cost of reducing carbon emissions from the transportation sector is high relative to other sectors, such as electricity generation. However, this paper shows that taxes to reduce passenger vehicle emissions produce large net benefits, rather than costs, when account is taken of (a) their impact on reducing non-carbon externalities from passenger vehicle use, and (b) interactions with the broader fiscal system. Both of these considerations also strengthen the cas...

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

    Science.gov (United States)

    von Thiele Schwarz, Ulrica; Hasson, Henna

    2012-05-01

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

  13. Procedural-support music therapy in the healthcare setting: a cost-effectiveness analysis.

    Science.gov (United States)

    DeLoach Walworth, Darcy

    2005-08-01

    This comparative analysis examined the cost-effectiveness of music therapy as a procedural support in the pediatric healthcare setting. Many healthcare organizations are actively attempting to reduce the amount of sedation for pediatric patients undergoing various procedures. Patients receiving music therapy-assisted computerized tomography scans ( n = 57), echocardiograms ( n = 92), and other procedures ( n = 17) were included in the analysis. Results of music therapy-assisted procedures indicate successful elimination of patient sedation, reduction in procedural times, and decrease in the number of staff members present for procedures. Implications for nurses and music therapists in the healthcare setting are discussed.

  14. Age and Social Support Seeking: Understanding the Role of Perceived Social Costs to Others.

    Science.gov (United States)

    Jiang, Li; Drolet, Aimee; Kim, Heejung S

    2018-07-01

    We examined age differences in the use of different types of social support and the reasons for these differences. We found that older adults (age 60+) seek explicit social support less compared with young adults (age 18-25), but there is no difference in implicit social support seeking. Concerns about the potential social costs of seeking explicit support mediate the age differences in explicit social support seeking. Whereas young adults view this strategy as conferring more benefits than costs, older adults have a more balanced view of the costs and benefits of explicit social support seeking. Older and young adults do not differ in perceptions of the relative costs versus benefits of implicit social support seeking. Finally, we found older adults benefit more from implicit (vs. explicit) social support emotionally than young adults, which further explains why age groups differ in their use of explicit versus implicit social support.

  15. When Using Facebook to Avoid Isolation Reduces Perceived Social Support.

    Science.gov (United States)

    Lee, Eun-Ju; Cho, Eugene

    2018-01-01

    A survey (N = 316) examined how other-directed Facebook use driven by fear of social isolation affects users' perception of social support they possess. As predicted, those higher on fear of isolation were more likely to (a) closely monitor others' activities for self-evaluation (i.e., social comparison) and (b) regulate their self-presentation to garner social approval (i.e., other-directed self-presentation), but less likely to (c) express their true inner feelings and thoughts (i.e., inner-directed self-presentation) on Facebook. Social comparison, in turn, lowered perceived social support among heavy Facebook users, whereas inner-directed self-presentation heightened it. Other-directed self-presentation had no significant effect on perceived social support. Results indicate that the desire to avoid social isolation may paradoxically diminish perceived social support by promoting social comparison, while suppressing the expression of true self on Facebook.

  16. Intraoperative costs of video-assisted thoracoscopic lobectomy can be dramatically reduced without compromising outcomes.

    Science.gov (United States)

    Richardson, Michael T; Backhus, Leah M; Berry, Mark F; Vail, Daniel G; Ayers, Kelsey C; Benson, Jalen A; Bhandari, Prasha; Teymourtash, Mehran; Shrager, Joseph B

    2018-03-01

    To determine whether surgeon selection of instrumentation and other supplies during video-assisted thoracoscopic lobectomy (VATSL) can safely reduce intraoperative costs. In this retrospective, cost-focused review of all video-assisted thoracoscopic surgery anatomic lung resections performed by 2 surgeons at a single institution between 2010 and 2014, we compared VATSL hospital costs and perioperative outcomes between the surgeons, as well as costs of VATSL compared with thoracotomy lobectomy (THORL). A total of 100 VATSLs were performed by surgeon A, and 70 were performed by surgeon B. The preoperative risk factors did not differ significantly between the 2 groups of surgeries. Mean VATSL total hospital costs per case were 24% percent greater for surgeon A compared with surgeon B (P = .0026). Intraoperative supply costs accounted for most of this cost difference and were 85% greater for surgeon A compared with surgeon B (P costs, accounting for 55% of the difference in intraoperative supply costs between the surgeons. Operative time was 25% longer for surgeon A compared with surgeon B (P accounted for only 11% of the difference in total cost. Surgeon A's overall VATSL costs per case were similar to those of THORLs (n = 100) performed over the same time period, whereas surgeon B's VATSL costs per case were 24% less than those of THORLs. On adjusted analysis, there was no difference in VATSL perioperative outcomes between the 2 surgeons. The costs of VATSL differ substantially among surgeons and are heavily influenced by the use of disposable equipment/devices. Surgeons can substantially reduce the costs of VATSL to far lower than those of THORL without compromising surgical outcomes through prudent use of costly instruments and technologies. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  17. Does "Enhanced Support" for Offenders Effectively Reduce Custodial Violence and Disruption? An Evaluation of the Enhanced Support Service Pilot.

    Science.gov (United States)

    Camp, Jake; Joy, Kerry; Freestone, Mark

    2018-01-01

    This study aimed to examine the effectiveness of The Enhanced Support Service (ESS) pilot in reducing custodial violence and disruption, and the associated costs, by observing the behavioural change of the 35 service users who participated in ESS intervention within its first 22 months of operation. Frequencies of recorded incidents of aggressive behaviours, self-harming behaviours, noncompliance, and positive behaviours were counted from routine administrative systems using a coding structure developed in previous studies. The count data were analysed using nonparametric tests and Poisson regression models to derive an Incident Rate Ratio (IRR). Findings suggest the ESS is associated with a reduction in aggressive behaviours and noncompliance, with medium to large effect sizes ( r = .31-.53); however, it was not associated with a reduction in deliberate self-harm or increased positive behaviours. The Poisson models revealed that levels of pre-intervention behaviour, intervention length, intervention completion, and service location had varying effects on postintervention behaviour, with those who completed intervention demonstrating more favourable outcomes. The ESS service model was associated with a reduction in behaviour that challenges, which has implications for the reduction in associated social, economic, and political costs-as well as the commissioning of interventions and future research in this area.

  18. A Support for Decision Making: Cost-Sensitive Learning System

    Czech Academy of Sciences Publication Activity Database

    Brůha, I.; Kočková, Sylva

    č. 6 (1994), s. 67-82 ISSN 0933-3657 R&D Projects: GA ČR GA201/93/0781 Keywords : learning algorithm * noisy environment * inductive algorithm * decision rule * cost-sensitive inference * evaluating function Impact factor: 0.672, year: 1994

  19. Defense Inventory Management: Expanding Use of Best Practices for Hardware Items Can Reduce Logistics Costs

    National Research Council Canada - National Science Library

    1998-01-01

    ...) logistics practices with those of the private sector. We are continuously examining DOD'S inventory management practices to identify areas where costs can be reduced and problems can be avoided by using leading private sector practices...

  20. Main means for reducing the production costs in process of leaching uranium

    International Nuclear Information System (INIS)

    Jiang Lang

    2000-01-01

    The production costs in process of leaching uranium have been reduced by controlling mixture ratio of crudes, milling particle size, liquid/solid mass ratio of leaching pulp, potential and residue acidity, and improving power equipment

  1. Navy Ordnance Analysis of Business Area Efforts to Streamline Operations and Reduce Costs

    National Research Council Canada - National Science Library

    1997-01-01

    .... The Navy reorganized this business area in 1993 in order to reduce costs and address various deficiencies in ordnance logistics management that were identified during Desert Shield/Desert Storm...

  2. Competitive investments in cost reducing process improvement : The role of managerial incentives and spillover learning

    NARCIS (Netherlands)

    Veldman, Jasper; Gaalman, Gerard J.c.

    2015-01-01

    We study the rivalry between two firms and consider the effect of spillovers when the firms' operations and technology managers are given bonuses for cost reduction. We model a game in which the firm owners independently offer their manager a bonus to stimulate cost reducing process improvement

  3. A reduced-cost iterated local search heuristic for the fixed-charge transportation problem

    NARCIS (Netherlands)

    Buson, Erika; Roberti, Roberto; Toth, Paolo

    2014-01-01

    The fixed-charge transportation problem (FCTP) is a generalization of the transportation problem where an additional fixed cost is paid for sending a flow from an origin to a destination. We propose an iterated local search heuristic based on the utilization of reduced costs for guiding the restart

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

    Science.gov (United States)

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

    2013-10-01

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

  5. Support and Against Historical Cost Accounting: Is it Value Relevance for Decision Making?

    Directory of Open Access Journals (Sweden)

    Evi Rahmawati

    2016-01-01

    Full Text Available This paper reviews the issues on the support and criticism of historical cost accounting (HCA and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of  economic condition, inflation, the change in high tech environment, price movements, and regulators statements. Studies shows that historical cost accounting. over the decade: still have power explanatory for investors, which indicates that its benefits outweigh its cost. However, Barth et al. (1996 provide strong evidence on incremental information of current cost disclosures for certain assets and liabilities. This paper concludes that even there are weaknesses (against HCA, still there are more benefits that we can gain through HCA.

  6. Sol–gel synthesis of palladium nanoparticles supported on reduced ...

    Indian Academy of Sciences (India)

    average particle size of the Pd nanoparticles supported on rGO obtained from TEM is ... Ag|AgCl|KCl3M, the current is .... was used for chemical characterization of a specimen. The ... mer's method.36 In a typical procedure, about 20 mg of GO.

  7. Using cost-effectiveness analysis to support research and development portfolio prioritization for product innovations in measles vaccination.

    Science.gov (United States)

    Garrison, Louis P; Bauch, Chris T; Bresnahan, Brian W; Hazlet, Tom K; Kadiyala, Srikanth; Veenstra, David L

    2011-07-01

    Several potential measles vaccine innovations are in development to address the shortcomings of the current vaccine. Funders need to prioritize their scarce research and development resources. This article demonstrates the usefulness of cost-effectiveness analysis to support these decisions. This study had 4 major components: (1) identifying potential innovations, (2) developing transmission models to assess mortality and morbidity impacts, (3) estimating the unit cost impacts, and (4) assessing aggregate cost-effectiveness in United Nations Children's Fund countries through 2049. Four promising technologies were evaluated: aerosol delivery, needle-free injection, inhalable dry powder, and early administration DNA vaccine. They are projected to have a small absolute impact in terms of reducing the number of measles cases in most scenarios because of already improving vaccine coverage. Three are projected to reduce unit cost per dose by $0.024 to $0.170 and would improve overall cost-effectiveness. Each will require additional investments to reach the market. Over the next 40 years, the aggregate cost savings could be substantial, ranging from $98.4 million to $689.4 million. Cost-effectiveness analysis can help to inform research and development portfolio prioritization decisions. Three new measles vaccination technologies under development hold promise to be cost-saving from a global perspective over the long-term, even after considering additional investment costs. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

  8. Reducing Nitrogen Pollution while Decreasing Farmers' Costs and Increasing Fertilizer Industry Profits.

    Science.gov (United States)

    Kanter, David R; Zhang, Xin; Mauzerall, Denise L

    2015-03-01

    Nitrogen (N) pollution is emerging as one of the most important environmental issues of the 21st Century, contributing to air and water pollution, climate change, and stratospheric ozone depletion. With agriculture being the dominant source, we tested whether it is possible to reduce agricultural N pollution in a way that benefits the environment, reduces farmers' costs, and increases fertilizer industry profitability, thereby creating a "sweet spot" for decision-makers that could significantly increase the viability of improved N management initiatives. Although studies of the economic impacts of improved N management have begun to take into account farmers and the environment, this is the first study to consider the fertilizer industry. Our "sweet spot" hypothesis is evaluated via a cost-benefit analysis of moderate and ambitious N use efficiency targets in U.S. and China corn sectors over the period 2015-2035. We use a blend of publicly available crop and energy price projections, original time-series modeling, and expert elicitation. The results present a mixed picture: although the potential for a "sweet spot" exists in both countries, it is more likely that one occurs in China due to the currently extensive overapplication of fertilizer, which creates a greater potential for farmers and the fertilizer industry to gain economically from improved N management. Nevertheless, the environmental benefits of improving N management consistently dwarf the economic impacts on farmers and the fertilizer industry in both countries, suggesting that viable policy options could include incentives to farmers and the fertilizer industry to increase their support for N management policies. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  9. Does Eco-efficency Reduce the Cost of Equity Capital? Empirical Evidence From Indonesia

    OpenAIRE

    Alviani, Lisa; Sholihin, Mahfud

    2015-01-01

    The objective of this study is to examine the effect of eco-efficiency on the cost of equity capital. The study hypothesizes that the implementation of eco-efficiency reduces the cost of equity capital. Using manufacturing companies listed on the Indonesian Stock Exchange for the period 2010-2012 as data, and controlling for beta, company size, Book to Market ratio, and leverage; the study finds that the implementation of eco-efficiency may reduce the cost of equity capital. The findings sugg...

  10. DOES ECO-EFFICENCY REDUCE THE COST OF EQUITY CAPITAL? EMPIRICAL EVIDENCE FROM INDONESIA

    OpenAIRE

    Lisa Alviani; Mahfud Sholihin

    2015-01-01

    The objective of this study is to examine the effect of eco-efficiency on the cost of equity capital. The study hypothesizes that the implementation of eco-efficiency reduces the cost of equity capital. Using manufacturing companies listed on the Indonesian Stock Exchange for the period 2010-2012 as data, and controlling for beta, company size, Book to Market ratio, and leverage; the study finds that the implementation of eco-efficiency may reduce the cost of equity capital. The findings sugg...

  11. DOES ECO-EFFICENCY REDUCE THE COST OF EQUITY CAPITAL? EMPIRICAL EVIDENCE FROM INDONESIA

    Directory of Open Access Journals (Sweden)

    Lisa Alviani

    2015-05-01

    Full Text Available The objective of this study is to examine the effect of eco-efficiency on the cost of equity capital. The study hypothesizes that the implementation of eco-efficiency reduces the cost of equity capital. Using manufacturing companies listed on the Indonesian Stock Exchange for the period 2010-2012 as data, and controlling for beta, company size, Book to Market ratio, and leverage; the study finds that the implementation of eco-efficiency may reduce the cost of equity capital. The findings suggest that companies should implement eco-efficency.

  12. The costs, benefits, and cost-effectiveness of interventions to reduce maternal morbidity and mortality in Mexico.

    Directory of Open Access Journals (Sweden)

    Delphine Hu

    Full Text Available BACKGROUND: In Mexico, the lifetime risk of dying from maternal causes is 1 in 370 compared to 1 in 2,500 in the U.S. Although national efforts have been made to improve maternal services in the last decade, it is unclear if Millennium Development Goal 5--to reduce maternal mortality by three-quarters by 2015--will be met. METHODOLOGY/PRINCIPAL FINDINGS: We developed an empirically calibrated model that simulates the natural history of pregnancy and pregnancy-related complications in a cohort of 15-year-old women followed over their lifetime. After synthesizing national and sub-national trends in maternal mortality, the model was calibrated to current intervention-specific coverage levels and validated by comparing model-projected life expectancy, total fertility rate, crude birth rate and maternal mortality ratio with Mexico-specific data. Using both published and primary data, we assessed the comparative health and economic outcomes of alternative strategies to reduce maternal morbidity and mortality. A dual approach that increased coverage of family planning by 15%, and assured access to safe abortion for all women desiring elective termination of pregnancy, reduced mortality by 43% and was cost saving compared to current practice. The most effective strategy added a third component, enhanced access to comprehensive emergency obstetric care for at least 90% of women requiring referral. At a national level, this strategy reduced mortality by 75%, cost less than current practice, and had an incremental cost-effectiveness ratio of $300 per DALY relative to the next best strategy. Analyses conducted at the state level yielded similar results. CONCLUSIONS/SIGNIFICANCE: Increasing the provision of family planning and assuring access to safe abortion are feasible, complementary and cost-effective strategies that would provide the greatest benefit within a short-time frame. Incremental improvements in access to high-quality intrapartum and emergency

  13. The cost-effectiveness of methanol for reducing motor vehicle emissions and urban ozone

    International Nuclear Information System (INIS)

    Krupnick, A.J.; Walls, M.A.

    1992-01-01

    This article analyzes the costs and emissions characteristics of methanol vehicles. The cost-effectiveness of methanol - the cost per ton of reactive hydrocarbon emissions reduced - is calculated and compared to the cost-effectiveness of other hydrocarbon reduction strategies. Methanol is found to cost from $33,000 to nearly $60,000 per ton, while several other options are available for under $10,000 per ton. The cost per part-per-million reduction in peak ambient ozone levels is also computed for two cities, Houston and Philadelphia. Despite the greater improvement in ozone in Philadelphia than Houston, methanol is found to be more cost-effective in Houston. This result occurs because Houston's distribution and marketing costs are lower than Philadelphia's. The costs in both cities, however, are far higher than estimates of the benefits from acute health improvements. Finally, the reduction in ozone exposure in Los Angeles is estimated and the costs of the reduction compared with an estimate of acute health benefits. Again, the benefits fall far short of the costs. 51 refs., 5 tabs

  14. Cost-Effective and Environmentally Safe Corrosion Prevention for 2nd Marine Air Wing Support Equipment Using Desiccant Wheel Dehumidification (DEW)

    National Research Council Canada - National Science Library

    McCarthy, David

    1994-01-01

    ...: change the material, coat its surface or keep the item dry. In an effort to reduce the cost and environmental impact of maintaining contingency support equipment, the 2nd Marine Air Wing (2nd MAW...

  15. Reducing eutrophication increases spatial extent of communities supporting commercial fisheries

    DEFF Research Database (Denmark)

    Bauer, Barbara; Meier, H.E. Markus; Casini, Michele

    2018-01-01

    distribution of functional groups within a marine ecosystem, which depends on their respective tolerances to abiotic factors, trophic interactions, and fishing. We simulate the future long-term spatial developments of the community composition and their potential implications for fisheries under three...... from climate research, physical oceanography, biogeochemistry, biogeography, and trophic ecology with economical information provides a strong foundation to produce scientific knowledge that can support a multisectoral management of ecosystems....

  16. Cost analysis of the development and implementation of a spatial decision support system for malaria elimination in Solomon Islands.

    Science.gov (United States)

    Marston, Luke; Kelly, Gerard C; Hale, Erick; Clements, Archie C A; Hodge, Andrew; Jimenez-Soto, Eliana

    2014-08-18

    The goal of malaria elimination faces numerous challenges. New tools are required to support the scale up of interventions and improve national malaria programme capacity to conduct detailed surveillance. This study investigates the cost factors influencing the development and implementation of a spatial decision support system (SDSS) for malaria elimination in the two elimination provinces of Isabel and Temotu, Solomon Islands. Financial and economic costs to develop and implement a SDSS were estimated using the Solomon Islands programme's financial records. Using an ingredients approach, verified by stakeholders and operational reports, total costs for each province were quantified. A budget impact sensitivity analysis was conducted to investigate the influence of variations in standard budgetary components on the costs and to identify potential cost savings. A total investment of US$ 96,046 (2012 constant dollars) was required to develop and implement the SDSS in two provinces (Temotu Province US$ 49,806 and Isabel Province US$ 46,240). The single largest expense category was for computerized equipment totalling approximately US$ 30,085. Geographical reconnaissance was the most expensive phase of development and implementation, accounting for approximately 62% of total costs. Sensitivity analysis identified different cost factors between the provinces. Reduced equipment costs would deliver a budget saving of approximately 10% in Isabel Province. Combined travel costs represented the greatest influence on the total budget in the more remote Temotu Province. This study provides the first cost analysis of an operational surveillance tool used specifically for malaria elimination in the South-West Pacific. It is demonstrated that the costs of such a decision support system are driven by specialized equipment and travel expenses. Such factors should be closely scrutinized in future programme budgets to ensure maximum efficiencies are gained and available resources

  17. Paying our way: thinking strategically to offset the cost of reducing fire hazard in western forests.

    Science.gov (United States)

    Rhonda Mazza

    2008-01-01

    The fire hazard in many western forests is unacceptably high, posing risks to human health and property, wildlife habitat, and air and water quality. Cost is an inhibiting factor for reducing hazardous fuel, given the amount of acreage needing treatment. Thinning overly dense forests is one way to reduce fuel loads. Much of the product removed during these treatments...

  18. Operation and Support Costs for the Department of Defense

    National Research Council Canada - National Science Library

    Pierrot, Lane; Kornfeld, Robert; Mechanic, Robert E; Miller, Michael; Bryton, Eugene; Berger, Michael; Dombey, Bonita; Kostak, William; Lussier, Frances; Moore, David

    1988-01-01

    Operation and support (O&S) funds -- the portion of the Department of Defense (DoD) budget that pays to operate DoD's forces -- have grown an average of about 2 percent per year from 1980 to 1988 in real...

  19. Supporting frail older people and their family carers at home using information and communication technology: cost analysis.

    Science.gov (United States)

    Magnusson, Lennart; Hanson, Elizabeth

    2005-09-01

    This paper describes a cost analysis of a home-based support service for frail older people and their family carers in two municipalities in West Sweden and using information and communication technology. A key challenge facing nurse managers across Europe is an increasingly aged population, combined with reduced numbers of young adults of working age. New solutions are needed to provide quality, cost-effective community care services to frail older people and their family carers. A case study methodology involving five families was used, and included a detailed cost description of the technology-based service compared with usual services. Cost data were collected in June 2002. This work formed part of a larger project exploring the impact of a technology-based service known as, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). In addition to cost data, information was gathered on the quality of life of frail older people and their family carers, and the job satisfaction and work methods of nurses and other practitioners based in the community. The cost analysis comprised a description of the family and their caring situation, the perceived benefits of the telematic based support service and an assessment of its impact on the use of other care services. These analyses were carried out with the help of needs assessors who were known to the families, and nurses working in the ACTION call centre. All results were validated by the five participating families. Cost savings were achieved in all cases, and the benefits to older people and their carers were also considerable. As a result of the cost analysis and overall evaluation data, ACTION has been implemented as a mainstream service in the municipalities involved. Researchers, nurses, other practitioners and community care managers can work together with frail older people and their family carers to develop quality, cost-effective support services that reduce demands on staff

  20. REDUCING THE LOAD OF THE ELASTIC SUPPORT OF THE RESONANCE VIBRATING CONVEYOR MACHINES

    Directory of Open Access Journals (Sweden)

    A. I. Afanas'ev

    2018-03-01

    of the lower mass will be close to zero, since it almost does not oscillate. Thereby it is possible to significantly reduce the rigidity of the elastic supports, i.e. their mass and loading, as well as the total mass of the screen and the cost of its manufacture.

  1. Optimizing power plant cycling operations while reducing generating plant damage and costs

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S.A.; Besuner, P.H.; Grimsrud, P. [Aptech Engineering Services, Inc., Sunnyvale, CA (United States); Bissel, A. [Electric Supply Board, Dublin (Ireland)

    1998-12-31

    This presentation describes a method for analyzing, quantifying, and minimizing the total cost of fossil, combined cycle, and pumped hydro power plant cycling operation. The method has been developed, refined, and applied during engineering studies at some 160 units in the United States and 8 units at the Irish Electric Supply Board (ESB) generating system. The basic premise of these studies was that utilities are underestimating the cost of cycling operation. The studies showed that the cost of cycling conventional boiler/turbine fossil power plants can range from between $2,500 and $500,000 per start-stop cycle. It was found that utilities typically estimate these costs by factors of 3 to 30 below actual costs and, thus, often significantly underestimate their true cycling costs. Knowledge of the actual, or total, cost of cycling will reduce power production costs by enabling utilities to more accurately dispatch their units to manage unit life expectancies, maintenance strategies and reliability. Utility management responses to these costs are presented and utility cost savings have been demonstrated. (orig.) 7 refs.

  2. Optimizing power plant cycling operations while reducing generating plant damage and costs

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S A; Besuner, P H; Grimsrud, P [Aptech Engineering Services, Inc., Sunnyvale, CA (United States); Bissel, A [Electric Supply Board, Dublin (Ireland)

    1999-12-31

    This presentation describes a method for analyzing, quantifying, and minimizing the total cost of fossil, combined cycle, and pumped hydro power plant cycling operation. The method has been developed, refined, and applied during engineering studies at some 160 units in the United States and 8 units at the Irish Electric Supply Board (ESB) generating system. The basic premise of these studies was that utilities are underestimating the cost of cycling operation. The studies showed that the cost of cycling conventional boiler/turbine fossil power plants can range from between $2,500 and $500,000 per start-stop cycle. It was found that utilities typically estimate these costs by factors of 3 to 30 below actual costs and, thus, often significantly underestimate their true cycling costs. Knowledge of the actual, or total, cost of cycling will reduce power production costs by enabling utilities to more accurately dispatch their units to manage unit life expectancies, maintenance strategies and reliability. Utility management responses to these costs are presented and utility cost savings have been demonstrated. (orig.) 7 refs.

  3. Using performance indicators to reduce cost uncertainty of China's CO2 mitigation goals

    International Nuclear Information System (INIS)

    Xu, Yuan

    2013-01-01

    Goals on absolute emissions and intensity play key roles in CO 2 mitigation. However, like cap-and-trade policies with price uncertainty, they suffer from significant uncertainty in abatement costs. This article examines whether an indicator could be established to complement CO 2 mitigation goals and help reduce cost uncertainty with a particular focus on China. Performance indicators on CO 2 emissions per unit of energy consumption could satisfy three criteria: compared with the mitigation goals, (i) they are more closely associated with active mitigation efforts and (ii) their baselines have more stable projections from historical trajectories. (iii) Their abatement costs are generally higher than other mitigation methods, particularly energy efficiency and conservation. Performance indicators could be used in the following way: if a CO 2 goal on absolute emissions or intensity is attained, the performance indicator should still reach a lower threshold as a cost floor. If the goal cannot be attained, an upper performance threshold should be achieved as a cost ceiling. The narrower cost uncertainty may encourage wider and greater mitigation efforts. - Highlights: ► CO 2 emissions per unit of energy consumption could act as performance indicators. ► Performance indicators are more closely related to active mitigation activities. ► Performance indicators have more stable historical trajectories. ► Abatement costs are higher for performance indicators than for other activities. ► Performance thresholds could reduce the cost uncertainty of CO 2 mitigation goals.

  4. Cost implications of reduced work hours and workloads for resident physicians.

    Science.gov (United States)

    Nuckols, Teryl K; Bhattacharya, Jay; Wolman, Dianne Miller; Ulmer, Cheryl; Escarce, José J

    2009-05-21

    Although the Accreditation Council for Graduate Medical Education (ACGME) limits the work hours of residents, concerns about fatigue persist. A new Institute of Medicine (IOM) report recommends, among other changes, improved adherence to the 2003 ACGME limits, naps during extended shifts, a 16-hour limit for shifts without naps, and reduced workloads. We used published data to estimate labor costs associated with transferring excess work from residents to substitute providers, and we examined the effects of our assumptions in sensitivity analyses. Next, using a probability model to represent labor costs as well as mortality and costs associated with preventable adverse events, we determined the net costs to major teaching hospitals and cost-effectiveness across a range of hypothetical changes in the rate of preventable adverse events. Annual labor costs from implementing the IOM recommendations were estimated to be $1.6 billion (in 2006 U.S. dollars) across all ACGME-accredited programs ($1.1 billion to $2.5 billion in sensitivity analyses). From a 10% decrease to a 10% increase in preventable adverse events, net costs per admission ranged from $99 to $183 for major teaching hospitals and from $17 to $266 for society. With 2.5% to 11.3% decreases in preventable adverse events, costs to society per averted death ranged from $3.4 million to $0. Implementing the four IOM recommendations would be costly, and their effectiveness is unknown. If highly effective, they could prevent patient harm at reduced or no cost from the societal perspective. However, net costs to teaching hospitals would remain high. 2009 Massachusetts Medical Society

  5. Reducing the length of postnatal hospital stay: implications for cost and quality of care.

    Science.gov (United States)

    Bowers, John; Cheyne, Helen

    2016-01-15

    UK health services are under pressure to make cost savings while maintaining quality of care. Typically reducing the length of time patients stay in hospital and increasing bed occupancy are advocated to achieve service efficiency. Around 800,000 women give birth in the UK each year making maternity care a high volume, high cost service. Although average length of stay on the postnatal ward has fallen substantially over the years there is pressure to make still further reductions. This paper explores and discusses the possible cost savings of further reductions in length of stay, the consequences for postnatal services in the community, and the impact on quality of care. We draw on a range of pre-existing data sources including, national level routinely collected data, workforce planning data and data from national surveys of women's experience. Simulation and a financial model were used to estimate excess demand, work intensity and bed occupancy to explore the quantitative, organisational consequences of reducing the length of stay. These data are discussed in relation to findings of national surveys to draw inferences about potential impacts on cost and quality of care. Reducing the length of time women spend in hospital after birth implies that staff and bed numbers can be reduced. However, the cost savings may be reduced if quality and access to services are maintained. Admission and discharge procedures are relatively fixed and involve high cost, trained staff time. Furthermore, it is important to retain a sufficient bed contingency capacity to ensure a reasonable level of service. If quality of care is maintained, staffing and bed capacity cannot be simply reduced proportionately: reducing average length of stay on a typical postnatal ward by six hours or 17% would reduce costs by just 8%. This might still be a significant saving over a high volume service however, earlier discharge results in more women and babies with significant care needs at home. Quality

  6. Reducing IT costs and ensuring safe operation with application of the portfolio management

    Directory of Open Access Journals (Sweden)

    Livia Alice Mozsar Kovacsne

    2017-05-01

    Full Text Available Large companies need to give focus on their cost components related to their information technology. Business growths is supported by their IT and hundreds or thousands of applications worldwide. Top level management needs to focus more on their information strategy and the applications they need to manage. A structured and transparent application landscape supports not only the current business but it also enables faster business growth for the future as well. Structuring and organizing the applications related to the various risks supports secure business and information operations within a company. Capturing the applications gives the companies an overview of their information costs and provides the possibility of measurement and control of their IT costs elements. Application portfolio management and information security management are important elements of the corporate strategies.

  7. The policy implications of the different interpretations of the cost-effectiveness of renewable electricity support

    International Nuclear Information System (INIS)

    Río, Pablo del; Cerdá, Emilio

    2014-01-01

    The cost-effectiveness of support for renewable electricity is a main criterion to assess the success of policy instruments, together with effectiveness. The costs of support are also a source of significant concern for governments all over the world. However, significant confusion exists in the literature on the cost-effectiveness of public support for renewable electricity. While some authors define the concept of cost-effectiveness as that which complies with the equimarginality principle, many others, including documents from relevant organisations (European Commission, International Energy Agency, Intergovernmental Panel on Climate Change) define it as “the lowest costs of support”, generally equating it with the minimisation of consumer costs. The aim of this paper is to clarify the differences between both approaches and their policy implications regarding the choice of instruments and design elements. It is shown that they partly overlap and that their policy implications clearly differ, leading to very different policy prescriptions. While the former favours technology neutral instruments and design elements, the “minimisation of consumer costs” approach favours instruments and design elements which adjust support levels to the costs of the technologies. - Highlights: • Significant confusion exists in the literature on the cost-effectiveness of public support for renewable electricity. • Clarify the differences between two main approaches to cost-effectiveness. • Policy implications clearly differ, leading to very different policy prescriptions

  8. Spatial analyses of cost efficient measures to reduce N-leaching

    DEFF Research Database (Denmark)

    Jacobsen, Brian H.; Abildtrup, Jens; Ørum, Jens Erik

    (WFD). The analysis shows that the geographical position of the measures are very important in order to achieve the expected nutrient reduction. The current income varies a lot in the River basin and this might influence the choice of cost effective measures to reduce nutrient load. Furthermore a close......The Nitrate Directive has only been implemented satisfactorily in a few EU countries. The Commission have accepted the Danish implementation of the directive based on the Plan for the Aquatic Environment II. The costs of this plan has been calculated to 70 million € or 2,0 € per kg N in reduced...... leaching. The farmers have paid 60% of the costs. The paper then describes an example of a regional analysis covering the River Basin of Ringkøbing Fjord in Denmark, which indicates the type of calculations needed to find the measures and costs in order to comply with parts of the Water Framework Directive...

  9. Can E-Filing Reduce Tax Compliance Costs in Developing Countries?

    OpenAIRE

    Yilmaz, Fatih; Coolidge, Jacqueline

    2013-01-01

    The purpose of this study is to investigate the association between electronic filing (e-filing) and the total tax compliance costs incurred by small and medium size businesses in developing countries, based on survey data from South Africa, Ukraine, and Nepal. A priori, most observers expect that use of e-filing should reduce tax compliance costs, but this analysis suggests that the assum...

  10. The logistics and cost-effectiveness of circulatory support: advantages of the ABIOMED BVS 5000.

    Science.gov (United States)

    Couper, G S; Dekkers, R J; Adams, D H

    1999-08-01

    In 1994, the ABIOMED BVS 5000 was incorporated into our acute cardiac assist armamentarium. This report is a general overview of our experience. A hypothetical cost analysis focusing on specific devices and device-related personnel contrasted the BVS 5000 with our prior model of centrifugal pump use. In 3 years, 22 patients were supported with the BVS 5000, as a biventricular assist device in 40%, right ventricular assist device in 27%, and left ventricular assist device in 32%. Indications were postcardiotomy support in 12, acute myocarditis in 2, bridge to transplant in 4, and failed heart transplant in 4. The cost analysis was performed retrospectively. The actual cost of disposable blood pumps, including replacement pumps, and cannulae constituted the BVS cost. The hypothetical centrifugal costs included the disposables, replacement cones, as well as the labor costs of the continuous perfusionist coverage. Of the 22 patients, 10 (45%) were weaned and 13 (59%) were successfully discharged. Five patients were transplanted while on BVS 5000 support, accounting for a higher rate of discharge. Comparison of "actual" BVS costs with "projected" centrifugal costs revealed differences based upon the intended application of the BVS. In bridge-to-transplant patients with long duration of support, the daily cost of support was dramatically lower with the BVS 5000. For short-term postcardiotomy support, acute myocarditis, or failed transplant, the differences were small. Because the BVS 5000 was readily managed by the intensive care unit nursing staff, this system displaced centrifugal systems in our program. Outcome measures of weaning and successful discharge were improved relative to our prior experience with centrifugal pumps. Even without taking indirect costs into account, the hypothetical cost analysis supported continued use of the BVS system for acute cardiac assistance.

  11. Multi-faceted case management: reducing compensation costs of musculoskeletal work injuries in Australia.

    Science.gov (United States)

    Iles, Ross Anthony; Wyatt, M; Pransky, G

    2012-12-01

    This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.

  12. Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity.

    Science.gov (United States)

    Forster, M; Veerman, J L; Barendregt, J J; Vos, T

    2011-08-01

    To analyze whether two dietary weight loss interventions--the dietary approaches to stop hypertension (DASH) program and a low-fat diet program--would be cost-effective in Australia, and to assess their potential to reduce the disease burden related to excess body weight. We constructed a multi-state life-table-based Markov model in which the distribution of body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. The target population was the overweight and obese adult population in Australia in 2003. We used a lifetime horizon for health effects and costs, and a health sector perspective for costs. We populated the model with data identified from Medline and Cochrane searches, Australian Bureau of Statistics published catalogues, Australian Institute of Health and Welfare, and Department of Health and Ageing. Disability adjusted life years (DALYs) averted, incremental cost-effectiveness ratios (ICERs) and proportions of disease burden avoided. ICERs under AUS$50,000 per DALY are considered cost-effective. The DASH and low-fat diet programs have ICERs of AUS$12,000 per DALY (95% uncertainty range: Cost-saving- 68,000) and AUS$13,000 per DALY (Cost-saving--130,000), respectively. Neither intervention reduced the body weight-related disease burden at population level by more than 0.1%. The sensitivity analysis showed that when participants' costs for time and travel are included, the ICERs increase to AUS$75,000 per DALY for DASH and AUS$49,000 per DALY for the low-fat diet. Modest weight loss during the interventions, post-intervention weight regain and low participation limit the health benefits. Diet and exercise interventions to reduce obesity are potentially cost-effective but have a negligible impact on the total body weight-related disease burden.

  13. Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in High-Risk Hospitalized Patients.

    Science.gov (United States)

    Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

    2016-06-01

    To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.

  14. Decommissioning Programme Management: reducing risk and cost while accelerating schedules through improved planning, Earned Value Management and safe work execution

    International Nuclear Information System (INIS)

    Hansen, S.E.

    2008-01-01

    CH2M HILL experience includes more than two decades of managing nuclear facilities and providing clean-up and operations support for commercial and government facilities worldwide. Our expertise ranges from decommissioning and defence sector businesses to nuclear technology development and innovation. Our approach places top priority on the safe execution of work while reducing both risk and cost. Our nuclear services include: programme management, nuclear safety analysis, radiological protection, radioactive waste management, nuclear remediation, nuclear materials and waste transportation management, nuclear safeguards and security services, and nuclear decontamination and decommissioning. This paper will discuss our approach which has resulted in a strong track record of accelerating schedules and reducing costs of major nuclear programmes, including Rocky Flats, Idaho, and our work at UKAEA sites. (author)

  15. A Simple Exoskeleton That Assists Plantarflexion Can Reduce the Metabolic Cost of Human Walking

    Science.gov (United States)

    Malcolm, Philippe; Derave, Wim; Galle, Samuel; De Clercq, Dirk

    2013-01-01

    Background Even though walking can be sustained for great distances, considerable energy is required for plantarflexion around the instant of opposite leg heel contact. Different groups attempted to reduce metabolic cost with exoskeletons but none could achieve a reduction beyond the level of walking without exoskeleton, possibly because there is no consensus on the optimal actuation timing. The main research question of our study was whether it is possible to obtain a higher reduction in metabolic cost by tuning the actuation timing. Methodology/Principal Findings We measured metabolic cost by means of respiratory gas analysis. Test subjects walked with a simple pneumatic exoskeleton that assists plantarflexion with different actuation timings. We found that the exoskeleton can reduce metabolic cost by 0.18±0.06 W kg−1 or 6±2% (standard error of the mean) (p = 0.019) below the cost of walking without exoskeleton if actuation starts just before opposite leg heel contact. Conclusions/Significance The optimum timing that we found concurs with the prediction from a mathematical model of walking. While the present exoskeleton was not ambulant, measurements of joint kinetics reveal that the required power could be recycled from knee extension deceleration work that occurs naturally during walking. This demonstrates that it is theoretically possible to build future ambulant exoskeletons that reduce metabolic cost, without power supply restrictions. PMID:23418524

  16. Costs of Reducing Greenhouse Gas Emissions: A Case Study of India’s Power Generation Sector

    OpenAIRE

    Manish Gupta

    2006-01-01

    If India were to participate in any international effort towards mitigating CO2 emissions, the power sector which is one of the largest emitters of CO2 in the country would be required to play a major role. In this context the study estimates the marginal abatement costs, which correspond to the costs incurred by the power plants to reduce one unit of CO2 from the current level. The study uses an output distance function approach and its duality with the revenue function to derive these costs...

  17. Alternative strategies to reduce cost and waste volume in HEPA filtration using metallic filter media - 59348

    International Nuclear Information System (INIS)

    Chadwick, Chris

    2012-01-01

    Document available in abstract form only. Full text of publication follows: The disposal costs of contaminated HEPA and THE filter elements have been proved to be disproportionately high compared with the cost of the elements themselves. Work published elsewhere (Moore, et el 1992; Bergman et al 1997) suggests that the cost of use of traditional, panel type, glass fibre HEPA filtration trains to the DOE was, during that period, $29.5 million, based on a five year life cycle, and including installation, testing, removal and disposal life cycle costs being based on estimates dating from 1987-1990. Within that cost estimate, $300 was the value given to the filter and $4, 450 was given to the peripheral activity. Clearly, if the $4, 450 component could be reduced, tremendous saving could ensue, in addition to the reduction of the legacy burden of waste volume. This issue exists for operators in both the US and in Europe. If HEPA filters could be cleaned to a condition where they could either be re-used or decontaminated to the extent that they could be stored as a lower cost wasteform or if HEPA/THE filter elements were available without any organic content likely to give rise to flammable or explosive decomposition gases during long term storage this would also reduce the costs and monitoring necessary in storage. (author)

  18. New tube fitting range can slash assembly time, reduce tube material costs and eliminate hot work

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2008-09-15

    Parker Instrumentation has developed a permanent tube connection technology known as Phastite for use in high pressure applications such as in the offshore oil and gas sector. The Phastite push-fit connector offers major savings over traditional permanent and higher pressure connection techniques such as welded or cone-and-thread tube fittings. It also reduces assembly times by 20-fold or more and eliminates the need for hot work permits. The fittings are designed to withstand working pressures up to 1,379 bar. Phastite tube fittings can be used on offshore platforms, as well as on support vessels,, subsea equipment and ROVs such as hydraulic systems for wellhead control, emergency shut down, chemical injection, pumping packages, gas booster systems and test equipment. The connectors offer considerable savings in material cost and weight because they do not need to be used with more expensive tubing with extra thickness to accommodate a thread. Phastite is also resistant to vibration and does not need any anti-vibration accessories. A joint can be made in a matter of seconds with a simple handheld hydraulic tool that makes the push-fit connection. A sealing mechanism based on a series of defined internal ridges creates a secure seal by radial compression. The ridges grip in a way that retains all of the tubing's strength. An additional characteristic is the maintenance free nature of the Phastite connection. 1 fig.

  19. Reducing the energy penalty costs of postcombustion CCS systems with amine-storage.

    Science.gov (United States)

    Patiño-Echeverri, Dalia; Hoppock, David C

    2012-01-17

    Carbon capture and storage (CCS) can significantly reduce the amount of CO(2) emitted from coal-fired power plants but its operation significantly reduces the plant's net electrical output and decreases profits, especially during times of high electricity prices. An amine-based CCS system can be modified adding amine-storage to allow postponing 92% of all its energy consumption to times of lower electricity prices, and in this way has the potential to effectively reduce the cost of CO(2) capture by reducing the costs of the forgone electricity sales. However adding amine-storage to a CCS system implies a significant capital cost that will be outweighed by the price-arbitrage revenue only if the difference between low and high electricity prices is substantial. In this paper we find a threshold for the variability in electricity prices that make the benefits from electricity price arbitrage outweigh the capital costs of amine-storage. We then look at wholesale electricity markets in the Eastern Interconnect of the United States to determine profitability of amine-storage systems in this region. Using hourly electricity price data from years 2007 and 2008 we find that amine storage may be cost-effective in areas with high price variability.

  20. Spring-like Ankle Foot Orthoses reduce the energy cost of walking by taking over ankle work.

    Science.gov (United States)

    Bregman, D J J; Harlaar, J; Meskers, C G M; de Groot, V

    2012-01-01

    In patients with central neurological disorders, gait is often limited by a reduced ability to push off with the ankle. To overcome this reduced ankle push-off, energy-storing, spring-like carbon-composite Ankle Foot Orthoses (AFO) can be prescribed. It is expected that the energy returned by the AFO in late stance will support ankle push-off, and reduce the energy cost of walking. In 10 patients with multiple sclerosis and stroke the energy cost of walking, 3D kinematics, joint power, and joint work were measured during gait, with and without the AFO. The mechanical characteristics of the AFO were measured separately, and used to calculate the contribution of the AFO to the ankle kinetics. We found a significant decrease of 9.8% in energy cost of walking when walking with the AFO. With the AFO, the range of motion of the ankle was reduced by 12.3°, and the net work around the ankle was reduced by 29%. The total net work in the affected leg remained unchanged. The AFO accounted for 60% of the positive ankle work, which reduced the total amount of work performed by the leg by 11.1% when walking with the AFO. The decrease in energy cost when walking with a spring-like energy-storing AFO in central neurological patients is not induced by an augmented net ankle push-off, but by the AFO partially taking over ankle work. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Reduced Multivariate Polynomial Model for Manufacturing Costs Estimation of Piping Elements

    Directory of Open Access Journals (Sweden)

    Nibaldo Rodriguez

    2013-01-01

    Full Text Available This paper discusses the development and evaluation of an estimation model of manufacturing costs of piping elements through the application of a Reduced Multivariate Polynomial (RMP. The model allows obtaining accurate estimations, even when enough and adequate information is not available. This situation typically occurs in the early stages of the design process of industrial products. The experimental evaluations show that the approach is capable, with a low complexity, of reducing uncertainties and to predict costs with significant precision. Comparisons with a neural network showed also that the RMP performs better considering a set of classical performance measures with the corresponding lower complexity and higher accuracy.

  2. Costing support and cost control in manufacturing. A cost estimation tool applied in the sheet metal domain.

    NARCIS (Netherlands)

    ten Brinke, E.

    2002-01-01

    In the product development cycle several engineering tasks like design, process planning and production planning have to be executed. The execution of these tasks mainly involves information processing and decision-making. Because costs is an important factor in manufacturing, adequate information

  3. Patient education after stoma creation may reduce health-care costs.

    Science.gov (United States)

    Danielsen, Anne Kjærgaard; Rosenberg, Jacob

    2014-04-01

    Researchers are urged to include health-economic assessments when exploring the benefits and drawbacks of a new treatment. The aim of the study was to assess the costs associated with the establishment of a new patient education programme for patients with a stoma. Following a previous case-control study that explored the effect of patient education for stoma patients, we set out to examine the costs related to such a patient education programme. The primary outcome was disease-specific health-related quality of life measured with the Ostomy Adjustment Scale six months after surgery. The secondary outcome was generic health-related quality of life measured with Short Form (SF)-36. In this secondary analysis, we calculated direct health-care costs for the first six months post-operatively from the perspective of the health-care system, including costs related to the hospital as well as primary health care. The overall cost related to establishing a patient education programme showed no significant increase in the overall average costs. However, we found a significant reduction in costs related to unplanned readmissions (p = 0.01) as well as a reduction in visits to the general practitioner (p = 0.05). Establishing a patient education programme - which increased quality of life - will probably not increase the overall costs associated with the patient course. The study received financial support from Søster Inge Marie Dahlgaards Fond, Diakonissestiftelsen, Denmark, and from Aase and Ejnar Danielsens Foundation, Denmark. NCT01154725.

  4. Optimal distributed energy resources and the cost of reduced greenhouse gas emissions in a large retail shopping centre

    International Nuclear Information System (INIS)

    Braslavsky, Julio H.; Wall, Josh R.; Reedman, Luke J.

    2015-01-01

    Highlights: • Optimal options for distributed energy resources are analysed for a shopping centre. • A multiobjective optimisation model is formulated and solved using DER-CAM. • Cost and emission trade-offs are compared in four key optimal investment scenarios. • Moderate investment in DER technologies lowers emissions by 29.6% and costs by 8.5%. • Larger investment in DER technologies lowers emissions by 72% at 47% higher costs. - Abstract: This paper presents a case study on optimal options for distributed energy resource (DER) technologies to reduce greenhouse gas emissions in a large retail shopping centre located in Sydney, Australia. Large retail shopping centres take the largest share of energy consumed by all commercial buildings, and present a strong case for adoption of DER technologies to reduce energy costs and emissions. However, the complexity of optimally designing and operating DER systems has hindered their widespread adoption in practice. This paper examines and demonstrates the value of DER in reducing the carbon footprint of the shopping centre by formulating and solving a multiobjective optimisation problem using the Distributed Energy Resources Customer Adoption Model (DER-CAM) tool. An economic model of the shopping centre is developed in DER-CAM using on-site-specific demand, tariffs, and performance data for each DER technology option available. Four key optimal DER technology investment scenarios are then analysed by comparing: (1) solution trade-offs of costs and emissions, (2) the cost of reduced emissions attained in each investment scenario, and (3) investment benefits with respect to the business-as-usual scenario. The analysis shows that a moderate investment in combined cooling, heat and power (CCHP) technology alone can reduce annual energy costs by 8.5% and carbon dioxide-equivalent emissions by 29.6%. A larger investment in CCHP technology, in conjunction with on-site solar photovoltaic (PV) generation, can deliver

  5. An Analysis of Aviation Maintenance Operations and Supporting Costs, and Cost Capturing Systems

    Science.gov (United States)

    2012-12-04

    the La Mesa Parent Teacher Association. = ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= do^ar^qb=p`elli=lc=_rpfkbpp=C=mr_if`=mlif`v= = - vii -= k^s^i=mlpqdo^ar^qb=p...host.uniroma3.it/facolta/ economia /db/materiali/insegnamenti/588_3930.pdf Cost Analysis Improvement Group (CAIG). (2007). Office of the Secretary of

  6. Concepts of increasing productivity and reducing the processing cost of machine parts

    Directory of Open Access Journals (Sweden)

    О. С. Кленов

    2017-06-01

    Full Text Available The basic conditions to reduce the cost of processing technology and improve productivity through the use of modern cutting tools produced by leading foreign firms producing tools have been appraised from theory in the work. Theoretically, it has been found that an increase in the cost of processing varies according to extremum dependence, passing the minimum point. It is possible to reduce the minimum processing cost due to the increase of productivity using cutting edge tools, characterized by a high capacity for work in high cutting temperatures. The criterion showing the technological price cost minimum is the ratio of the expenditures on workers’ wages to the expenditures on the cutting tools, it being quite specific for various processing conditions. To analyze the possibilities of practical use of the proposed criterion, a complex of experimental researches of the technological prime cost and productivity of the processing with hard alloy cutting tools with wear-resistant coatings produced by the company «Iscar» has been carried out. It has been established that their use makes it possible by more than one half to reduce the labour consumption and overall costs as compared to the hard alloy cutting tools traditionally used in home industry. It has been shown that this effect is achieved by increasing the cutting speed and feed due to increased wear resistance and heat resistance of the «Iscar» company tools. It was established that it is much more possible to achieve low processing cost at milling than at turning. It was stated with regard to all major expenditures including the workers' wages, the cost of the cutting tools, equipment and other costs, allowing more correctly estimate the cost-effectiveness of mechanical processing. Experiments confirmed that the main condition for reducing the processing cost to its minimum value is to increase the processing performance through the use of a heat-resistant and wear-resistant cutting

  7. Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction.

    Science.gov (United States)

    Sandhu, Alexander T; Ollendorf, Daniel A; Chapman, Richard H; Pearson, Steven D; Heidenreich, Paul A

    2016-11-15

    Sacubitril-valsartan therapy reduces cardiovascular mortality compared with enalapril therapy in patients with heart failure with reduced ejection fraction. To evaluate the cost-effectiveness of sacubitril-valsartan versus angiotensin-converting enzyme inhibitor therapy in patients with chronic heart failure. Markov decision model. Clinical trials, observational analyses, reimbursement data from the Centers for Medicare & Medicaid Services, drug pricing databases, and Centers for Disease Control and Prevention life tables. Patients at an average age of 64 years, New York Heart Association (NYHA) class II to IV heart failure, and left ventricular ejection fraction of 0.40 or less. Lifetime. Societal. Treatment with sacubitril-valsartan or lisinopril. Life-years, quality-adjusted life-years (QALYs), costs, heart failure hospitalizations, and incremental cost-effectiveness ratios. The sacubitril-valsartan group experienced 0.08 fewer heart failure hospitalization, 0.69 additional life-year, 0.62 additional QALY, and $29 203 in incremental costs, equating to a cost per QALY gained of $47 053. The cost per QALY gained was $44 531 in patients with NYHA class II heart failure and $58 194 in those with class III or IV heart failure. Sacubitril-valsartan treatment was most sensitive to the duration of improved outcomes, with a cost per QALY gained of $120 623 if the duration was limited to the length of the trial (median, 27 months). No variations in other parameters caused the cost to exceed $100 000 per QALY gained. The benefit of sacubitril-valsartan is based on a single clinical trial. Treatment with sacubitril-valsartan provides reasonable value in reducing cardiovascular mortality and morbidity in patients with NYHA class II to IV heart failure. U.S. Department of Veterans Affairs and Institute for Clinical and Economic Review.

  8. Making renewable energy competitive in India: Reducing financing costs via a government-sponsored hedging facility

    International Nuclear Information System (INIS)

    Farooquee, Arsalan Ali; Shrimali, Gireesh

    2016-01-01

    In India, a significant barrier to market-competitiveness of renewable energy is a shortage of attractive debt. Domestic debt has high cost, short tenors, and variable interest rates, adding 30% to the cost of renewable energy compared to renewable energy projects elsewhere. Foreign debt is as expensive as domestic debt because it requires costly market-based currency hedging solutions. We investigate a government-sponsored foreign exchange facility as an alternative to reducing hedging costs. Using the geometric Brownian motion (GBM) as a representative stochastic model of the INR–USD foreign exchange rate, we find that the expected cost of providing a currency hedge via this facility is 3.5 percentage points, 50% lower than market. This leads to an up to 9% reduction in the per unit cost of renewable energy. However, this requires the government to manage the risks related to unexpected currency movements appropriately. One option to manage these risks is via a capital buffer; for the facility to obtain India's sovereign rating, the capital buffer would need to be almost 30% of the underlying loan. Our findings have significant policy implications given that the Indian government can use this facility to make renewable energy more competitive and, therefore, hasten its deployment. - Highlights: • We analyze a government-sponsored foreign exchange facility in India. •We use geometric Brownian motion to represent the INR–USD exchange rate. •This facility can reduce the currency hedging costs by 50%. •This facility can reduce the levelized cost of renewable energy by 9%. •The capital buffer to reach India's sovereign rating is 30% of the original loan.

  9. Does bank competition reduce cost of credit? Cross-country evidence from Europe

    Czech Academy of Sciences Publication Activity Database

    Fungáčová, Z.; Shamshur, Anastasiya; Weill, L.

    2017-01-01

    Roč. 83, October (2017), s. 104-120 ISSN 0378-4266 R&D Projects: GA ČR(CZ) GA14-31783S Institutional support: RVO:67985998 Keywords : bank competition * bank concentration * cost of credit Subject RIV: AH - Economics OBOR OECD: Finance Impact factor: 1.776, year: 2016

  10. The Dynamics of Bertrand Price Competition with Cost-Reducing Investments

    DEFF Research Database (Denmark)

    Iskhakov, Fedor; Rust, John; Schjerning, Bertel

    We present a dynamic extension of the classic static model of Bertrand price competition that allows competing duopolists to undertake cost-reducing investments in an attempt to “leapfrog” their rival to attain low-cost leadership – at least temporarily. We show that leapfrogging occurs in equili......We present a dynamic extension of the classic static model of Bertrand price competition that allows competing duopolists to undertake cost-reducing investments in an attempt to “leapfrog” their rival to attain low-cost leadership – at least temporarily. We show that leapfrogging occurs...... in equilibrium, resolving the Bertrand investment paradox., i.e. leapfrogging explains why firms have an ex ante incentive to undertake cost-reducing investments even though they realize that simultaneous investments to acquire the state of the art production technology would result in Bertrand price competition...... leader. We show that the equilibrium involves investment preemption only when the firms invest in a deterministically alternating fashion and technological progress is deterministic. We prove that when technological progress is deterministic and firms move in an alternating fashion, the game has a unique...

  11. One Improvement Method of Reducing Duration Directly to Solve Time-Cost Tradeoff Problem

    Science.gov (United States)

    Jian-xun, Qi; Dedong, Sun

    Time and cost are two of the most important factors for project plan and schedule management, and specially, time-cost tradeoff problem is one classical problem in project scheduling, which is also a difficult problem. Methods of solving the problem mainly contain method of network flow and method of mending the minimal cost. Thereinto, for the method of mending the minimal cost is intuitionistic, convenient and lesser computation, these advantages make the method being used widely in practice. But disadvantage of the method is that the result of each step is optimal but the terminal result maybe not optimal. In this paper, firstly, method of confirming the maximal effective quantity of reducing duration is designed; secondly, on the basis of above method and the method of mending the minimal cost, the main method of reducing duration directly is designed to solve time-cost tradeoff problem, and by analyzing validity of the method, the method could obtain more optimal result for the problem.

  12. An Active Learning Classifier for Further Reducing Diabetic Retinopathy Screening System Cost

    Directory of Open Access Journals (Sweden)

    Yinan Zhang

    2016-01-01

    Full Text Available Diabetic retinopathy (DR screening system raises a financial problem. For further reducing DR screening cost, an active learning classifier is proposed in this paper. Our approach identifies retinal images based on features extracted by anatomical part recognition and lesion detection algorithms. Kernel extreme learning machine (KELM is a rapid classifier for solving classification problems in high dimensional space. Both active learning and ensemble technique elevate performance of KELM when using small training dataset. The committee only proposes necessary manual work to doctor for saving cost. On the publicly available Messidor database, our classifier is trained with 20%–35% of labeled retinal images and comparative classifiers are trained with 80% of labeled retinal images. Results show that our classifier can achieve better classification accuracy than Classification and Regression Tree, radial basis function SVM, Multilayer Perceptron SVM, Linear SVM, and K Nearest Neighbor. Empirical experiments suggest that our active learning classifier is efficient for further reducing DR screening cost.

  13. Modelling of the costs of decision support for small and medium-sized enterprises

    Directory of Open Access Journals (Sweden)

    Viera Tomišová

    2017-01-01

    Full Text Available The support of decision-making activities in small and medium-sized enterprises (SME has its specific features. When suggesting steps for the implementation of decision-support tools in the enterprise, we identified two main ways of decision-making support based on the data analysis: ERP (Enterprise Resource Planning without BI (Business Intelligence and ERP with BI. In our contribution, we present costs models of both mentioned decision support systems and their practical interpretation.

  14. Cost-effectiveness of universal rotavirus vaccination in reducing rotavirus gastroenteritis in Ireland.

    LENUS (Irish Health Repository)

    Tilson, L

    2011-10-06

    We evaluated the cost-effectiveness of universal infant rotavirus (RV) vaccination compared to current standard of care of "no vaccination". Two RV vaccines are currently licensed in Ireland: Rotarix and RotaTeq. A cohort model used in several European countries was adapted using Irish epidemiological, resource utilisation and cost data. The base case model considers the impact of Rotarix vaccination on health-related quality of life of children under five years old from a healthcare payer perspective. Other scenarios explored the use of RotaTeq, impact on one caregiver, on societal costs and on cases that do not seek medical attention. Cost was varied between the vaccine list price (€100\\/course) in the base case and an assumed tender price (€70\\/course). One-way and probabilistic sensitivity analyses were conducted. Implementing universal RV vaccination may prevent around 1970 GP visits, 3280 A&E attendances and 2490 hospitalisations. A vaccination programme was estimated to cost approximately €6.54 million per year but €4.65 million of this would be offset by reducing healthcare resource use. The baseline ICER was €112,048\\/QALY and €72,736\\/QALY from the healthcare payer and societal perspective, respectively, falling to €68,896 and €43,916\\/QALY, respectively, if the impact on one caregiver was considered. If the price fell to €70 per course, universal RV vaccination would be cost saving under all scenarios. Results were sensitive to vaccination costs, incidence of RV infection and direct medical costs. Universal RV vaccination would not be cost-effective under base case assumptions. However, it could be cost-effective at a lower vaccine price or from a wider societal perspective.

  15. Development of Advanced Technologies to Reduce Design, Fabrication and Construction Costs for Future Nuclear Power Plants

    International Nuclear Information System (INIS)

    DiNunzio, Camillo A.; Gupta, Abhinav; Golay, Michael; Luk, Vincent; Turk, Rich; Morrow, Charles; Geum-Taek Jin

    2002-01-01

    OAK-B135 This report presents a summation of the third and final year of a three-year investigation into methods and technologies for substantially reducing the capital costs and total schedule for future nuclear plants. In addition, this is the final technical report for the three-year period of studies

  16. Development of Advanced Technologies to Reduce Design, Fabrication and Construction Costs for Future Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    DiNunzio, Camillo A. [Framatome ANP DE& S, Marlborough, MA (United States); Gupta, Abhinav [Univ. of North Carolina, Raleigh, NC (United States); Golay, Michael [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Luk, Vincent [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Turk, Rich [Westinghouse Electric Company Nuclear Systems, Windsor, CT (United States); Morrow, Charles [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jin, Geum-Taek [Korea Power Engineering Company Inc., Yongin-si, Gyeonggi-do (Korea, Republic of)

    2002-11-30

    This report presents a summation of the third and final year of a three-year investigation into methods and technologies for substantially reducing the capital costs and total schedule for future nuclear plants. In addition, this is the final technical report for the three-year period of studies.

  17. How to save costs by reducing unnecessary testing: Lean thinking in clinical practice

    NARCIS (Netherlands)

    Vegting, I.L.; van Beneden, M.; Kramer, M.H.H.; Thijs, A.; Kostense, P.J.; Nanayakkara, P.W.B.

    2012-01-01

    Background: The burden of health care expenditure on national budgets has increased dramatically over the past decade. A pilot study in our hospital demonstrated that many unnecessary diagnostic tests were performed routinely. The aim of this study was to reduce the costs of unnecessary diagnostic

  18. Reducing the costs of landscape restoration by using invasive alien plant biomass for bioenergy

    CSIR Research Space (South Africa)

    Stafford, William HL

    2018-02-01

    Full Text Available reviews the extent of IAPs as well as efforts to eradicate them, and identifies value-adding opportunities to use the cleared IAP biomass for reducing the costs of landscape restoration. Since bioenergy is suited to a large portion of the biomass...

  19. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming

    NARCIS (Netherlands)

    Middelaar, van C.E.; Dijkstra, J.; Berentsen, P.B.M.; Boer, de I.J.M.

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the

  20. [Reduce Energy Costs While Maintaining Healthy IAQ.] "Indoor Air Quality Tools for Schools" Update #17

    Science.gov (United States)

    US Environmental Protection Agency, 2009

    2009-01-01

    This issue of "Indoor Air Quality Tools for Schools" Update ("IAQ TfS" Update) contains the following items: (1) News and Events; (2) Feature Article: Reduce Energy Costs while Maintaining Healthy IAQ; (3) Insight into Excellence: North East Independent School District ; (4) School Building Week 2009; and (5) Have Your Questions Answered!

  1. The role of technology in reducing health care costs. Phase II and phase III.

    Energy Technology Data Exchange (ETDEWEB)

    Cilke, John F.; Parks, Raymond C.; Funkhouser, Donald Ray; Tebo, Michael A.; Murphy, Martin D.; Hightower, Marion Michael; Gallagher, Linda K.; Craft, Richard Layne, II; Garcia, Rudy John

    2004-04-01

    In Phase I of this project, reported in SAND97-1922, Sandia National Laboratories applied a systems approach to identifying innovative biomedical technologies with the potential to reduce U.S. health care delivery costs while maintaining care quality. The effort provided roadmaps for the development and integration of technology to meet perceived care delivery requirements and an economic analysis model for development of care pathway costs for two conditions: coronary artery disease (CAD) and benign prostatic hypertrophy (BPH). Phases II and III of this project, which are presented in this report, were directed at detailing the parameters of telemedicine that influence care delivery costs and quality. These results were used to identify and field test the communication, interoperability, and security capabilities needed for cost-effective, secure, and reliable health care via telemedicine.

  2. Reduce operational cost and extend the life of pipeline infrastructure by automating remote cathodic protection systems

    Energy Technology Data Exchange (ETDEWEB)

    Rosado, Elroy [Freewave Technologies, Inc., Boulder, CO (United States). Latin America

    2009-07-01

    Energy and Pipeline Companies wrestle to control operating costs largely affected by new government regulations, ageing buried metal assets, rising steel prices, expanding pipeline operations, new interference points, HCA encroachment, restrictive land use policies, heightened network security, and an ageing soon-to-retire work force. With operating costs on the rise, seemingly out of control, many CP and Operations Professionals look to past best practices in cost containment through automation. Many companies achieve solid business results through deployment of telemetry and SCADA automation of remote assets and now hope to expand this success to further optimize operations by automating remote cathodic protection systems. This presentation will provide examples of how new remote cathodic protection systems are helping energy and pipeline companies address the growing issue of the aging pipeline infrastructure and reduce their costs while optimizing their operations. (author)

  3. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  4. Fitness costs of animal medication: antiparasitic plant chemicals reduce fitness of monarch butterfly hosts.

    Science.gov (United States)

    Tao, Leiling; Hoang, Kevin M; Hunter, Mark D; de Roode, Jacobus C

    2016-09-01

    The emerging field of ecological immunology demonstrates that allocation by hosts to immune defence against parasites is constrained by the costs of those defences. However, the costs of non-immunological defences, which are important alternatives to canonical immune systems, are less well characterized. Estimating such costs is essential for our understanding of the ecology and evolution of alternative host defence strategies. Many animals have evolved medication behaviours, whereby they use antiparasitic compounds from their environment to protect themselves or their kin from parasitism. Documenting the costs of medication behaviours is complicated by natural variation in the medicinal components of diets and their covariance with other dietary components, such as macronutrients. In the current study, we explore the costs of the usage of antiparasitic compounds in monarch butterflies (Danaus plexippus), using natural variation in concentrations of antiparasitic compounds among plants. Upon infection by their specialist protozoan parasite Ophryocystis elektroscirrha, monarch butterflies can selectively oviposit on milkweed with high foliar concentrations of cardenolides, secondary chemicals that reduce parasite growth. Here, we show that these antiparasitic cardenolides can also impose significant costs on both uninfected and infected butterflies. Among eight milkweed species that vary substantially in their foliar cardenolide concentration and composition, we observed the opposing effects of cardenolides on monarch fitness traits. While high foliar cardenolide concentrations increased the tolerance of monarch butterflies to infection, they reduced the survival rate of caterpillars to adulthood. Additionally, although non-polar cardenolide compounds decreased the spore load of infected butterflies, they also reduced the life span of uninfected butterflies, resulting in a hump-shaped curve between cardenolide non-polarity and the life span of infected butterflies

  5. The Cost of Providing Comprehensive HIV Treatment in PEPFAR-Supported Programs

    Science.gov (United States)

    Menzies, Nicolas A; Berruti, Andres A; Berzon, Richard; Filler, Scott; Ferris, Robert; Ellerbrock, Tedd V; Blandford, John M

    2011-01-01

    PEPFAR, national governments, and other stakeholders are investing unprecedented resources to provide HIV treatment in developing countries. This study reports empirical data on costs and cost trends in a large sample of HIV treatment sites. In 2006–2007, we conducted cost analyses at 43 PEPFAR-supported outpatient clinics providing free comprehensive HIV treatment in Botswana, Ethiopia, Nigeria, Uganda, and Vietnam. We collected data on HIV treatment costs over consecutive 6-month periods from scale-up of dedicated HIV treatment services at each site. The study included all patients receiving HIV treatment and care at study sites (62,512 ART and 44,394 pre-ART patients). Outcomes were costs per-patient and total program costs, subdivided by major cost categories. Median annual economic costs were $202 (2009 USD) for pre-ART patients and $880 for ART patients. Excluding ARVs, per-patient ART costs were $298. Care for newly initiated ART patients cost 15–20% more than for established patients. Per-patient costs dropped rapidly as sites matured, with per-patient ART costs dropping 46.8% between first and second 6-month periods after the beginning of scale-up, and an additional 29.5% the following year. PEPFAR provided 79.4% of funding for service delivery, and national governments provided 15.2%. Treatment costs vary widely between sites, and high early costs drop rapidly as sites mature. Treatment costs vary between countries and respond to changes in ARV regimen costs and the package of services. While cost reductions may allow near-term program growth, programs need to weigh the trade-off between improving services for current patients and expanding coverage to new patients. PMID:21412127

  6. SunShot solar power reduces costs and uncertainty in future low-carbon electricity systems.

    Science.gov (United States)

    Mileva, Ana; Nelson, James H; Johnston, Josiah; Kammen, Daniel M

    2013-08-20

    The United States Department of Energy's SunShot Initiative has set cost-reduction targets of $1/watt for central-station solar technologies. We use SWITCH, a high-resolution electricity system planning model, to study the implications of achieving these targets for technology deployment and electricity costs in western North America, focusing on scenarios limiting carbon emissions to 80% below 1990 levels by 2050. We find that achieving the SunShot target for solar photovoltaics would allow this technology to provide more than a third of electric power in the region, displacing natural gas in the medium term and reducing the need for nuclear and carbon capture and sequestration (CCS) technologies, which face technological and cost uncertainties, by 2050. We demonstrate that a diverse portfolio of technological options can help integrate high levels of solar generation successfully and cost-effectively. The deployment of GW-scale storage plays a central role in facilitating solar deployment and the availability of flexible loads could increase the solar penetration level further. In the scenarios investigated, achieving the SunShot target can substantially mitigate the cost of implementing a carbon cap, decreasing power costs by up to 14% and saving up to $20 billion ($2010) annually by 2050 relative to scenarios with Reference solar costs.

  7. The Life Cycle Cost (LCC) of Life Support Recycling and Resupply

    Science.gov (United States)

    Jones, Harry W.

    2015-01-01

    Brief human space missions supply all the crew's water and oxygen from Earth. The multiyear International Space Station (ISS) program instead uses physicochemical life support systems to recycle water and oxygen. This paper compares the Life Cycle Cost (LCC) of recycling to the LCC of resupply for potential future long duration human space missions. Recycling systems have high initial development costs but relatively low durationdependent support costs. This means that recycling is more cost effective for longer missions. Resupplying all the water and oxygen requires little initial development cost but has a much higher launch mass and launch cost. The cost of resupply increases as the mission duration increases. Resupply is therefore more cost effective than recycling for shorter missions. A recycling system pays for itself when the resupply LCC grows greater over time than the recycling LCC. The time when this occurs is called the recycling breakeven date. Recycling will cost very much less than resupply for long duration missions within the Earth-Moon system, such as a future space station or Moon base. But recycling would cost about the same as resupply for long duration deep space missions, such as a Mars trip. Because it is not possible to provide emergency supplies or quick return options on the way to Mars, more expensive redundant recycling systems will be needed.

  8. Improving the delivery of care and reducing healthcare costs with the digitization of information.

    Science.gov (United States)

    Noffsinger, R; Chin, S

    2000-01-01

    In the coming years, the digitization of information and the Internet will be extremely powerful in reducing healthcare costs while assisting providers in the delivery of care. One example of healthcare inefficiency that can be managed through information digitization is the process of prescription writing. Due to the handwritten and verbal communication surrounding prescription writing, as well as the multiple tiers of authorizations, the prescription drug process causes extensive financial waste as well as medical errors, lost time, and even fatal accidents. Electronic prescription management systems are being designed to address these inefficiencies. By utilizing new electronic prescription systems, physicians not only prescribe more accurately, but also improve formulary compliance thereby reducing pharmacy utilization. These systems expand patient care by presenting proactive alternatives at the point of prescription while reducing costs and providing additional benefits for consumers and healthcare providers.

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

    Directory of Open Access Journals (Sweden)

    Carolyn Dudley

    2016-01-01

    Full Text Available WHY IS THIS AN IMPORTANT ISSUE? An estimated 1 in 86 children are diagnosed with Autism Spectrum Disorder (ASD1 making it the most commonly diagnosed childhood neurological condition in Canada.2 The true costs of lifelong support for people living with ASD3 are often underestimated and fail to acknowledge the value of caregiver time over the lifespan. Significant gaps in publically provided support systems leave the cost burden to be picked up by families. Relying on continued family supports where community services are fragmented or unavailable is not a sustainable approach. WHAT DOES THE RESEARCH TELL US? A continuum of supports are needed Most people living with ASD need supports that range from occasional assistance with higher level tasks, like organizing appointments or banking, to those who need continuous help with daily living.4 Areas where supportive care may be needed can be categorized broadly to include: self care, home living, service co-ordination, personal organization, health and safety management, adult day opportunities/employment, transportation, advocacy and social skills. These supports are most successful when they address the individual’s uniqueness in terms of communication, social, sensory, behavioural needs and physical and/or mental health conditions. Currently there are a lack of available supports, limiting opportunities for socialization, employment and residential living resulting in reduced independence for adults with ASD.

  10. A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times.

    Science.gov (United States)

    Qiu, Shanshan; Chinnam, Ratna Babu; Murat, Alper; Batarse, Bassam; Neemuchwala, Hakimuddin; Jordan, Will

    2015-03-01

    Emergency departments (ED) in hospitals are experiencing severe crowding and prolonged patient waiting times. A significant contributing factor is boarding delays where admitted patients are held in ED (occupying critical resources) until an inpatient bed is identified and readied in the admit wards. Recent research has suggested that if the hospital admissions of ED patients can be predicted during triage or soon after, then bed requests and preparations can be triggered early on to reduce patient boarding time. We propose a cost sensitive bed reservation policy that recommends optimal bed reservation times for patients. The policy relies on a classifier that estimates the probability that the ED patient will be admitted using the patient information collected and readily available at triage or right after. The policy is cost sensitive in that it accounts for costs associated with patient admission prediction misclassification as well as costs associated with incorrectly selecting the reservation time. Results from testing the proposed bed reservation policy using data from a VA Medical Center are very promising and suggest significant cost saving opportunities and reduced patient boarding times.

  11. IFMIF (International Fusion Materials Irradiation Facility) conceptual design activity reduced cost report

    International Nuclear Information System (INIS)

    2000-02-01

    This report describes the results of a preliminary reevaluation of the design and cost of the International Fusion Materials Irradiation Facility (IFMIF) Project in response to the request from the 28th FPCC meeting in January 1999. Two major ideas have been considered: 1) reduction of the total construction cost through elimination of the previously planned facility upgrade and 2) a facility deployment in 3 stages with capabilities for limited experiments in the first stage. As a result, the size and complexity of the facility could be significantly reduced, leading to substantial cost savings. In addition to these two ideas, this study also included a critical review of the original CDA specification with the objective of elimination of nonessential items. For example, the number of lithium targets was reduced from two to one. As a result of these changes in addition to the elimination of the upgrade, the total cost estimate was very substantially reduced from 797.2 MICF to 487.8 MICF, where 1 MICF = 1 Million of the IFMIF Conversion Units (approximately $1M US January, 1996). (author)

  12. Operating and support costs and affordability of a 324 ship Naval battle force

    OpenAIRE

    Antonucci, Kevin C.

    2011-01-01

    The purpose of this research was to determine both the added operating and support (OandS) costs and affordability of operating and maintaining a future naval battle force of 324 ships as proposed in the Navy's 30-year shipbuilding plan. Cost estimation including regression, 3-year moving averages, point, expert and analogous modeling was used to capture both historical and future OandS costs from FY1991 to FY2024. With an emphasis on the three main cost drivers, (manpower, fuel and maintena...

  13. Model implementation for dynamic computation of system cost for advanced life support

    Science.gov (United States)

    Levri, J. A.; Vaccari, D. A.

    2004-01-01

    Life support system designs for long-duration space missions have a multitude of requirements drivers, such as mission objectives, political considerations, cost, crew wellness, inherent mission attributes, as well as many other influences. Evaluation of requirements satisfaction can be difficult, particularly at an early stage of mission design. Because launch cost is a critical factor and relatively easy to quantify, it is a point of focus in early mission design. The method used to determine launch cost influences the accuracy of the estimate. This paper discusses the appropriateness of dynamic mission simulation in estimating the launch cost of a life support system. This paper also provides an abbreviated example of a dynamic simulation life support model and possible ways in which such a model might be utilized for design improvement. c2004 COSPAR. Published by Elsevier Ltd. All rights reserved.

  14. The cost-effectiveness of household photovoltaic systems in reducing greenhouse gas emissions in Australia: Linking subsidies with emission reductions

    International Nuclear Information System (INIS)

    Burtt, D.; Dargusch, P.

    2015-01-01

    Highlights: • Payback period for Australian household PV fell to four years in 2011 and 2012. • PV became attractive due to high feed-in tariffs and declining PV costs. • Cost was AU$200/t CO 2 e in 2010, expected to be AU$65 to AU$100/t CO 2 e by 2020. • PV resulted in greenhouse gas emissions reducing by 3.7 million t CO 2 e in 2013. • PV expected to reduce greenhouse gas emissions by 8 million t CO 2 e in 2020. - Abstract: This paper examines the cost-effectiveness of subsidies (feed-in tariffs and renewable energy credits) paid for by electricity consumers to support the uptake of roof top photovoltaic (PV) systems by households in Australia. We estimate annual payback periods, and then regress these against the actual uptake of household PV and associated emission reductions, creating a relationship not apparent in other research. Sensitivity analysis reveals that the declining cost of PV panels had most impact on PV uptake followed by feed-in tariffs, renewable energy credits and the increasing cost of household electricity tariffs. Our modelling shows that feed-in tariffs were higher than necessary to achieve the resultant levels of PV uptake and that the low cost of PV panels and comparatively high electricity tariffs are likely to result in a continuing strong uptake of household PV in Australia. Our modelling shows that subsidies peaked in 2011 and 2012, with payback periods of three to four years, having since increased to five to six years. Emission reduction costs are expected to reduce from over AU$200 per t CO 2 e in 2013 to between AU$65 and AU$100 per t CO 2 e in 2020. Household PV reduced Australia’s emissions by 3.7 million t CO 2 e in 2013 (1.7% of Australia’s total emissions) and is expected to reach eight million tonnes (3.7% of Australia’s total emissions) by 2020

  15. The role of information technology (IT) in reducing offshore operating costs

    International Nuclear Information System (INIS)

    Stern, M.J.

    1993-01-01

    The rapid changes in information technology (IT) and its application have helped to improve efficiency and reduce operating costs offshore. Developments in IT itself, in terms of technology, organization and standards together with cultural change have created new opportunities. In the application of IT, the most significant impact on operations costs and effectiveness has come from the use of information throughout the life cycle, and improved telecommunications. This paper describes recent developments in IT and its application, and cites examples where oil companies have derived major benefits

  16. Economic feasibility of invesment alternatives for reducing torula yeast' production cost

    International Nuclear Information System (INIS)

    Torres Fernández, Alfredo; Díaz de los Ríos, Manuel; Saura Laria, Gustavo

    2016-01-01

    The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application. (author)

  17. ECONOMIC FEASIBILITY OF INVESMENT ALTERNATIVES FOR REDUCING TORULA YEAST' PRODUCTION COST

    Directory of Open Access Journals (Sweden)

    Alfredo Torres Fernández

    2016-01-01

    Full Text Available The prices of ammonium salts which are used in the torula yeast production technology are very high nowadays. In the other hand, this technology has very high energy costs which are consumed by blowers in fermentation, separators machines and in the concentration and drying of yeast. In this paper, different technical alternatives are analyzed for reducing the production cost of torula yeast, through changes in production inputs, electric motors and the replacement of a portion of the fuel used for drying by biogas. Then, the economic feasibility in both currencies is evaluated for practical application.

  18. The effective cost of tritium for tokamak fusion power reactors with reduced tritium production systems

    International Nuclear Information System (INIS)

    Gilligan, J.G.; Evans, K.

    1983-01-01

    If sufficient tritium cannot be produced and processed in tokamak blankets then at least two alternatives are possible. Tritium can be purchased; or reactors with reduced tritium (RT) content in the plasma can be designed. The latter choice may require development of magnet technology etc., but the authors show that the impact on the cost-of-electricity may be mild. Cost tradeoffs are compared to the market value of tritium. Adequate tritium production in fusion blankets is preferred, but the authors show there is some flexibility in the deployment of fusion if this is not possible

  19. Installation, Operation, and Maintenance Strategies to Reduce the Cost of Offshore Wind Energy

    Energy Technology Data Exchange (ETDEWEB)

    Maples, B. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Saur, G. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hand, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); van de Pietermen, R. [Energy Research Center of the Netherlands (Netherlands); Obdam, T. [Energy Research Center of the Netherlands (Netherlands)

    2013-07-01

    Currently, installation, operation, and maintenance (IO&M) costs contribute approximately 30% to the LCOE of offshore wind plants. To reduce LCOE while ensuring safety, this paper identifies principal cost drivers associated with IO&M and quantifies their impacts on LCOE. The paper identifies technology improvement opportunities and provides a basis for evaluating innovative engineering and scientific concepts developed subsequently to the study. Through the completion of a case study, an optimum IO&M strategy for a hypothetical offshore wind project is identified.

  20. The Cost-Effectiveness of Supported Employment for Adults with Autism in the United Kingdom

    Science.gov (United States)

    Mavranezouli, Ifigeneia; Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

    2014-01-01

    Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom.…

  1. Validated Feasibility Study of Integrally Stiffened Metallic Fuselage Panels for Reducing Manufacturing Costs

    Science.gov (United States)

    Pettit, R. G.; Wang, J. J.; Toh, C.

    2000-01-01

    The continual need to reduce airframe cost and the emergence of high speed machining and other manufacturing technologies has brought about a renewed interest in large-scale integral structures for aircraft applications. Applications have been inhibited, however, because of the need to demonstrate damage tolerance, and by cost and manufacturing risks associated with the size and complexity of the parts. The Integral Airframe Structures (IAS) Program identified a feasible integrally stiffened fuselage concept and evaluated performance and manufacturing cost compared to conventional designs. An integral skin/stiffener concept was produced both by plate hog-out and near-net extrusion. Alloys evaluated included 7050-T7451 plate, 7050-T74511 extrusion, 6013-T6511 extrusion, and 7475-T7351 plate. Mechanical properties, structural details, and joint performance were evaluated as well as repair, static compression, and two-bay crack residual strength panels. Crack turning behavior was characterized through panel tests and improved methods for predicting crack turning were developed. Manufacturing cost was evaluated using COSTRAN. A hybrid design, made from high-speed machined extruded frames that are mechanically fastened to high-speed machined plate skin/stringer panels, was identified as the most cost-effective manufacturing solution. Recurring labor and material costs of the hybrid design are up to 61 percent less than the current technology baseline.

  2. Cost-effectiveness of implant-supported mandibular removable partial dentures.

    Science.gov (United States)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    2017-05-01

    The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Dynamic Cost-Contingency Management: A Method for Reducing Project Costs While Increasing the Probability of Success

    National Research Council Canada - National Science Library

    Kujawski, Edouard

    2007-01-01

    In the real world, "Money Allocated is Money Spent" (MAIMS). As a consequence, cost underruns are rarely available to protect against cost overruns, while task overruns are passed on to the total project cost...

  4. A comparative analysis of the costs of onshore wind energy: Is there a case for community-specific policy support?

    International Nuclear Information System (INIS)

    Berka, Anna L.; Harnmeijer, Jelte; Roberts, Deborah; Phimister, Euan; Msika, Joshua

    2017-01-01

    There is growing policy interest in increasing the share of community-owned renewable energy generation. This study explores why and how the costs of community-owned projects differ from commercially-owned projects by examining the case of onshore wind in the UK. Based on cross-sectoral literature on the challenges of community ownership, cost differences are attributed to six facets of an organisation or project: internal processes, internal knowledge and skills, perceived local legitimacy of the project, perceived external legitimacy of the organisation, investor motivation and expectations, and finally, project scale. These facets impact not only development costs but also project development times and the probability that projects pass certain critical stages in the development process. Using survey-based and secondary cost data on community and commercial projects in the UK, a model is developed to show the overall impact of cost, time and risk differences on the value of a hypothetical 500 kW onshore wind project. The results show that the main factors accounting for differences are higher pre-planning costs and additional risks born by community projects, and suggest that policy interventions may be required to place community- owned projects on a level playing field with commercial projects. - Highlights: • Policy support for community energy projects should be targeted at reducing early costs and risk factors. • Hurdle rates are critical in determining the financial viability of projects. • Shared ownership arrangements may help remove some of key challenges to community-only projects.

  5. Reducing Dropouts in Online Education-Group Tutoring in Virtual Seminars and Support Structures

    Science.gov (United States)

    Holmgren, Robert; Johansson, Sigurd

    2012-01-01

    This paper describes a development project aimed at reducing the large number of dropouts in online degree project courses. The idea was that the introduction of group tutorials in virtual seminars, combined with extensive support materials, would reduce dropout rates. Among the students who participated, the dropout rate was reduced by 50%…

  6. Income Tax Returns: Reducing Compliance Costs for Personal Income Taxpayers in Slovenia

    Directory of Open Access Journals (Sweden)

    Maja Klun

    2009-06-01

    Full Text Available Simplifying procedures and improving legislation generally lead to a reduction in the compliance costs. The introduction of pre-filled tax returns clearly simplifies the tax compliance procedure. Before the introduction of pre-filled tax returns for personal income taxpayers in Slovenia, tax legislation was also modified. This paper presents the results of research into the compliance costs for personal income taxpayers before and after the simplification of the compliance procedure in Slovenia, irrespective of tax legislation itself not being simplified. The results indicate that pre-filled tax returns reduce compliance costs for personal income taxpayers by around 73%. Nevertheless, this is only a tentative estimate, since several assumptions are taken into account.

  7. Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool

    Science.gov (United States)

    Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David

    Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.

  8. Reduced prosthetic stiffness lowers the metabolic cost of running for athletes with bilateral transtibial amputations.

    Science.gov (United States)

    Beck, Owen N; Taboga, Paolo; Grabowski, Alena M

    2017-04-01

    Inspired by the springlike action of biological legs, running-specific prostheses are designed to enable athletes with lower-limb amputations to run. However, manufacturer's recommendations for prosthetic stiffness and height may not optimize running performance. Therefore, we investigated the effects of using different prosthetic configurations on the metabolic cost and biomechanics of running. Five athletes with bilateral transtibial amputations each performed 15 trials on a force-measuring treadmill at 2.5 or 3.0 m/s. Athletes ran using each of 3 different prosthetic models (Freedom Innovations Catapult FX6, Össur Flex-Run, and Ottobock 1E90 Sprinter) with 5 combinations of stiffness categories (manufacturer's recommended and ± 1) and heights (International Paralympic Committee's maximum competition height and ± 2 cm) while we measured metabolic rates and ground reaction forces. Overall, prosthetic stiffness [fixed effect (β) = 0.036; P = 0.008] but not height ( P ≥ 0.089) affected the net metabolic cost of transport; less stiff prostheses reduced metabolic cost. While controlling for prosthetic stiffness (in kilonewtons per meter), using the Flex-Run (β = -0.139; P = 0.044) and 1E90 Sprinter prostheses (β = -0.176; P = 0.009) reduced net metabolic costs by 4.3-4.9% compared with using the Catapult prostheses. The metabolic cost of running improved when athletes used prosthetic configurations that decreased peak horizontal braking ground reaction forces (β = 2.786; P = 0.001), stride frequencies (β = 0.911; P < 0.001), and leg stiffness values (β = 0.053; P = 0.009). Remarkably, athletes did not maintain overall leg stiffness across prosthetic stiffness conditions. Rather, the in-series prosthetic stiffness governed overall leg stiffness. The metabolic cost of running in athletes with bilateral transtibial amputations is influenced by prosthetic model and stiffness but not height. NEW & NOTEWORTHY We measured the

  9. Analysis characteristics determination of electrohydraulic control system operation to reduce the operation time of a powered roof support

    Science.gov (United States)

    Szurgacz, Dawid

    2018-01-01

    The article discusses basic functions of a powered roof support in a longwall unit. The support function is to provide safety by protecting mine workings against uncontrolled falling of rocks. The subject of the research includes the measures to shorten the time of roof support shifting. The roof support is adapted to transfer, in hazard conditions of rock mass tremors, dynamic loads caused by mining exploitation. The article presents preliminary research results on the time reduction of the unit advance to increase the extraction process and thus reduce operating costs. Conducted stand tests showed the ability to increase the flow for 3/2-way valve cartridges. The level of fluid flowing through the cartridges is adequate to control individual actuators.

  10. Effect of reducing cost sharing for outpatient care on children's inpatient services in Japan.

    Science.gov (United States)

    Kato, Hirotaka; Goto, Rei

    2017-08-15

    Assessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood. This paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children's outpatient services in Japan. Data were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013. A total of 366,566 inpatients from 1390 municipalities were identified. The impact of expanding outpatient care subsidy on the volume of inpatient care for 1390 Japanese municipalities was investigated using the generalized linear model with fixed effects. A decrease in cost sharing for outpatient care has no significant effect on overall hospital admissions, although this effect varies by region. The subsidy reduces the number of overall admissions in low-income areas, but increases it in high-income areas. In addition, the results for admissions by type show that admissions for diagnosis increase particularly in high-income areas, but emergency admissions and ambulatory-care-sensitive-condition admissions decrease in low-income areas. These results suggest that outpatient and inpatient services are substitutes in low-income areas but complements in high-income ones. Although the subsidy for children's healthcare would increase medical costs, it would not improve the health status in high-income areas. Nevertheless, it could lead to some health improvements in low-income areas and, to some extent, offset costs by reducing admissions in these regions.

  11. Cost Analysis of Physician Assistant Home Visit Program to Reduce Readmissions After Cardiac Surgery.

    Science.gov (United States)

    Nabagiez, John P; Shariff, Masood A; Molloy, William J; Demissie, Seleshi; McGinn, Joseph T

    2016-09-01

    A physician assistant home care (PAHC) program providing house calls was initiated to reduce hospital readmissions after adult cardiac surgery. The purpose of our study was to compare 30-day PAHC and pre-PAHC readmission rate, length of stay, and cost. Patients who underwent adult cardiac surgery in the 48 months from September 2008 through August 2012 were retrospectively reviewed using pre-PAHC patients as the control group. Readmission rate, length of stay, and health care cost, as measured by hospital billing, were compared between groups matched with propensity score. Of the 1,185 patients who were discharged directly home, 155 (13%) were readmitted. Total readmissions for the control group (n = 648) was 101 patients (16%) compared with the PAHC group (n = 537) total readmissions of 54 (10%), a 38% reduction in the rate of readmission (p = 0.0049). Propensity score matched groups showed a rate reduction of 41% with 17% (62 of 363) for the control compared with 10% (37 of 363) for the PAHC group (p = 0.0061). The average hospital bill per readmission was $39,100 for the control group and $56,600 for the PAHC group (p = 0.0547). The cost of providing home visits was $25,300 for 363 propensity score matched patients. The PAHC program reduced the 30-day readmission rate by 41% for propensity score matched patients. Analysis demonstrated a savings of $977,500 at a cost of $25,300 over 2 years, or $39 in health care saved, in terms of hospital billing, for every $1 spent. Therefore, a home visit by a cardiac surgical physician assistant is a cost-effective strategy to reduce readmissions after cardiac surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Methodology for reducing energy and resource costs in construction of trenchless crossover of pipelines

    Science.gov (United States)

    Toropov, V. S.

    2018-05-01

    The paper suggests a set of measures to select the equipment and its components in order to reduce energy costs in the process of pulling the pipeline into the well in the constructing the trenchless pipeline crossings of various materials using horizontal directional drilling technology. A methodology for reducing energy costs has been developed by regulating the operation modes of equipment during the process of pulling the working pipeline into a drilled and pre-expanded well. Since the power of the drilling rig is the most important criterion in the selection of equipment for the construction of a trenchless crossover, an algorithm is proposed for calculating the required capacity of the rig when operating in different modes in the process of pulling the pipeline into the well.

  13. Estimating the marginal cost of reducing global fossil fuel CO2 emissions

    International Nuclear Information System (INIS)

    Edmonds, J.; Barns, D.W.; McDonald, S.

    1992-01-01

    This paper estimates the marginal, total, and average cost and effectiveness of carbon taxes applied either by the Organization for Economic Cooperation and Development (OECD) members alone, or as part of a global cooperative strategy, to reduce potential future emissions and their direct implications for employment in the US coal industry. Two sets of cases are examined, one set in which OECD members acts alone, and another set in which the world acts in concert. In each case set taxes are examined which achieve four alternative levels of emissions reduction: halve the rate of emissions growth, no emissions growth, 20% reduction from 1988 levels, and 50% reduction from 1988 levels. For the global cooperation case, carbon tax rates of $32, $113, $161, and $517 per metric ton of carbon (mtC) were needed in the year 2025 to achieve the objectives. Total costs were respectively $40, $178, $253, and $848 billions of 1990 US dollars per year in the year 2025. Average costs were $32, $55, $59, and $135 per mtC. Costs were significantly higher in the cases in which the OECD members states acted alone. OECD member states, acting alone, could not reduce global emissions by 50% or 20% relative to 1988, given reference case assumptions regarding developing and recently planned nations economic growth

  14. Low polymer hydraulic fracturing applications in Reconcavo basin wells can reduce cost and improve conductivity

    International Nuclear Information System (INIS)

    Suzart, Joao Walter Pereira; Araujo, Paulo Fernando de

    2000-01-01

    Gels used for hydraulic-fracturing treatments generally contain high concentrations of polymer. The polymer helps the fracturing fluid achieve the level of viscosity necessary for transporting proppant through the rock matrix. However, high-polymer gels leave greater amounts of residue in the formation and can therefore cause formation damage. This paper describes how low polymer (L P) gels can be used for hydraulic-fracturing operations to reduce job costs and increase conductivity by reducing formation damage while maintaining the characteristics of a high-polymer gel. The L P fluid system has a low p H and contains an appropriate breaker concentration. Operators have achieved positive results with this system, which allows them to measure robust gel breaks and reduces the necessity for well cleaning. Consequently, formation damage can be significantly reduced. (author)

  15. ENHANCING VOLUNTARY COMPLIANCE BY REDUCING COMPLIANCE COSTS: A TAXPAYER SERVICE APPROACH

    OpenAIRE

    Glenn Jenkins; EDWIN FORLEMU

    1993-01-01

    In this paper an overview is made of the determinants of voluntary tax compliance. Unlike previous treatments of this subject, the cost of taxpayer compliance is considered as an important determinant of overall level of voluntary compliance in a country. A number of ways that tax authorities reduce compliance are discussed, and the most common uses of information technology in providing taxpayer service is described. Finally, the paper considers some of the ways that such activities might be...

  16. Integrated cost estimation methodology to support high-performance building design

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

  17. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

    Science.gov (United States)

    Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

    2009-06-27

    This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

  18. Ablation - breakthrough technology to reduce uranium mining cost and increase resources

    International Nuclear Information System (INIS)

    Scriven, D.

    2014-01-01

    Ablation Technologies, LLC has developed and patented a revolutionary mining technology termed “ablation”. Ablation is a process using only mechanical forces to upgrade sandstone uranium ores. Uranium bearing sandstone orebodies are formed from a uranium enriched solution flowing through an aquifer until it reached some type of a “red/ox” zone forcing the uranium and other heavy metals to come out of solution. The precipitate forms a thin coating on the sand grains and fills the interstitial space between the sand grains but does no penetrate the sand grains. The ablation process knocks the precipitate off the sand grains using the forces of abrasion, elastic compression and rebounding, much like a mud coated tennis ball will sheds the mud when bounced off the ground, and to some extent, sonic waves. This produces a product which collectively is exactly the same as the ore going in but with all the individual components separated. This allows for disgressionary separation, the most important of which is screening. The uranium and heavy metals report to the finer fractions of the material, typically less than 250 mesh. The larger fractions contain less than five percent of the uranium but 90 to 95 percent of the mass. The advantages of making an enriched ore are numerous: • Reduce haulage costs from 90 to 95 percent. • Reduce milling costs by reducing material handling costs, acid consumption and tailings disposal costs. • In addition to reducing overall mining and milling costs, the overall recovery of the recourse is increased because the ablation process is so inexpensive, if the material has to be mined it will be ablated and screened. This basically means ore control is significantly reduced, cutoff grade goes to practically zero and overall resource recovery is significantly increased. • Environmentally, the two major advantages are reduced tailings requirements at the mill site and cleaner waste dumps at the mine site. This paper will show

  19. Incentivizing the public to support invasive species management: eurasian milfoil reduces lakefront property values.

    Science.gov (United States)

    Olden, Julian D; Tamayo, Mariana

    2014-01-01

    Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995-2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management.

  20. Incentivizing the public to support invasive species management: eurasian milfoil reduces lakefront property values.

    Directory of Open Access Journals (Sweden)

    Julian D Olden

    Full Text Available Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995-2006 in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA. After accounting for structural (e.g., house size, locational (e.g., boat launch, and environmental characteristics (e.g., water clarity of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price, corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue, justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management.

  1. The production of reduced graphene oxide by a low-cost vacuum system for supercapacitors applications

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Q.A.; Sakata, S.K.; Faria, R.N. [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil); Silva, F.M.; Vieira, L.S.; Casini, J.C.S., E-mail: julio.casini@ifro.edu.br [Instituto Federal de Ciencia e Tecnologia de Rondonia (IFRO), RO (Brazil)

    2016-07-01

    Graphene (G) has attracted great interest for its excellent electrical properties. However, the large-scale production of graphene is still currently under investigations. Graphene oxide (GO) can be partially reduced to graphene-like sheets by removing the oxygen-containing groups with the recovery of a conjugated structure. It can be produced using inexpensive graphite as raw material by cost-effective chemical methods. High vacuum and temperature (10{sup -7}mbar/1100 deg C) is well established as an effective route for reduced powder preparation on a laboratory scale. However, a high vacuum reduction system, which can be routinely operated at 10{sup -7} mbar, has a considerable capital, operational and maintenance cost to be used in a large scale. In the present work, a low-cost route aiming large scale reduction of graphene oxide has been investigated. A stainless steel vessel has been evacuated to backing-pump pressure (10{sup -2} mbar) to process graphene oxide at low and high temperatures. Attempts of reducing GO powder using low vacuum pressures have been carried out and investigated by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). The experimental results of processing graphene oxide powder at various temperatures (200-1000°C) at relatively low pressures have been reported. The microstructures of the processed material have been investigated using scanning electron microscopy (SEM) and chemical microanalyses employing energy dispersive X-ray analysis (EDX). (author)

  2. The production of reduced graphene oxide by a low-cost vacuum system for supercapacitors applications

    International Nuclear Information System (INIS)

    Cardoso, Q.A.; Sakata, S.K.; Faria, R.N.; Silva, F.M.; Vieira, L.S.; Casini, J.C.S.

    2016-01-01

    Graphene (G) has attracted great interest for its excellent electrical properties. However, the large-scale production of graphene is still currently under investigations. Graphene oxide (GO) can be partially reduced to graphene-like sheets by removing the oxygen-containing groups with the recovery of a conjugated structure. It can be produced using inexpensive graphite as raw material by cost-effective chemical methods. High vacuum and temperature (10 -7 mbar/1100 deg C) is well established as an effective route for reduced powder preparation on a laboratory scale. However, a high vacuum reduction system, which can be routinely operated at 10 -7 mbar, has a considerable capital, operational and maintenance cost to be used in a large scale. In the present work, a low-cost route aiming large scale reduction of graphene oxide has been investigated. A stainless steel vessel has been evacuated to backing-pump pressure (10 -2 mbar) to process graphene oxide at low and high temperatures. Attempts of reducing GO powder using low vacuum pressures have been carried out and investigated by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). The experimental results of processing graphene oxide powder at various temperatures (200-1000°C) at relatively low pressures have been reported. The microstructures of the processed material have been investigated using scanning electron microscopy (SEM) and chemical microanalyses employing energy dispersive X-ray analysis (EDX). (author)

  3. Societal value of generic medicines beyond cost-saving through reduced prices.

    Science.gov (United States)

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2015-01-01

    This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

  4. Reusable single-port access device shortens operative time and reduces operative costs.

    Science.gov (United States)

    Shussman, Noam; Kedar, Asaf; Elazary, Ram; Abu Gazala, Mahmoud; Rivkind, Avraham I; Mintz, Yoav

    2014-06-01

    In recent years, single-port laparoscopy (SPL) has become an attractive approach for performing surgical procedures. The pitfalls of this approach are technical and financial. Financial concerns are due to the increased cost of dedicated devices and prolonged operating room time. Our aim was to calculate the cost of SPL using a reusable port and instruments in order to evaluate the cost difference between this approach to SPL using the available disposable ports and standard laparoscopy. We performed 22 laparoscopic procedures via the SPL approach using a reusable single-port access system and reusable laparoscopic instruments. These included 17 cholecystectomies and five other procedures. Operative time, postoperative length of stay (LOS) and complications were prospectively recorded and were compared with similar data from our SPL database. Student's t test was used for statistical analysis. SPL was successfully performed in all cases. Mean operative time for cholecystectomy was 72 min (range 40-116). Postoperative LOS was not changed from our standard protocols and was 1.1 days for cholecystectomy. The postoperative course was within normal limits for all patients and perioperative morbidity was recorded. Both operative time and length of hospital stay were shorter for the 17 patients who underwent cholecystectomy using a reusable port than for the matched previous 17 SPL cholecystectomies we performed (p cost difference. Operating with a reusable port ended up with an average cost savings of US$388 compared with using disposable ports, and US$240 compared with standard laparoscopy. Single-port laparoscopic surgery is a technically challenging and expensive surgical approach. Financial concerns among others have been advocated against this approach; however, we demonstrate herein that using a reusable port and instruments reduces operative time and overall operative costs, even beyond the cost of standard laparoscopy.

  5. GIS to support cost-effective decisions on renewable sources applications for low temperature geothermal energy

    CERN Document Server

    Gemelli, Alberto; Diamantini, Claudia; Longhi, Sauro

    2013-01-01

    Through the results of a developed case study of information system for low temperature geothermal energy, GIS to Support Cost-effective Decisions on Renewable Sources addresses the issue of the use of Geographic Information Systems (GIS) in evaluating cost-effectiveness of renewable resource exploitation regional scale. Focusing on the design of a Decision Support System, a process is presented aimed to transform geographic data into knowledge useful for analysis and decision-making on the economic exploitation of geothermal energy. This detailed description includes a literature review and technical issues related to data collection, data mining, decision analysis for the informative system developed for the case study. A multi-disciplinary approach to GIS design is presented which is also an innovative example of fusion of georeferenced data acquired from multiple sources including remote sensing, networks of sensors and socio-economic censuses. GIS to Support Cost-effective Decisions on Renewable Sources ...

  6. Simulation at the point of care: reduced-cost, in situ training via a mobile cart.

    Science.gov (United States)

    Weinstock, Peter H; Kappus, Liana J; Garden, Alexander; Burns, Jeffrey P

    2009-03-01

    The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams. Descriptive study. A tertiary care pediatric teaching hospital. A self-contained mobile simulation cart was constructed at a cost of $8054 (mannequin not included). The cart is compatible with any mannequin and contains all equipment needed to produce a high quality simulation experience equivalent to that of our on-site center--including didactics and debriefing with videotaped recordings complete with vital sign overlay. Over a 3-year period the cart delivered 57 courses to 425 participants from five pediatric departments. All individuals were trained among their native teams and within their own clinical environment. By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.

  7. Building Commissioning: A Golden Opportunity for Reducing Energy Costs and Greenhouse-gas Emissions

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2009-07-16

    data are available revealed over 10,000 energy-related problems, resulting in 16% median whole-building energy savings in existing buildings and 13% in new construction, with payback time of 1.1 years and 4.2 years, respectively. In terms of other cost-benefit indicators, median benefit-cost ratios of 4.5 and 1.1, and cash-on-cash returns of 91% and 23% were attained for existing and new buildings, respectively. High-tech buildings were particularly cost-effective, and saved higher amounts of energy due to their energy-intensiveness. Projects with a comprehensive approach to commissioning attained nearly twice the overall median level of savings and five-times the savings of the least-thorough projects. It is noteworthy that virtually all existing building projects were cost-effective by each metric (0.4 years for the upper quartile and 2.4 years for the lower quartile), as were the majority of new-construction projects (1.5 years and 10.8 years, respectively). We also found high cost-effectiveness for each specific measure for which we have data. Contrary to a common perception, cost-effectiveness is often achieved even in smaller buildings. Thanks to energy savings valued more than the cost of the commissioning process, associated reductions in greenhouse gas emissions come at 'negative' cost. In fact, the median cost of conserved carbon is negative - -$110 per tonne for existing buildings and -$25/tonne for new construction - as compared with market prices for carbon trading and offsets in the +$10 to +$30/tonne range. Further enhancing the value of commissioning, its non-energy benefits surpass those of most other energy-management practices. Significant first-cost savings (e.g., through right-sizing of heating and cooling equipment) routinely offset at least a portion of commissioning costs - fully in some cases. When accounting for these benefits, the net median commissioning project cost was reduced by 49% on average, while in many cases they exceeded

  8. Familial social support predicts a reduced cortisol response to stress in sexual minority young adults.

    Science.gov (United States)

    Burton, C L; Bonanno, G A; Hatzenbuehler, M L

    2014-09-01

    Social support has been repeatedly associated with mental and physical health outcomes, with hypothalamic-pituitary-adrenocortical (HPA) axis activity posited as a potential mechanism. The influence of social bonds appears particularly important in the face of stigma-related stress; however, there is a dearth of research examining social support and HPA axis response among members of a stigmatized group. To address this gap in the literature, we tested in a sample of 70 lesbian, gay, and bisexual (LGB) young adults whether family support or peer support differentially predict cortisol reactivity in response to a laboratory stressor, the Trier Social Stress Test. While greater levels of family support were associated with reduced cortisol reactivity, neither peer support nor overall support satisfaction was associated with cortisol response. These findings suggest that the association between social support and neuroendocrine functioning differs according to the source of support among members of one stigmatized group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Cost-effectiveness of combustion turbines: recommendations for reliability, maintainability, supportability and maintenance requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meuwisse, C.; Despujols, A. [Electricite de France, Research and Development Division, Chatou (France); Givaudan, B. [Electricite de France, Research and Development Division - SEPTEN, Villeurbanne (France); Lafage, L. [Electricite de France, Engineering and Construction Division - CNET, Paris (France)

    1998-12-31

    The profitability of combustion turbines intended for export is of extreme importance for Electricite de France. It is principally during the development phase of a project that one can ensure resect of two indissociable factors, essential to the per-kWh production cost: global operating costs and performance in terms of reliability and availability. The approach proposed here advocates the global acquisition of the installation and its logistic support. Generally applicable recommendations are given. They enable integrating in the future plant specifications all requirements relative to plant reliability, availability, maintainability and logistic support. They are structured according to type: expression of needs and management factors. (orig.) 4 refs.

  10. Cost-effectiveness of combustion turbines: recommendations for reliability, maintainability, supportability and maintenance requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meuwisse, C; Despujols, A [Electricite de France, Research and Development Division, Chatou (France); Givaudan, B [Electricite de France, Research and Development Division - SEPTEN, Villeurbanne (France); Lafage, L [Electricite de France, Engineering and Construction Division - CNET, Paris (France)

    1999-12-31

    The profitability of combustion turbines intended for export is of extreme importance for Electricite de France. It is principally during the development phase of a project that one can ensure resect of two indissociable factors, essential to the per-kWh production cost: global operating costs and performance in terms of reliability and availability. The approach proposed here advocates the global acquisition of the installation and its logistic support. Generally applicable recommendations are given. They enable integrating in the future plant specifications all requirements relative to plant reliability, availability, maintainability and logistic support. They are structured according to type: expression of needs and management factors. (orig.) 4 refs.

  11. Experiences of operational costs of HPV vaccine delivery strategies in Gavi-supported demonstration projects

    Science.gov (United States)

    Holroyd, Taylor; Nanda, Shreya; Bloem, Paul; Griffiths, Ulla K.; Sidibe, Anissa; Hutubessy, Raymond C. W.

    2017-01-01

    From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool. The World Health Organization Cervical Cancer Prevention and Control Costing Tool was used to collect costing data, which were then aggregated and analyzed to assess the costs and cost determinants of vaccination. Across the one-year demonstration projects, the average economic and financial costs per dose amounted to US$19.98 (standard deviation ±12.5) and US$8.74 (standard deviation ±5.8), respectively. The greatest activities representing the greatest share of financial costs were social mobilization at approximately 30% (range, 6–67%) and service delivery at about 25% (range, 3–46%). Districts implemented varying combinations of school-based, facility-based, or outreach delivery strategies and experienced wide variation in vaccine coverage, drop-out rates, and service delivery costs, including transportation costs and per diems. Size of target population, number of students per school, and average length of time to reach an outreach post influenced cost per dose. Although the operational costs from demonstration projects are much higher than those of other routine vaccine immunization programs, findings from our analysis suggest that HPV vaccination operational costs will decrease substantially for national introduction. Vaccination costs may be decreased further by annual vaccination, high initial investment in social mobilization, or introducing/strengthening school health programs. Our analysis shows that drivers of cost are dependent on

  12. Tuning the reactivity of Ru nanoparticles by defect engineering of the reduced graphene oxide support

    KAUST Repository

    Liu, Xin; Sui, Yanhui; Meng, Changgong; Han, Yu

    2014-01-01

    We systematically investigated the electronic structure of Ru nanoparticles supported on various local structures on reduced graphene oxide (rGO) by first-principles-based calculations. We showed that Ru nanoparticles prefer to nucleate

  13. Cost-effectiveness of reducing emissions from tropical deforestation, 2016-2050

    Science.gov (United States)

    Busch, Jonah; Engelmann, Jens

    2017-12-01

    Reducing tropical deforestation is potentially a large-scale and low-cost strategy for mitigating climate change. Yet previous efforts to project the cost-effectiveness of policies to reduce greenhouse gas emissions from future deforestation across the tropics were hampered by crude available data on historical forest loss. Here we use recently available satellite-based maps of annual forest loss between 2001-2012, along with information on topography, accessibility, protected status, potential agricultural revenue, and an observed inverted-U-shaped relationship between forest cover loss and forest cover, to project tropical deforestation from 2016-2050 under alternative policy scenarios and to construct new marginal abatement cost curves for reducing emissions from tropical deforestation. We project that without new forest conservation policies 289 million hectares of tropical forest will be cleared from 2016-2050, releasing 169 GtCO2. A carbon price of US20/tCO2 (50/tCO2) across tropical countries would avoid 41 GtCO2 (77 GtCO2) from 2016-2050. By comparison, we estimate that Brazil’s restrictive policies in the Amazon between 2004-2012 successfully decoupled potential agricultural revenue from deforestation and reduced deforestation by 47% below what would have otherwise occurred, preventing the emission of 5.2 GtCO2. All tropical countries enacting restrictive anti-deforestation policies as effective as those in the Brazilian Amazon between 2004-2012 would avoid 58 GtCO2 from 2016-2050.

  14. Implementation of Continuous Video-Electroencephalography at a Community Hospital Enhances Care and Reduces Costs.

    Science.gov (United States)

    Kolls, Brad J; Mace, Brian E; Dombrowski, Keith E

    2017-10-24

    Despite data indicating the importance of continuous video-electroencephalography (cvEEG) monitoring, adoption has been slow outside major academic centers. Barriers to adoption include the need for technologists, equipment, and cvEEG readers. Advancements in lower-cost lead placement templates and commercial systems with remote review may reduce barriers to allow community centers to implement cvEEG. Here, we report our experience, lessons learned, and financial impact of implementing a community hospital cvEEG-monitoring program. We implemented an adult cvEEG service at Duke Regional Hospital (DRH), a community hospital affiliate, in June of 2012. Lead placement templates were used in the implementation to reduce the impact on technologists by using other bedside providers for EEG initiation. Utilization of the service, study quality, and patient outcomes were tracked over a 3-year period following initiation of service. Service was implemented at essentially no cost. Utilization varied from a number of factors: intensive care unit (ICU) attending awareness, limited willingness of bedside providers to perform lead placement, and variation in practice of the consulting neurologists. A total of 92 studies were performed on 88 patients in the first 3 years of the program, 24 in year one, 27 in year two, and 38 in year three, showing progressive adoption. Seizures were seen in 25 patients (27%), 19 were in status, of which 18 were successfully treated. Transfers to the main hospital, Duke University Medical Center, were prevented for 53 patients, producing an estimated cost savings of $145,750. The retained patients produced a direct contribution margin of about $75,000, and the margin was just over $100,000 for the entire monitored cohort. ICU cvEEG service is feasible and practical to implement at the community hospital level. Service was initiated at little to no cost and clearly enhanced care, increased breadth of care, increased ICU census, and reduced

  15. Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

    Energy Technology Data Exchange (ETDEWEB)

    Busch, Jonah [Center for Applied Biodiversity Science, Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Strassburg, Bernardo [Center for Social and Economic Research on the Global Environment, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Cattaneo, Andrea [Woods Hole Research Center, 149 Woods Hole Road, Falmouth, MA 02540-1644 (United States); Lubowski, Ruben [Environmental Defense Fund, 1875 Connecticut Avenue NW, Washington, DC (United States); Bruner, Aaron; Rice, Richard; Boltz, Frederick [Conservation International, 2011 Crystal Drive, Suite 500, Arlington, VA (United States); Creed, Anna; Ashton, Ralph, E-mail: jbusch@conservation.or [Terrestrial Carbon Group, 900 17th Street NW, Suite 700, Washington, DC (United States)

    2009-10-15

    The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

  16. Comparing climate and cost impacts of reference levels for reducing emissions from deforestation

    International Nuclear Information System (INIS)

    Busch, Jonah; Strassburg, Bernardo; Cattaneo, Andrea; Lubowski, Ruben; Bruner, Aaron; Rice, Richard; Boltz, Frederick; Creed, Anna; Ashton, Ralph

    2009-01-01

    The climate benefit and economic cost of an international mechanism for reducing emissions from deforestation and degradation (REDD) will depend on the design of reference levels for crediting emission reductions. We compare the impacts of six proposed reference level designs on emission reduction levels and on cost per emission reduction using a stylized partial equilibrium model (the open source impacts of REDD incentives spreadsheet; OSIRIS). The model explicitly incorporates national incentives to participate in an international REDD mechanism as well as international leakage of deforestation emissions. Our results show that a REDD mechanism can provide cost-efficient climate change mitigation benefits under a broad range of reference level designs. We find that the most effective reference level designs balance incentives to reduce historically high deforestation emissions with incentives to maintain historically low deforestation emissions. Estimates of emission reductions under REDD depend critically on the degree to which demand for tropical frontier agriculture generates leakage. This underscores the potential importance to REDD of complementary strategies to supply agricultural needs outside of the forest frontier.

  17. The "basic" approach: a single-centre experience with a cost-reducing model for paediatric cardiac extracorporeal membrane oxygenation.

    Science.gov (United States)

    Padalino, Massimo A; Tessari, Chiara; Guariento, Alvise; Frigo, Anna C; Vida, Vladimiro L; Marcolongo, Andrea; Zanella, Fabio; Harvey, Michael J; Thiagarajan, Ravi R; Stellin, Giovanni

    2017-04-01

    Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014. Outcomes included postimplant complications and survival at weaning and at discharge. We used activity based costing to compare the costs of current basic ECMO with those of a 'full optional' dedicated ECMO team (hypothesis 1); ECMO with a bedside nurse and perfusionist (hypothesis 2), and ECMO with a bedside perfusionist (hypothesis 3). Basic cardiac ECMO was required for 121 patients (median age 75 days, median weight 4.4 kg). A total of 107 patients (88%) had congenital heart disease; 37 had univentricular physiology. The median duration of ECMO was 7 days (interquartile range [IQR], 4-15 days). Overall survival at weaning and at 30 days in the neonatal and paediatric age groups was 58.6% and 30.6%, respectively; these results were not significantly different from Extracorporeal Life Support Organization data. Cost analysis revealed a saving of €30 366, €22 144 and €13 837 for each patient on basic ECMO for hypotheses 1, 2 and 3, respectively. Despite reduced human, technical and economical resources, a basic ECMO model without a bedside specialist was associated with satisfactory survival and lower costs. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Reduced metabolic cost of locomotion in Svalbard rock ptarmigan (Lagopus muta hyperborea during winter.

    Directory of Open Access Journals (Sweden)

    John Lees

    2010-11-01

    Full Text Available The Svalbard rock ptarmigan, Lagopus muta hyperborea experiences extreme photoperiodic and climatic conditions on the Arctic archipelago of Svalbard. This species, however, is highly adapted to live in this harsh environment. One of the most striking adaptations found in these birds is the deposition, prior to onset of winter, of fat stores which may comprise up to 32% of body mass and are located primarily around the sternum and abdominal region. This fat, while crucial to the birds' survival, also presents a challenge in that the bird must maintain normal physiological function with this additional mass. In particular these stores are likely to constrain the respiratory system, as the sternum and pelvic region must be moved during ventilation and carrying this extra load may also impact upon the energetic cost of locomotion. Here we demonstrate that winter birds have a reduced cost of locomotion when compared to summer birds. A remarkable finding given that during winter these birds have almost twice the body mass of those in summer. These results suggest that Svalbard ptarmigan are able to carry the additional winter fat without incurring any energetic cost. As energy conservation is paramount to these birds, minimising the costs of moving around when resources are limited would appear to be a key adaptation crucial for their survival in the barren Arctic environment.

  19. Costs of reducing water use of concentrating solar power to sustainable levels: Scenarios for North Africa

    International Nuclear Information System (INIS)

    Damerau, Kerstin; Williges, Keith; Patt, Anthony G.; Gauche, Paul

    2011-01-01

    Concentrating solar power (CSP) has the potential to become a leading sustainable energy technology for the European electricity system. In order to reach a substantial share in the energy mix, European investment in CSP appears most profitable in North Africa, where solar potential is significantly higher than in southern Europe. As well as sufficient solar irradiance, however, the majority of today's CSP plants also require a considerable amount of water, primarily for cooling purposes. In this paper we examine water usage associated with CSP in North Africa, and the cost penalties associated with technologies that could reduce those needs. We inspect four representative sites to compare the ecological and economical drawbacks from conventional and alternative cooling systems, depending on the local environment, and including an outlook with climate change to the mid-century. Scaling our results up to a regional level indicates that the use of wet cooling technologies would likely be unsustainable. Dry cooling systems, as well as sourcing of alternative water supplies, would allow for sustainable operation. Their cost penalty would be minor compared to the variance in CSP costs due to different average solar irradiance values. - Highlights: → Scaling up CSP with wet cooling from ground water will be unsustainable in North Africa. → Desalination and alternative cooling systems can assure a sustainable water supply. → On large-scale, the cost penalties of alternative cooling technologies appear minor.

  20. 78 FR 41857 - Simplified Cost Accounting and Other Actions To Reduce Paperwork in the Summer Food Service...

    Science.gov (United States)

    2013-07-12

    ... CFR Parts 210 and 225 RIN 0584-AD84 Simplified Cost Accounting and Other Actions To Reduce Paperwork... Consolidated Appropriations Act, 2008. The changes extend simplified cost accounting and reporting procedures... nondiscretionary simplified cost accounting and reporting procedures established in the Consolidated Appropriations...

  1. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming.

    Science.gov (United States)

    Van Middelaar, C E; Dijkstra, J; Berentsen, P B M; De Boer, I J M

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the farm gate). Strategies included were (1) dietary supplementation of an extruded linseed product (56% linseed; 1kg/cow per day in summer and 2kg/cow per day in winter), (2) dietary supplementation of a nitrate source (75% nitrate; 1% of dry matter intake), and (3) reducing the maturity stage of grass and grass silage (grazing at 1,400 instead of 1,700kg of dry matter/ha and harvesting at 3,000 instead of 3,500kg of dry matter/ha). A dairy farm linear programing model was used to define an average Dutch dairy farm on sandy soil without a predefined feeding strategy (reference situation). Subsequently, 1 of the 3 feeding strategies was implemented and the model was optimized again to determine the new economically optimal farm situation. Enteric CH4 production in the reference situation and after implementing the strategies was calculated based on a mechanistic model for enteric CH4 and empirical formulas explaining the effect of fat and nitrate supplementation on enteric CH4 production. Other GHG emissions along the chain were calculated using life cycle assessment. Total GHG emissions in the reference situation added up to 840kg of CO2 equivalents (CO2e) per t of fat- and protein-corrected milk (FPCM) and yearly labor income of €42,605. Supplementation of the extruded linseed product reduced emissions by 9kg of CO2e/t of FPCM and labor income by €16,041; supplementation of the dietary nitrate source reduced emissions by 32kg of CO2e/t of FPCM and labor income by €5,463; reducing the maturity stage of grass and grass silage reduced emissions by 11kg of CO2e/t of FPCM and labor income by €463. Of the 3 strategies, reducing grass maturity was the most cost

  2. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs.

    Science.gov (United States)

    Neelemaat, Floor; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

    2012-04-01

    Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. This randomized controlled trial included hospital admitted malnourished elderly (≥ 60 y) patients. Patients in the intervention group received nutritional supplementation (energy and protein enriched diet, oral nutritional support, calcium-vitamin D supplement, telephone counselling by a dietician) until three months after discharge from hospital. Patients in the control group received usual care (control). Primary outcomes were Quality Adjusted Life Years (QALYs), physical activities and functional limitations. Measurements were performed at hospital admission and three months after discharge. Data were analyzed according to the intention-to-treat principle and multiple imputation was used to impute missing data. Incremental cost-effectiveness ratios were calculated and bootstrapping was applied to evaluate cost-effectiveness. Cost-effectiveness was expressed by cost-effectiveness planes and cost-effectiveness acceptability curves. 210 patients were included, 105 in each group. After three months, no statistically significant differences in quality of life and physical activities were observed between groups. Functional limitations decreased significantly more in the intervention group (mean difference -0.72, 95% CI-1.15; -0.28). There were no differences in costs between groups. Cost-effectiveness for QALYs and physical activities could not be demonstrated. For functional limitations we found a 0.95 probability that the intervention is cost-effective in comparison with usual care for ceiling ratios > €6500. A multi-component nutritional intervention to malnourished elderly patients for three months after hospital discharge leads to significant improvement in functional limitations and is neutral in costs. A follow-up of three months is probably too

  3. Priming media stereotypes reduces support for social welfare policies: the mediating role of empathy.

    Science.gov (United States)

    Johnson, James D; Olivo, Nelgy; Gibson, Nathan; Reed, William; Ashburn-Nardo, Leslie

    2009-04-01

    Two experiments involving White participants tested the influence of media-based priming of Black stereotypes on support for government policy that assisted Black versus White persons-in-need. Experiment 1 showed that priming the "Black criminal" stereotype through exposure to photographs of Blacks looting after Hurricane Katrina reduced policy support for Black evacuees-in-need but did not influence support responses toward White evacuees-in-need. Experiment 2 showed that priming the "promiscuous Black female" stereotype through exposure to sexual rap music reduced policy support for a Black pregnant woman-in-need but did not influence support responses toward a White pregnant woman-in-need. Further tests of mediated moderation demonstrated that in both experiments, the interactive influence of priming Black stereotypes and race of persons-in-need on policy support was mediated by empathic responding.

  4. The cost effectiveness of NHS physiotherapy support for occupational health (OH) services.

    Science.gov (United States)

    Phillips, Ceri J; Phillips Nee Buck, Rhiannon; Main, Chris J; Watson, Paul J; Davies, Shân; Farr, Angela; Harper, Christie; Noble, Gareth; Aylward, Mansel; Packman, Julie; Downton, Matt; Hale, Janine

    2012-02-23

    -£7760, which would represent value for money according to current UK thresholds. Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user. This pragmatic evaluation of the OHPPP indicated that it was likely to be feasible in terms of service usage and could potentially be cost effective in terms of QALYs. Further, the study confirmed that improving physical health status for musculoskeletal pain patients is important in reducing problems with work capacity and related costs. This study suggests that this type of service could be potentially be useful in reducing the burden of pain and should be further investigated, ideally via randomised controlled trials assessing effectiveness and cost-effectiveness.

  5. Use of configuration management to reduce development costs in metal parts

    International Nuclear Information System (INIS)

    Kalsoom, T.; Ahmad, S.

    2005-01-01

    In development and manufacturing phases of metal parts, design efforts are converted in set of engineering data pack under the given guidelines of Configuration Management (CM). These engineering documents define Configuration Management of metal parts production in a local industry. The development phase is normally less structured and open to Engineering Change Proposals. In our local engineering organizations most of the work done is normally not well documented for future revisions and modernization. This leads to delays in development and increase in production costs of metal parts. This becomes more pronounced if any member of the design team disassociates and leaves the organization. The Configuration Management helps to reduce development costs by providing infrastructure for product identification, documentation, change control, interface control and technical reviews and product audits. Automated or Computer-Assisted CM activities can also be used to shorten response time and increase accuracy and reliability of the produced metal components. (author)

  6. Facility Management as a Way of Reducing Costs in Transport Companies

    Science.gov (United States)

    Matusova, Dominika; Gogolova, Martina

    2017-10-01

    For facility management exists a several interpretations. These interpretations emerged progressively. At the time of the notion of facility management was designed to manage an administrative building, in the United States (US). They can ensure their operation and maintenance. From the US, this trend is further moved to Europe and now it start becoming a current and actual topic also in Slovakia. Facility management is contractually agreed scheme of services, semantically recalls traditional building management. There by finally pushed for activities related to real estates. For facility management is fundamental - certification and certification systems. Therefore, is essential to know, the cost structure of certification. The most commonly occurring austerity measures include: heat pumps, use of renewable energy, solar panels and water savings. These measures can reduce the cost.

  7. Great hammerhead sharks swim on their side to reduce transport costs.

    Science.gov (United States)

    Payne, Nicholas L; Iosilevskii, Gil; Barnett, Adam; Fischer, Chris; Graham, Rachel T; Gleiss, Adrian C; Watanabe, Yuuki Y

    2016-07-26

    Animals exhibit various physiological and behavioural strategies for minimizing travel costs. Fins of aquatic animals play key roles in efficient travel and, for sharks, the functions of dorsal and pectoral fins are considered well divided: the former assists propulsion and generates lateral hydrodynamic forces during turns and the latter generates vertical forces that offset sharks' negative buoyancy. Here we show that great hammerhead sharks drastically reconfigure the function of these structures, using an exaggerated dorsal fin to generate lift by swimming rolled on their side. Tagged wild sharks spend up to 90% of time swimming at roll angles between 50° and 75°, and hydrodynamic modelling shows that doing so reduces drag-and in turn, the cost of transport-by around 10% compared with traditional upright swimming. Employment of such a strongly selected feature for such a unique purpose raises interesting questions about evolutionary pathways to hydrodynamic adaptations, and our perception of form and function.

  8. New roller cone bits with unique nozzle designs reduce drilling costs

    International Nuclear Information System (INIS)

    Moffitt, S.R.; Pearce, D.E.; Ivie, C.R.

    1992-01-01

    This paper reports that selection of the optimum rock bit design to achieve the lowest drilling cost in a given application is often difficult due to a large number of rock bit performance considerations. However, in a majority of applications increased penetration rate is the key consideration in reducing drilling costs. Discovery of a new bit design concept has led to the development of roller cone bits that achieve significant penetration rate increases using superior hydraulic nozzle designs. Prototype designs have achieved 20 to 40% increases in penetration rate with comparable footage drilled when tested in 6 1/2, 8 1/2, 8-3/4, 9-7/8 and 12 1/4 IADC 437, 517 and 537 type bits in the U.S., North Sea, Italy, and Oman. Second-generation designs tested in a full-scale drilling laboratory have delivered 70% increases in penetration rates

  9. The role of technology in reducing health care costs. Final project report

    Energy Technology Data Exchange (ETDEWEB)

    Sill, A.E.; Warren, S.; Dillinger, J.D.; Cloer, B.K.

    1997-08-01

    Sandia National Laboratories applied a systems approach to identifying innovative biomedical technologies with the potential to reduce U.S. health care delivery costs while maintaining care quality. This study was conducted by implementing both top-down and bottom-up strategies. The top-down approach used prosperity gaming methodology to identify future health care delivery needs. This effort provided roadmaps for the development and integration of technology to meet perceived care delivery requirements. The bottom-up approach identified and ranked interventional therapies employed in existing care delivery systems for a host of health-related conditions. Economic analysis formed the basis for development of care pathway interaction models for two of the most pervasive, chronic disease/disability conditions: coronary artery disease (CAD) and benign prostatic hypertrophy (BPH). Societal cost-benefit relationships based on these analyses were used to evaluate the effect of emerging technology in these treatment areas. 17 figs., 48 tabs.

  10. THE ROLE OF TIPPING IN REDUCING LABOUR COSTS: CASE OF SECTOR RETAIL PETROLEUM PRODUCTS

    Directory of Open Access Journals (Sweden)

    Andrej Raspor

    2014-05-01

    Full Text Available The purpose of this paper was to determine whether tipping could reduce labour costs in the petroleum products retail sector. The research we present was designed on the basis of survey results gathered from Slovenian petrol stations in 2009 and 2010. We have identified the following factors in the tipping process: job satisfaction, flexibility, service quality, satisfaction, motivation and the factor of receiving tips. The analysis showed correlation between methods used to increase the value of tips and better service quality, increased financial and numerical flexibility, motivation, satisfaction upon receipt of tips and the method used to increase the value of tips. In order to decrease labour costs we propose that the management take control of tipping and integrates tips into the reward system. Also, the employees should be made aware about how tipping improves service and increases their income.

  11. Are financial incentives cost-effective to support smoking cessation during pregnancy?

    Science.gov (United States)

    Boyd, Kathleen A; Briggs, Andrew H; Bauld, Linda; Sinclair, Lesley; Tappin, David

    2016-02-01

    To investigate the cost-effectiveness of up to £400 worth of financial incentives for smoking cessation in pregnancy as an adjunct to routine health care. Cost-effectiveness analysis based on a Phase II randomized controlled trial (RCT) and a cost-utility analysis using a life-time Markov model. The RCT was undertaken in Glasgow, Scotland. The economic analysis was undertaken from the UK National Health Service (NHS) perspective. A total of 612 pregnant women randomized to receive usual cessation support plus or minus financial incentives of up to £400 vouchers (US $609), contingent upon smoking cessation. Comparison of usual support and incentive interventions in terms of cotinine-validated quitters, quality-adjusted life years (QALYs) and direct costs to the NHS. The incremental cost per quitter at 34-38 weeks pregnant was £1127 ($1716).This is similar to the standard look-up value derived from Stapleton & West's published ICER tables, £1390 per quitter, by looking up the Cessation in Pregnancy Incentives Trial (CIPT) incremental cost (£157) and incremental 6-month quit outcome (0.14). The life-time model resulted in an incremental cost of £17 [95% confidence interval (CI) = -£93, £107] and a gain of 0.04 QALYs (95% CI = -0.058, 0.145), giving an ICER of £482/QALY ($734/QALY). Probabilistic sensitivity analysis indicates uncertainty in these results, particularly regarding relapse after birth. The expected value of perfect information was £30 million (at a willingness to pay of £30 000/QALY), so given current uncertainty, additional research is potentially worthwhile. Financial incentives for smoking cessation in pregnancy are highly cost-effective, with an incremental cost per quality-adjusted life years of £482, which is well below recommended decision thresholds. © 2015 Society for the Study of Addiction.

  12. Effectiveness and cost of failure mode and effects analysis methodology to reduce neurosurgical site infections.

    Science.gov (United States)

    Hover, Alexander R; Sistrunk, William W; Cavagnol, Robert M; Scarrow, Alan; Finley, Phillip J; Kroencke, Audrey D; Walker, Judith L

    2014-01-01

    Mercy Hospital Springfield is a tertiary care facility with 32 000 discharges and 15 000 inpatient surgeries in 2011. From June 2009 through January 2011, a stable inpatient elective neurosurgery infection rate of 2.15% was observed. The failure mode and effects analysis (FMEA) methodology to reduce inpatient neurosurgery infections was utilized. Following FMEA implementation, overall elective neurosurgery infection rates were reduced to 1.51% and sustained through May 2012. Compared with baseline, the post-FMEA deep-space and organ infection rate was reduced by 41% (P = .052). Overall hospital inpatient clean surgery infection rates for the same time frame did not decrease to the same extent, suggesting a specific effect of the FMEA. The study team believes that the FMEA interventions resulted in 14 fewer expected infections, $270 270 in savings, a 168-day reduction in expected length of stay, and 22 fewer readmissions. Given the serious morbidity and cost of health care-associated infections, the study team concludes that FMEA implementation was clinically cost-effective. © 2013 by the American College of Medical Quality.

  13. Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals.

    Science.gov (United States)

    Banks, M D; Graves, N; Bauer, J D; Ash, S

    2013-01-01

    This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Statistical models were developed to predict 'cases of pressure ulcer avoided', 'number of bed days gained' and 'change to economic costs' in public hospitals in 2002-2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12, 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

  14. Nurse led versus lay educators support for those with asthma in primary care: a costing study

    Science.gov (United States)

    2012-01-01

    Background Regular review and support for asthma self-management is promoted in guidelines. A randomised controlled trial suggested that unscheduled health care usage was similar when patients were offered self management support by a lay-trainer or practice nurses. Methods Following the RCT, a costing study was undertaken using the trial data to account for the cost of delivery of the service under both strategies and the resulting impact on unscheduled healthcare (measure of effectiveness) in this trial. Results One year data (n = 418) showed that 29% (61/205) of the nurse group required unscheduled healthcare (177 events) compared with 30.5% (65/213) for lay-trainers (178 events). The training costs for the lay-trainers were greater than nurses (£36 versus £18 respectively per patient, play-trainers were lower than nurses (£6 per patient versus £24, play-trainers (mean difference £25, [95% CI = −£97, £149, p = 0.681]). The total costs (delivery and unscheduled healthcare) were £202 per patient for nurses versus £178 for lay-trainers, (mean difference £24, [95%CI = −£100, £147, p = 0.707]). Conclusions There were no significant differences in the cost of training and healthcare delivery between nurse and lay trainers, and no significant difference in the cost of unscheduled health care use. PMID:22958541

  15. Waste Management Strategy for Dismantling Waste to Reduce Costs for Power Plant Decommissioning - 13543

    Energy Technology Data Exchange (ETDEWEB)

    Larsson, Arne; Lidar, Per [Studsvik Nuclear AB, SE-611 82 Nykoeping (Sweden); Bergh, Niklas; Hedin, Gunnar [Westinghouse Electric Sweden AB, Fredholmsgatan 2, SE-721 63, Vaesteraas (Sweden)

    2013-07-01

    interruptions. Bottle-necks in the process causes increased space requirements and will have negative impact on the project schedule, which increases not only the cost but also the dose exposure to personnel. For these reasons it is critical to create a process that transfers material into conditioned waste ready for disposal as quickly as possible. To a certain extent the decommissioning program should be led by the waste management process. With the objective to reduce time for handling of dismantled material at site and to efficiently and environmental-friendly use waste management methods (clearance for re-use followed by clearance for recycling), the costs for the plant decommissioning could be reduced as well as time needed for performing the decommissioning project. Also, risks for delays would be reduced with a well-defined handling scheme which limits surprises. Delays are a major cost driver for decommissioning projects. (authors)

  16. Waste Management Strategy for Dismantling Waste to Reduce Costs for Power Plant Decommissioning - 13543

    International Nuclear Information System (INIS)

    Larsson, Arne; Lidar, Per; Bergh, Niklas; Hedin, Gunnar

    2013-01-01

    -necks in the process causes increased space requirements and will have negative impact on the project schedule, which increases not only the cost but also the dose exposure to personnel. For these reasons it is critical to create a process that transfers material into conditioned waste ready for disposal as quickly as possible. To a certain extent the decommissioning program should be led by the waste management process. With the objective to reduce time for handling of dismantled material at site and to efficiently and environmental-friendly use waste management methods (clearance for re-use followed by clearance for recycling), the costs for the plant decommissioning could be reduced as well as time needed for performing the decommissioning project. Also, risks for delays would be reduced with a well-defined handling scheme which limits surprises. Delays are a major cost driver for decommissioning projects. (authors)

  17. Do Statins Reduce the Health and Health Care Costs of Obesity?

    Science.gov (United States)

    Gaudette, Étienne; Goldman, Dana P; Messali, Andrew; Sood, Neeraj

    2015-07-01

    Obesity impacts both individual health and, given its high prevalence, total health care spending. However, as medical technology evolves, health outcomes for a number of obesity-related illnesses improve. This article examines whether medical innovation can mitigate the adverse health and spending associated with obesity, using statins as a case study. Because of the relationship between obesity and hypercholesterolaemia, statins play an important role in the medical management of obese individuals and the prevention of costly obesity-related sequelae. Using well-recognized estimates of the health impact of statins and the Future Elderly Model (FEM)-an established dynamic microsimulation model of the health of Americans aged over 50 years-we estimate the changes in life expectancy, functional status and health care costs of obesity due to the introduction and widespread use of statins. Life expectancy gains of statins are estimated to be 5-6 % greater for obese individuals than for healthy-weight individuals, but most of these additional gains are associated with some level of disability. Considering both medical spending and the value of quality-adjusted life-years, statins do not significantly alter the costs of class 1 and 2 obesity (body mass index [BMI] ≥30 and ≥35 kg/m(2), respectively) and they increase the costs of class 3 obesity (BMI ≥40 kg/m(2)) by 1.2 %. Although statins are very effective medications for lowering the risk of obesity-associated illnesses, they do not significantly reduce the costs of obesity.

  18. A way for reducing drug supply chain cost for a hospital district: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Postacchini, L.; Ciarapica, F.E.; Bevilacqua, M.; Mazzuto, G.; Paciarotti, C.

    2016-07-01

    This work aims at providing insights to optimise healthcare logistic of the drug management, in order to deal with the healthcare expenditure cut. In this paper the effects of different drug supply chain configurations, on the resulting average stock, service level and Bullwhip effect, of the studied supply chain, is quantitatively assessed. A case study of an Italian district has been studied, taking into account three echelons: suppliers, central stock, and hospitals. A model of the various supply chain configurations has been created with the use of the simulation. Specifically, 24 supply chain configurations have been examined, stemming from the combination of several supply chain design parameters, namely: transshipment policies (Emergency Lateral Transshipment or Total Inventory Equalization); re-order and inventory management policies (Economic Order Quantity or Economic Order Interval); required service levels (90% or 95%); the number of available vans (one or two). For each configuration, hospital average stock, service level and a “Bullwhip effect” analysis are computed. To know which input variables are statistically significant, a DoE (Design of Experiments) analysis has been executed. The output of this paper provides useful insights and suggestions to optimize the healthcare logistic and drug supply chain. According to the developed DoE analysis, it can be stated that the introduction of transshipment policies provides important improvement in terms of service and stock levels. To reduce the Bullwhip effect, which results in a service level decreasing, and in a managing stock costs increasing, it is worth to adopt an EOQ re-order policy. This research gives practical recommendations to the studied system, in order to reduce costs and maintain a very satisfactory service level. This paper fulfils an identified need to study which combination of transshipment policies, re-order/inventory management policies and required service levels, can be the

  19. Reducing the metabolic cost of walking with an ankle exoskeleton: interaction between actuation timing and power.

    Science.gov (United States)

    Galle, Samuel; Malcolm, Philippe; Collins, Steven Hartley; De Clercq, Dirk

    2017-04-27

    Powered ankle-foot exoskeletons can reduce the metabolic cost of human walking to below normal levels, but optimal assistance properties remain unclear. The purpose of this study was to test the effects of different assistance timing and power characteristics in an experiment with a tethered ankle-foot exoskeleton. Ten healthy female subjects walked on a treadmill with bilateral ankle-foot exoskeletons in 10 different assistance conditions. Artificial pneumatic muscles assisted plantarflexion during ankle push-off using one of four actuation onset timings (36, 42, 48 and 54% of the stride) and three power levels (average positive exoskeleton power over a stride, summed for both legs, of 0.2, 0.4 and 0.5 W∙kg -1 ). We compared metabolic rate, kinematics and electromyography (EMG) between conditions. Optimal assistance was achieved with an onset of 42% stride and average power of 0.4 W∙kg -1 , leading to 21% reduction in metabolic cost compared to walking with the exoskeleton deactivated and 12% reduction compared to normal walking without the exoskeleton. With suboptimal timing or power, the exoskeleton still reduced metabolic cost, but substantially less so. The relationship between timing, power and metabolic rate was well-characterized by a two-dimensional quadratic function. The assistive mechanisms leading to these improvements included reducing muscular activity in the ankle plantarflexors and assisting leg swing initiation. These results emphasize the importance of optimizing exoskeleton actuation properties when assisting or augmenting human locomotion. Our optimal assistance onset timing and average power levels could be used for other exoskeletons to improve assistance and resulting benefits.

  20. Effect of balance support on the energy cost of walking after stroke

    NARCIS (Netherlands)

    IJmker, Trienke; Houdijk, Han; Lamoth, Claudine J.; Jarbandhan, Ameerani V.; Rijntjes, Danielle; Beek, Peter J.; van der Woude, Lucas H.

    Objective: To examine the influence of balance support on the energy cost of treadmill and overground walking in ambulatory patients with stroke. Design: Cross-sectional. Setting: Research laboratory at a rehabilitation center. Participants: Patients with stroke depending on a walking aid in daily

  1. Cost-effectiveness of implant-supported mandibular removable partial dentures

    NARCIS (Netherlands)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    ObjectivesThe aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Material and methodsThirty

  2. The Relationship between Return on Profitability and Costs of Outsourcing Information Technology Technical Support

    Science.gov (United States)

    Odion, Segun

    2011-01-01

    The purpose of this quantitative correlational research study was to examine the relationship between costs of operation and total return on profitability of outsourcing information technology technical support in a two-year period of outsourcing operations. United States of America list of Fortune 1000 companies' chief information officers…

  3. Using Common Themes: Cost-Effectiveness of Permanent Supported Housing for People with Mental Illness

    Science.gov (United States)

    McLaughlin, Thomas Chalmers

    2011-01-01

    This article examines the cost-effectiveness of providing permanent supported housing to homeless people with mental illness. Through the use of billing records and frequency of use charts, researchers were able to map the service usage of a cohort of 268 homeless individuals from both urban and rural communities. The results suggest that…

  4. Composite decision support by combining cost-benefit and multi-criteria decision

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Salling, Kim Bang; Leleur, Steen

    2011-01-01

    This paper concerns composite decision support based on combining cost-benefit analysis (CBA) with multi-criteria decision analysis (MCDA) for the assessment of economic as well as strategic impacts within transport projects. Specifically a composite model for assessment (COSIMA) is presented...

  5. Effectiveness of Multimedia Elements in Computer Supported Instruction: Analysis of Personalization Effects, Students' Performances and Costs

    Science.gov (United States)

    Zaidel, Mark; Luo, XiaoHui

    2010-01-01

    This study investigates the efficiency of multimedia instruction at the college level by comparing the effectiveness of multimedia elements used in the computer supported learning with the cost of their preparation. Among the various technologies that advance learning, instructors and students generally identify interactive multimedia elements as…

  6. Long-term costs and health impact of continued global fund support for antiretroviral therapy

    NARCIS (Netherlands)

    J. Stover (John); E.L. Korenromp (Eline); M. Blakley (Matthew); R. Komatsu (Ryuichi); K.M. Viisainen (Kirsi); L. Bollinger (Lori); R. Atun (Rifat)

    2011-01-01

    textabstractBackground: By the end of 2011 Global Fund investments will be supporting 3.5 million people on antiretroviral therapy (ART) in 104 low- and middle-income countries. We estimated the cost and health impact of continuing treatment for these patients through 2020. Methods and Findings:

  7. Cost of reproduction in a long-lived bird: incubation effort reduces immune function and future reproduction

    OpenAIRE

    Hanssen, S A; Hasselquist, Dennis; Folstad, I; Erikstad, K E

    2005-01-01

    Life-history theory predicts that increased current reproductive effort should lead to a fitness cost. This cost of reproduction may be observed as reduced survival or future reproduction, and may be caused by temporal suppression of immune function in stressed or hard-working individuals. In birds, consideration of the costs of incubating eggs has largely been neglected in favour of the costs of brood rearing. We manipulated incubation demand in two breeding seasons (2000 and 2001) in female...

  8. Proven Innovations and New Initiatives in Ground System Development: Reducing Costs in the Ground System

    Science.gov (United States)

    Gunn, Jody M.

    2006-01-01

    The state-of-the-practice for engineering and development of Ground Systems has evolved significantly over the past half decade. Missions that challenge ground system developers with significantly reduced budgets in spite of requirements for greater and previously unimagined functionality are now the norm. Making the right trades early in the mission lifecycle is one of the key factors to minimizing ground system costs. The Mission Operations Strategic Leadership Team at the Jet Propulsion Laboratory has spent the last year collecting and working through successes and failures in ground systems for application to future missions.

  9. Quality improvement in hospitals: how much does it reduce healthcare costs?

    Science.gov (United States)

    Jones, S B

    1995-01-01

    The philosophy of W.E. Deming suggests that continuous quality improvement efforts, when properly applied, ultimately will lead to financial dividends and will help ensure business longevity. Reducing hospital charges can be exciting for the participants and can provide an impetus for expanding quality improvement efforts. Americans, however, tend to demand almost instant gratification and have limited patience for longer-term results. This factor, coupled with minimal knowledge of actual operational costs and inaccurate charge accounting systems, may lead hospital managers to misinterpret the potential net long-term effects of their quality improvement efforts. In the approaching environment of capitated reimbursement, such mistakes may have serious consequences.

  10. Enrichment: CRISLA [chemical reaction by isotope selective activation] aims to reduce costs

    International Nuclear Information System (INIS)

    Eerkens, J.W.

    1989-01-01

    Every year, more than $3 billion is spent on enriching uranium. CRISLA (Chemical Reaction by Isotope Selective Activation) uses a laser-catalyzed chemical reaction which, its proponents claim, could substantially reduce these costs. In CRISLA, an infrared CO laser illuminates the intracavity reaction cell (IC) at a frequency tuned to excite primarily UF 6 . When UF 6 and co-reactant RX are passed through the IC, the tuned laser photons preferentially enhance the reaction of UF 6 with RX ten-thousand-fold over the thermal reaction rate. Thus the laser serves as an activator and the chemical energy for separation is largely chemical. (author)

  11. Reducing costs of wind power with a gearless permanent-magnet generator

    International Nuclear Information System (INIS)

    Vihriaelae, H.; Peraelae, R.; Soederlund, L.; Eriksson, J.T.

    1995-01-01

    This article examines a disc-type axial-field permanent magnet generator (PMG) utilizing the latest generation of permanent magnet material, namely Nd 15 B 8 Fe 77 . A frequency converter (FC) is needed to keep the system synchronized with the grid. It also offers a possibility to use variable speed. The main advantages of this novel system compared to the conventional one are a higher overall efficiency, better reliability, reduced weight and diminished need for maintenance, all contributing to the cost-reduction of wind power. (author)

  12. Reducing costs of wind power with a gearless permanent-magnet generator

    Energy Technology Data Exchange (ETDEWEB)

    Vihriaelae, H; Peraelae, R; Soederlund, L; Eriksson, J T [Tampere Univ. of Technology (Finland). Lab. of Electricity and Magnetism

    1996-12-31

    This article examines a disc-type axial-field permanent magnet generator (PMG) utilizing the latest generation of permanent magnet material, namely Nd{sub 15}B{sub 8}Fe{sub 77}. A frequency converter (FC) is needed to keep the system synchronized with the grid. It also offers a possibility to use variable speed. The main advantages of this novel system compared to the conventional one are a higher overall efficiency, better reliability, reduced weight and diminished need for maintenance, all contributing to the cost-reduction of wind power. (author)

  13. Reducing costs of wind power with a gearless permanent-magnet generator

    Energy Technology Data Exchange (ETDEWEB)

    Vihriaelae, H.; Peraelae, R.; Soederlund, L.; Eriksson, J.T. [Tampere Univ. of Technology (Finland). Lab. of Electricity and Magnetism

    1995-12-31

    This article examines a disc-type axial-field permanent magnet generator (PMG) utilizing the latest generation of permanent magnet material, namely Nd{sub 15}B{sub 8}Fe{sub 77}. A frequency converter (FC) is needed to keep the system synchronized with the grid. It also offers a possibility to use variable speed. The main advantages of this novel system compared to the conventional one are a higher overall efficiency, better reliability, reduced weight and diminished need for maintenance, all contributing to the cost-reduction of wind power. (author)

  14. Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.

    Science.gov (United States)

    Hassell, J T; Games, A D; Shaffer, B; Harkins, L E

    1994-09-01

    To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P group (P team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.

  15. Micro-costing the provision of emotional support and information in UK eye clinics.

    Science.gov (United States)

    Gillespie-Gallery, Hanna; Subramanian, Ahalya; Conway, Miriam L

    2013-11-19

    Sight loss has wide ranging implications for an individual in terms of education, employment, mobility and mental health. Therefore there is a need for information and support to be provided in eye clinics at the point of diagnosis of sight threatening conditions, but these aspects of care are often missing from clinics. To meet these needs, some clinics employ an Eye Clinic Liaison Officer (ECLO) but the position has yet to be widely implemented. The aims of this study were:(1) To evaluate the forms of advice and emotional support in eye clinics provided by ECLOs.(2) To determine the cost of the ECLO service per patient. Micro-costing was carried out using interviews, a survey and administrative data. The survey was completed by 18 of the 49 accredited ECLOs in the UK (37%) and provided information on the activities performed by ECLOs, numbers of patients seen per day, training costs incurred and the salary of the ECLOs. ECLOs provided information about the services in eye clinics and the community, referral to social services, emotional support to patients and also other advice. The cost of an ECLO per patient per contact was £17.94 based on an average annual ECLO salary of £23,349.60 per year, reviewing on average 9.1 patients per day, in a 42 week year. This study provides the first costing of support services in hospital eye clinics, providing a range of estimates to suit the circumstances of different clinics. The information can be used by local decision makers to estimate the cost of implementing an ECLO service.

  16. [A cost-benefit analysis of a Mexican food-support program].

    Science.gov (United States)

    Ventura-Alfaro, Carmelita E; Gutiérrez-Reyes, Juan P; Bertozzi-Kenefick, Stefano M; Caldés-Gómez, Natalia

    2011-06-01

    Objective Presenting an estimate of a Mexican food-support program (FSP) program's cost transfer ratio (CTR) from start-up (2003) to May 2005. Methods The program's activities were listed by constructing a time allocation matrix to ascertain how much time was spent on each of the program's activities by the personnel so involved. Another cost matrix was also constructed which was completed with information from the program's accountancy records. The program's total cost, activity cost and the value of given FSP transfers were thus estimated. Results Food delivery CRT for 2003, 2004 and 2005 was 0.150, 0.218, 0.230, respectively; cash CTR was 0.132in 2004 and 0.105 in 2005. Conclusion Comparing CTR values according to transfer type is a good way to promote discussion related to this topic; however, the decision for making a transfer does not depend exclusively on efficiency but on both mechanisms' effectiveness.

  17. Cost-effectiveness of clinical decision support system in improving maternal health care in Ghana.

    Directory of Open Access Journals (Sweden)

    Maxwell Ayindenaba Dalaba

    Full Text Available This paper investigated the cost-effectiveness of a computer-assisted Clinical Decision Support System (CDSS in the identification of maternal complications in Ghana.A cost-effectiveness analysis was performed in a before- and after-intervention study. Analysis was conducted from the provider's perspective. The intervention area was the Kassena- Nankana district where computer-assisted CDSS was used by midwives in maternal care in six selected health centres. Six selected health centers in the Builsa district served as the non-intervention group, where the normal Ghana Health Service activities were being carried out.Computer-assisted CDSS increased the detection of pregnancy complications during antenatal care (ANC in the intervention health centres (before-intervention = 9 /1,000 ANC attendance; after-intervention = 12/1,000 ANC attendance; P-value = 0.010. In the intervention health centres, there was a decrease in the number of complications during labour by 1.1%, though the difference was not statistically significant (before-intervention =107/1,000 labour clients; after-intervention = 96/1,000 labour clients; P-value = 0.305. Also, at the intervention health centres, the average cost per pregnancy complication detected during ANC (cost -effectiveness ratio decreased from US$17,017.58 (before-intervention to US$15,207.5 (after-intervention. Incremental cost -effectiveness ratio (ICER was estimated at US$1,142. Considering only additional costs (cost of computer-assisted CDSS, cost per pregnancy complication detected was US$285.Computer -assisted CDSS has the potential to identify complications during pregnancy and marginal reduction in labour complications. Implementing computer-assisted CDSS is more costly but more effective in the detection of pregnancy complications compared to routine maternal care, hence making the decision to implement CDSS very complex. Policy makers should however be guided by whether the additional benefit is worth

  18. Costs and cost-effectiveness of training traditional birth attendants to reduce neonatal mortality in the Lufwanyama Neonatal Survival study (LUNESP).

    Science.gov (United States)

    Sabin, Lora L; Knapp, Anna B; MacLeod, William B; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H; Gill, Christopher J

    2012-01-01

    The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.

  19. Costs and cost-effectiveness of training traditional birth attendants to reduce neonatal mortality in the Lufwanyama Neonatal Survival study (LUNESP.

    Directory of Open Access Journals (Sweden)

    Lora L Sabin

    Full Text Available The Lufwanyama Neonatal Survival Project ("LUNESP" was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness.We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020. In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation.Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.

  20. What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits.

    Science.gov (United States)

    Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A

    2016-10-01

    More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median duration, 68 s). We identified 4 strategies to lower costs without changing the care plan. They were, in order of overall frequency: 1) changing logistics of care, 2) facilitating co-pay assistance, 3) providing free samples, and 4) changing/adding insurance plans. We also identified 4 strategies to reduce costs by changing the care plan: 1) switching to lower-cost alternative therapy/diagnostic, 2) switching from brand name to generic, 3) changing dosage/frequency, and 4) stopping/withholding interventions. Strategies were relatively consistent across health conditions, except for switching to a lower-cost alternative (more common in breast oncology) and providing free samples (more common in depression). Focus on 3 conditions with potentially high out-of-pocket costs. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. © The Author(s) 2016.

  1. Options for cost-effectively reducing atmospheric methane concentrations from anthropogenic biomass sources

    International Nuclear Information System (INIS)

    Roos, K.F.; Jacobs, C.; Orlic, M.

    1993-01-01

    Methane is a major greenhouse gas, second only to carbon dioxide in its contribution to future global warming. Methane concentrations have more than doubled over the last two centuries and continue to rise annually. These increases are largely correlated with increasing human populations. Methane emissions from human related activities currently account for about 70 percent of annual emissions. Of these human related emissions, biomass sources account for about 75 percent and non-biomass sources about 25 percent. Because methane has a shorter lifetime than other major greenhouse gases, efforts to reduce methane emissions may fairly quickly be translated into lower atmospheric concentrations of methane and lower levels of radiative forcing. This fairly quick response would have the benefit of slowing the rate of climate change and hence allow natural ecosystems more time to adapt. Importantly, methane may be cost-effectively reduced from a number of biomass and non-biomass sources in the United States and worldwide. Methane is a valuable fuel, not just a waste by-product, and often systems may be reconfigured to reap the fuel value of the methane and more than justify the necessary expenditures. Such options for reducing methane emission from biomass sources exist for landfills, livestock manures, and ruminant livestock, and have been implemented to varying degrees in countries around the world. However, there are a number of barriers that hinder the more widespread use of technologies, including institutional, financial, regulatory, informational, and other barriers. This paper describes an array of available options that may be cost-effectively implemented to reduce methane emissions from biomass sources. This paper also discusses a number of programs that have been developed in the United States and internationally to promote the implementation of these methane reduction options and overcome existing barriers

  2. Increasing coal-fired power generation efficiency to reduce electric cost and environmental emissions

    International Nuclear Information System (INIS)

    Torrens, I.M.; Stenzel, W.C.

    1997-01-01

    New generating capacity required globally between 1993 and 2010 is estimated to be around 1500 GW, of which some two-thirds will be outside the OECD, and some 40 % in the Asian non-OECD countries. Coal is likely to account for a substantial fraction of this new generation. Today's state-of-the-art supercritical coal-fired power plant has a conversion efficiency of some 42-45 %. The capital cost increase associated with the supercritical or ultra-supercritical pulverized coal power plant compared to a conventional subcritical plant is small to negligible. The increased efficiency associated with the supercritical plant leads to an actual reduction in the total cost of electricity generated in cents/kWh, relative to a conventional plant. Despite this, the power sector continues to build subcritical plants and has no near term plans to increase the efficiency of power plants in the projects it is developing. Advanced clean coal technologies such as integrated gasification combined cycle and pressurized fluidized bed combustion will be selected for independent power projects only in very specific circumstances. Advanced clean coal plants can be operated reliably and with superior performance, and specifically that their present estimated capital costs can be reduced substantially to a point where they are competitive with state-of-the-art pulverized coal technologies. (R.P.)

  3. Reducing the Cost and Time to Perform a Human Factors Engineering Evaluation

    International Nuclear Information System (INIS)

    Geary, L.C. Dr.

    2003-01-01

    The Westinghouse Savannah River Company, a contractor to the Department of Energy, has developed a new software tool for automating the Human Factors Engineering design review, analysis, and evaluation processes. The set of design guidelines, used in the tool, was obtained from the United States Nuclear Regulatory Commission Nuclear Regulatory Guide, NUREG- 0700 - Human System Interface Design Review Guideline. This tool has been described at a previous IEEE Conference on Human Factors and Power Plants. The original software tool in NUREG- 0700 was used to evaluate a facility and a separate independent evaluation was performed using the new tool for the same facility. A comparison was made between the two different tools; both in results obtained and cost and time to complete the evaluation. The results demonstrate a five to ten fold reduction in time and cost to complete the evaluation using the newly developed tool while maintaining consistent evaluation results. The time to per form the review was measured in weeks using the new software tool rather than months using the existing NUREG-0700 tool. The new tool has been so successful that it was applied to two additional facilities with the same reduced time and cost savings. Plans have been made to use the new tool at other facilities in order to provide the same savings

  4. Reducing operating costs: A collaborative approach between industry and electric utilities

    International Nuclear Information System (INIS)

    Tyers, B.; Sibbald, L.

    1993-01-01

    The unit cost of electricity to industrial consumers is expected to increase at a rate of 5% annually in the 1990s. The partnership that has been created between Amoco Canada Petroleum Company and TransAlta Utilities to control the cost of electricity is described. To allow the company to receive lower rates for interruptible power, a number of measures have been taken. The Amoco Whitecourt plant has standby generators in reserve that can be used when utility power is not available. A Pembina compressor can be turned off for up to 12 hours, at 30 minutes notice, without affecting field pressure. At the East Crossfield plant sales gas can be compressed using electricity or a gas-driven engine. Spot market energy is used in a number of plants allowing electric drive alternatives to plant operators and offering short term energy markets. TransAlta invests in electrical equipment such as switchgear as well as transmission lines and transformers. New rate alternatives offered by TransAlta Utilities include review of the need for a demand ratchet, additional time of use rates, unbundling of rates allowing power purchase from alternative sources, rates that follow product costs, reduced rates for conversion of gas to electric drives certain circumstances, energy audits, and power factor credits. 5 figs

  5. ePrescribing: Reducing Costs through In-Class Therapeutic Interchange.

    Science.gov (United States)

    Stenner, Shane P; Chakravarthy, Rohini; Johnson, Kevin B; Miller, William L; Olson, Julie; Wickizer, Marleen; Johnson, Nate N; Ohmer, Rick; Uskavitch, David R; Bernard, Gordon R; Neal, Erin B; Lehmann, Christoph U

    2016-12-14

    Spending on pharmaceuticals in the US reached $373.9 billion in 2014. Therapeutic interchange offers potential medication cost savings by replacing a prescribed drug for an equally efficacious therapeutic alternative. Hard-stop therapeutic interchange recommendation alerts were developed for four medication classes (HMG-CoA reductase inhibitors, serotonin receptor agonists, intranasal steroid sprays, and proton-pump inhibitors) in an electronic prescription-writing tool for outpatient prescriptions. Using prescription data from January 2012 to June 2015, the Compliance Ratio (CR) was calculated by dividing the number of prescriptions with recommended therapeutic interchange medications by the number of prescriptions with non-recommended medications to measure effectiveness. To explore potential cost savings, prescription data and medication costs were analyzed for the 45,000 Vanderbilt Employee Health Plan members. For all medication classes, significant improvements were demonstrated - the CR improved (proton-pump inhibitors 2.8 to 5.32, nasal steroids 2.44 to 8.16, statins 2.06 to 5.51, and serotonin receptor agonists 0.8 to 1.52). Quarterly savings through the four therapeutic interchange interventions combined exceeded $200,000 with an estimated annual savings for the health plan of $800,000, or more than $17 per member. A therapeutic interchange clinical decision support tool at the point of prescribing resulted in increased compliance with recommendations for outpatient prescriptions while producing substantial cost savings to the Vanderbilt Employee Health Plan - $17.77 per member per year. Therapeutic interchange rules require rational targeting, appropriate governance, and vigilant content updates.

  6. Missile Defense: Actions Needed to Improve Planning and Cost Estimates for Long-Term Support of Ballistic Missile Defense

    National Research Council Canada - National Science Library

    2008-01-01

    .... Since the cost to operate and support a weapon system usually accounts for most of a system's lifetime costs, the resources needed to fund BMDS could be significant as DOD fields an increasing number of BMDS elements...

  7. Reduced cost design of liquid lithium target for international fusion material irradiation facility (IFMIF)

    International Nuclear Information System (INIS)

    Nakamura, Hiroo; Ida, Mizuho; Sugimoto, Masayoshi; Takeuchi, Hiroshi; Yutani, Toshiaki

    2001-01-01

    The International Fusion Materials Irradiation Facility (IFMIF) is being jointly planned to provide an accelerator-based D-Li neutron source to produce intense high energy neutrons (2 MW/m 2 ) up to 200 dpa and a sufficient irradiation volume (500 cm 3 ) for testing the candidate materials and components up to about a full lifetime of their anticipated use in ITER and DEMO. To realize such a condition, 40 MeV deuteron beam with a current of 250 mA is injected into high speed liquid lithium flow with a speed of 20 m/s. Following Conceptual Design Activity (1995-1998), a design study with focus on cost reduction without changing its original mission has been done in 1999. The following major changes to the CAD target design have been considered in the study and included in the new design: i) number of the Li target has been changed from 2 to 1, ii) spare of impurity traps of the Li loop was removed although the spare will be stored in a laboratory for quick exchange, iii) building volume was reduced via design changes in lithium loop length. This paper describes the reduced cost design of the lithium target system and recent status of Key Element Technology activities. (author)

  8. Effective information channels for reducing costs of environmentally- friendly technologies: evidence from residential PV markets

    International Nuclear Information System (INIS)

    Rai, Varun; Robinson, Scott A

    2013-01-01

    Realizing the environmental benefits of solar photovoltaics (PV) will require reducing costs associated with perception, informational gaps and technological uncertainties. To identify opportunities to decrease costs associated with residential PV adoption, in this letter we use multivariate regression models to analyze a unique, household-level dataset of PV adopters in Texas (USA) to systematically quantify the effect of different information channels on aspiring PV adopters’ decision-making. We find that the length of the decision period depends on the business model, such as whether the system was bought or leased, and on special opportunities to learn, such as the influence of other PV owners in the neighborhood. This influence accrues passively through merely witnessing PV systems in the neighborhood, increasing confidence and motivation, as well as actively through peer-to-peer communications. Using these insights we propose a new framework to provide public information on PV that could drastically reduce barriers to PV adoption, thereby accelerating its market penetration and environmental benefits. This framework could also serve as a model for other distributed generation technologies. (letter)

  9. Effective information channels for reducing costs of environmentally- friendly technologies: evidence from residential PV markets

    Science.gov (United States)

    Rai, Varun; Robinson, Scott A.

    2013-03-01

    Realizing the environmental benefits of solar photovoltaics (PV) will require reducing costs associated with perception, informational gaps and technological uncertainties. To identify opportunities to decrease costs associated with residential PV adoption, in this letter we use multivariate regression models to analyze a unique, household-level dataset of PV adopters in Texas (USA) to systematically quantify the effect of different information channels on aspiring PV adopters’ decision-making. We find that the length of the decision period depends on the business model, such as whether the system was bought or leased, and on special opportunities to learn, such as the influence of other PV owners in the neighborhood. This influence accrues passively through merely witnessing PV systems in the neighborhood, increasing confidence and motivation, as well as actively through peer-to-peer communications. Using these insights we propose a new framework to provide public information on PV that could drastically reduce barriers to PV adoption, thereby accelerating its market penetration and environmental benefits. This framework could also serve as a model for other distributed generation technologies.

  10. The Perceived Social Costs and Importance of Seeking Emotional Support in the Workplace: Gender Differences and Similarities.

    Science.gov (United States)

    Cahill, Daniel J.; Sias, Patricia M.

    1997-01-01

    Investigates gender differences and similarities in the perceived social costs and importance of seeking emotional support regarding work-related problems. Finds women perceived such support to be more important than did men. Finds no gender differences regarding perceived social costs associated with seeking support from coworkers. Finds women…

  11. Increase plant safety and reduce cost by implementing risk-informed in-service inspection programs

    International Nuclear Information System (INIS)

    Billington, A.; Monette, P.

    2001-01-01

    The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less that 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used to improve the effectiveness of inspecting safety-significant piping components, to reduce inspection requirements on other piping components, to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure, and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits from past projects is presented, since the methodology is applicable for WWER plant design. (author)

  12. Increase plant safety and reduce cost by implementing risk-informed In-Service Inspection programs

    International Nuclear Information System (INIS)

    Billington, A.; Monette, P.; Doumont, C.

    2000-01-01

    The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less than 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used: to improve the effectiveness of inspecting safety-significant piping components; to reduce inspection requirements on other piping components; to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure; and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits of past projects is presented, since the methodology is applicable for VVER plant design. (author)

  13. Older adults learn less, but still reduce metabolic cost, during motor adaptation

    Science.gov (United States)

    Huang, Helen J.

    2013-01-01

    The ability to learn new movements and dynamics is important for maintaining independence with advancing age. Age-related sensorimotor changes and increased muscle coactivation likely alter the trial-and-error-based process of adapting to new movement demands (motor adaptation). Here, we asked, to what extent is motor adaptation to novel dynamics maintained in older adults (≥65 yr)? We hypothesized that older adults would adapt to the novel dynamics less well than young adults. Because older adults often use muscle coactivation, we expected older adults to use greater muscle coactivation during motor adaptation than young adults. Nevertheless, we predicted that older adults would reduce muscle activity and metabolic cost with motor adaptation, similar to young adults. Seated older (n = 11, 73.8 ± 5.6 yr) and young (n = 15, 23.8 ± 4.7 yr) adults made targeted reaching movements while grasping a robotic arm. We measured their metabolic rate continuously via expired gas analysis. A force field was used to add novel dynamics. Older adults had greater movement deviations and compensated for just 65% of the novel dynamics compared with 84% in young adults. As expected, older adults used greater muscle coactivation than young adults. Last, older adults reduced muscle activity with motor adaptation and had consistent reductions in metabolic cost later during motor adaptation, similar to young adults. These results suggest that despite increased muscle coactivation, older adults can adapt to the novel dynamics, albeit less accurately. These results also suggest that reductions in metabolic cost may be a fundamental feature of motor adaptation. PMID:24133222

  14. The costs of reducing loss to follow-up in South African cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Kuhn Louise

    2005-11-01

    Full Text Available Abstract Background This study was designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting. Methods Women were enrolled in this Cape Town, South Africa-based screening study between 2000 and 2003, and all had scheduled follow-up visits in 2003. Community health worker (CHW time, vehicle use, maintenance, and depreciation were estimated from weekly logs and cost accounting systems. The percentage of women who attended their scheduled visit, those who attended after CHW contact(s, and those who never returned despite attempted contact(s were determined. The number of CHW visits per woman was also estimated. Results 3,711 visits were scheduled in 2003. Of these, 2,321 (62.5% occurred without CHW contact, 918 (24.8% occurred after contact(s, and 472 (12.7% did not occur despite contact(s. Loss to follow-up was reduced from 21% to 6%, 39% to 10%, and 50% to 24% for 6, 12, and 24-month visits. CHWs attempted 3,200 contacts in 530 trips. On average, 3 CHWs attempted to contact 6 participants over each 111 minute trip. The per-person cost (2003 Rand for these activities was 12.75, 24.92, and 40.50 for 6, 12, and 24-month visits. Conclusion CHW contact with women who missed scheduled visits increased their return rate. Cost-effectiveness analyses aimed at policy decisions about cervical cancer screening in developing countries should incorporate these findings.

  15. The benefits and costs of reducing emissions from the electricity sector.

    Science.gov (United States)

    Palmer, Karen; Burtraw, Dallas; Shih, Jhih-Shyang

    2007-04-01

    Recent federal policy proposals to reduce emissions of sulfur dioxide (SO(2)), nitrogen oxides (NO(x)), and mercury from the US electricity sector promise important improvements in air quality and reductions in acid deposition. The cost of achieving these reductions depends on the form and stringency of the regulation. In this research, we analyze the economic benefits and costs of the US Environmental Protection Agency's (EPA's) Clean Air Interstate Rule (CAIR) as characterized in the supplemental rule proposed in June 2004, and the Clean Air Mercury Rule (CAMR) as proposed in February 2004. The assessment integrates a model of the electricity sector, two models of atmospheric transport of air pollutants, and a model of environmental and public health endpoints affected by pollution. We model explicitly the emissions of SO(2), NO(x), mercury and carbon dioxide (CO(2)) and the effects of changes in emissions of SO(2) and NO(x) on environmental and public health. The manner in which mercury emissions are regulated will have important implications not only for the cost of the regulation, but also for emission levels for SO(2) and NO(x) and where those emissions are located. We find the economic benefits of CAIR and CAMR are far greater than the costs. Recent estimates of benefits of reductions in mercury and acidification indicate that our model captures the lion's share of quantifiable benefits. We also find that the EPA would have been justified on economic grounds in pursuing additional SO(2) emissions reductions beyond the requirements of CAIR.

  16. Origin of how steam rockets can reduce space transport cost by orders of magnitude

    International Nuclear Information System (INIS)

    Zuppero, A.; Larson, T.K.; Schnitzler, B.G.; Rice, J.W.; Hill, T.J.; Richins, W.D.; Parlier, L.; Werner, J.E.

    1999-01-01

    A brief sketch shows the origin of why and how thermal rocket propulsion has the unique potential to dramatically reduce the cost of space transportation for most inner solar system missions of interest. Orders of magnitude reduction in cost are apparently possible when compared to all processes requiring electrolysis for the production of rocket fuels or propellants and to all electric propulsion systems. An order of magnitude advantage can be attributed to rocket propellant tank factors associated with storing water propellant, compared to cryogenic liquids. An order of magnitude can also be attributed to the simplicity of the extraction and processing of ice on the lunar surface, into an easily stored, non-cryogenic rocket propellant (water). A nuclear heated thermal rocket can deliver thousands of times its mass to Low Earth Orbit from the Lunar surface, providing the equivalent to orders of magnitude drop in launch cost for mass in Earth orbit. Mass includes water ice. These cost reductions depend (exponentially) on the mission delta-v requirements being less than about 6 km/s, or about 3 times the specific velocity of steam rockets (2 km/s, from Isp 200 sec). Such missions include: from the lunar surface to Low Lunar Orbit, (LLO), from LLO to lunar escape, from Low Earth Orbit (LEO) to Geosynchronous Orbit (GEO), from LEO to Earth Escape, from LEO to Mars Transfer Orbit, from LLO to GEO, missions returning payloads from about 10% of the periodic comets using propulsive capture to orbits around Earth itself, and fast, 100 day missions from Lunar Escape to Mars. All the assertions depend entirely and completely on the existence of abundant, nearly pure ice at the permanently dark North and South Poles of the Moon. copyright 1999 American Institute of Physics

  17. Costs, benefits, and the malleability of public support for “Fracking”

    International Nuclear Information System (INIS)

    Christenson, Dino P.; Goldfarb, Jillian L.; Kriner, Douglas L.

    2017-01-01

    Public opinion plays an important role in shaping the policy debate over hydraulic fracturing at both the state and national level. However, most Americans report having little to no information about this controversial practice that has transformed the U.S. energy market. Employing an experiment embedded on a nationally representative survey, we examine how citizens respond to arguments concerning the costs and benefits of fracking, and incorporate them into their policy preferences. Arguments emphasizing the economic benefits of fracking bolster support for the technique; however, these gains are completely canceled if paired with a discussion of fracking's environmental costs. Additionally, we find mixed evidence of partisan motivated reasoning in how this information is processed. Individuals whose partisan attachments and preexisting beliefs about global climate change conflict are particularly responsive to arguments about the benefits and costs of fracking. Our results have important implications for scholars and policymakers concerned with partisan polarization in public opinion toward energy and environmental policy. - Highlights: • Nationally representative survey experiment on factors influencing fracking support. • Information about economic and environmental benefits of fracking increase support. • These gains are neutralized by providing information about environmental costs. • Limited evidence of partisan motivated reasoning. • Effects are largest for those whose partisanship and climate change beliefs conflict.

  18. Cost on Reliability and Production Loss for Power Converters in the Doubly Fed Induction Generator to Support Modern Grid Codes

    DEFF Research Database (Denmark)

    Zhou, Dao; Blaabjerg, Frede; Lau, Mogens

    2016-01-01

    As wind farms are normally located in remote areas, many grid codes have been issued especially related to the reactive power support. Although the Doubly-Fed Induction Generator (DFIG) based power converter is able to control the active power and reactive power independently, the effects...... of providing reactive power on the lifetime of the power converter and the cost-of-energy of the whole system are seldom evaluated, even though it is an important topic. In this paper, the loss models of the DFIG system are established at various conditions of the reactive power injection. If the mission...... profile is taken into account, the lifespan of the power semiconductors as well as the cost of the reactive power can be calculated. It is concluded that an over-excited reactive power injection significantly reduces the power converter lifetime, only 1/4 of the case that there is no reactive power...

  19. Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost

    Directory of Open Access Journals (Sweden)

    J. Gary Wheeler

    2009-01-01

    Full Text Available Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113 were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10-50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.

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

    Science.gov (United States)

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

    2018-03-01

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

  1. A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

    Directory of Open Access Journals (Sweden)

    Helen Mason

    Full Text Available BACKGROUND: Coronary Heart Disease (CHD is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy. All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30% resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives.

  2. A Cost Effectiveness Analysis of Salt Reduction Policies to Reduce Coronary Heart Disease in Four Eastern Mediterranean Countries

    Science.gov (United States)

    Mason, Helen; Shoaibi, Azza; Ghandour, Rula; O'Flaherty, Martin; Capewell, Simon; Khatib, Rana; Jabr, Samer; Unal, Belgin; Sözmen, Kaan; Arfa, Chokri; Aissi, Wafa; Romdhane, Habiba Ben; Fouad, Fouad; Al-Ali, Radwan; Husseini, Abdullatif

    2014-01-01

    Background Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and Findings Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives. PMID:24409297

  3. A conceptual framework for the evaluation of cost-effectiveness of projects to reduce GHG emissions and sequester carbon

    International Nuclear Information System (INIS)

    Sathaye, J.; Norgaard, R.; Makundi, W.

    1993-07-01

    This paper proposes a conceptual framework for evaluating the cost of projects to reduce atmospheric greenhouse gases (GHGs). The evaluation of cost-effectiveness should account for both the timing of carbon emissions and the damage caused by the atmospheric stock of carbon. We develop a conceptual basis to estimate the cost-effectiveness of projects in terms of the cost of reducing atmospheric carbon (CRAC) and other GHGs. CRAC accounts for the economic discount rate, alternative functional forms of the shadow price, the residence period of carbon in the atmosphere, and the multiple monetary benefits of projects. The last item is of particular importance to the developing countries

  4. Trade in the US and Mexico helps reduce environmental costs of agriculture

    Science.gov (United States)

    Martinez-Melendez, Luz A.; Bennett, Elena M.

    2016-05-01

    Increasing international crop trade has enlarged global shares of cropland, water and fertilizers used to grow crops for export. Crop trade can reduce the environmental burden on importing countries, which benefit from embedded environmental resources in imported crops, and from avoided environmental impacts of production in their territory. International trade can also reduce the universal environmental impact of food production if crops are grown where they are produced in the most environmentally efficient way. We compared production efficiencies for the same crops in the US and Mexico to determine whether current crop trade between these two countries provides an overall benefit to the environment. Our economic and environmental accounting for the key traded crops from 2010 to 2014 shows that exports to Mexico are just 3% (∼16 thousand Gg) of the total production of these crops in the US, and exports to US represent roughly 0.13% (∼46 Gg) of Mexican total production of the same crops. Yields were higher in US than Mexico for all crops except wheat. Use of nitrogen fertilizer was higher in US than in Mexico for all crops except corn. Current trade reduces some, but not all, environmental costs of agriculture. A counterfactual trade scenario showed that an overall annual reduction in cultivated land (∼371 thousand ha), water use (∼923 million m3), fertilizer use (∼122 Gg; ∼68 Gg nitrogen) and pollution (∼681 tonnes of N2O emissions to the atmosphere and ∼511 tonnes of leached nitrogen) can be achieved by changing the composition of food products traded. In this case, corn, soybeans and rice should be grown in the US, while wheat, sorghum and barley should be grown in Mexico. Assigning greater economic weight to the environmental costs of agriculture might improve the balance of trade to be more universally beneficial, environmentally.

  5. Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-01-01

    Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

  6. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Sue J Goldie

    2010-04-01

    Full Text Available BACKGROUND: Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. METHODS AND FINDINGS: Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35% without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC. An integrated and stepwise approach was

  7. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Science.gov (United States)

    Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-04-20

    Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

  8. Integration of EEG lead placement templates into traditional technologist-based staffing models reduces costs in continuous video-EEG monitoring service.

    Science.gov (United States)

    Kolls, Brad J; Lai, Amy H; Srinivas, Anang A; Reid, Robert R

    2014-06-01

    The purpose of this study was to determine the relative cost reductions within different staffing models for continuous video-electroencephalography (cvEEG) service by introducing a template system for 10/20 lead application. We compared six staffing models using decision tree modeling based on historical service line utilization data from the cvEEG service at our center. Templates were integrated into technologist-based service lines in six different ways. The six models studied were templates for all studies, templates for intensive care unit (ICU) studies, templates for on-call studies, templates for studies of ≤ 24-hour duration, technologists for on-call studies, and technologists for all studies. Cost was linearly related to the study volume for all models with the "templates for all" model incurring the lowest cost. The "technologists for all" model carried the greatest cost. Direct cost comparison shows that any introduction of templates results in cost savings, with the templates being used for patients located in the ICU being the second most cost efficient and the most practical of the combined models to implement. Cost difference between the highest and lowest cost models under the base case produced an annual estimated savings of $267,574. Implementation of the ICU template model at our institution under base case conditions would result in a $205,230 savings over our current "technologist for all" model. Any implementation of templates into a technologist-based cvEEG service line results in cost savings, with the most significant annual savings coming from using the templates for all studies, but the most practical implementation approach with the second highest cost reduction being the template used in the ICU. The lowered costs determined in this work suggest that a template-based cvEEG service could be supported at smaller centers with significantly reduced costs and could allow for broader use of cvEEG patient monitoring.

  9. Locomotor Adaptation Improves Balance Control, Multitasking Ability and Reduces the Metabolic Cost of Postural Instability

    Science.gov (United States)

    Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Miller, C. A.; Ploutz-Snyder, R. J.; Guined, J. R.; Buxton, R. E.; Cohen, H. S.

    2011-01-01

    During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The overall goal of our current project is to develop a sensorimotor adaptability training program to facilitate rapid adaptation to these environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene. It provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. Greater metabolic cost incurred during balance instability means more physical work is required during adaptation to new environments possibly affecting crewmembers? ability to perform mission critical tasks during early surface operations on planetary expeditions. The goal of this study was to characterize adaptation to a discordant sensory challenge across a number of performance modalities including locomotor stability, multi-tasking ability and metabolic cost. METHODS: Subjects (n=15) walked (4.0 km/h) on a treadmill for an 8 -minute baseline walking period followed by 20-minutes of walking (4.0 km/h) with support surface motion (0.3 Hz, sinusoidal lateral motion, peak amplitude 25.4 cm) provided by the treadmill/motion-base system. Stride frequency and auditory reaction time were collected as measures of locomotor stability and multi-tasking ability, respectively. Metabolic data (VO2) were collected via a portable metabolic gas analysis system. RESULTS: At the onset of lateral support surface motion, subj ects walking on our treadmill showed an increase in stride frequency and auditory reaction time indicating initial balance and multi-tasking disturbances. During the 20-minute adaptation period, balance control and multi-tasking performance improved. Similarly, throughout the 20-minute adaptation period, VO2 gradually

  10. Costs of genetic testing: Supporting Brazilian Public Policies for the incorporating of molecular diagnostic technologies

    Directory of Open Access Journals (Sweden)

    Rosane Paixão Schlatter

    2015-09-01

    Full Text Available This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%, microsatellite instability analysis (181%, gene rearrangement analysis by multiplex ligation probe amplification (412%, non-labeled sequencing (173%, and quantitation of nucleic acids (169%. These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System.

  11. Modelling the cost-effectiveness of mass screening and treatment for reducing Plasmodium falciparum malaria burden

    Directory of Open Access Journals (Sweden)

    Crowell Valerie

    2013-01-01

    Full Text Available Abstract Background Past experience and modelling suggest that, in most cases, mass treatment strategies are not likely to succeed in interrupting Plasmodium falciparum malaria transmission. However, this does not preclude their use to reduce disease burden. Mass screening and treatment (MSAT is preferred to mass drug administration (MDA, as the latter involves massive over-use of drugs. This paper reports simulations of the incremental cost-effectiveness of well-conducted MSAT campaigns as a strategy for P. falciparum malaria disease-burden reduction in settings with varying receptivity (ability of the combined vector population in a setting to transmit disease and access to case management. Methods MSAT incremental cost-effectiveness ratios (ICERs were estimated in different sub-Saharan African settings using simulation models of the dynamics of malaria and a literature-based MSAT cost estimate. Imported infections were simulated at a rate of two per 1,000 population per annum. These estimates were compared to the ICERs of scaling up case management or insecticide-treated net (ITN coverage in each baseline health system, in the absence of MSAT. Results MSAT averted most episodes, and resulted in the lowest ICERs, in settings with a moderate level of disease burden. At a low pre-intervention entomological inoculation rate (EIR of two infectious bites per adult per annum (IBPAPA MSAT was never more cost-effective than scaling up ITNs or case management coverage. However, at pre-intervention entomological inoculation rates (EIRs of 20 and 50 IBPAPA and ITN coverage levels of 40 or 60%, respectively, the ICER of MSAT was similar to that of scaling up ITN coverage further. Conclusions In all the transmission settings considered, achieving a minimal level of ITN coverage is a “best buy”. At low transmission, MSAT probably is not worth considering. Instead, MSAT may be suitable at medium to high levels of transmission and at moderate ITN coverage

  12. Factors Affecting Examination Attrition: Does Academic Support Help? A Survey of ACN203S (Cost Accounting and Control) Students at Unisa

    Science.gov (United States)

    Tladi, Lerato Sonia

    2013-01-01

    This study sought to determine the attributing and contributing factors to examination absence as well as whether the academic and social support available to students had a role to play in discouraging or reducing absence from examinations using results from a quantitative survey of ACN203S (Cost Accounting and Control) students who were admitted…

  13. A way for reducing drug supply chain cost for a hospital district: A case study

    Directory of Open Access Journals (Sweden)

    Leonardo Postacchini

    2016-03-01

    Full Text Available Purpose: This work aims at providing insights to optimise healthcare logistic of the drug management, in order to deal with the healthcare expenditure cut. In this paper the effects of different drug supply chain configurations, on the resulting average stock, service level and Bullwhip effect, of the studied supply chain, is quantitatively assessed. Design/methodology/approach: A case study of an Italian district has been studied, taking into account three echelons: suppliers, central stock, and hospitals. A model of the various supply chain configurations has been created with the use of the simulation. Specifically, 24 supply chain configurations have been examined, stemming from the combination of several supply chain design parameters, namely: transshipment policies (Emergency Lateral Transshipment or Total Inventory Equalization; re-order and inventory management policies (Economic Order Quantity or Economic Order Interval; required service levels (90% or 95%; the number of available vans (one or two. For each configuration, hospital average stock, service level and a “Bullwhip effect” analysis are computed. To know which input variables are statistically significant, a DoE (Design of Experiments analysis has been executed. Findings: The output of this paper provides useful insights and suggestions to optimize the healthcare logistic and drug supply chain. According to the developed DoE analysis, it can be stated that the introduction of transshipment policies provides important improvement in terms of service and stock levels. To reduce the Bullwhip effect, which results in a service level decreasing, and in a managing stock costs increasing, it is worth to adopt an EOQ re-order policy. Practical implications: This research gives practical recommendations to the studied system, in order to reduce costs and maintain a very satisfactory service level. Originality/value: This paper fulfils an identified need to study which combination of

  14. Evaluation of ways and procedures to reduce construction cost and increase competition.

    Science.gov (United States)

    2009-01-01

    Construction cost inflation is affecting many state highway agencies including the Texas Department of : Transportation While some of this increase can be attributed to factors such as soaring cost of energy, : reports of large variations in cost of ...

  15. Reduced graphene oxide supported gold nanoparticles for electrocatalytic reduction of carbon dioxide

    Science.gov (United States)

    Saquib, Mohammad; Halder, Aditi

    2018-02-01

    Electrochemical reduction of carbon dioxide is one of the methods which have the capability to recycle CO2 into valuable products for energy and industrial applications. This research article describes about a new electrocatalyst "reduced graphene oxide supported gold nanoparticles" for selective electrochemical conversion of carbon dioxide to carbon monoxide. The main aim for conversion of CO2 to CO lies in the fact that the latter is an important component of syn gas (a mixture of hydrogen and carbon monoxide), which is then converted into liquid fuel via well-known industrial process called Fischer-Tropsch process. In this work, we have synthesized different composites of the gold nanoparticles supported on defective reduced graphene oxide to evaluate the catalytic activity of reduced graphene oxide (RGO)-supported gold nanoparticles and the role of defective RGO support towards the electrochemical reduction of CO2. Electrochemical and impedance measurements demonstrate that higher concentration of gold nanoparticles on the graphene support led to remarkable decrease in the onset potential of 240 mV and increase in the current density for CO2 reduction. Lower impedance and Tafel slope values also clearly support our findings for the better performance of RGOAu than bare Au for CO2 reduction.

  16. Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index.

    Science.gov (United States)

    Walters, Carrie; Webb, Paula J

    2017-10-01

    Perioperative leaders at our facility were struggling to meet efficiency targets for robotic surgery procedures while also maintaining the satisfaction of the surgical team. We developed a human resources time and motion study tool and used it in conjunction with the NASA Task Load Index to observe and analyze the required workload of personnel assigned to 25 robotic surgery procedures. The time and motion study identified opportunities to enlist the help of nonlicensed support personnel to ensure safe patient care and improve OR efficiency. Using the NASA Task Load Index demonstrated that high temporal, effort, and physical demands existed for personnel assisting with and performing robotic surgery. We believe that this process could be used to develop cost-effective staffing models, resulting in safe and efficient care for all surgical patients. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  17. Associations Between Supportive Leadership Behavior and the Costs of Absenteeism and Presenteeism: An Epidemiological and Economic Approach.

    Science.gov (United States)

    Schmid, Johannes Albert; Jarczok, Marc Nicolas; Sonntag, Diana; Herr, Raphael Manfred; Fischer, Joachim Ernst; Schmidt, Burkhard

    2017-02-01

    This study investigates associations between supportive leadership behavior (SLB) and presenteeism/absenteeism, and estimates related costs. Cross-sectional data from a German industrial sample (n = 17,060) assessing SLB and presenteeism/absenteeism were used. Adjusted interval regressions were performed. The study population was split into tertiles with respect to SLB, and minimum and maximum costs for each tertile were estimated on the basis of national industry averages. Low SLB was associated with higher presenteeism [-0.31, 95% confidence interval (95% CI) -0.33 to -0.28)] and absenteeism (-0.36, 95% CI -0.40 to -0.32). Compared with high SLB, the costs of low SLB for absenteeism are between 534.54 and 1675.16 Euro higher per person and year. For presenteeism, this difference ranges between 63.76 and 433.7 Euro. SLB has the potential to reduce absenteeism, presenteeism, and associated costs. To contribute to workforce health, productivity, and efficiency, SLB merits being fostered by corporate policy.

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

    Science.gov (United States)

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

    2018-01-01

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

  19. Support of Publication Costs, Atlantic Meridional Overturning Circulation Special Issue of Deep Sea Research II Journal

    Energy Technology Data Exchange (ETDEWEB)

    Amy Honchar

    2012-11-12

    The contribution of funds from DOE supported publication costs of a special issue of Deep Sea Research arising from presentations at the First U.S. Atlantic Meridional Overturning Circulation (AMOC) Meeting held 4-6 May, 2009 to review the US implementation plan and its coordination with other monitoring activities. The special issue includes a total of 16 papers, including publications from three DOE-supported investigators (ie Sevellec, F., and A.V. Fedorov; Hu et. al., and Wan et. al.,). The special issue addresses DOE interests in understanding and simulation/modeling of abrupt climate change.

  20. Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs.

    Science.gov (United States)

    Baldissera-Aradas, J V; Rodríguez-Villamil, L; Blanco-Fernández, R; Pérez-García, C; Viejo de la Guerra, G; González-Rodríguez, I; Mosquera-Madera, J

    2018-01-10

    Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Reducing Cost of Rabies Post Exposure Prophylaxis: Experience of a Tertiary Care Hospital in Pakistan.

    Directory of Open Access Journals (Sweden)

    Naseem Salahuddin

    2016-02-01

    Full Text Available Rabies is a uniformly fatal disease, but preventable by timely and correct use of post exposure prophylaxis (PEP. Unfortunately, many health care facilities in Pakistan do not carry modern life-saving vaccines and rabies immunoglobulin (RIG, assuming them to be prohibitively expensive and unsafe. Consequently, Emergency Department (ED health care professionals remain untrained in its application and refer patients out to other hospitals. The conventional Essen regimen requires five vials of cell culture vaccine (CCV per patient, whereas Thai Red Cross intradermal (TRC-id regimen requires only one vial per patient, and gives equal seroconversion as compared with Essen regimen.This study documents the cost savings in using the Thai Red Cross intradermal regimen with cell culture vaccine instead of the customary 5-dose Essen intramuscular regimen for eligible bite victims. All patients presenting to the Indus Hospital ED between July 2013 to June 2014 with animal bites received WHO recommended PEP. WHO Category 2 bites received intradermal vaccine alone, while Category 3 victims received vaccine plus wound infiltration with Equine RIG. Patients were counseled, and subsequent doses of the vaccine administered on days 3, 7 and 28. Throughput of cases, consumption utilization of vaccine and ERIG and the cost per patient were recorded.Government hospitals in Pakistan are generally underfinanced and cannot afford treatment of the enormous burden of dog bite victims. Hence, patients are either not treated at all, or asked to purchase their own vaccine, which most cannot afford, resulting in neglect and high incidence of rabies deaths. TRC-id regimen reduced the cost of vaccine to 1/5th of Essen regimen and is strongly recommended for institutions with large throughput. Training ED staff would save lives through a safe, effective and affordable technique.

  2. Long-term costs and health impact of continued global fund support for antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    John Stover

    Full Text Available BACKGROUND: By the end of 2011 Global Fund investments will be supporting 3.5 million people on antiretroviral therapy (ART in 104 low- and middle-income countries. We estimated the cost and health impact of continuing treatment for these patients through 2020. METHODS AND FINDINGS: Survival on first-line and second-line ART regimens is estimated based on annual retention rates reported by national AIDS programs. Costs per patient-year were calculated from country-reported ARV procurement prices, and expenditures on laboratory tests, health care utilization and end-of-life care from in-depth costing studies. Of the 3.5 million ART patients in 2011, 2.3 million will still need treatment in 2020. The annual cost of maintaining ART falls from $1.9 billion in 2011 to $1.7 billion in 2020, as a result of a declining number of surviving patients partially offset by increasing costs as more patients migrate to second-line therapy. The Global Fund is expected to continue being a major contributor to meeting this financial need, alongside other international funders and domestic resources. Costs would be $150 million less in 2020 with an annual 5% decline in first-line ARV prices and $150-370 million less with a 5%-12% annual decline in second-line prices, but $200 million higher in 2020 with phase out of stavudine (d4T, or $200 million higher with increased migration to second-line regimens expected if all countries routinely adopted viral load monitoring. Deaths postponed by ART correspond to 830,000 life-years saved in 2011, increasing to around 2.3 million life-years every year between 2015 and 2020. CONCLUSIONS: Annual patient-level direct costs of supporting a patient cohort remain fairly stable over 2011-2020, if current antiretroviral prices and delivery costs are maintained. Second-line antiretroviral prices are a major cost driver, underscoring the importance of investing in treatment quality to improve retention on first-line regimens.

  3. Low cost concepts to reduce the voltage ripple of the DC power supply

    International Nuclear Information System (INIS)

    Cheng, Y.; Liu, K.B.

    1993-01-01

    If the gain of current feedback is low, the short term stability of magnet power supply will be affected by a soft power line. Typically, the step-charge and the imbalance of the three phase power line cause the most serious voltage ripple. Usually, the voltage feedback with a coupling transformer is considered to reduce the voltage ripple. However, for the high current power supply, the space and cooling problem of the coupling transformer become inconvenient. In this paper, the authors suggest to use the toroidal core with the compensation winding, working like a DCCT, as the coupling transformer. Then, a high speed detector of the AC line level is developed. It restricts the voltage ripple passing to the coupling transformer. These methods have the advantage of small size, low power consumption and low cost

  4. Enhanced methods for operating refueling station tube-trailers to reduce refueling cost

    Science.gov (United States)

    Elgowainy, Amgad; Reddi, Krishna

    2017-08-22

    A method and apparatus are provided for operating a refueling station including source tube-trailers and at least one compressor to reduce refueling cost. The refueling station includes a gaseous fuel supply source including a plurality of tanks on a tube trailer coupled to a first control unit, and high pressure buffer storage having predefined capacity coupled to a second control unit and the first tanks by a pressure control valve and the first control unit, and at least one compressor. The refueling station is operated at different modes depending on a state of the refueling station at the beginning of each operational mode. The refueling system is assessed at the end of each operational mode to identify the state of the system and select a next mode of operation. The operational modes include consolidating hydrogen, or any gaseous fuel, within the tubes mounted on the trailer.

  5. Successful pilot of thermosyphon process heater reduces GHG emissions and operating costs

    International Nuclear Information System (INIS)

    Arnold, W.A.; Neulander, J.I.

    1999-01-01

    A joint pilot study was conducted by Hudson Products Corporation and PanCanadian Petroleum Ltd. to test the feasibility of using a thermosyphon as a part of a thermal recovery process for cold heavy oil reservoir exploitation in the Western Canada Sedimentary Basin. A thermosyphon process heater can transfer heat from an external combustion chamber to a liquid inside a tank. This paper described the pilot project in which such a heater was successfully tested in a heavy oil field production tank. The field trial was conducted at the Marwayne Field in northeastern Alberta. The results of the pilot study demonstrated that the thermosyphon not only improved process efficiency, but also reduced greenhouse gas (GHG) emissions, lowered operating costs and improved safety. 5 refs., 3 tabs., 1 fig., 3 appendices

  6. Recycling Flight Hardware Components and Systems to Reduce Next Generation Research Costs

    Science.gov (United States)

    Turner, Wlat

    2011-01-01

    With the recent 'new direction' put forth by President Obama identifying NASA's new focus in research rather than continuing on a path to return to the Moon and Mars, the focus of work at Kennedy Space Center (KSC) may be changing dramatically. Research opportunities within the micro-gravity community potentially stands at the threshold of resurgence when the new direction of the agency takes hold for the next generation of experimenters. This presentation defines a strategy for recycling flight experiment components or part numbers, in order to reduce research project costs, not just in component selection and fabrication, but in expediting qualification of hardware for flight. A key component of the strategy is effective communication of relevant flight hardware information and available flight hardware components to researchers, with the goal of 'short circuiting' the design process for flight experiments

  7. Cesarean Delivery Rates Vary 10-Fold Among US Hospitals; Reducing Variation May Address Quality, Cost Issues

    Science.gov (United States)

    Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.

    2013-01-01

    Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732

  8. Feasibility studies to improve plant availability and reduce total installed cost in IGCC plants

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, Kevin [General Electric Company, Houston, TX (United States); Anasti, William [General Electric Company, Houston, TX (United States); Fang, Yichuan [General Electric Company, Houston, TX (United States); Subramanyan, Karthik [General Electric Company, Houston, TX (United States); Leininger, Tom [General Electric Company, Houston, TX (United States); Zemsky, Christine [General Electric Company, Houston, TX (United States)

    2015-03-30

    The main purpose of this project is to look at technologies and philosophies that would help reduce the costs of an Integrated Gasification Combined Cycle (IGCC) plant, increase its availability or do both. GE’s approach to this problem is to consider options in three different areas: 1) technology evaluations and development; 2) constructability approaches; and 3) design and operation methodologies. Five separate tasks were identified that fall under the three areas: Task 2 – Integrated Operations Philosophy; Task 3 – Slip Forming of IGCC Components; Task 4 – Modularization of IGCC Components; Task 5 – Fouling Removal; and Task 6 – Improved Slag Handling. Overall, this project produced results on many fronts. Some of the ideas could be utilized immediately by those seeking to build an IGCC plant in the near future. These include the considerations from the Integrated Operations Philosophy task and the different construction techniques of Slip Forming and Modularization (especially if the proposed site is in a remote location or has a lack of a skilled workforce). Other results include ideas for promising technologies that require further development and testing to realize their full potential and be available for commercial operation. In both areas GE considers this project to be a success in identifying areas outside the core IGCC plant systems that are ripe for cost reduction and ity improvement opportunities.

  9. Back to Back: A Focus on Reducing the Logistics Costs and Tax

    Directory of Open Access Journals (Sweden)

    Rogério João Lunkes

    2012-06-01

    Full Text Available The objective is to identify the main aspects related to the operation of Back to Back set out in international trade, which enables reduction of logistics costs and taxes. The operation of Back to Back is an excellent opportunity to increase foreign exchange gain and offer greater flexibility to commercial operations that the business requires. The methodology used in preparing this study was qualitative research according to the characteristics and nature of the problem. From the use of descriptive research study aims to demonstrate the main theoretical aspects underlying the subject in reference. This study aimed to identify the main aspects related to the operation of Back to Back set out in international trade and tax effects in an organization and logistics of industrial electronics segment of the State of Santa Catarina. The study demonstrated that the benefits of the operation of Back to Back is of paramount importance for companies having a positive impact in financial terms by reducing the need for tax payments and logistics costs which affect the processes of import and export. The results presented showed that the company studied the operation of Back to Back is essential for international negotiations.

  10. Tracking unnecessary negative urinalyses to reduce healthcare costs: a transversal study.

    Science.gov (United States)

    Malmartel, A; Dutron, M; Ghasarossian, C

    2017-09-01

    About 7 million urinalyses are reimbursed yearly by the French public healthcare system, but the results of most of these tests are normal. The aim of this study was to estimate the prevalence of negative urinalyses in ambulatory care, identify the associated factors and assess the relevance of prescriptions by general practitioners (GPs) according to French guidelines. A cross-sectional study was conducted in patients over 18 coming for urinalyses in two French ambulatory laboratories. Patients received a questionnaire on their symptoms, the reason for performing urinalysis and the use of urinary dipsticks. GP who prescribed urinalyses received a questionnaire assessing their practice. A total of 510 patients were included, and 71% of urinalyses were negative. Urinalyses were prescribed to 283 patients by GPs. Compared to those of specialists, GP prescriptions were associated with fewer negative urinalyses (59 vs 86%; p GPs, the reasons of prescription were as follows: suspected urinary tract infection (UTI) (42.7%), control of bacteriological cure after UTI (24%), fever or abdominal pain (13%) and routine test (7%). About 35% of urinalyses were not indicated according to guidelines. Only 12% of patients used dipsticks before performing urinalysis although 87% of GPs were favourable to their use if they were provided by healthcare services. The annual cost of non-indicated urinalyses is estimated at 13 million euro. A systematic use of dipsticks provided by healthcare services could help to reduce health costs and the unnecessary use of antibiotics.

  11. Autonomous exoskeleton reduces metabolic cost of human walking during load carriage

    Science.gov (United States)

    2014-01-01

    Background Many soldiers are expected to carry heavy loads over extended distances, often resulting in physical and mental fatigue. In this study, the design and testing of an autonomous leg exoskeleton is presented. The aim of the device is to reduce the energetic cost of loaded walking. In addition, we present the Augmentation Factor, a general framework of exoskeletal performance that unifies our results with the varying abilities of previously developed exoskeletons. Methods We developed an autonomous battery powered exoskeleton that is capable of providing substantial levels of positive mechanical power to the ankle during the push-off region of stance phase. We measured the metabolic energy consumption of seven subjects walking on a level treadmill at 1.5 m/s, while wearing a 23 kg vest. Results During the push-off portion of the stance phase, the exoskeleton applied positive mechanical power with an average across the gait cycle equal to 23 ± 2 W (11.5 W per ankle). Use of the autonomous leg exoskeleton significantly reduced the metabolic cost of walking by 36 ± 12 W, which was an improvement of 8 ± 3% (p = 0.025) relative to the control condition of not wearing the exoskeleton. Conclusions In the design of leg exoskeletons, the results of this study highlight the importance of minimizing exoskeletal power dissipation and added limb mass, while providing substantial positive power during the walking gait cycle. PMID:24885527

  12. Co-solvent pretreatment reduces costly enzyme requirements for high sugar and ethanol yields from lignocellulosic biomass.

    Science.gov (United States)

    Nguyen, Thanh Yen; Cai, Charles M; Kumar, Rajeev; Wyman, Charles E

    2015-05-22

    We introduce a new pretreatment called co-solvent-enhanced lignocellulosic fractionation (CELF) to reduce enzyme costs dramatically for high sugar yields from hemicellulose and cellulose, which is essential for the low-cost conversion of biomass to fuels. CELF employs THF miscible with aqueous dilute acid to obtain up to 95 % theoretical yield of glucose, xylose, and arabinose from corn stover even if coupled with enzymatic hydrolysis at only 2 mgenzyme  gglucan (-1) . The unusually high saccharification with such low enzyme loadings can be attributed to a very high lignin removal, which is supported by compositional analysis, fractal kinetic modeling, and SEM imaging. Subsequently, nearly pure lignin product can be precipitated by the evaporation of volatile THF for recovery and recycling. Simultaneous saccharification and fermentation of CELF-pretreated solids with low enzyme loadings and Saccharomyces cerevisiae produced twice as much ethanol as that from dilute-acid-pretreated solids if both were optimized for corn stover. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Cost-effectiveness of supported employment adapted for people with affective disorders.

    Science.gov (United States)

    Saha, Sanjib; Bejerholm, Ulrika; Gerdtham, Ulf-G; Jarl, Johan

    2018-04-01

    The individual enabling and support (IES) model was effective in gaining competitive employment for people with affective disorders compared with traditional vocational rehabilitation (TVR) services in a randomized controlled trial in a Swedish setting. The object of this study is to perform a cost-effectiveness analysis of IES comparing to TVR. We considered the costs of intervention and productivity gain due to increased competitive employment. We estimated quality of life using EuroQol 5 Dimension (EQ-5D) and Manchester Short Assessment of Quality of Life (MANSA) scale. EQ-5D was translated into quality-adjusted life-years (QALY), using the UK, Danish, and Swedish tariffs. We performed the analysis from a societal perspective with a one-year timeframe. The cost of IES was €7247 lower per person per year (2014 prices) compared to TVR. There were no significant differences in QALY improvement within or between groups. However, quality of life measured by the MANSA scale significantly improved over the study period in IES. Besides the small sample size, details on the intervention costs for both IES and TVR group were unavailable and had to be obtained from external sources. Implementation of IES for people with affective disorders is most likely cost-saving and is potentially even dominating TVR, although a larger trial is required to establish this.

  14. Use of the Decision Support System for VA cost-effectiveness research.

    Science.gov (United States)

    Barnett, P G; Rodgers, J H

    1999-04-01

    The Department of Veterans Affairs is adopting the Decision Support System (DSS), computer software and databases which include a cost-accounting system which determines the cost of health care products and patient encounters. A system for providing cost data for cost-effectiveness analysis should be provide valid, detailed, and comprehensive data that can be aggregated. The design of DSS is described and compared with those criteria. Utilization data from DSS was compared with other VA utilization data. Aggregate DSS cost data from 35 medical centers was compared with relative resource weights developed for the Medicare program. Data on hospital stays at 3 facilities found that 3.7% of the stays in DSS were not in the VA discharge database, whereas 7.6% of the stays in the discharge data were not in DSS. DSS reported between 68.8% and 97.1% of the outpatient encounters reported by six facilities in the ambulatory care data base. Relative weights for each Diagnosis Related Group based on DSS data from 35 VA facilities correlated with Medicare weights (correlation coefficient of .853). DSS will be useful for research if certain problems are overcome. It is difficult to distinguish long-term from acute hospital care. VA does not have a complete database of all inpatient procedures, so DSS has not assigned them a specific cost. The authority to access encounter-level DSS data needs to be centralized. Researchers can provide the feedback needed to improve DSS cost estimates. A comprehensive encounter-level extract would facilitate use of DSS for research.

  15. The cost effectiveness of NHS physiotherapy support for occupational health (OH services

    Directory of Open Access Journals (Sweden)

    Phillips Ceri J

    2012-02-01

    health gains contributed to a cost/QALY of £1386-£7760, which would represent value for money according to current UK thresholds. Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user. Conclusions This pragmatic evaluation of the OHPPP indicated that it was likely to be feasible in terms of service usage and could potentially be cost effective in terms of QALYs. Further, the study confirmed that improving physical health status for musculoskeletal pain patients is important in reducing problems with work capacity and related costs. This study suggests that this type of service could be potentially be useful in reducing the burden of pain and should be further investigated, ideally via randomised controlled trials assessing effectiveness and cost-effectiveness.

  16. Spacecraft Software Maintenance: An Effective Approach to Reducing Costs and Increasing Science Return

    Science.gov (United States)

    Shell, Elaine M.; Lue, Yvonne; Chu, Martha I.

    1999-01-01

    -orbit environment, may find the developer unprepared for the challenges. The second approach is to train a member of the flight operations team to maintain the spacecraft software. This can prove to be a costly and inflexible solution. The person assigned to this duty may not have enough work to do during a problem free period and may have too much to do when a problem arises. If the person is a talented software engineer, he/she may not enjoy the limited software opportunities available in this position; and may eventually leave for newer technology computer science opportunities. Training replacement flight software personnel can be a difficult and lengthy process. The third approach is to assemble a center of excellence for on-orbit spacecraft software maintenance. Personnel in this specialty center can be managed to support flight software of multiple missions at once. The variety of challenges among a set of on-orbit missions, can result in a dedicated, talented staff which is fully trained and available to support each mission's needs. Such staff are not software developers but are rather spacecraft software systems engineers. The cost to any one mission is extremely low because the software staff works and charges, minimally on missions with no current operations issues; and their professional insight into on-orbit software troubleshooting and maintenance methods ensures low risk, effective and minimal-cost solutions to on-orbit issues.

  17. Human Responding on Random-Interval Schedules of Response-Cost Punishment: The Role of Reduced Reinforcement Density

    Science.gov (United States)

    Pietras, Cynthia J.; Brandt, Andrew E.; Searcy, Gabriel D.

    2010-01-01

    An experiment with adult humans investigated the effects of response-contingent money loss (response-cost punishment) on monetary-reinforced responding. A yoked-control procedure was used to separate the effects on responding of the response-cost contingency from the effects of reduced reinforcement density. Eight adults pressed buttons for money…

  18. Supporting the upper body with the hand on the thigh reduces back loading during lifting

    NARCIS (Netherlands)

    Kingma, I.; Faber, G.S.; van Dieen, J.H.

    2016-01-01

    When picking objects from the floor, low back pain patients often tend to support the upper body by leaning with one hand on a thigh. While this strategy may reduce back load, this has not yet been assessed, probably due to the difficulty of measuring the forces between hand and thigh.Ten healthy

  19. Instructional Support for Novice Law Students: Reducing Search Processes and Explaining Concepts in Cases

    NARCIS (Netherlands)

    Nievelstein, Fleurie; Van Gog, Tamara; Van Dijck, Gijs; Boshuizen, Els

    2010-01-01

    Nievelstein, F., Van Gog, T., Van Dijck, C., & Boshuizen, H. P. A. (2011). Instructional support for novice law students: Reducing search processes and explaining concepts in cases. Applied Cognitive Psychology, 25(3), 408-413. doi:10.1002/acp.1707

  20. A structured blood conservation programme reduces transfusions and costs in cardiac surgery.

    Science.gov (United States)

    Ternström, Lisa; Hyllner, Monica; Backlund, Erika; Schersten, Henrik; Jeppsson, Anders

    2014-11-01

    Transfusions of blood products can be lifesaving, but they are also associated with considerable risks and adverse effects, including immune response and infections. In cardiac surgery, transfusions have also been associated with increased mortality. We prospectively studied the effects of a structured programme to reduce transfusions and transfusion-associated costs in cardiac surgery. The programme included: (i) education of all staff about the risks and benefits of blood transfusions; (ii) revised guidelines for transfusions; and (iii) a transfusion log where indication for transfusion, status of the patient and prescribing physician were registered. Transfusion prevalence, complications and costs for blood products were registered for all acute and elective cardiac operations during a 12-month period before (n = 1128) and after (n = 1034) the programme was started. The two time periods were compared. In addition, the prevalence of transfusions was registered for 2 more years after the programme was initiated. The first year after the programme was initiated the proportion of patients transfused with red blood cell concentrate decreased by 21.8% (from 58.2 to 45.5%, P platelets by 21.0% (from 20.5 to 16.2%, P = 0.010). Reoperations for bleeding (5.8 vs 5.0%), early complication rate and 30-day mortality (2.5 vs 2.6%) were not significantly different before and after the start date. Based on the 2009 institutional prices for red blood cell concentrate (102 €/unit), plasma (35 €/unit) and platelets (290 €/unit), the savings on blood products were €161,623 during the first 12 months after the programme was launched. The proportion of patients transfused with any blood product was 60.9% before the programme was started and 48.3, 54.0 and 50.7% 1-3 years after its start (all P conservation programme reduces transfusions and costs for blood products in cardiac surgery, without any signs of compromised medical safety. The effects of introducing such a programme

  1. Clinical effectiveness and cost savings in diabetes care, supported by pharmacist counselling.

    Science.gov (United States)

    Rodriguez de Bittner, Magaly; Chirikov, Viktor V; Breunig, Ian M; Zaghab, Roxanne W; Shaya, Fadia Tohme

    To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. The Patients, Pharmacists Partnerships (P 3 Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2.5 years per patient. Of these patients, 162 had health plan cost and utilization data. A network of 50 trained pharmacists provided chronic disease management to patients with diabetes using a common process of care. Communications were provided to patients and physicians. Employers provided incentives for patients who opted in, including waived medication copayments and free diabetes self-monitoring supplies. The service was provided at no cost to the patient. A Web-based, electronic medical record that complied with the Health Insurance Portability and Accountability Act helped to standardize care. Quality assurance was conducted to ensure the standard of care. Glycosylated hemoglobin (A1c), blood pressure, and total health care costs (before and after enrollment). Statistically significant improvements were shown by mean decreases in A1c (-0.41%, P care costs to employers declined by $1031 per beneficiary after the cost of the program was deducted. This 66-month real-world study confirms earlier findings. Employers netted savings through improved clinical outcomes and reduced emergency and hospital utilization when comparing costs 12 months before and after enrollment. The P 3 program had positive clinical outcomes and economic outcomes. Pharmacist-provided comprehensive medication therapy management services should be included as a required element of insurance offered by employers and health insurance

  2. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust.

    Science.gov (United States)

    Jones, Ray B; O'Connor, Anita; Brelsford, Jade; Parsons, Neil; Skirton, Heather

    2012-03-29

    Better use of e-health services by patients could improve outcomes and reduce costs but there are concerns about inequalities of access. Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients more. This pilot study explored the feasibility and cost of recruiting patients for an e-health intervention in one primary care trust. The sample comprised 46 practices with total patient population of 250,000. We approached all practices using various methods, seeking collaboration to recruit patients via methods agreed with each practice. A detailed research diary was kept of time spent recruiting practices and patients. Researcher time was used to estimate costs. Patients who consented to participate were offered email support for their use of the Internet for health. Eighteen practices agreed to take part; we recruited 27 patients, most (23/27) from five practices. Practices agreed to recruit patients for an e-health intervention via waiting room leaflets (16), posters (16), practice nurses (15), doctors giving patients leaflets (5), a study website link (7), inclusion in planned mailshots (2), and a special mailshot to patients selected from practice computers (1). After low recruitment response we also recruited directly in five practices through research assistants giving leaflets to patients in waiting rooms. Ten practices recruited no patients. Those practices that were more difficult to recruit were less likely to recruit patients. Leaving leaflets for practice staff to distribute and placing posters in the practice were not effective in recruiting patients. Leaflets handed out by practice nurses and website links were more successful. The practice with lowest costs per patient recruited (£70) used a special mailshot to selected patients. Recruitment via general practice was not successful and was therefore expensive

  3. Catalytic Hydrolysis of Ammonia Borane by Cobalt Nickel Nanoparticles Supported on Reduced Graphene Oxide for Hydrogen Generation

    Directory of Open Access Journals (Sweden)

    Yuwen Yang

    2014-01-01

    Full Text Available Well dispersed magnetically recyclable bimetallic CoNi nanoparticles (NPs supported on the reduced graphene oxide (RGO were synthesized by one-step in situ coreduction of aqueous solution of cobalt(II chloride, nickel (II chloride, and graphite oxide (GO with ammonia borane (AB as the reducing agent under ambient condition. The CoNi/RGO NPs exhibits excellent catalytic activity with a total turnover frequency (TOF value of 19.54 mol H2 mol catalyst−1 min−1 and a low activation energy value of 39.89 kJ mol−1 at room temperature. Additionally, the RGO supported CoNi NPs exhibit much higher catalytic activity than the monometallic and RGO-free CoNi counterparts. Moreover, the as-prepared catalysts exert satisfying durable stability and magnetically recyclability for the hydrolytic dehydrogenation of AB, which make the practical reusing application of the catalysts more convenient. The usage of the low-cost, easy-getting catalyst to realize the production of hydrogen under mild condition gives more confidence for the application of ammonia borane as a hydrogen storage material. Hence, this general method indicates that AB can be used as both a potential hydrogen storage material and an efficient reducing agent, and can be easily extended to facile preparation of other RGO-based metallic systems.

  4. 45 CFR 1351.15 - What costs are supportable under a Runaway and Homeless Youth Program grant?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false What costs are supportable under a Runaway and... FOR CHILDREN, YOUTH AND FAMILIES, FAMILY AND YOUTH SERVICES BUREAU RUNAWAY AND HOMELESS YOUTH PROGRAM Runaway and Homeless Youth Program Grant § 1351.15 What costs are supportable under a Runaway and Homeless...

  5. Basking hamsters reduce resting metabolism, body temperature and energy costs during rewarming from torpor.

    Science.gov (United States)

    Geiser, Fritz; Gasch, Kristina; Bieber, Claudia; Stalder, Gabrielle L; Gerritsmann, Hanno; Ruf, Thomas

    2016-07-15

    Basking can substantially reduce thermoregulatory energy expenditure of mammals. We tested the hypothesis that the largely white winter fur of hamsters (Phodopus sungorus), originating from Asian steppes, may be related to camouflage to permit sun basking on or near snow. Winter-acclimated hamsters in our study were largely white and had a high proclivity to bask when resting and torpid. Resting hamsters reduced metabolic rate (MR) significantly (>30%) when basking at ambient temperatures (Ta) of ∼15 and 0°C. Interestingly, body temperature (Tb) also was significantly reduced from 34.7±0.6°C (Ta 15°C, not basking) to 30.4±2.0°C (Ta 0°C, basking), which resulted in an extremely low (thermal conductance. Induced torpor (food withheld) during respirometry at Ta 15°C occurred on 83.3±36.0% of days and the minimum torpor MR was 36% of basal MR at an average Tb of 22.0±2.6°C; movement to the basking lamp occurred at Tb50%) during radiant heat-assisted rewarming; however, radiant heat per se without an endogenous contribution by animals did not strongly affect metabolism and Tb during torpor. Our data show that basking substantially modifies thermal energetics in hamsters, with a drop of resting Tb and MR not previously observed and a reduction of rewarming costs. The energy savings afforded by basking in hamsters suggest that this behaviour is of energetic significance not only for mammals living in deserts, where basking is common, but also for P. sungorus and probably other cold-climate mammals. © 2016. Published by The Company of Biologists Ltd.

  6. Reducing support loss in micromechanical ring resonators using phononic band-gap structures

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Feng-Chia; Huang, Tsun-Che; Wang, Chin-Hung; Chang, Pin [Industrial Technology Research Institute-South, Tainan 709, Taiwan (China); Hsu, Jin-Chen, E-mail: fengchiahsu@itri.org.t, E-mail: hsujc@yuntech.edu.t [Department of Mechanical Engineering, National Yunlin University of Science and Technology, Douliou, Yunlin 64002, Taiwan (China)

    2011-09-21

    In micromechanical resonators, energy loss via supports into the substrates may lead to a low quality factor. To eliminate the support loss, in this paper a phononic band-gap structure is employed. We demonstrate a design of phononic-crystal (PC) strips used to support extensional wine-glass mode ring resonators to increase the quality factor. The PC strips are introduced to stop elastic-wave propagation by the band-gap and deaf-band effects. Analyses of resonant characteristics of the ring resonators and the dispersion relations, eigenmodes, and transmission properties of the PC strips are presented. With the proposed resonator architecture, the finite-element simulations show that the leaky power is effectively reduced and the stored energy inside the resonators is enhanced simultaneously as the operating frequencies of the resonators are within the band gap or deaf bands. Realization of a high quality factor micromechanical ring resonator with minimized support loss is expected.

  7. Reducing support loss in micromechanical ring resonators using phononic band-gap structures

    International Nuclear Information System (INIS)

    Hsu, Feng-Chia; Huang, Tsun-Che; Wang, Chin-Hung; Chang, Pin; Hsu, Jin-Chen

    2011-01-01

    In micromechanical resonators, energy loss via supports into the substrates may lead to a low quality factor. To eliminate the support loss, in this paper a phononic band-gap structure is employed. We demonstrate a design of phononic-crystal (PC) strips used to support extensional wine-glass mode ring resonators to increase the quality factor. The PC strips are introduced to stop elastic-wave propagation by the band-gap and deaf-band effects. Analyses of resonant characteristics of the ring resonators and the dispersion relations, eigenmodes, and transmission properties of the PC strips are presented. With the proposed resonator architecture, the finite-element simulations show that the leaky power is effectively reduced and the stored energy inside the resonators is enhanced simultaneously as the operating frequencies of the resonators are within the band gap or deaf bands. Realization of a high quality factor micromechanical ring resonator with minimized support loss is expected.

  8. Applying Costs, Risks and Values Evaluation (CRAVE) methodology to Engineering Support Request (ESR) prioritization

    Science.gov (United States)

    Joglekar, Prafulla N.

    1994-01-01

    Given limited budget, the problem of prioritization among Engineering Support Requests (ESR's) with varied sizes, shapes, and colors is a difficult one. At the Kennedy Space Center (KSC), the recently developed 4-Matrix (4-M) method represents a step in the right direction as it attempts to combine the traditional criteria of technical merits only with the new concern for cost-effectiveness. However, the 4-M method was not adequately successful in the actual prioritization of ESRs for the fiscal year 1995 (FY95). This research identifies a number of design issues that should help us to develop better methods. It emphasizes that given the variety and diversity of ESR's one should not expect that a single method could help in the assessment of all ESR's. One conclusion is that a methodology such as Costs, Risks, and Values Evaluation (CRAVE) should be adopted. It also is clear that the development of methods such as 4-M requires input not only from engineers with technical expertise in ESR's but also from personnel with adequate background in the theory and practice of cost-effectiveness analysis. At KSC, ESR prioritization is one part of the Ground Support Working Teams (GSWT) Integration Process. It was discovered that the more important barriers to the incorporation of cost-effectiveness considerations in ESR prioritization lie in this process. The culture of integration, and the corresponding structure of review by a committee of peers, is not conducive to the analysis and confrontation necessary in the assessment and prioritization of ESR's. Without assistance from appropriately trained analysts charged with the responsibility to analyze and be confrontational about each ESR, the GSWT steering committee will continue to make its decisions based on incomplete understanding, inconsistent numbers, and at times, colored facts. The current organizational separation of the prioritization and the funding processes is also identified as an important barrier to the

  9. Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD.

    LENUS (Irish Health Repository)

    Lawlor, Maria

    2012-02-01

    BACKGROUND: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD), do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients. METHODS: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, follow-up education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort. RESULTS: The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme. CONCLUSIONS: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.

  10. Effect of medial arch-heel support in inserts on reducing ankle eversion: a biomechanics study

    Directory of Open Access Journals (Sweden)

    Yung Patrick SH

    2008-02-01

    Full Text Available Abstract Background Excessive pronation (or eversion at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running. Methods Thirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1 barefoot, and shod condition with insert with (2 no, (3 low, (4 medium, and (5 high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion was calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-hoc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately. Results Results showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5–3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively. Conclusion Medial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators.

  11. Estimation of the laser cutting operating cost by support vector regression methodology

    Science.gov (United States)

    Jović, Srđan; Radović, Aleksandar; Šarkoćević, Živče; Petković, Dalibor; Alizamir, Meysam

    2016-09-01

    Laser cutting is a popular manufacturing process utilized to cut various types of materials economically. The operating cost is affected by laser power, cutting speed, assist gas pressure, nozzle diameter and focus point position as well as the workpiece material. In this article, the process factors investigated were: laser power, cutting speed, air pressure and focal point position. The aim of this work is to relate the operating cost to the process parameters mentioned above. CO2 laser cutting of stainless steel of medical grade AISI316L has been investigated. The main goal was to analyze the operating cost through the laser power, cutting speed, air pressure, focal point position and material thickness. Since the laser operating cost is a complex, non-linear task, soft computing optimization algorithms can be used. Intelligent soft computing scheme support vector regression (SVR) was implemented. The performance of the proposed estimator was confirmed with the simulation results. The SVR results are then compared with artificial neural network and genetic programing. According to the results, a greater improvement in estimation accuracy can be achieved through the SVR compared to other soft computing methodologies. The new optimization methods benefit from the soft computing capabilities of global optimization and multiobjective optimization rather than choosing a starting point by trial and error and combining multiple criteria into a single criterion.

  12. A Cost-Constrained Sampling Strategy in Support of LAI Product Validation in Mountainous Areas

    Directory of Open Access Journals (Sweden)

    Gaofei Yin

    2016-08-01

    Full Text Available Increasing attention is being paid on leaf area index (LAI retrieval in mountainous areas. Mountainous areas present extreme topographic variability, and are characterized by more spatial heterogeneity and inaccessibility compared with flat terrain. It is difficult to collect representative ground-truth measurements, and the validation of LAI in mountainous areas is still problematic. A cost-constrained sampling strategy (CSS in support of LAI validation was presented in this study. To account for the influence of rugged terrain on implementation cost, a cost-objective function was incorporated to traditional conditioned Latin hypercube (CLH sampling strategy. A case study in Hailuogou, Sichuan province, China was used to assess the efficiency of CSS. Normalized difference vegetation index (NDVI, land cover type, and slope were selected as auxiliary variables to present the variability of LAI in the study area. Results show that CSS can satisfactorily capture the variability across the site extent, while minimizing field efforts. One appealing feature of CSS is that the compromise between representativeness and implementation cost can be regulated according to actual surface heterogeneity and budget constraints, and this makes CSS flexible. Although the proposed method was only validated for the auxiliary variables rather than the LAI measurements, it serves as a starting point for establishing the locations of field plots and facilitates the preparation of field campaigns in mountainous areas.

  13. Cost of reproduction in a long-lived bird: incubation effort reduces immune function and future reproduction.

    Science.gov (United States)

    Hanssen, Sveinn Are; Hasselquist, Dennis; Folstad, Ivar; Erikstad, Kjell Einar

    2005-05-22

    Life-history theory predicts that increased current reproductive effort should lead to a fitness cost. This cost of reproduction may be observed as reduced survival or future reproduction, and may be caused by temporal suppression of immune function in stressed or hard-working individuals. In birds, consideration of the costs of incubating eggs has largely been neglected in favour of the costs of brood rearing. We manipulated incubation demand in two breeding seasons (2000 and 2001) in female common eiders (Somateria mollissima) by creating clutches of three and six eggs (natural range 3-6 eggs). The common eider is a long-lived sea-duck where females do not eat during the incubation period. Mass loss increased and immune function (lymphocyte levels and specific antibody response to the non-pathogenic antigens diphtheria and tetanus toxoid) was reduced in females incubating large clutches. The increased incubation effort among females assigned to large incubation demand did not lead to adverse effects on current reproduction or return rate in the next breeding season. However, large incubation demand resulted in long-term fitness costs through reduced fecundity the year after manipulation. Our data show that in eiders, a long-lived species, the cost of high incubation demand is paid in the currency of reduced future fecundity, possibly mediated by reduced immune function.

  14. A low cost support post for SSC quadrupole magnets and other cryogenic applications

    International Nuclear Information System (INIS)

    Hiller, M.W.; Kunz, R.J.; Lehmann, G.A.; Nilles, M.J.

    1994-01-01

    An injection molded support post has been designed and tested for use in the cryostat of the 5.4 meter long SSC Collider Quadrupole Magnet (CQM). This glass reinforced thermoplastic support is less costly than the complex alternative post designs that consist of filament wound tubes with thermal shrink fit metallic end pieces. The near net shape injection molding process delivers customized components at production rates suitable for present and proposed large scale cryogenic projects such as large accelerators, SMES, and Maglev. In addition, standard shapes (plates, tubes, threaded rods, and fasteners) comprised of this composite are available as catalog items. This paper presents the design considerations, material testing, and validation of predicted structural performance through component testing. Test results reported herein include compressive strength validations as well as previously unreported creep, thermal conductivity, and thermal contraction data. A delineated reliability method is discussed for verifying compliance with apportioned reliability targets using a synthesis of the FEA and test data. Also the design approach and data presented here can be extended toward the design of low cost mass produced supports for other cryogenic applications

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

    Science.gov (United States)

    1981-08-07

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

  16. Capsiate supplementation reduces oxidative cost of contraction in exercising mouse skeletal muscle in vivo.

    Science.gov (United States)

    Yashiro, Kazuya; Tonson, Anne; Pecchi, Émilie; Vilmen, Christophe; Le Fur, Yann; Bernard, Monique; Bendahan, David; Giannesini, Benoît

    2015-01-01

    Chronic administration of capsiate is known to accelerate whole-body basal energy metabolism, but the consequences in exercising skeletal muscle remain very poorly documented. In order to clarify this issue, the effect of 2-week daily administration of either vehicle (control) or purified capsiate (at 10- or 100-mg/kg body weight) on skeletal muscle function and energetics were investigated throughout a multidisciplinary approach combining in vivo and in vitro measurements in mice. Mechanical performance and energy metabolism were assessed strictly non-invasively in contracting gastrocnemius muscle using magnetic resonance (MR) imaging and 31-phosphorus MR spectroscopy (31P-MRS). Regardless of the dose, capsiate treatments markedly disturbed basal bioenergetics in vivo including intracellular pH alkalosis and decreased phosphocreatine content. Besides, capsiate administration did affect neither mitochondrial uncoupling protein-3 gene expression nor both basal and maximal oxygen consumption in isolated saponin-permeabilized fibers, but decreased by about twofold the Km of mitochondrial respiration for ADP. During a standardized in vivo fatiguing protocol (6-min of repeated maximal isometric contractions electrically induced at a frequency of 1.7 Hz), both capsiate treatments reduced oxidative cost of contraction by 30-40%, whereas force-generating capacity and fatigability were not changed. Moreover, the rate of phosphocreatine resynthesis during the post-electrostimulation recovery period remained unaffected by capsiate. Both capsiate treatments further promoted muscle mass gain, and the higher dose also reduced body weight gain and abdominal fat content. These findings demonstrate that, in addition to its anti-obesity effect, capsiate supplementation improves oxidative metabolism in exercising muscle, which strengthen this compound as a natural compound for improving health.

  17. Does NGAL reduce costs? A cost analysis of urine NGAL (uNGAL) & serum creatinine (sCr) for acute kidney injury (AKI) diagnosis.

    Science.gov (United States)

    Parikh, Amay; Rizzo, John A; Canetta, Pietro; Forster, Catherine; Sise, Meghan; Maarouf, Omar; Singer, Eugenia; Elger, Antje; Elitok, Saban; Schmidt-Ott, Kai; Barasch, Jonathon; Nickolas, Thomas L

    2017-01-01

    Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs. uNGAL plus sCr (uNGAL+sCr). A cost minimization analysis was performed to determine total expected costs for patients with AKI. uNGAL test characteristics were validated with eight-hundred forty-nine patients with sCr ≥1.5 from a completed study of 1635 patients recruited from EDs at two U.S. hospitals from 2007-8. Biomarker test, AKI work-up, and diagnostic imaging costs were incorporated. For a hypothetical cohort of 10,000 patients, the model predicted that the expected costs were $900 per patient (pp) in the sCr arm and $950 in the uNGAL+sCr arm. uNGAL+sCr resulted in 1,578 fewer patients with delayed diagnosis and treatment than sCr alone (2,013 vs. 436 pts) at center 1 and 1,973 fewer patients with delayed diagnosis and treatment than sCr alone at center 2 (2,227 vs. 254 patients). Although initial evaluation costs at each center were $50 pp higher in with uNGAL+sCr, total costs declined by $408 pp at Center 1 and by $522 pp at Center 2 due to expected reduced delays in diagnosis and treatment. Sensitivity analyses confirmed savings with uNGAL + sCr for a range of cost inputs. Using uNGAL with sCr as a clinical diagnostic test for AKI may improve patient management and reduce expected costs. Any cost savings would likely result from avoiding delays in diagnosis and treatment and from avoidance of unnecessary testing in patients given a false positive AKI diagnosis by use of sCr alone.

  18. Does NGAL reduce costs? A cost analysis of urine NGAL (uNGAL & serum creatinine (sCr for acute kidney injury (AKI diagnosis.

    Directory of Open Access Journals (Sweden)

    Amay Parikh

    Full Text Available Urine neutrophil gelatinase-associated lipocalin (uNGAL is a sensitive and specific diagnostic test for acute kidney injury (AKI in the Emergency Department (ED, but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone.A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs. uNGAL plus sCr (uNGAL+sCr. A cost minimization analysis was performed to determine total expected costs for patients with AKI. uNGAL test characteristics were validated with eight-hundred forty-nine patients with sCr ≥1.5 from a completed study of 1635 patients recruited from EDs at two U.S. hospitals from 2007-8. Biomarker test, AKI work-up, and diagnostic imaging costs were incorporated.For a hypothetical cohort of 10,000 patients, the model predicted that the expected costs were $900 per patient (pp in the sCr arm and $950 in the uNGAL+sCr arm. uNGAL+sCr resulted in 1,578 fewer patients with delayed diagnosis and treatment than sCr alone (2,013 vs. 436 pts at center 1 and 1,973 fewer patients with delayed diagnosis and treatment than sCr alone at center 2 (2,227 vs. 254 patients. Although initial evaluation costs at each center were $50 pp higher in with uNGAL+sCr, total costs declined by $408 pp at Center 1 and by $522 pp at Center 2 due to expected reduced delays in diagnosis and treatment. Sensitivity analyses confirmed savings with uNGAL + sCr for a range of cost inputs.Using uNGAL with sCr as a clinical diagnostic test for AKI may improve patient management and reduce expected costs. Any cost savings would likely result from avoiding delays in diagnosis and treatment and from avoidance of unnecessary testing in patients given a false positive AKI diagnosis by use of sCr alone.

  19. Long-range planning cost model for support of future space missions by the deep space network

    Science.gov (United States)

    Sherif, J. S.; Remer, D. S.; Buchanan, H. R.

    1990-01-01

    A simple model is suggested to do long-range planning cost estimates for Deep Space Network (DSP) support of future space missions. The model estimates total DSN preparation costs and the annual distribution of these costs for long-range budgetary planning. The cost model is based on actual DSN preparation costs from four space missions: Galileo, Voyager (Uranus), Voyager (Neptune), and Magellan. The model was tested against the four projects and gave cost estimates that range from 18 percent above the actual total preparation costs of the projects to 25 percent below. The model was also compared to two other independent projects: Viking and Mariner Jupiter/Saturn (MJS later became Voyager). The model gave cost estimates that range from 2 percent (for Viking) to 10 percent (for MJS) below the actual total preparation costs of these missions.

  20. LCA and external costs in comparative assessment of electricity chains. Decision support for sustainable electricity provision?

    International Nuclear Information System (INIS)

    Voss, A.

    2002-01-01

    The provision of energy and electricity plays an important role in a country's economic and environmental performance and the sustainability of its development. Sustainable development of the energy and electricity sector depends on finding ways of meeting energy service demands of the present generation that are economically viable, environmentally sound, and socially acceptable and do not jeopardize the ability of future generations to meet their own energy needs. Life Cycle Assessment (LCA) and external cost valuation are considered to offer opportunities to assist energy policy in a comprehensive comparative evaluation of electricity supply options with regard to the different dimensions of sustainable energy provision as well as in the implementation of appropriate internalization strategies. The paper addresses life cycle assessment and external cost analysis carried out for selected electricity systems of interest under German conditions. Results from a comprehensive comparative assessment of various electricity supply options with regard to their environmental impacts, health risks, raw materials requirements as well as their resulting external cost will be summarised. The use of LCA based indicators for assessing the relative sustainability of electricity systems and the use of total (internal plus external) cost assessment as measure of economic and environmental efficiency of energy systems will be discussed. Open problems related to life cycle analysis of energy chains and the assessment of environmental damage costs are critically reviewed, to illustrate how in spite of existing uncertainties the state of the art results may provide helpful energy policy decision support. The paper starts with some remarks on what the concept of sustainability in terms of energy systems means. (author)

  1. Real-time motion analytics during brain MRI improve data quality and reduce costs.

    Science.gov (United States)

    Dosenbach, Nico U F; Koller, Jonathan M; Earl, Eric A; Miranda-Dominguez, Oscar; Klein, Rachel L; Van, Andrew N; Snyder, Abraham Z; Nagel, Bonnie J; Nigg, Joel T; Nguyen, Annie L; Wesevich, Victoria; Greene, Deanna J; Fair, Damien A

    2017-11-01

    Head motion systematically distorts clinical and research MRI data. Motion artifacts have biased findings from many structural and functional brain MRI studies. An effective way to remove motion artifacts is to exclude MRI data frames affected by head motion. However, such post-hoc frame censoring can lead to data loss rates of 50% or more in our pediatric patient cohorts. Hence, many scanner operators collect additional 'buffer data', an expensive practice that, by itself, does not guarantee sufficient high-quality MRI data for a given participant. Therefore, we developed an easy-to-setup, easy-to-use Framewise Integrated Real-time MRI Monitoring (FIRMM) software suite that provides scanner operators with head motion analytics in real-time, allowing them to scan each subject until the desired amount of low-movement data has been collected. Our analyses show that using FIRMM to identify the ideal scan time for each person can reduce total brain MRI scan times and associated costs by 50% or more. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Short-term strategies for Dutch wind power producers to reduce imbalance costs

    International Nuclear Information System (INIS)

    Chaves-Ávila, José Pablo; Hakvoort, Rudi A.; Ramos, Andrés

    2013-01-01

    The paper assesses bidding strategies for a wind power producer in the Netherlands. To this end, a three-stage stochastic optimization framework is used, maximizing wind power producer's profit using the day-ahead and cross-border intraday market, taking into account available interconnection capacity. Results show that the wind power producer can increase its profits by trading on the intraday market and – under certain imbalance prices – by intentionally creating imbalances. It has been considered uncertainties about prices, power forecast and interconnection capacity at the day-ahead and intraday timeframes. - Highlights: ► A cross-border bidding strategy model for wind power producers has been developed. ► The model was applied to a real case study of a Dutch offshore wind power producer. ► Under certain imbalance prices, it is not profitable to deliver all possible power. ► Intraday markets give the possibility to reduce imbalance costs. ► Integration of intraday markets will increase liquidity.

  3. Reducing BWR O and M costs through on-line performance monitoring

    International Nuclear Information System (INIS)

    Jonas, T.; Gross, R.; Logback, F.; Josyula, R.

    1995-01-01

    Competition in the electric power industry has placed significant emphasis on reducing operating and maintenance (O and M) costs at nuclear facilities. Therefore, on-line performance monitoring to locate power losses for boiling water reactor (BWR) plants is creating tremendous interest. In addition, the ability to automate activities such as data collection, analysis, and reporting increases the efficiency of plant engineers and gives them more time to concentrate on solving plant efficiency problems. This capability is now available with a unique software product called GEBOPS. GE Nuclear Energy, in conjunction with Joint Venture partner Black and Veatch, has undertaken development of the General Electric/Black and Veatch On-line Performance System (GEBOPS), an on-line performance monitoring system for BWR plants. The experience and expertise of GE Nuclear Energy with BWR plants, coupled with the proven on-line monitoring software development experience and capability of Black and Veatch, provide the foundation for a unique product which addresses the needs of today's BWR plants

  4. Mechanism and capacities of reducing ecological cost through rice-duck cultivation.

    Science.gov (United States)

    Long, Pan; Huang, Huang; Liao, Xiaolan; Fu, Zhiqiang; Zheng, Huabin; Chen, Aiwu; Chen, Can

    2013-09-01

    Rice-duck cultivation is the essence of Chinese traditional agriculture. A scientific assessment of the mechanism and its capacity is of theoretical significance and practical value in improving modern agricultural technology. The duck's secretions, excreta and their treading, pecking and predation decrease the occurrence of plant diseases, pests and weeds, enrich species diversity and improve the field environment. The rice-duck intergrowth system effectively prevents rice planthoppers and rice leafhoppers. The control effects can be up to 98.47% and 100% respectively; it also has effects on the control of Chilo suppressalis, Tryporyza incertulas and the rice leafrollers. Notable control results are found on sheath blight, while the effects on other diseases are about 50%. Harm from weeds is placed under primary control; prevention of weeds is sequenced by broadleaf weeds > sedge weeds > Gramineae weeds. Contents of soil organic matter, N, P and K are improved by the system; nutrient utilization is accelerated, resulting in decreased fertilizer application. Greenhouse gas emissions are reduced by 1-2% and duck fodder is saved in this system. There is also an obvious economic benefit. Compared to conventional rice cultivation, rice-duck cultivation shows great benefits to ecologic cost and economic income. © 2013 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

  5. Patient engagement: four case studies that highlight the potential for improved health outcomes and reduced costs.

    Science.gov (United States)

    Laurance, Jeremy; Henderson, Sarah; Howitt, Peter J; Matar, Mariam; Al Kuwari, Hanan; Edgman-Levitan, Susan; Darzi, Ara

    2014-09-01

    The energy of patients and members of the public worldwide who care about improving health is a huge, but still largely unrecognized and untapped, resource. The aim of patient engagement is to shift the clinical paradigm from determining "what is the matter?" to discovering "what matters to you?" This article presents four case studies from around the world that highlight the proven and potential abilities of increased patient engagement to improve health outcomes and reduce costs, while extending the reach of treatment and diagnostic programs into the community. The cases are an online mental health community in the United Kingdom, a genetic screening program in the United Arab Emirates, a World Health Organization checklist for new mothers, and a hospital-based patient engagement initiative in the United States. Evidence from these and similar endeavors suggests that closer collaboration on the part of patients, families, health care providers, health care systems, and policy makers at multiple levels could help diverse nations provide more effective and population-appropriate health care with fewer resources. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010-2020.

    Science.gov (United States)

    Wilcox, Meredith L; Mason, Helen; Fouad, Fouad M; Rastam, Samer; al Ali, Radwan; Page, Timothy F; Capewell, Simon; O'Flaherty, Martin; Maziak, Wasim

    2015-01-01

    This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region's established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. HP, L, and R+HP+L were cost-saving using the best estimates. The remaining policies were cost-effective (CERs: R=$5,453 PPP/LYG; R+HP=$2,201 PPP/LYG; R+L=$2,125 PPP/LYG). R+HP+L provided the largest benefit with net savings using the best and maximum estimates, while R+L was cost-effective with the lowest marginal cost using the minimum estimates. This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.

  7. Mission possible: creating a technology infrastructure to help reduce administrative costs.

    Science.gov (United States)

    Alper, Michael

    2003-01-01

    Controlling administrative costs associated with managed care benefits has traditionally been considered a "mission impossible" in healthcare, with the unreasonably high cost of paperwork and administration pushing past the $420 billion mark. Why administrative costs remain a critical problem in healthcare while other industries have alleviated their administrative burdens must be carefully examined. This article looks at the key factors contributing to high administrative costs and how these costs can be controlled in the future with "mission possible" tools, including business process outsourcing, IT outsourcing, technology that helps to bring "consumerism" to managed care, and an IT infrastructure that improves quality and outcomes.

  8. Cost Forecasting of Substation Projects Based on Cuckoo Search Algorithm and Support Vector Machines

    Directory of Open Access Journals (Sweden)

    Dongxiao Niu

    2018-01-01

    Full Text Available Accurate prediction of substation project cost is helpful to improve the investment management and sustainability. It is also directly related to the economy of substation project. Ensemble Empirical Mode Decomposition (EEMD can decompose variables with non-stationary sequence signals into significant regularity and periodicity, which is helpful in improving the accuracy of prediction model. Adding the Gauss perturbation to the traditional Cuckoo Search (CS algorithm can improve the searching vigor and precision of CS algorithm. Thus, the parameters and kernel functions of Support Vector Machines (SVM model are optimized. By comparing the prediction results with other models, this model has higher prediction accuracy.

  9. Multi-Site Project Management A Program for Reducing the Cost of Technology Deployment at Department of Energy Sites

    International Nuclear Information System (INIS)

    Davis, N.R.; Selden, E.R.; Little, D.B.; Coleman, M.C.; Bennett, J.T.

    2009-01-01

    Retrieval and processing of High Level Waste (HLW) stored in Department of Energy (DOE) waste tanks is performed to support closure of the tanks as required by site specific regulatory agreements. Currently, there are four sites in the DOE Complex that have HLW tanks and must process and disposition HLW. As such, there is an opportunity to achieve an economy of scale and reduce duplication of efforts. Two or more sites typically have similar technology development and deployment needs. Technology development is already executed at the national level. As the technology is matured, the next step is to commission a design/build project. Typically each site performs this separately due to differences in waste type, tank design, site specific considerations such as proximity to the water table or to the site boundary. The focus of the individual sites tends to be on the differences between sites versus on the similarities thus there is an opportunity to minimize the cost for similar deployments. A team of engineers and project management professionals from the Savannah River Site has evaluated technology needs at the four HLW sites and determined that there is an economy of scale that can be achieved by specific technology deployments in the area of waste retrieval, waste pretreatment and waste disposition. As an example, the Waste on Wheels tank retrieval system (presented in the 2006 Waste Management Symposium) was designed and fabricated in portable modules that could be installed in HLW tanks at Hanford, Savannah River or Idaho. This same concept could be used for modular in-tank cesium removal process and equipment, tank cleaning mechanical equipment, and chemical tank cleaning process and equipment. The purpose of this paper is to present a multi-site project management approach that will reduce deployment costs and be consistent with DOE Order 413.3 project management principles. The approach will describe how projects can be managed by a lead site with

  10. Reducing duplicate testing: a comparison of two clinical decision support tools.

    Science.gov (United States)

    Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

    2015-05-01

    Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

  11. The real cost of desalted water and how to reduce it further

    International Nuclear Information System (INIS)

    Nisan, S.; Blank, J.E.; Tusel, G.F.

    2007-01-01

    Freshwater scarcity on a worldwide level is now a burning problem, widely discussed in media inter-views and in major newspapers. In this context, the majority of the media are underlining the importance of seawater desalination as an attractive and logical alternative source to fight the freshwater scarcity. Unfortunately the majority of all these discussions are providing a totally wrong picture of the real cost of freshwater production from seawater. Figures for desalted water costs from below 0.25 Euro/m 3 to over 0.6 Euro/m 3 for large-scale realisation are frequently quoted. In some media, however, the costs given for desalted water production are too prohibitive for large-scale applications. Many so-called experts are enhancing the confusion with incorrect or in incomplete statements. Even simple considerations, such as water cost ex desalination plant vs. water cost at consumer tap, are neglected. Yet another neglected point is that freshwater of any kind is either highly subsidized or overpriced to finance costs which are not water-related costs. Even in the EU Commission the real cost of seawater desalination is sometimes incorrectly perceived. In principle, the calculation of specific freshwater cost is simple and based on a few clear parameters such as investment cost for a given desalting capacity, energy cost, cost for distribution, amortization period and concept, financing cost, inflation rate, operation and maintenance cost and, last but not least, plant availability and lifetime. A typical example to illustrate the reigning confusion is the primary energy cost. Today, the barrel of crude oil costs in the world market approximately 70 US dollars or more. However, many tenders or BOT projects compare the water and energy cost on a 5 US dollars/barrel level. With this energy cost level and other unrealistic conditions even old-fashioned, low-GOR MSF plant can produce freshwater for a nominal cost of 0.60 Euro/m 3 . With today's world-market prices

  12. MonitoringResources.org—Supporting coordinated and cost-effective natural resource monitoring across organizations

    Science.gov (United States)

    Bayer, Jennifer M.; Scully, Rebecca A.; Weltzin, Jake F.

    2018-05-21

    Natural resource managers who oversee the Nation’s resources require data to support informed decision-making at a variety of spatial and temporal scales that often cross typical jurisdictional boundaries such as states, agency regions, and watersheds. These data come from multiple agencies, programs, and sources, often with their own methods and standards for data collection and organization. Coordinating standards and methods is often prohibitively time-intensive and expensive. MonitoringResources.org offers a suite of tools and resources that support coordination of monitoring efforts, cost-effective planning, and sharing of knowledge among organizations. The website was developed by the Pacific Northwest Aquatic Monitoring Partnership—a collaboration of Federal, state, tribal, local, and private monitoring programs—and the U.S. Geological Survey (USGS), with funding from the Bonneville Power Administration and USGS. It is a key component of a coordinated monitoring and information network.

  13. Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

    Science.gov (United States)

    Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

    2017-12-01

    Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

  14. Potential cost-effectiveness of schistosomiasis treatment for reducing HIV transmission in Africa--the case of Zimbabwean women.

    Directory of Open Access Journals (Sweden)

    Martial L Ndeffo Mbah

    Full Text Available Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV infection in young women. Therefore, the treatment of Schistosoma haematobium with praziquantel could be a potential strategy for reducing HIV infection. Here we assess the potential cost-effectiveness of praziquantel as a novel intervention strategy against HIV infection.We developed a mathematical model of female genital schistosomiasis (FGS and HIV infections in Zimbabwe that we fitted to cross-sectional data of FGS and HIV prevalence of 1999. We validated our epidemic projections using antenatal clinic data on HIV prevalence. We simulated annual praziquantel administration to school-age children. We then used these model predictions to perform a cost-effectiveness analysis of annual administration of praziquantel as a potential measure to reduce the burden of HIV in sub-Saharan Africa.We showed that for a variation of efficacy between 30-70% of mass praziquantel administration for reducing the enhanced risk of HIV transmission per sexual act due to FGS, annual administration of praziquantel to school-age children in Zimbabwe could result in net savings of US$16-101 million compared with no mass treatment of schistosomiasis over a ten-year period. For a variation in efficacy between 30-70% of mass praziquantel administration for reducing the acquisition of FGS, annual administration of praziquantel to school-age children could result in net savings of US$36-92 million over a ten-year period.In addition to reducing schistosomiasis burden, mass praziquantel administration may be a highly cost-effective way of reducing HIV infections in sub-Saharan Africa. Program costs per case of HIV averted are similar to, and under some conditions much better than, other interventions that are currently implemented in Africa to reduce HIV transmission. As a cost-saving strategy, mass praziquantel administration should be prioritized

  15. The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis.

    Science.gov (United States)

    Gaunt, Francesca; Devine, Maria; Pennington, Mark; Vernazza, Chris; Gwynnett, Erika; Steen, Nick; Heasman, Peter

    2008-09-01

    To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC. Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology. SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome. Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Deltas CAL for patients undergoing "specialist" SPC were 0.1 mm (2 years), 0.2 mm (6 years) and -0.01 mm (3 years) respectively. In generalist care the Deltas CAL during SPC were -2.2, -1.8 and -2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra 288 euros for one tooth year or an extra 1503 euros/1 mm reduction in loss of attachment for SPC delivered in specialist care. SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.

  16. Total staff costs to implement a decision support system in nursing

    Directory of Open Access Journals (Sweden)

    Valéria Castilho

    2014-01-01

    Full Text Available OBJECTIVE: to identify the direct labor (DL costs to put in practice a decision support system (DSS in nursing at the University Hospital of the University of São Paulo (HU-USP. METHOD: the development of the DSS was mapped in four sub-processes: Conception, Elaboration, Construction and Transition. To calculate the DL, the baseline salary per professional category was added to the five-year additional remuneration, representation fees and social charges, and then divided by the number of hours contracted, resulting in the hour wage/professional, which was multiplied by the time spend on each activity in the sub-processes. RESULTS: the DL cost corresponded to R$ 752,618.56 (100%, R$ 26,000.00 (3.45% of which were funded by a funding agency, while R$ 726,618.56 (96,55% came from Hospital and University resources. CONCLUSION: considering the total DL cost, 72.1% related to staff wages for the informatics consulting company and 27.9% to the DL of professionals at the HU and the School of Nursing.

  17. Health Care Coach Support in Reducing Acute Care Use and Cost in Patients With Cancer

    Science.gov (United States)

    2017-05-12

    Acute Myeloid Leukemia; Brain Glioblastoma; Estrogen Receptor Negative; Extensive Stage Small Cell Lung Carcinoma; Head and Neck Carcinoma; HER2/Neu Negative; Hormone-Resistant Prostate Cancer; Limited Stage Small Cell Lung Carcinoma; Myelodysplastic Syndrome; Progesterone Receptor Negative; Progressive Disease; Recurrent Carcinoma; Stage II Pancreatic Cancer; Stage II Rectal Cancer; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIC Rectal Cancer; Stage III Colon Cancer; Stage III Esophageal Cancer; Stage III Gastric Cancer; Stage III Non-Small Cell Lung Cancer; Stage III Ovarian Cancer; Stage III Pancreatic Cancer; Stage III Rectal Cancer; Stage III Skin Melanoma; Stage IIIA Colon Cancer; Stage IIIA Esophageal Cancer; Stage IIIA Gastric Cancer; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Rectal Cancer; Stage IIIA Skin Melanoma; Stage IIIB Colon Cancer; Stage IIIB Esophageal Cancer; Stage IIIB Gastric Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Rectal Cancer; Stage IIIB Skin Melanoma; Stage IIIC Colon Cancer; Stage IIIC Esophageal Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Rectal Cancer; Stage IIIC Skin Melanoma; Stage IV Bladder Cancer; Stage IV Bone Sarcoma; Stage IV Breast Cancer; Stage IV Colon Cancer; Stage IV Esophageal Cancer; Stage IV Gastric Cancer; Stage IV Non-Small Cell Lung Cancer; Stage IV Ovarian Cancer; Stage IV Pancreatic Cancer; Stage IV Rectal Cancer; Stage IV Renal Cell Cancer; Stage IV Skin Melanoma; Stage IV Soft Tissue Sarcoma; Stage IVA Bone Sarcoma; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Bone Sarcoma; Stage IVB Colon Cancer; Stage IVB Rectal Cancer; Triple-Negative Breast Carcinoma

  18. Artificial intelligent decision support for low-cost launch vehicle integrated mission operations

    Science.gov (United States)

    Szatkowski, Gerard P.; Schultz, Roger

    1988-01-01

    The feasibility, benefits, and risks associated with Artificial Intelligence (AI) Expert Systems applied to low cost space expendable launch vehicle systems are reviewed. This study is in support of the joint USAF/NASA effort to define the next generation of a heavy-lift Advanced Launch System (ALS) which will provide economical and routine access to space. The significant technical goals of the ALS program include: a 10 fold reduction in cost per pound to orbit, launch processing in under 3 weeks, and higher reliability and safety standards than current expendables. Knowledge-based system techniques are being explored for the purpose of automating decision support processes in onboard and ground systems for pre-launch checkout and in-flight operations. Issues such as: satisfying real-time requirements, providing safety validation, hardware and Data Base Management System (DBMS) interfacing, system synergistic effects, human interfaces, and ease of maintainability, have an effect on the viability of expert systems as a useful tool.

  19. Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

    Directory of Open Access Journals (Sweden)

    Astrid Ledgaard Holm

    Full Text Available INTRODUCTION: Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. METHODS: We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. RESULTS: Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. CONCLUSION: Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost

  20. Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

    Science.gov (United States)

    Holm, Astrid Ledgaard; Veerman, Lennert; Cobiac, Linda; Ekholm, Ola; Diderichsen, Finn

    2014-01-01

    Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs) for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation) were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY) per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost-saving and should thus be first priority for implementation.

  1. Pt nanocatalysts supported on reduced graphene oxide for selective conversion of cellulose or cellobiose to sorbitol.

    Science.gov (United States)

    Wang, Ding; Niu, Wenqi; Tan, Minghui; Wu, Mingbo; Zheng, Xuejun; Li, Yanpeng; Tsubaki, Noritatsu

    2014-05-01

    Pt nanocatalysts loaded on reduced graphene oxide (Pt/RGO) were prepared by means of a convenient microwave-assisted reduction approach with ethylene glycol as reductant. The conversion of cellulose or cellobiose into sorbitol was used as an application reaction to investigate their catalytic performance. Various metal nanocatalysts loaded on RGO were compared and RGO-supported Pt exhibited the highest catalytic activity with 91.5 % of sorbitol yield from cellobiose. The catalytic performances of Pt nanocatalysts supported on different carbon materials or on silica support were also compared. The results showed that RGO was the best catalyst support, and the yield of sorbitol was as high as 91.5 % from cellobiose and 58.9 % from cellulose, respectively. The improvement of catalytic activity was attributed to the appropriate Pt particle size and hydrogen spillover effect of Pt/RGO catalyst. Interestingly, the size and dispersion of supported Pt particles could be easily regulated by convenient adjustment of the microwave heating temperature. The catalytic performance was found to initially increase and then decrease with increasing particle size. The optimum Pt particle size was 3.6 nm. These findings may offer useful guidelines for designing novel catalysts with beneficial catalytic performance for biomass conversion. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD

    Directory of Open Access Journals (Sweden)

    Maria Lawlor

    2008-10-01

    Full Text Available Maria Lawlor1, Sinead Kealy1, Michelle Agnew1, Bettina Korn1, Jennifer Quinn1, Ciara Cassidy1, Bernard Silke2, Finbarr O’Connell1, Rory O’Donnell11Department of Respiratory Medicine, CResT Directorate, St. James’ Hospital, Dublin 8, Ireland; 2Department of General Internal Medicine, Gems Directorate, St. James’ Hospital, Dublin 8, IrelandBackground: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD, do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients.Methods: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, followup education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort.Results: The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme.Conclusions: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.Keywords: COPD management outreach, follow-up, out-patient clinics

  3. Potential of remote multiplexing systems in reducing cabling cost and complexity in nuclear power stations

    International Nuclear Information System (INIS)

    Stirling, A.J.; L'Archeveque, J.V.R.

    1977-03-01

    Control and instrumentation cabling accounts for nearly 1% of the capital cost of a CANDU generating station. This study of cabling requirements, methods and costs for nuclear reactors, shows that efficient design and scale economies make CANDU wiring costs (per field point) among the lowest for comparable applications. Although attractive in other reactors, commercially available remote multiplexing systems are not, as yet, cost effective for general use in CANDU stations. The report, with its comprehensive tabulation of remote multiplexing equipment, and analysis of cabling procedures describes an approach for re-evaluating the tradeoff between remote multiplexing and conventional wiring as conditions change. (author)

  4. Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents.

    Directory of Open Access Journals (Sweden)

    Anne-Laura van Harmelen

    Full Text Available Early life stress (ELS consists of child family adversities (CFA: negative experiences that happened within the family environment and/or peer bullying. ELS plays an important role in the development of adolescent depressive symptoms and clinical disorders. Identifying factors that may reduce depressive symptoms in adolescents with ELS may have important public mental health implications.We used structural equation modelling and examined the impact of adolescent friendships and/or family support at age 14 on depressive symptoms at age 17 in adolescents exposed to ELS before age 11. To this end, we used structural equation modelling in a community sample of 771 adolescents (322 boys and 477 girls from a 3 year longitudinal study. Significant paths in the model were followed-up to test whether social support mediated or moderated the association between ELS and depressive symptoms at age 17.We found that adolescent social support in adolescence is negatively associated with subsequent depressive symptoms in boys and girls exposed to ELS. Specifically, we found evidence for two mediational pathways: In the first pathway family support mediated the link between CFA and depressive symptoms at age 17. Specifically, CFA was negatively associated with adolescent family support at age 14, which in turn was negatively associated with depressive symptoms at age 17. In the second pathway we found that adolescent friendships mediated the path between peer bullying and depressive symptoms. Specifically, relational bullying was negatively associated with adolescent friendships at age 14, which in turn were negatively associated with depressive symptoms at age 17. In contrast, we did not find a moderating effect of friendships and family support on the association between CFA and depressive symptoms.Friendships and/or family support in adolescence mediate the relationship between ELS and late adolescent depressive symptoms in boys and girls. Therefore

  5. COMPARISON BETWEEN RGB AND RGB-D CAMERAS FOR SUPPORTING LOW-COST GNSS URBAN NAVIGATION

    Directory of Open Access Journals (Sweden)

    L. Rossi

    2018-05-01

    Full Text Available A pure GNSS navigation is often unreliable in urban areas because of the presence of obstructions, thus preventing a correct reception of the satellite signal. The bridging between GNSS outages, as well as the vehicle attitude reconstruction, can be recovered by using complementary information, such as visual data acquired by RGB-D or RGB cameras. In this work, the possibility of integrating low-cost GNSS and visual data by means of an extended Kalman filter has been investigated. The focus is on the comparison between the use of RGB-D or RGB cameras. In particular, a Microsoft Kinect device (second generation and a mirrorless Canon EOS M RGB camera have been compared. The former is an interesting RGB-D camera because of its low-cost, easiness of use and raw data accessibility. The latter has been selected for the high-quality of the acquired images and for the possibility of mounting fixed focal length lenses with a lower weight and cost with respect to a reflex camera. The designed extended Kalman filter takes as input the GNSS-only trajectory and the relative orientation between subsequent pairs of images. Depending on the visual data acquisition system, the filter is different because RGB-D cameras acquire both RGB and depth data, allowing to solve the scale problem, which is instead typical of image-only solutions. The two systems and filtering approaches were assessed by ad-hoc experimental tests, showing that the use of a Kinect device for supporting a u-blox low-cost receiver led to a trajectory with a decimeter accuracy, that is 15 % better than the one obtained when using the Canon EOS M camera.

  6. An optimized OPC and MDP flow for reducing mask write time and mask cost

    Science.gov (United States)

    Yang, Ellyn; Li, Cheng He; Park, Se Jin; Zhu, Yu; Guo, Eric

    2010-09-01

    In the process of optical proximity correction, layout edge or fragment is migrating to proper position in order to minimize edge placement error (EPE). During this fragment migration, several factors other than EPE can be also taken into account as a part of cost function for optimal fragment displacement. Several factors are devised in favor of OPC stability, which can accommodate room for high mask error enhancement factor (MEEF), lack of process window, catastrophic pattern failure such as pinch/bridge and improper fragmentation. As technology node becomes finer, there happens conflict between OPC accuracy and stability. Especially for metal layers, OPC has focused on the stability by loss of accurate OPC results. On this purpose, several techniques have been introduced, which are target smoothing, process window aware OPC, model-based retargeting and adaptive OPC. By utilizing those techniques, OPC enables more stabilized patterning, instead of realizing design target exactly on wafer. Inevitably, post-OPC layouts become more complicated because those techniques invoke additional edge, or fragments prior to correction or during OPC iteration. As a result, jogs of post OPC layer can be dramatically increased, which results in huge number of shot count after data fracturing. In other words, there is trade-off relationship between data complexity and various methods for OPC stability. In this paper, those relationships have been investigated with respect to several technology nodes. The mask shot count reduction is achieved by reducing the number of jogs with which EPE difference are within pre-specified value. The effect of jog smoothing on OPC output - in view of OPC performance and mask data preparation - was studied quantitatively for respective technology nodes.

  7. The price of information: Increased inspection costs reduce the confirmation bias in visual search.

    Science.gov (United States)

    Rajsic, Jason; Wilson, Daryl E; Pratt, Jay

    2018-04-01

    In visual search, there is a confirmation bias such that attention is biased towards stimuli that match a target template, which has been attributed to covert costs of updating the templates that guide search [Rajsic, Wilson, & Pratt, 2015. Confirmation bias in visual search. Journal of Experimental Psychology: Human Perception and Performance. Advance online publication. doi:10.1037/xhp0000090]. In order to provide direct evidence for this speculation, the present study increased the cost of inspections in search by using gaze- and mouse-contingent searches, which restrict the manner in which information in search displays can be accrued, and incur additional motor costs (in the case of mouse-contingent searches). In a fourth experiment, we rhythmically mask elements in the search display to induce temporal inspection costs. Our results indicated that confirmation bias is indeed attenuated when inspection costs are increased. We conclude that confirmation bias results from the low-cost strategy of matching information to a single, concrete visual template, and that more sophisticated guidance strategies will be used when sufficiently beneficial. This demonstrates that search guidance itself comes at a cost, and that the form of guidance adopted in a given search depends on a comparison between guidance costs and the expected benefits of their implementation.

  8. Costs of solar and wind power variability for reducing CO2 emissions.

    Science.gov (United States)

    Lueken, Colleen; Cohen, Gilbert E; Apt, Jay

    2012-09-04

    We compare the power output from a year of electricity generation data from one solar thermal plant, two solar photovoltaic (PV) arrays, and twenty Electric Reliability Council of Texas (ERCOT) wind farms. The analysis shows that solar PV electricity generation is approximately one hundred times more variable at frequencies on the order of 10(-3) Hz than solar thermal electricity generation, and the variability of wind generation lies between that of solar PV and solar thermal. We calculate the cost of variability of the different solar power sources and wind by using the costs of ancillary services and the energy required to compensate for its variability and intermittency, and the cost of variability per unit of displaced CO(2) emissions. We show the costs of variability are highly dependent on both technology type and capacity factor. California emissions data were used to calculate the cost of variability per unit of displaced CO(2) emissions. Variability cost is greatest for solar PV generation at $8-11 per MWh. The cost of variability for solar thermal generation is $5 per MWh, while that of wind generation in ERCOT was found to be on average $4 per MWh. Variability adds ~$15/tonne CO(2) to the cost of abatement for solar thermal power, $25 for wind, and $33-$40 for PV.

  9. To the calculation of reduced cost capital component for power objects

    International Nuclear Information System (INIS)

    Andryushchenko, A.I.; Larin, E.A.

    1990-01-01

    The method for calculating capitalized cost component enabling comparison of alternative arrangement variants of power plant, is suggested. It is shown that in order to realize the technical-economical estimates in power industry for determination of capitalized cost component it is necessary to take into account capital construction expenditures as well as deductions for the plant dismountling and elimination of potential accidents

  10. Estimating the costs of reducing CO2 emission via avoided deforestation with integrated assessment modelling

    NARCIS (Netherlands)

    Overmars, K.P.; Tabeau, A.A.; Stehfest, E.; Meijl, van J.C.M.

    2012-01-01

    Estimates for deforestation and forest degradation were shown to account for about 17% of greenhouse gas emissions. The implementation of REDD is suggested to provide substantial emission reductions at low costs. Proper calculation of such a costs requires integrated modeling approach involving

  11. Routes to increasing efficiency and reducing the cost of thin-film solar panels

    NARCIS (Netherlands)

    Deelen, J. van; Barink, M.; Klerk, L.; Voorthuijzen, P.; Hovestad, A.

    2015-01-01

    Most development work in the laboratory is dedicated to efficiency enhancements at the cell level; improvements in efficiency can lead to higher cost-competitiveness of PV. However, the cost of panel manufacturing is an important aspect as well. For CIGS panels the deposition of the active layer is

  12. Low-Cost Synthesis of Smart Biocompatible Graphene Oxide Reduced Species by Means of GFP.

    Science.gov (United States)

    Masullo, Tiziana; Armata, Nerina; Pendolino, Flavio; Colombo, Paolo; Lo Celso, Fabrizio; Mazzola, Salvatore; Cuttitta, Angela

    2016-02-01

    The aim of this work is focused on the engineering of biocompatible complex systems composed of an inorganic and bio part. Graphene oxide (GO) and/or graphite oxide (GtO) were taken into account as potential substrates to the linkage of the protein such as Anemonia sulcata recombinant green fluorescent protein (rAsGFP). The complex system is obtained through a reduction process between GO/GtO and rAsGFP archiving an environmentally friendly biosynthesis. Spectroscopic measurements support the formation of reduced species. In particular, photoluminescence shows a change in the activity of the protein when a bond is formed, highlighted by a loss of the maximum emission signal of rAsGFP and a redshift of the maximum absorption peak of the GO/GtO species. Moreover, the hemolysis assay reveals a lower value in the presence of less oxidized graphene species providing evidence for a biocompatible material. This singular aspect can be approached as a promising method for circulating pharmaceutical preparations via intravenous administration in the field of drug delivery.

  13. Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

    Science.gov (United States)

    Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

    2014-01-01

    Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27-1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by

  14. Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

    Science.gov (United States)

    Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

    1999-08-01

    Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

  15. The cost of harm and savings through safety: using simulated patients for leadership decision support.

    Science.gov (United States)

    Denham, Charles R; Guilloteau, Franck R

    2012-09-01

    The ultimate objective of this program is to provide an approach to understanding and communicating health-care harm and cost to compel health-care provider leadership teams to vote "yes" to investments in patient safety initiatives, with the confidence that clinical, financial, and operational performance will be improved by such programs. Through a coordinated combination of literature evaluations, careful mapping of high impact scenarios using simulated patients and consensus review of clinical, operational, and financial factors, we confirmed value in such approaches to decision support information for hospital leadership teams to invest in patient safety projects. The study resulted in the following preliminary findings: ·Communication between hospital quality and finance departments can be much improved by direct collaborative relationships through regular meetings to help both clarify direct costs, indirect costs, and the savings of waste and harm to patients by avoidance of infections. ·Governance leaders and the professional administrative leaders should consider establishing the structures and systems necessary to act on risks and hazards as they evolve to deploy resources to areas of harm and risk. ·Quality and Infection Control Professionals can best wage their war on healthcare waste and harm by keeping abreast of the latest literature regarding the latest measures, standards, and safe practices for healthcare-acquired infections and hospital-acquired conditions. ·Regular reviews of patients with health-careYassociated infections, with direct attention to the attributable cost of treatment and how financial waste and harm to patients may be avoided, may provide hospital leaders with new insights for improvement. ·If hospitals developed their own risk scenarios to determine impact of harm and waste from hospital-acquired conditions in addition to impact scenarios for specific processes through technology and process innovations, they would have

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

    Science.gov (United States)

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

    2017-10-10

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

  17. Home modification to reduce falls at a health district level: Modeling health gain, health inequalities and health costs.

    Directory of Open Access Journals (Sweden)

    Nick Wilson

    Full Text Available There is some evidence that home safety assessment and modification (HSAM is effective in reducing falls in older people. But there are various knowledge gaps, including around cost-effectiveness and also the impacts at a health district-level.A previously established Markov macro-simulation model built for the whole New Zealand (NZ population (Pega et al 2016, Injury Prevention was enhanced and adapted to a health district level. This district was Counties Manukau District Health Board, which hosts 42,000 people aged 65+ years. A health system perspective was taken and a discount rate of 3% was used for both health gain and costs. Intervention effectiveness estimates came from a systematic review, and NZ-specific intervention costs were extracted from a randomized controlled trial. In the 65+ age-group in this health district, the HSAM program was estimated to achieve health gains of 2800 quality-adjusted life-years (QALYs; 95% uncertainty interval [UI]: 547 to 5280. The net health system cost was estimated at NZ$8.44 million (95% UI: $663 to $14.3 million. The incremental cost-effectiveness ratio (ICER was estimated at NZ$5480 suggesting HSAM is cost-effective (95%UI: cost saving to NZ$15,300 [equivalent to US$10,300]. Targeting HSAM only to people age 65+ or 75+ with previous injurious falls was estimated to be particularly cost-effective (ICERs: $700 and $832, respectively with the latter intervention being cost-saving. There was no evidence for differential cost-effectiveness by sex or by ethnicity: Māori (Indigenous population vs non-Māori.This modeling study suggests that a HSAM program could produce considerable health gain and be cost-effective for older people at a health district level. Nevertheless, comparisons may be desirable with other falls prevention interventions such as group exercise programs, which also provide social contact and may prevent various chronic diseases.

  18. Supporting law students’ skills development online – a strategy to improve skills and reduce student stress?

    Directory of Open Access Journals (Sweden)

    Anne Hewitt

    2017-08-01

    Full Text Available Law students internationally suffer from a high level of psychological distress compared with the general and student populations, and anecdotal evidence suggests that students developing skills without adequate support experience significant stress and anxiety. This article considers an initiative at one Australian law school to develop a degree-wide structured online skills development programme as a means to both improve student skills acquisition and reduce student stress. The project implements, through the use of learning technology, the principles proposed by McKinney for making small changes to law school teaching, informed by self-efficacy theory, which can have powerful results.

  19. Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010.

    LENUS (Irish Health Repository)

    Bennett, Kathleen

    2009-01-01

    OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000\\/LYG), followed by the statins for secondary prevention (< euro 6500\\/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000\\/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure.

  20. Cost-effectiveness Analysis of Sacubitril/Valsartan vs Enalapril in Patients With Heart Failure and Reduced Ejection Fraction.

    Science.gov (United States)

    Gaziano, Thomas A; Fonarow, Gregg C; Claggett, Brian; Chan, Wing W; Deschaseaux-Voinet, Celine; Turner, Stuart J; Rouleau, Jean L; Zile, Michael R; McMurray, John J V; Solomon, Scott D

    2016-09-01

    The angiotensin receptor neprilysin inhibitor sacubitril/valsartan was associated with a reduction in cardiovascular mortality, all-cause mortality, and hospitalizations compared with enalapril. Sacubitril/valsartan has been approved for use in heart failure (HF) with reduced ejection fraction in the United States and cost has been suggested as 1 factor that will influence the use of this agent. To estimate the cost-effectiveness of sacubitril/valsartan vs enalapril in the United States. Data from US adults (mean [SD] age, 63.8 [11.5] years) with HF with reduced ejection fraction and characteristics similar to those in the PARADIGM-HF trial were used as inputs for a 2-state Markov model simulated HF. Risks of all-cause mortality and hospitalization from HF or other reasons were estimated with a 30-year time horizon. Quality of life was based on trial EQ-5D scores. Hospital costs combined Medicare and private insurance reimbursement rates; medication costs included the wholesale acquisition cost for sacubitril/valsartan and enalapril. A discount rate of 3% was used. Sensitivity analyses were performed on key inputs including: hospital costs, mortality benefit, hazard ratio for hospitalization reduction, drug costs, and quality-of-life estimates. Hospitalizations, quality-adjusted life-years (QALYs), costs, and incremental costs per QALY gained. The 2-state Markov model of US adult patients (mean age, 63.8 years) calculated that there would be 220 fewer hospital admissions per 1000 patients with HF treated with sacubitril/valsartan vs enalapril over 30 years. The incremental costs and QALYs gained with sacubitril/valsartan treatment were estimated at $35 512 and 0.78, respectively, compared with enalapril, equating to an incremental cost-effectiveness ratio (ICER) of $45 017 per QALY for the base-case. Sensitivity analyses demonstrated ICERs ranging from $35 357 to $75 301 per QALY. For eligible patients with HF with reduced ejection fraction, the Markov

  1. 39 CFR 3050.22 - Documentation supporting attributable cost estimates in the Postal Service's section 3652 report.

    Science.gov (United States)

    2010-07-01

    ... the updated factors and input data sets from the supporting data systems used, including: (1) The In-Office Cost System (IOCS); (2) The Management Operating Data System (MODS); (3) The City Carrier Cost... International Revenue Accounting Systems (IAB data). (f) The econometric analysis of carrier street time...

  2. The Implementation of a Cost Effectiveness Analyzer for Web-Supported Academic Instruction: An Example from Life Science

    Science.gov (United States)

    Cohen, Anat; Nachmias, Rafi

    2012-01-01

    This paper describes implementation of a quantitative cost effectiveness analyzer for Web-supported academic instruction that was developed in our University. The paper presents the cost effectiveness analysis of one academic exemplary course in Life Science department and its introducing to the course lecturer for evaluation. The benefits and…

  3. The Use of Clinical Decision Support in Reducing Diagnosis of and Treatment of Asymptomatic Bacteriuria.

    Science.gov (United States)

    Keller, Sara C; Feldman, Leonard; Smith, Janessa; Pahwa, Amit; Cosgrove, Sara E; Chida, Natasha

    2018-06-01

    Clinical decision support (CDS) embedded within the electronic health record (EHR) is a potential antibiotic stewardship strategy for hospitalized patients. Reduction in urine testing and treating asymptomatic bacteriuria (ASB) is an important strategy to promote antibiotic stewardship. We created an intervention focused on reducing urine testing for asymptomatic patients at a large tertiary care center. The objective of this study was to design an intervention to reduce unnecessary urinalysis and urine culture (UC) orders as well as the treatment of ASB. We performed a quasiexperimental study among adult inpatients at a single academic institution. We implemented a bundled intervention, including information broadcast in newsletters, hospitalwide screensavers, and passive CDS messages in the EHR. We investigated the impact of this strategy on urinalysis, UC orders, and on the treatment of ASB by using an interrupted time series analysis. Our intervention led to reduced UC order as well as reduced antibiotic orders in response to urinalysis orders and UC results. This easily implementable bundle may play an important role as an antibiotic stewardship strategy. © 2018 Society of Hospital Medicine.

  4. DEVELOPMENT AND EVALUATION OF MEASURES TO REDUCE COSTS OF REGIONAL LOANS SERVICING

    Directory of Open Access Journals (Sweden)

    Pavel Arkadyevitch Galanskiy

    2014-10-01

    Full Text Available The paper discusses major problems of current concern connected with controlling direct obligations of Russian regions (the model of debt servicing cost parameter optimization has been worked out, and their key solutions. The methods offered to analyze debts and manage them are applicable to any Russian Federation regions characterized by budget deficit and forced to cover it using borrowed funds. The important leverage found and their impacts on sub-federal debt servicing cost are also treated in the article.Objective: to identify the direction and impact degree of various parameters on the cost of sub-federal loans.Methodology: there were used general scientific methods: analysis and synthesis, comparison, generalization, systematic approach.Results: main parameters that influence the cost of sub-federal loans servicing and allow its most effective reduction have been identified.

  5. Saving Blood and Reducing Costs: Updating Blood Transfusion Practice in Lower Limb Arthroplasty

    LENUS (Irish Health Repository)

    Fenelon, C

    2018-04-01

    Our aim was to quantify blood transfusion rates in lower limb arthroplasty following the introduction of a multimodal enhanced recovery programme (ERP). We then sought to update the maximum surgical blood ordering schedule (MSBOS) and calculate cost savings achieved.

  6. Lean Six Sigma to Reduce Intensive Care Unit Length of Stay and Costs in Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Trzeciak, Stephen; Mercincavage, Michael; Angelini, Cory; Cogliano, William; Damuth, Emily; Roberts, Brian W; Zanotti, Sergio; Mazzarelli, Anthony J

    Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. Before-and-after cohort study. Multidisciplinary intensive care unit (ICU) in an academic medical center. Adult patients admitted to the ICU and treated with PMV, as defined by diagnosis-related group (DRG). We implemented a clinical redesign intervention based on LSS principles. We identified eight distinct processes in preparing patients with PMV for post-acute care. Our clinical redesign included reengineering daily patient care rounds ("Lean ICU rounds") to reduce variation and waste in these processes. We compared hospital LOS and direct cost per case in patients with PMV before (2013) and after (2014) our LSS intervention. Among 259 patients with PMV (131 preintervention; 128 postintervention), median hospital LOS decreased by 24% during the intervention period (29 vs. 22 days, p < .001). Accordingly, median hospital direct cost per case decreased by 27% ($66,335 vs. $48,370, p < .001). We found that a LSS-based clinical redesign reduced hospital LOS and the costs of care for patients with PMV.

  7. Use of predefined biochemical admission profiles does not reduce the number of tests or total cost

    DEFF Research Database (Denmark)

    Pareek, Manan; Haidl, Felix; Folkestad, Lars

    2014-01-01

    The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost.......The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost....

  8. Forecasting the Number of Soil Samples Required to Reduce Remediation Cost Uncertainty

    OpenAIRE

    Demougeot-Renard, Hélène; de Fouquet, Chantal; Renard, Philippe

    2008-01-01

    Sampling scheme design is an important step in the management of polluted sites. It largely controls the accuracy of remediation cost estimates. In practice, however, sampling is seldom designed to comply with a given level of remediation cost uncertainty. In this paper, we present a new technique that allows one to estimate of the number of samples that should be taken at a given stage of investigation to reach a forecasted level of accuracy. The uncertainty is expressed both in terms of vol...

  9. Cost-Effectiveness Analysis of a Navigation Program for Colorectal Cancer Screening to Reduce Social Health Inequalities: A French Cluster Randomized Controlled Trial.

    Science.gov (United States)

    De Mil, Rémy; Guillaume, Elodie; Guittet, Lydia; Dejardin, Olivier; Bouvier, Véronique; Pornet, Carole; Christophe, Véronique; Notari, Annick; Delattre-Massy, Hélène; De Seze, Chantal; Peng, Jérôme; Launoy, Guy; Berchi, Célia

    2018-06-01

    Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations. To evaluate the cost-effectiveness of the first patient navigation program in France. A total of 16,250 participants were randomized to either the usual screening group (n = 8145) or the navigation group (n = 8105). Navigation consisted of personalized support provided by social workers. A cost-effectiveness analysis of navigation versus usual screening was conducted from the payer perspective in the Picardy region of northern France. We considered nonmedical direct costs in the analysis. Navigation was associated with a significant increase of 3.3% (24.4% vs. 21.1%; P = 0.003) in participation. The increase in participation was higher among affluent participants (+4.1%; P = 0.01) than among deprived ones (+2.6%; P = 0.07). The cost per additional individual screened by navigation compared with usual screening (incremental cost-effectiveness ratio) was €1212 globally and €1527 among deprived participants. Results were sensitive to navigator wages and to the intervention effectiveness whose variations had the greatest impact on the incremental cost-effectiveness ratio. Patient navigation aiming at increasing CRC screening participation is more efficient among affluent individuals. Nevertheless, when the intervention is implemented for the entire population, social inequalities in CRC screening adherence increase. To reduce social inequalities, patient navigation should therefore be restricted to deprived populations, despite not being the most cost-effective strategy, and accepted to bear a higher extra cost per additional individual screened. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. When sex doesn't sell: using sexualized images of women reduces support for ethical campaigns.

    Science.gov (United States)

    Bongiorno, Renata; Bain, Paul G; Haslam, Nick

    2013-01-01

    Images of scantily clad women are used by advertisers to make products more attractive to men. This "sex sells" approach is increasingly employed to promote ethical causes, most prominently by the animal-rights organization PETA. Yet sexualized images can dehumanize women, leaving an unresolved paradox--is it effective to advertise an ethical cause using unethical means? In Study 1, a sample of Australian male undergraduates (N = 82) viewed PETA advertisements containing either sexualized or non-sexualized images of women. Intentions to support the ethical organization were reduced for those exposed to the sexualized advertising, and this was explained by their dehumanization of the sexualized women, and not by increased arousal. Study 2 used a mixed-gender community sample from the United States (N = 280), replicating this finding and extending it by showing that behaviors helpful to the ethical cause diminished after viewing the sexualized advertisements, which was again mediated by the dehumanization of the women depicted. Alternative explanations relating to the reduced credibility of the sexualized women and their objectification were not supported. When promoting ethical causes, organizations may benefit from using advertising strategies that do not dehumanize women.

  11. A Universal Rig for Supporting Large Hammer Drills: Reduced Injury Risk and Improved Productivity.

    Science.gov (United States)

    Rempel, David; Barr, Alan

    2015-10-01

    Drilling holes into concrete with heavy hammer and rock drills is one of the most physically demanding tasks performed in commercial construction and poses risks for musculoskeletal disorders, noise induced hearing loss, hand arm vibration syndrome and silicosis. The aim of this study was to (1) use a participatory process to develop a rig to support pneumatic rock drills or large electric hammer drills in order to reduce the health risks and (2) evaluate the usability of the rig. Seven prototype rigs for supporting large hammer drills were developed and modified with feedback from commercial contractors and construction workers. The final design was evaluated by laborers and electricians (N=29) who performed their usual concrete drilling with the usual method and the new rig. Subjective regional fatigue was significantly less in the neck, shoulders, hands and arms, and lower back) when using the universal rig compared to the usual manual method. Usability ratings for the rig were significantly better than the usual method on stability, control, drilling, accuracy, and vibration. Drilling time was reduced by approximately 50% with the rig. Commercial construction contractors, laborers and electricians who use large hammer drills for drilling many holes should consider using such a rig to prevent musculoskeletal disorders, fatigue, and silicosis.

  12. When sex doesn't sell: using sexualized images of women reduces support for ethical campaigns.

    Directory of Open Access Journals (Sweden)

    Renata Bongiorno

    Full Text Available Images of scantily clad women are used by advertisers to make products more attractive to men. This "sex sells" approach is increasingly employed to promote ethical causes, most prominently by the animal-rights organization PETA. Yet sexualized images can dehumanize women, leaving an unresolved paradox--is it effective to advertise an ethical cause using unethical means? In Study 1, a sample of Australian male undergraduates (N = 82 viewed PETA advertisements containing either sexualized or non-sexualized images of women. Intentions to support the ethical organization were reduced for those exposed to the sexualized advertising, and this was explained by their dehumanization of the sexualized women, and not by increased arousal. Study 2 used a mixed-gender community sample from the United States (N = 280, replicating this finding and extending it by showing that behaviors helpful to the ethical cause diminished after viewing the sexualized advertisements, which was again mediated by the dehumanization of the women depicted. Alternative explanations relating to the reduced credibility of the sexualized women and their objectification were not supported. When promoting ethical causes, organizations may benefit from using advertising strategies that do not dehumanize women.

  13. Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

    International Nuclear Information System (INIS)

    Andrianov, A.; Kuptsov, I.

    2013-01-01

    This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure

  14. Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

    Energy Technology Data Exchange (ETDEWEB)

    Andrianov, A.; Kuptsov, I. [Obninsk Institute for Nuclear Power Engineering, Studgorodok 1, Obninsk, Kaluga region 249030 (Russian Federation)

    2013-07-01

    This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure.

  15. A Case Report: Cornerstone Health Care Reduced the Total Cost of Care Through Population Segmentation and Care Model Redesign.

    Science.gov (United States)

    Green, Dale E; Hamory, Bruce H; Terrell, Grace E; O'Connell, Jasmine

    2017-08-01

    Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment. All fully implemented programs delivered between 10% and 16% cost savings. The key area for savings factor was hospitalization, which was reduced by 30% across all programs. The greatest area of cost increase was "other," a category that consisted in large part of hospice services. Full implementation was key; 2 primary care sites that reverted to more traditional models failed to show the same pattern of savings.

  16. Cost-effectiveness of sacubitril/valsartan in chronic heart-failure patients with reduced ejection fraction.

    Science.gov (United States)

    Ademi, Zanfina; Pfeil, Alena M; Hancock, Elizabeth; Trueman, David; Haroun, Rola Haroun; Deschaseaux, Celine; Schwenkglenks, Matthias

    2017-11-29

    We aimed to assess the cost effectiveness of sacubitril/valsartan compared to angiotensin-converting enzyme inhibitors (ACEIs) for the treatment of individuals with chronic heart failure and reduced-ejection fraction (HFrEF) from the perspective of the Swiss health care system. The cost-effectiveness analysis was implemented as a lifelong regression-based cohort model. We compared sacubitril/valsartan with enalapril in chronic heart failure patients with HFrEF and New York-Heart Association Functional Classification II-IV symptoms. Regression models based on the randomised clinical phase III PARADIGM-HF trials were used to predict events (all-cause mortality, hospitalisations, adverse events and quality of life) for each treatment strategy modelled over the lifetime horizon, with adjustments for patient characteristics. Unit costs were obtained from Swiss public sources for the year 2014, and costs and effects were discounted by 3%. The main outcome of interest was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life years (QALYs) gained. Deterministic sensitivity analysis (DSA) and scenario and probabilistic sensitivity analysis (PSA) were performed. In the base-case analysis, the sacubitril/valsartan strategy showed a decrease in the number of hospitalisations (6.0% per year absolute reduction) and lifetime hospital costs by 8.0% (discounted) when compared with enalapril. Sacubitril/valsartan was predicted to improve overall and quality-adjusted survival by 0.50 years and 0.42 QALYs, respectively. Additional net-total costs were CHF 10 926. This led to an ICER of CHF 25 684. In PSA, the probability of sacubitril/valsartan being cost-effective at thresholds of CHF 50 000 was 99.0%. The treatment of HFrEF patients with sacubitril/valsartan versus enalapril is cost effective, if a willingness-to-pay threshold of CHF 50 000 per QALY gained ratio is assumed.

  17. 12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment.

    Science.gov (United States)

    Mundt, Marlon P; Parthasarathy, Sujaya; Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I

    2012-11-01

    Adolescents who attend 12-step groups following alcohol and other drug (AOD) treatment are more likely to remain abstinent and to avoid relapse post-treatment. We examined whether 12-step attendance is also associated with a corresponding reduction in health care use and costs. We used difference-in-difference analysis to compare changes in seven-year follow-up health care use and costs by changes in 12-step participation. Four Kaiser Permanente Northern California AOD treatment programs enrolled 403 adolescents, 13-18-years old, into a longitudinal cohort study upon AOD treatment entry. Participants self-reported 12-step meeting attendance at six-month, one-year, three-year, and five-year follow-up. Outcomes included counts of hospital inpatient days, emergency room (ER) visits, primary care visits, psychiatric visits, AOD treatment costs and total medical care costs. Each additional 12-step meeting attended was associated with an incremental medical cost reduction of 4.7% during seven-year follow-up. The medical cost offset was largely due to reductions in hospital inpatient days, psychiatric visits, and AOD treatment costs. We estimate total medical use cost savings at $145 per year (in 2010 U.S. dollars) per additional 12-step meeting attended. The findings suggest that 12-step participation conveys medical cost offsets for youth who undergo AOD treatment. Reduced costs may be related to improved AOD outcomes due to 12-step participation, improved general health due to changes in social network following 12-step participation, or better compliance to both AOD treatment and 12-step meetings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money. Energy-Smart Building Choices.

    Science.gov (United States)

    Department of Energy, Washington, DC.

    This guide addresses contributions that school facility administrators and business officials can make in an effort to reduce operating costs and free up money for capital improvements. The guide explores opportunities available to utilize energy-saving strategies at any stage in a building's life, from its initial design phase through renovation.…

  19. Mitigation options for reducing nutrient emissions from agriculture : a study amongst European member states of Cost action 869

    NARCIS (Netherlands)

    Schoumans, O.F.; Chardon, W.J.; Bechmann, M.; Gascuel-Odoux, C.; Hofman, G.; Kronvang, B.; Litaor, I.; Porto, Lo A.; Newell, P.; Rubaek, G.H.

    2011-01-01

    The Water Framework Directive (WFD) requires improvement to the quality of surface water and groundwater. In the past many measures have been implemented to reduce the contribution of point sources, and as a result diffuse pollution from agricultural became more important. The main objective of COST

  20. Reducing Idle Power Consumption in Office Spaces Saves U.S. Navy in Energy Costs (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2014-04-01

    As part of a two-year project to demonstrate energy efficiency measures, renewable energy generation, and energy systems integration, the National Renewable Energy Laboratory (NREL) has identified advanced plug load controls as a promising technology for reducing energy use and related costs in the U.S. Navy's Naval Facilities Engineering Command (NAVFAC) office spaces.

  1. Dietary nitrate does not reduce oxygen cost of exercise or improve muscle mitochondrial function in patients with mitochondrial myopathy

    NARCIS (Netherlands)

    Nabben, M.; Schmitz, J.P.J.; Ciapaite, J.; le Clercq, C.M.P.; van Riel, N.A.; Haak, H.R.; Nicolay, K.; de Coo, I.F.M.; Smeets, H.; Praet, S.F.; van Loon, L.J.; Prompers, J.J.

    2017-01-01

    Muscle weakness and exercise intol erance negatively affect the quality of life of patients with mitochondrial myopathy. Short-term dietary nitrate supplementation has been shown to improve exercise performance and reduce oxygen cost of exercise in healthy humans and trained athletes. We

  2. Reducing the risk of injury from table saw use: the potential benefits and costs of automatic protection.

    Science.gov (United States)

    Graham, John D; Chang, Joice

    2015-02-01

    The use of table saws in the United States is associated with approximately 28,000 emergency department (ED) visits and 2,000 cases of finger amputation per year. This article provides a quantitative estimate of the economic benefits of automatic protection systems that could be designed into new table saw products. Benefits are defined as reduced health-care costs, enhanced production at work, and diminished pain and suffering. The present value of the benefits of automatic protection over the life of the table saw are interpreted as the switch-point cost value, the maximum investment in automatic protection that can be justified by benefit-cost comparison. Using two alternative methods for monetizing pain and suffering, the study finds switch-point cost values of $753 and $561 per saw. These point estimates are sensitive to the values of inputs, especially the average cost of injury. The various switch-point cost values are substantially higher than rough estimates of the incremental cost of automatic protection systems. Uncertainties and future research needs are discussed. © 2014 Society for Risk Analysis.

  3. South Korean energy scenarios show how nuclear power can reduce future energy and environmental costs

    International Nuclear Information System (INIS)

    Hong, Sanghyun; Bradshaw, Corey J.A.; Brook, Barry W.

    2014-01-01

    South Korea is an important case study for understanding the future role of nuclear power in countries with on-going economic growth, and limited renewable energy resources. We compared quantitatively the sustainability of two ‘future-mapping’ exercises (the ‘Governmental’ scenario, which relies on fossil fuels, and the Greenpeace scenario, which emphasises renewable energy and excludes nuclear power). The comparison was based on a range of environmental and technological perspectives, and contrasted against two additional nuclear scenarios that instead envisage a dominant role for nuclear energy. Sustainability metrics included energy costs, external costs (greenhouse-gas emissions, air pollutants, land transformation, water consumption and discharge, and safety) and additional costs. The nuclear-centred scenarios yielded the lowest total cost per unit of final energy consumption by 2050 ($14.37 GJ −1 ), whereas the Greenpeace scenario has the highest ($25.36 GJ −1 ). We used probabilistic simulations based on multi-factor distributional sampling of impact and cost metrics to estimate the overlapping likelihoods among scenarios to understand the effect of parameter uncertainty on the integrated recommendations. Our simulation modelling implies that, despite inherent uncertainties, pursuing a large-scale expansion of nuclear-power capacity offers the most sustainable pathway for South Korea, and that adopting a nuclear-free pathway will be more costly and produce more greenhouse-gas emissions. - Highlights: • Nuclear power has a key role to play in mitigating greenhouse-gas emissions. • The Greenpeace scenario has higher total external cost than the nuclear scenarios. • The nuclear-centred scenarios offer the most sustainable option for South Korea. • The similar conclusions are likely to apply to other Asian countries

  4. Magnetic bimetallic nanoparticles supported reduced graphene oxide nanocomposite: Fabrication, characterization and catalytic capability

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Lei; Wu, Tao; Xu, Xiaoyang; Xia, Fengling; Na, Heya [School of Science, Tianjin University, Tianjin 300072 (China); Liu, Yu, E-mail: liuyuls@163.com [School of Science, Tianjin University, Tianjin 300072 (China); Qiu, Haixia [School of Science, Tianjin University, Tianjin 300072 (China); Wang, Wei [School of Chemical Engineering, Tianjin University, Tianjin 300072 (China); Gao, Jianping, E-mail: jianpinggao2012@126.com [School of Science, Tianjin University, Tianjin 300072 (China)

    2015-04-15

    Highlights: • Ni and Ag nanoparticles loaded on RGO (Ni–Ag@RGO) were fabricated in a one-pot reaction. • The Ni–Ag@RGO were excellent catalysts for the reduction of 4-nitrophenol. • The Ni–Ag@RGO showed superior catalytic activity for photodegradation of methyl orange. • The Ni–Ag@RGO exhibit good reusability in a magnetic field. - Abstract: A facile method for preparing Ni–Ag bimetallic nanoparticles supported on reduced graphene oxide (Ni–Ag@RGO hybrid) has been established. Hydrazine hydrate was used as the reducing agent to reduce the graphene oxide, Ni{sup 2+} and Ag{sup +} to form Ni–Ag@RGO hybrid. The prepared hybrid was further characterized by X-ray diffraction, thermogravimetric analysis, X-ray photoelectron spectroscopy, and transmission electron microscopy. Interestingly, the prepared material shown good magnetic properties, which were determined by vibrating sample magnetometer. In addition, the Ni–Ag@RGO hybrid exhibited excellent catalytic activity for the reduction of 4-nitrophenol and the photodegradation of methyl orange. The catalytic process was monitored by determining the change in the concentration of the reactants with time using ultraviolet–visible absorption spectroscopy. After completion of the reaction, the catalyst can be separated from the reaction system simply under a magnet field and shows good recyclability.

  5. The Feasibility of a Land Ferry System to Reduce Highway Maintenance Cost and Associated Externalities

    Directory of Open Access Journals (Sweden)

    Steve J. Merrill

    2016-01-01

    Full Text Available This study provides an economic evaluation for a Land Ferry, which is a rail system capable of carrying trucks and all other types of vehicles, passengers, and cargo. The Land Ferry system involves a sliding loading system to roll heavy loads onto a flatbed; as a result, loading and unloading of all vehicles and cargo could be accomplished simultaneously. The evaluation for this system included (1 the design of a new track alignment over which the Land Ferry system would run, (2 evaluation of various sources of power, (3 estimation of how many local jobs the Land Ferry would generate, and (4 a benefit-cost analysis. It was estimated that the Land Ferry would create over 45,788 temporary jobs in Nevada during the three-year construction period and 318 permanent jobs during operation. The majority of the benefits were attributed to savings in travel time ($356.4 M, vehicle operating costs ($1000.4 M, reduction of accidents ($544.6 M, and pavement maintenance ($503.2 M. These benefits would be a consequence of the shift of trucks from the highway, thus resulting in higher speeds, decrease fuel consumption, and decrease vehicle maintenance costs. The overall benefit-cost ratio of 1.7 implies a cost-effective project.

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

    Science.gov (United States)

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

    2017-09-01

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

  7. Innovation in product design as a factor for reducing logistic and production costs

    Directory of Open Access Journals (Sweden)

    Luciana Fighera Marzall

    2016-03-01

    Full Text Available Innovation has been considered of fundamental importance for organizations competing in dynamic environments, which along with cost management has been shown as an organizational strategy that allows the company to measure its results and implement measures that impact on the organization's performance as a whole. This paper, carried out in a metal mechanical industry of a telecommunications engineering branch, aims to analyse cost reduction in logistics raw materials areas through innovation in the product design, which are antennas and towers for telephone networks. In terms of methodology, this study presents itself as a qualitative and quantitative research-action, which from the link between theory and practice allows for intervention in the middle of the researchers studied. As a result, an innovative project was developed, which allowed for the reduction costs of production by 68% and logistics by 32%. Despite the significant decrease in costs, the quality of manufactured products not declined and customer needs were met, thus making the company more competitive against competitors. Not widespread in the literature, this analysis of the impact on logistics and production costs due to improvements in the project is the main contribution theoretical of this paper.

  8. Near-linear cost increase to reduce climate-change risk

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffer, M. [Environmental Systems Analysis Group, Wageningen University and Research Centre, P.O. Box 47, 6700 AA Wageningen (Netherlands); Kram, T.; Van Vuuren, D.P. [Climate and Global Sustainability Group, Netherlands Environmental Assessment Agency, P.O. Box 303, 3720 AH Bilthoven (Netherlands); Meinshausen, M.; Hare, W.L. [Potsdam Institute for Climate Impact Research, P.O. Box 60 12 03, 14412 Potsdam (Germany); Schneider, S.H. (ed.) [Stanford University, Stanford, CA (United States)

    2008-12-30

    One approach in climate-change policy is to set normative long-term targets first and then infer the implied emissions pathways. An important example of a normative target is to limit the global-mean temperature change to a certain maximum. In general, reported cost estimates for limiting global warming often rise rapidly, even exponentially, as the scale of emission reductions from a reference level increases. This rapid rise may suggest that more ambitious policies may be prohibitively expensive. Here, we propose a probabilistic perspective, focused on the relationship between mitigation costs and the likelihood of achieving a climate target. We investigate the qualitative, functional relationship between the likelihood of achieving a normative target and the costs of climate-change mitigation. In contrast to the example of exponentially rising costs for lowering concentration levels, we show that the mitigation costs rise proportionally to the likelihood of meeting a temperature target, across a range of concentration levels. In economic terms investing in climate mitigation to increase the probability of achieving climate targets yields 'constant returns to scale', because of a counterbalancing rapid rise in the probabilities of meeting a temperature target as concentration is lowered.

  9. Design Options to Reduce Development Cost of First Generation Surface Reactors

    International Nuclear Information System (INIS)

    Poston, David I.; Marcille, Thomas F.

    2006-01-01

    Low-power surface reactors have the potential to have the lowest development cost of any space reactor application, primarily because system alpha (mass/kg) is not of utmost importance and mission lifetimes do not have to be a decade or more. Even then, the development cost of a surface reactor can vary substantially depending on the performance requirements (e.g. mass, power, lifetime, reliability) and technical development risk deemed acceptable by the end-user. It is important for potential users to be aware of these relationships before they determine their future architecture (i.e. decide what they need). Generally, the greatest potential costs of a space reactor program are a nuclear-powered ground test and extensive material development campaigns, so it is important to consider options that can minimize the need for or complexity of such tasks. The intended goal of this paper is to inform potential surface reactor users of the potential sensitivities of surface reactor development cost to design requirements, and areas where technical risk can be traded with development cost

  10. Reducing the cost of MWT module technology based on conductive back-sheet foils

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, I.J.; Goris, M.J.A.A.; Eerenstein, W. [ECN Solar Energy, P.O. Box 1, 1755 ZG Petten (Netherlands)

    2013-10-15

    MWT cell and module technology has shown to result in modules with a higher power output than H-pattern modules and to be suitable for use with thin and fragile cells. In this work, the use of low-cost module materials and their effect on module performance and reliability has been assessed. These materials include a conductive back-sheet patterned by milling with no silver plating at the contacts on the foil and no isolation coating on the copper and a low-silver content conductive adhesive. The sensitivity of module performance for the anti-corrosion coating on the copper of the conductive back-sheet is measured, as is the reliability in climate chamber testing of mini-modules made with these materials. The results show that these low cost materials can be used to manufacture module with good performance and reliability. Options are given for further cost reduction.

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

    Science.gov (United States)

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

    2018-01-01

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

  12. The diabetes medication Canagliflozin reduces cancer cell proliferation by inhibiting mitochondrial complex-I supported respiration

    Directory of Open Access Journals (Sweden)

    Linda A. Villani

    2016-10-01

    Full Text Available Objective: The sodium-glucose transporter 2 (SGLT2 inhibitors Canagliflozin and Dapagliflozin are recently approved medications for type 2 diabetes. Recent studies indicate that SGLT2 inhibitors may inhibit the growth of some cancer cells but the mechanism(s remain unclear. Methods: Cellular proliferation and clonogenic survival were used to assess the sensitivity of prostate and lung cancer cell growth to the SGLT2 inhibitors. Oxygen consumption, extracellular acidification rate, cellular ATP, glucose uptake, lipogenesis, and phosphorylation of AMP-activated protein kinase (AMPK, acetyl-CoA carboxylase, and the p70S6 kinase were assessed. Overexpression of a protein that maintains complex-I supported mitochondrial respiration (NDI1 was used to establish the importance of this pathway for mediating the anti-proliferative effects of Canagliflozin. Results: Clinically achievable concentrations of Canagliflozin, but not Dapagliflozin, inhibit cellular proliferation and clonogenic survival of prostate and lung cancer cells alone and in combination with ionizing radiation and the chemotherapy Docetaxel. Canagliflozin reduced glucose uptake, mitochondrial complex-I supported respiration, ATP, and lipogenesis while increasing the activating phosphorylation of AMPK. The overexpression of NDI1 blocked the anti-proliferative effects of Canagliflozin indicating reductions in mitochondrial respiration are critical for anti-proliferative actions. Conclusion: These data indicate that like the biguanide metformin, Canagliflozin not only lowers blood glucose but also inhibits complex-I supported respiration and cellular proliferation in prostate and lung cancer cells. These observations support the initiation of studies evaluating the clinical efficacy of Canagliflozin on limiting tumorigenesis in pre-clinical animal models as well epidemiological studies on cancer incidence relative to other glucose lowering therapies in clinical populations. Keywords: AMP

  13. Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam

    Directory of Open Access Journals (Sweden)

    Thanh Duong Cong

    2012-11-01

    Full Text Available Abstract Background Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men. Methods In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected. Results Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a “scare tactic” mainly focusing on drug users and sex workers, who were defined as “social evils” in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV. Conclusions A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the “social evil“ approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.

  14. Potential and cost-effectiveness of CO{sub 2}-reducing measures in the pulp and paper industry

    Energy Technology Data Exchange (ETDEWEB)

    Moellersten, K.; Westermark, M.; Yan, J. [Royal Institute of Technology (KTH), Stockholm (Sweden). Dept. of Chemical Engineering and Technology/Energy Processes

    2001-07-01

    Using the two criteria of potential CO{sub 2} reduction and cost of CO{sub 2} reduction several technical options in the pulp and paper industry are investigated. Principal CO{sub 2} reducing measures include: decreasing fuel consumption through improved heat exchanging or new processes with lower heat demand, decreasing electricity consumption, substituting fossil fuels with biofuels, exporting refined biofuels for external use, increasing CO{sub 2} neutral electricity generation, improving waste heat utilization and decreasing specific raw material consumption. The results show that electricity conservation and improvement of existing steam power cycles are the most cost-effective options that have a large potential to reduce CO{sub 2} emissions. Outsourcing of industrial energy operations to utilities may enable CO{sub 2} reducing measures that would not be carried out by industry due to differences in demands for profit on spent capita. 21 refs., 1 fig., 2 tabs.

  15. Low-Cost, Class D Testing of Spacecraft Photovoltaic Systems Can Reduce Risk

    Science.gov (United States)

    Forgione, Joshua B.; Kojima, Gilbert K.; Hanel, Robert; Mallinson, Mark V.

    2014-01-01

    The end-to-end verification of a spacecraft photovoltaic power generation system requires light! Specifically, the standard practice for doing so is the Large Area Pulsed Solar Simulation (LAPSS). A LAPSS test can characterize a photovoltaic system's efficiency via its response to rapidly applied impulses of simulated sunlight. However, a Class D program on a constrained budget and schedule may not have the resources to ship an entire satellite for a LAPSS test alone. Such was the case with the Lunar Atmospheric and Dust Environment Explorer (LADEE) program, which was also averse to the risk of hardware damage during shipment. When the Electrical Power System (EPS) team was denied a spacecraft-level LAPSS test, the lack of an end-to-end power generation test elevated to a project-level technical risk. The team pulled together very limited resources to not only eliminate the risk, but build a process to monitor the health of the system through mission operations. We discuss a process for performing a low-cost, end-to-end test of the LADEE photovoltaic system. The approach combines system-level functional test, panel-level performance results, and periodic inspection (and repair) up until launch. Following launch, mission operations tools are utilized to assess system performance based on a scant amount of data. The process starts in manufacturing at the subcontractor. The panel manufacturer provides functional test and LAPSS data on each individual panel. We apply an initial assumption that the per-panel performance is sufficient to meet the power generation requirements. The manufacturer's data is also carried as the performance allocation for each panel during EPS system modeling and initial mission operations. During integration and test, a high-power, professional theater lamp system provides simulated sunlight to each panel on the spacecraft, thereby permitting a true end-to-end system test. A passing test results in a step response to nearly full-rated current

  16. Do workplace wellness programs reduce medical costs? Evidence from a Fortune 500 company.