Predicting Cost/Reliability/Maintainability of Advanced General Aviation Avionics Equipment

Science.gov (United States)

Davis, M. R.; Kamins, M.; Mooz, W. E.

1978-01-01

A methodology is provided for assisting NASA in estimating the cost, reliability, and maintenance (CRM) requirements for general avionics equipment operating in the 1980's. Practical problems of predicting these factors are examined. The usefulness and short comings of different approaches for modeling coast and reliability estimates are discussed together with special problems caused by the lack of historical data on the cost of maintaining general aviation avionics. Suggestions are offered on how NASA might proceed in assessing cost reliability CRM implications in the absence of reliable generalized predictive models.

The Stickiness of Selling, General, and Administrative Costs in the Indonesian Companies

Directory of Open Access Journals (Sweden)

Benny Armanto

2014-04-01

Full Text Available Selling, general and administration costs are the main components in the Income Statement. A large number of permanent staff in sales and marketing department will make the company dominated by the fixed costs. This fact could lead to sticky cost behavior. In addition, role of the manager can also cause the cost stickiness. When the company’s revenue decreases, manager may delay to decrease the cost or not even decrease cost at all. The objective of the study is to determine whether cost stickiness of selling, general and administrative in the Indonesian listed companies. This study applied log-linear data panel regression with 3605 firm years that is listed in Indonesian Stock Exchange (BEI from 1993 – 2013. This study finds that selling, general, and administrative costs are sticky only for the manufacturing companies. Furthermore, the results show that adjustment of sales, general, and administrative costs delayed by the manager when revenue decreases, yet the cost stickiness will be reduced in the next period.

The regional costs and benefits of acid rain control

International Nuclear Information System (INIS)

Berkman, M.P.

1991-01-01

Congress recently enacted acid rain control legislation as part of the 1990 Clean Air Act Amendments following a decade-long debate among disparate regional interests. Although Congress succeeded in drafting a law acceptable to all regions, the regional costs and benefits of the legislation remain uncertain. The research presented here attempts to estimate the regional costs and benefits and the economic impacts of acid rain controls. These estimates are made using a modeling system composed of econometric, linear programming and input-output models. The econometric and linear programming components describe markets for electricity and coal. The outputs of these components including capital investment, electricity demand, and coal production are taken as exogenous inputs by a multiregional input-output model. The input-output model produces estimates of changes in final demand, gross output, and employment. The utility linear programming model also predicts sulfur dioxide emissions (an acid-rain precursor). According to model simulations, the costs of acid rain control exceed the benefits for many regions including several regions customarily thought to be the major beneficiaries of acid rain control such as New England

42 CFR 417.564 - Apportionment and allocation of administrative and general costs.

Science.gov (United States)

2010-10-01

... general costs. 417.564 Section 417.564 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the... benefit of which cannot be quantitatively measured (such as facility costs), the total allowable costs of...

Generalized cost-effectiveness analysis for national-level priority-setting in the health sector

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Edejer Tessa

2003-12-01

Full Text Available Abstract Cost-effectiveness analysis (CEA is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease. The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs or the coverage, efficacy and adherence rates of interventions (effectiveness. The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness. Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.

Cost-benefit analysis of multi-regional nuclear energy systems deployment

International Nuclear Information System (INIS)

Van Den Durpel, L.G.G.; Wade, D.C.; Yacout, A.M.

2007-01-01

The paper describes the preliminary results of a cost/benefit-analysis of multi-regional nuclear energy system approaches with a focus on how multi-regional approaches may benefit a growing nuclear energy system in various world regions also being able to limit, or even reduce, the costs associated with the nuclear fuel cycle and facilitating the introduction of nuclear energy in various regions in the world. The paper highlights the trade-off one might envisage in deploying such multi-regional approaches but also the pay backs possible and concludes on the economical benefits one may associate to regional fuel cycle centres serving a world-fleet of STAR (small fast reactors of long refueling interval) where these STARs may be competitive compared to the LWRs (Light Water Reactors) as a base-case nuclear reactor option. (authors)

Estimating External Costs of Transportation in Regional Areas: Using Available Statistical Data the Case of the Region of Campania

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Mariano Gallo

2010-04-01

Full Text Available In this paper simplified methods for estimating the external costs due to transportation in regional areas are proposed. The methods are based on data available by national and regional statistical sources and do not need specific surveys; they allow obtaining approximate estimates useful for a preliminary evaluation of transportation plans, policies and projects. In more detail, a negative externality is defined as a cost that is produced by subject A and is borne by subject B; moreover, subject A does not consider the effects of his/her behavior on subject B and does not compensate subject B for the costs that this last one is forced to bear. In this paper after a literature review on methodologies proposed for estimating external costs, in national and international ambits, the main external costs produced by transportation systems in the Region of Campania are estimated. The main external costs considered are: greenhouse gas emissions, air pollution, noise, accidents and congestion. In the paper the secondary external costs are neglected; the main ones are: water and soil pollution; landscape and nature damages; upstream and downstream effects; visual intrusion; separation effects; soil occupancy. In this paper the external costs estimated are the ones produced not only by road traffic, that anyway is the main “culprit”, but also by rail and air transportation systems. The evaluation of external costs has required the collection of several data on the regional mobility and the estimation of veh-kms per year produced in Campania by cars and freight vehicles. The estimation of veh-kms per year is based on circulating vehicles, subdivided by the COPERT classification, and on average yearly distances covered by each vehicle class. Other regional statistical data are collected about regional rail transport and air services at the main airports of the region. Moreover, since the evaluation of some external costs is based on damages on human

Cost analysis of robotic versus laparoscopic general surgery procedures.

Science.gov (United States)

Higgins, Rana M; Frelich, Matthew J; Bosler, Matthew E; Gould, Jon C

2017-01-01

Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization. De-identified procedural cost and equipment utilization data were collected from the Surgical Profitability Compass Procedure Cost Manager System (The Advisory Board Company, Washington, DC) for our health care system for laparoscopic and robotic cholecystectomy, fundoplication, and inguinal hernia between the years 2013 and 2015. Outcomes were length of stay, case duration, and supply cost. Statistical analysis was performed using a t-test for continuous variables, and statistical significance was defined as p robotic procedures. Length of stay did not differ for fundoplication or cholecystectomy. Length of stay was greater for robotic inguinal hernia repair. Case duration was similar for cholecystectomy (84.3 robotic and 75.5 min laparoscopic, p = 0.08), but significantly longer for robotic fundoplication (197.2 robotic and 162.1 min laparoscopic, p = 0.01) and inguinal hernia repair (124.0 robotic and 84.4 min laparoscopic, p = ≪0.01). We found a significantly increased cost of general surgery procedures for our health care system when cases commonly performed laparoscopically are instead performed robotically. Our analysis is limited by the fact that we only included costs associated with consumable surgical supplies. The initial acquisition cost (over $1 million for robotic surgical system), depreciation, and service contract for the robotic and laparoscopic systems were not included in this analysis.

Robotics in general surgery: A systematic cost assessment.

Science.gov (United States)

Gkegkes, Ioannis D; Mamais, Ioannis A; Iavazzo, Christos

2017-01-01

The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from 2539 to 57,002, 7888 to 16,851 and 1799 to 50,408 Euros, respectively. The mean operative charges ranged from 273.74 to 13,670 Euros. More specifically, for the robotic and laparoscopic gastric fundoplication, the cost ranged from 1534 to 2257 and 657 to 763 Euros, respectively. For the robotic and laparoscopic colectomy, it ranged from 3739 to 17,080 and 3109 to 33,865 Euros, respectively. For the robotic and laparoscopic cholecystectomy, ranged from 1163.75 to 1291 and from 273.74 to 1223 Euros, respectively. The mean non-operative costs ranged from 900 to 48,796 from 8347 to 8800 and from 870 to 42,055 Euros, for robotic, open and laparoscopic technique, respectively. Conversions to laparotomy were present in 34/18,620 (0.18%) cases of laparoscopic and in 22/1488 (1.5%) cases of robotic technique. Duration of surgery robotic, open and laparoscopic ranged from 54.6 to 328.7, 129 to 234, and from 50.2 to 260 min, respectively. The present evidence reveals that robotic surgery, under specific conditions, has the potential to become cost-effective. Large number of cases, presence of industry competition and multidisciplinary team utilisation are some of the factors that could make more reasonable and cost-effective the robotic-assisted technique.

Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals.

Science.gov (United States)

Han, Kyu-Tae; Kim, Sun Jung; Lee, Seo Yoon; Park, Eun-Cheol

2014-01-01

After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

Strategic trade between two regions with partial local consumer protection - General setup and nash equilibria

Science.gov (United States)

Iordanov, Iordan V.; Vassilev, Andrey A.

2017-12-01

We construct a model of the trade relations between two regions for the case when the trading entities (consumers) compete for a scarce good and there is an element of strategic interdependence in the trading process. Additionally, local consumers enjoy partial protection in the form of guaranteed access to a part of the locally-supplied quantity of the good. The model is formulated for the general asymmetric case, where the two regions differ in terms of parameters such as income, size of the local market supply, degree of protection and transportation costs. For this general model we establish the existence of Nash equilibria and obtain their form as a function of the model parameters, producing a typology of the equilibria. This is a required step in order to rigorously study various types of price dynamics for the model.

Hospital costs associated with surgical site infections in general and vascular surgery patients.

Science.gov (United States)

Boltz, Melissa M; Hollenbeak, Christopher S; Julian, Kathleen G; Ortenzi, Gail; Dillon, Peter W

2011-11-01

Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery. Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database. Logistic regression was used to determine which patient and preoperative variables influenced the occurrence of SSIs. After adjusting for patient characteristics, costs and DOS were fit to linear regression models to determine the effect of SSIs. Of the 2,250 general and vascular surgery patients sampled, SSIs were observed in 186 inpatients. Predisposing factors of SSIs were male sex, insulin-dependent diabetes, steroid use, wound classification, and operative time (P surgery. Although the excess costs and DOS associated with SSIs after general and vascular surgery are somewhat less, they still represent substantial financial and opportunity costs to hospitals and suggest, along with the implications for patient care, a continuing need for cost-effective quality improvement and programs of infection prevention. Copyright © 2011 Mosby, Inc. All rights reserved.

Cost-effectiveness of USAID's regional program for family planning in West Africa.

Science.gov (United States)

Shepard, Donald S; Bail, Richard N; Merritt, C Gary

2003-06-01

Between 1994 and 1996, the United States Agency for International Development (USAID) closed 23 country missions worldwide, of which eight were in West and Central Africa. To preserve United States support for family planning and reproductive health in four countries in that region, USAID created a subregional program through a consortium of US-based groups that hired mainly African managers and African organizations. This study assesses cost-effectiveness of the program through an interrupted time-series design spanning the 1990s and compares cost-effectiveness in four similar countries in which mission-based programs continued. Key indicators include costs, contraceptive prevalence rates, and imputed "women-years of protection." The study found that, taking into account all external financing for population and family planning, the USAID West Africa regional approach generated women-years of protection at one-third the cost of the mission-based programs. This regional approach delivered family planning assistance in West Africa cost-effectively, and the findings suggest that regional models may work well for many health and population services in small countries.

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

Science.gov (United States)

2012-01-01

Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

Development of regional stump-to-mill logging cost estimators

Science.gov (United States)

Chris B. LeDoux; John E. Baumgras

1989-01-01

Planning logging operations requires estimating the logging costs for the sale or tract being harvested. Decisions need to be made on equipment selection and its application to terrain. In this paper a methodology is described that has been developed and implemented to solve the problem of accurately estimating logging costs by region. The methodology blends field time...

TRIUMF: Regional government offers KAON operating costs

Energy Technology Data Exchange (ETDEWEB)

Anon.

1992-09-15

After a period of uncertainty, confidence in the major KAON project for the Canadian TRIUMF Laboratory in Vancouver was boosted on 28 May at a rally of about a thousand KAON supporters in downtown Vancouver when the regional government of British Columbia announced its willingness to pay part of KAON's operating costs.

TRIUMF: Regional government offers KAON operating costs

International Nuclear Information System (INIS)

Anon.

1992-01-01

After a period of uncertainty, confidence in the major KAON project for the Canadian TRIUMF Laboratory in Vancouver was boosted on 28 May at a rally of about a thousand KAON supporters in downtown Vancouver when the regional government of British Columbia announced its willingness to pay part of KAON's operating costs

Regional Comparative Unit Cost Studies for Maintenance and Operation of Physical Plants in Universities and Colleges in Central States Region and Rocky Mountain Region.

Science.gov (United States)

Association of Physical Plant Administrators, Corvallis, OR.

Presented in this document are data pertaining to maintenance and operations costs at colleges and universities in the central states region and the Rocky Mountain region. The major accounts included in the cost analysis are: (1) physical plant administration, (2) building maintenance, (3) custodial services, (4) utilities, (5) landscape and…

Cost of osteoporotic hip fracture in Spain per Autonomous Region.

Science.gov (United States)

Bartra, A; Caeiro, J-R; Mesa-Ramos, M; Etxebarría-Foronda, I; Montejo, J; Carpintero, P; Sorio-Vilela, F; Gatell, S; Canals, L

2018-05-21

We estimated the health resource utilization (HRU) and associated costs during the 12months after a first osteoporotic hip fracture (OHF) in six Spanish Regions. Observational, prospective study including patients ≥65years-old hospitalized due to a first OHF in: Andalusia, Catalonia, Valencian Community, Galicia, Madrid and the Basque Country. HRU related to OHF, quality of life and patient autonomy were collected, and HRU-associated costs were estimated. Four hundred and eighty-seven patients (mean age: 83.1years, 77% women) were included, with demographic characteristics that were similar across the Regions. Mean hospital stay was longest in Madrid and Galicia (women/men: 15.0/18.6 and 16.9/12.6days, respectively) and shortest in Andalusia and the Valencian Community (8.2/7.2 and 8.4/9.4days). There were more rehabilitation sessions and formal home care days in Catalonia and Madrid (women/men: 16/21 and 17/29 sessions; 19/20 and 30/27days) and fewer in Andalusia and Galicia (4/1 and 3/0 sessions; 3/1 and 1/0days). Mean HRU costs were higher in Madrid and lower in Andalusia (women/men: 12,321€/12,297€ and 7,031€/6,115€, respectively). OHF place a large burden on Spanish Regional Health Systems, including high economic costs. We found notable differences in mean costs across the Regions, mainly caused by the differential length of the first hospital stay and the outpatient care in subsequent months. These differences may be associated with differences in surgical delay. A national consensus on the management of OHF is desirable; moreover, agreeing common guidelines could have major socio-economic and healthcare benefits. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

On the relation between cost and service models for general inventory systems

NARCIS (Netherlands)

Houtum, van G.J.J.A.N.; Zijm, W.H.M.

2000-01-01

In this paper, we present a systematic overview of possible relations between cost and service models for fairly general single- and multi-stage inventory systems. In particular, we relate various types of penalty costs in pure cost models to equivalent types of service measures in service models.

A generalized cost Malmquist index in DEA for DMUs with negative data

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Ghasem Tohidi

2014-10-01

Full Text Available In some data envelopment analysis (DEA applications, some inputs of DMUs have negative values with positive cost. This paper generalizes the global cost Malmquist productivity index to compare the productivity of different DMUs with negative inputs in any two periods of times under variable returns to scale (VRS technology, and then the generalized index is decomposed to several components. The obtained components are computed using the nonparametric linear programming models, known as DEA. To illustrate the generalized index and its components, a numerical example at three successive periods of time is given.

The health regionalization process from the perspective of the transation cost theory.

Science.gov (United States)

Sancho, Leyla Gomes; Geremia, Daniela Savi; Dain, Sulamis; Geremia, Fabiano; Leão, Cláudio José Silva

2017-04-01

This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest. However, regionalization can reduce the incidence of social and/or operational costs, through improved access to health and the construction of more efficient governance models.

Automotive Lithium-ion Cell Manufacturing: Regional Cost Structures and Supply Chain Considerations

Energy Technology Data Exchange (ETDEWEB)

Donald Chung, Emma Elgqvist, and Shriram Santhanagopalan

2016-04-01

Manufacturing capacity for lithium-ion batteries (LIBs) — which power many consumer electronics and are increasingly used to power electric vehicles — is heavily concentrated in East Asia. To illuminate the factors that drive regional competitiveness in automotive LIB cell production, this study models cell manufacturing cost and minimum sustainable price, and examines development of LIB supply chains and current LIB market conditions. The study shows that factors driving the cost competitiveness of LIB manufacturing locations are mostly built—supply chain developments and competition, access to materials, and production expertise. Some regional costs — including cost of capital, labor, and materials — are significant and should be considered.

Some regional costs of a synthetic fuel industry: The case of illinois

Science.gov (United States)

Attanasi, E.D.; Green, E.K.

1981-01-01

The Federal Government's efforts to induce development of a coal-based synthetic fuel industry include direct subsidies, tax concessions, and assurances that it will purchase the industry's output, even if above the market price. In this note it is argued that these subsidies will enable this industry to secure a region's largest and lowest-cost coal deposits and that the costs imposed on other coal users will be substantial. Moreover, because the lowest-cost coal deposits will be committed to synthetic fuels production regardless of the industry's commercial viability, distortions in regional coal markets will develop. If economic efficiency requires that the price of the resource reflect its replacement value, then a State government is justified in imposing a tax on coal destined for subsidized synthetic fuel plants. Amounts of such a tax, based on the higher costs of coal that must be accepted by other users as the result of the subsidized synthetic fuel plants' preempting the largest and lowest-cost deposits, are estimated for the case of Illinois strippable coal. ?? 1981 Annals of Regional Science.

Use, cost, complications, and mortality of robotic versus nonrobotic general surgery procedures based on a nationwide database.

Science.gov (United States)

Salman, Muhammad; Bell, Theodore; Martin, Jennifer; Bhuva, Kalpesh; Grim, Rod; Ahuja, Vanita

2013-06-01

Since its introduction in 1997, robotic surgery has overcome many limitations, including setup costs and surgeon training. The use of robotics in general surgery remains unknown. This study evaluates robotic-assisted procedures in general surgery by comparing characteristics with its nonrobotic (laparoscopic and open) counterparts. Weighted Healthcare Cost and Utilization Project Nationwide Inpatient Sample data (2008, 2009) were used to identify the top 12 procedures for robotic general surgery. Robotic cases were identified by Current Procedural Terminology codes 17.41 and 17.42. Procedures were grouped: esophagogastric, colorectal, adrenalectomy, lysis of adhesion, and cholecystectomy. Analyses were descriptive, t tests, χ(2)s, and logistic regression. Charges and length of stay were adjusted for gender, age, race, payer, hospital bed size, hospital location, hospital region, median household income, Charlson score, and procedure type. There were 1,389,235 (97.4%) nonrobotic and 37,270 (2.6%) robotic cases. Robotic cases increased from 0.8 per cent (2008) to 4.3 per cent (2009, P robotic surgery had significantly shorter lengths of stay (4.9 days) than open surgery (6.1 days) and lower charges (median $30,540) than laparoscopic ($34,537) and open ($46,704) surgery. Fewer complications were seen in robotic-assisted colorectal, adrenalectomy and lysis of adhesion; however, robotic cholecystectomy and esophagogastric procedures had higher complications than nonrobotic surgery (P robotic surgery had a lower mortality rate (0.097%) than nonrobotic surgeries per 10,000 procedures (laparoscopic 0.48%, open 0.92%; P robotic surgery is generally considered a prohibitive factor. In the present study, when overall cost was considered, including length of stay, robotic surgery appeared to be cost-effective and as safe as nonrobotic surgery except in cholecystectomy and esophagogastric procedures. Further study is needed to fully understand the long-term implications of

The Costs of Producing Biodiesel from Microalgae in the Asia-Pacific Region

Directory of Open Access Journals (Sweden)

G.J. Griffin

2013-10-01

Full Text Available Capital and operating cost estimates for converting microalgae to oil or biodiesel are compared. These cost comparisons are based on Australian locations, which are expected to fall at the lower end of the cost spectrum in the Asia-Pacific Region and other parts of the world.  It is assumed that microalgae are grown in a concentrated saltwater medium in raceway ponds, then are harvested, dewatered and the oil is extracted and converted to biodiesel by transesterification. The size of the desired pond system affects the number of potential locations due to constraints in resource availability. Cost estimates vary significantly due to differences in the assumed oil productivity, the harvesting equipment and the method of converting residual biomass to electric power. A comparison is made with recent cost estimates from other parts of the world, in which the expected costs of microalgae oil production from a number of publicly available sources lay between 0.34–31.0 USD/L.  The resulting cost estimates of between 1.37—2.66 USD/L are at the lower end of this scale, thereby confirming that Australia has the potential to be a low-cost producer of algal oil and biodiesel in the Asia-Pacific Region.  It was significant that, despite similar assumptions for the microalgae-to-oil process, cost estimates for the final biodiesel or oil price differed by a factor of 2.  This highlights the high degree of uncertainty in such economic predictions. Keywords: Asia-Pacific region; biodiesel; economics; microalgaeThis article is cited as :Griffin, G., Batten, D., Beer, T., & Campbell, P. (2013. The Costs of Producing Biodiesel from Microalgae in the Asia-Pacific Region. International Journal Of Renewable Energy Development (IJRED, 2(3, 105-113. doi:10.14710/ijred.2.3.105-113Permalinkhttp://dx.doi.org/10.14710/ijred.2.3.105-113

Survey of Transmission Cost Allocation Methodologies for Regional Transmission Organizations

Energy Technology Data Exchange (ETDEWEB)

Fink, S.; Porter, K.; Mudd, C.; Rogers, J.

2011-02-01

The report presents transmission cost allocation methodologies for reliability transmission projects, generation interconnection, and economic transmission projects for all Regional Transmission Organizations.

The Cost of Brain Surgery: Awake vs Asleep Craniotomy for Perirolandic Region Tumors.

Science.gov (United States)

Eseonu, Chikezie I; Rincon-Torroella, Jordina; ReFaey, Karim; Quiñones-Hinojosa, Alfredo

2017-08-01

Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. To evaluate the cost effectiveness and clinical outcomes between AC and GA patients. Retrospective analysis of a cohort of 17 patients with perirolandic gliomas who underwent an AC with DCS were case-control matched with 23 patients with perirolandic gliomas who underwent surgery under GA with neuromonitoring (ie, motor-evoked potentials, somatosensory-evoked potentials, phase reversal). Inpatient costs, quality-adjusted life years (QALY), extent of resection, and neurological outcome were compared between the groups. Total inpatient expense per patient was $34 804 in the AC group and $46 798 in the GA group ( P = .046). QALY score for the AC group was 0.97 and 0.47 for the GA group ( P = .041). The incremental cost per QALY for the AC group was $82 720 less than the GA group. Postoperative Karnofsky performance status was 91.8 in the AC group and 81.3 in the GA group (P = .047). Length of hospitalization was 4.12 days in the AC group and 7.61 days in the GA group ( P = .049). The total inpatient costs for awake craniotomies were lower than surgery under GA. This study suggests better cost effectiveness and neurological outcome with awake craniotomies for perirolandic gliomas. Copyright © 2017 by the Congress of Neurological Surgeons

Adoption of robotics in a general surgery residency program: at what cost?

Science.gov (United States)

Mehaffey, J Hunter; Michaels, Alex D; Mullen, Matthew G; Yount, Kenan W; Meneveau, Max O; Smith, Philip W; Friel, Charles M; Schirmer, Bruce D

2017-06-01

Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified. The effect of robotic surgery on laparoscopic case volume was assessed with linear regression analysis. Resident participation, operative time, hospital costs, and patient charges were also evaluated. We identified 2260 laparoscopic and 139 robotic operations. As the volume of robotic cases increased, the number of laparoscopic cases steadily decreased. Residents participated in all laparoscopic cases and 70% of robotic cases but operated from the robot console in only 21% of cases. Mean operative time was increased for robotic cholecystectomy (+22%), IHR (+55%), and VHR (+61%). Financial analysis revealed higher median hospital costs per case for robotic cholecystectomy (+$411), IHR (+$887), and VHR (+$1124) as well as substantial associated fixed costs. Introduction of robotic surgery had considerable negative impact on laparoscopic case volume and significantly decreased resident participation. Increased operative time and hospital costs are substantial. An institution must be cognizant of these effects when considering implementing robotics in departments with a general surgery residency program. Copyright © 2017 Elsevier Inc. All rights reserved.

Energy balance and cost analysis for raisin production in Aegean Region in Turkey

Directory of Open Access Journals (Sweden)

Uysal Hülya

2016-01-01

Full Text Available The aim of this study is to determine energy consumption of input and output used in raisin production and making a cost analysis in Aegean Region. Energy output-input analysis is generally done to determine the scope of environment and energy efficiency of agricultural production. In this study the cost of raisin production was calculated by Manisa Viticulture Research Institute's records in 2015. Costs of inputs and prices of raisin were obtained from various sources such as Turkish Statistical Institute, Aegean Exporters' Association and Turkish Ministry of Food, Agriculture and Livestock. The total energy input necessity for raisin production was 39,066.91 MJ/ha. The research results indicated that the total energy input used for raisin was mainly dependent on non-renewable energy forms (%97. The high ratio of non-renewable energy in the total used energy inputs causes negative effects on the sustainability in agricultural production. Among input energy sources, diesel oil, chemical fertilizers and electricity contained highest energy shares with 34.30%, 26.96%, and 22.50% respectively. The energy ratio and energy productivity were found to be 6.04 and 0.51 kg/MJ. Gross production value and total variable costs for raisin were $ 8,600 and $ 4,528.25, respectively. As a result of cost analysis, gross margin was calculated as $ 4,071.75.

Cost of near-roadway and regional air pollution-attributable childhood asthma in Los Angeles County

Science.gov (United States)

Brandt, Sylvia; Perez, Laura; Künzli, Nino; Lurmann, Fred; Wilson, John; Pastor, Manuel; McConnell, Rob

2014-01-01

Background Emerging evidence suggests that near-roadway air pollution (NRP) exposure causes childhood asthma. Associated costs are not well documented. Objective We estimated the cost of childhood asthma attributable to residential NRP exposure and regional ozone (O3) and nitrogen dioxide (NO2) in Los Angeles County. We developed a novel approach to apportion the costs between these exposures under different pollution scenarios. Methods We integrated results from a study of willingness to pay to reduce the burden of asthma with studies of health care utilization and charges to estimate the costs of an asthma case and exacerbation. We applied those costs to the number of asthma cases and exacerbations due to regional pollution in 2007 and to hypothetical scenarios of a 20% reduction in regional pollution in combination with a 20% reduction or increase in the proportion of the total population living within 75m of a major roadway. Results Cost of air pollution-related asthma in Los Angeles County in 2007 was $441 million for O3 and $202 million for NO2 in 2010 dollars. Cost of routine care (care in absence of exacerbation) accounted for 18% of the combined NRP and O3 cost and 39% of the combined NRP and NO2 cost—costs not recognized in previous analyses. NRP-attributable asthma accounted for 43% (O3) to 51% (NO2) of the total annual cost of exacerbations and routine care associated with pollution. Hypothetical scenarios showed that costs from increased NRP exposure may offset savings from reduced regional pollution. Conclusions Our model disaggregates the costs of regional pollution and NRP exposure and illustrates how they might vary under alternative exposure scenarios. The cost of air pollution is a substantial burden on families and an economic loss for society. PMID:25439228

Generalized belief propagation on tree robust structured region graphs

NARCIS (Netherlands)

Gelfand, A.E.; Welling, M.; Murphy, K.; de Freitas, N.

2012-01-01

This paper provides some new guidance in the construction of region graphs for Generalized Belief Propagation (GBP). We connect the problem of choosing the outer regions of a LoopStructured Region Graph (SRG) to that of finding a fundamental cycle basis of the corresponding Markov network. We also

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

Science.gov (United States)

Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

2018-02-01

To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

Provision of general paediatric surgical services in a regional hospital.

LENUS (Irish Health Repository)

Zgraj, O

2012-01-31

BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

Wastewater Reuse for Agriculture: Development of a Regional Water Reuse Decision-Support Model (RWRM) for Cost-Effective Irrigation Sources.

Science.gov (United States)

Tran, Quynh K; Schwabe, Kurt A; Jassby, David

2016-09-06

Water scarcity has become a critical problem in many semiarid and arid regions. The single largest water use in such regions is for crop irrigation, which typically relies on groundwater and surface water sources. With increasing stress on these traditional water sources, it is important to consider alternative irrigation sources for areas with limited freshwater resources. One potential irrigation water resource is treated wastewater for agricultural fields located near urban centers. In addition, treated wastewater can contribute an appreciable amount of necessary nutrients for plants. The suitability of reclaimed water for specific applications depends on water quality and usage requirements. The main factors that determine the suitability of recycled water for agricultural irrigation are salinity, heavy metals, and pathogens, which cause adverse effects on human, plants, and soils. In this paper, we develop a regional water reuse decision-support model (RWRM) using the general algebraic modeling system to analyze the cost-effectiveness of alternative treatment trains to generate irrigation water from reclaimed wastewater, with the irrigation water designed to meet crop requirements as well as California's wastewater reuse regulations (Title 22). Using a cost-minimization framework, least-cost solutions consisting of treatment processes and their intensities (blending ratios) are identified to produce alternative irrigation sources for citrus and turfgrass. Our analysis illustrates the benefits of employing an optimization framework and flexible treatment design to identify cost-effective blending opportunities that may produce high-quality irrigation water for a wide range of end uses.

The effects of regional insolation differences upon advanced solar thermal electric power plant performance and energy costs

Science.gov (United States)

Latta, A. F.; Bowyer, J. M.; Fujita, T.

1979-01-01

This paper presents the performance and cost of four 10-MWe advanced solar thermal electric power plants sited in various regions of the continental United States. Each region has different insolation characteristics which result in varying collector field areas, plant performance, capital costs, and energy costs. The paraboloidal dish, central receiver, cylindrical parabolic trough, and compound parabolic concentrator (CPC) comprise the advanced concepts studied. This paper contains a discussion of the regional insolation data base, a description of the solar systems' performances and costs, and a presentation of a range for the forecast cost of conventional electricity by region and nationally over the next several decades.

Cost of paricá wood production in Paragominas region, Para State, Brazil

Directory of Open Access Journals (Sweden)

Rafaela da Silveira

2017-12-01

Full Text Available The silvicultural and economic potential of paricá (Schizolobium amazonicum has encouraged the expansion of this crop, mainly in the northern region of the country, provoking the need for studies on the species. The objective of this study was to estimate paricá production in Paragominas region, Para State, Brazil, at 5, 6 and 7 years, in three classes of productivity considering five plant arrangements, being identified the main costs of production, in addition to those most affected by plant arrangements. The volumetric estimation was obtained by modeling in population level and the analysis of the costs, through the methodology of the operational cost. It was possible to infer that the arrangement of plants 3 m x 2 m was superior in volume, compared to the other analyzed plant arrangements. The effective operating cost represented on average 65% of the total production costs. Transport was the most significant individual cost, in all analyzed plant arrangements. The maintenance, among the set of activities, was the most significant in planting, fact that may be related to the number and the long period for the activities execution. Smaller plant arrangements presented the higher total costs of production, depending or not on the remuneration for the use of the permanent and current capital.

Cost implication of irrational prescribing of chloroquine in Lagos State general hospitals.

Science.gov (United States)

Aina, Bolajoko A; Tayo, Fola; Taylor, Ogori

2008-02-01

A major share of the hospital budget is spent on drugs. Irrational use of these drugs is a waste of financial and human resources that could have been deployed for another use within the hospital setting especially in cases where such drugs are provided free to patients. Also there is increased morbidity and progression of severity with irrational use. The objective of this study was to determine the irrational use of chloroquine and the subsequent cost implications in Lagos State general hospitals. A retrospective study period of one year (January to December, 2000) was selected. A total of 18,781 prescription forms of "Free Eko Malaria" were sampled for children and adults from all the Lagos State general hospitals. Drug costs in each prescription form were identified. Cost effectiveness analysis of chloroquine tablet and intramuscular injection was undertaken. The average cost of medicine per prescription was 132.071 ($1.03) which should have been 94.22 ($0.73) if prescribed rationally. The total cost of prescriptions for malaria under study was 2,480,425.00 ($19,348.09). About 68% {(1,679,444.00) ($13,100.19)} of the total cost was lost to irrational prescribing. This is a waste of scarce resources. When the prescriptions were differentiated into the different dosage forms prescribed, the prescriptions containing intramuscular injections only had over 90% of the cost lost to irrational prescribing. Cost effectiveness analysis showed that chloroquine tablet was 17 times more cost effective than chloroquine injection (intramuscular) from a health care system perspective while it was 14 times more cost effective from a patient perspective. There is waste of scarce resources with irrational dispensing of drugs and these resources could have been deployed to other uses or areas within the hospitals. The tablet chloroquine was more cost effective than injection chloroquine (intramuscular). Increasing the cost of tablets, decreasing effectiveness of tablets

Use of a Combination of Regional and General Anesthesia during Emergency Thoracic Surgery

Directory of Open Access Journals (Sweden)

V. Kh. Sharipova

2015-01-01

Full Text Available Objective: to elaborate multimodal anesthetic regimens and to evaluate their efficiency during emergency thoracic surgeries for varying injuries. Subjects and methods. A total of 116 patients emergently admitted to the Republican Research Center for Emergency Medical Care for chest traumatic injuries were examined and divided into 3 groups according to the mode of anesthesia. Results. Perioperative multimodal anesthetic regimens for emergency thoracic surgery, which involved all components of the pathogenesis of pain, were elaborated. Conclusion. The combination of regional and general anesthesia contributes to the smooth course of an intra operative period with minimal hemodynamic stress and it is cost effective in decreasing the use of narcotic anal gesics in the intraoperative period. 

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs*

Science.gov (United States)

Eisenhauer, Philipp; Heckman, James J.; Vytlacil, Edward

2015-01-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college. PMID:26709315

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs.

Science.gov (United States)

Eisenhauer, Philipp; Heckman, James J; Vytlacil, Edward

2015-04-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college.

Cost estimation for solid waste management in industrialising regions – Precedents, problems and prospects

International Nuclear Information System (INIS)

Parthan, Shantha R.; Milke, Mark W.; Wilson, David C.; Cocks, John H.

2012-01-01

Highlights: ► We review cost estimation approaches for solid waste management. ► Unit cost method and benchmarking techniques used in industrialising regions (IR). ► Variety in scope, quality and stakeholders makes cost estimation challenging in IR. ► Integrate waste flow and cost models using cost functions to improve cost planning. - Abstract: The importance of cost planning for solid waste management (SWM) in industrialising regions (IR) is not well recognised. The approaches used to estimate costs of SWM can broadly be classified into three categories – the unit cost method, benchmarking techniques and developing cost models using sub-approaches such as cost and production function analysis. These methods have been developed into computer programmes with varying functionality and utility. IR mostly use the unit cost and benchmarking approach to estimate their SWM costs. The models for cost estimation, on the other hand, are used at times in industrialised countries, but not in IR. Taken together, these approaches could be viewed as precedents that can be modified appropriately to suit waste management systems in IR. The main challenges (or problems) one might face while attempting to do so are a lack of cost data, and a lack of quality for what data do exist. There are practical benefits to planners in IR where solid waste problems are critical and budgets are limited.

Cost-effectiveness of diagnostic for malaria in Extra-Amazon Region, Brazil

Directory of Open Access Journals (Sweden)

de Oliveira Maria Regina F

2012-11-01

Full Text Available Abstract Background Rapid diagnostic tests (RDT for malaria have been demonstrated to be effective and they should replace microscopy in certain areas. Method The cost-effectiveness of five RDT and thick smear microscopy was estimated and compared. Data were collected on Brazilian Extra-Amazon Region. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, laboratory suppliers and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2010. Two costing methods were produced, based on exclusive-use microscopy or shared-use microscopy. The results were expressed in costs per adequately diagnosed cases in 2010 U.S. dollars. One-way sensitivity analysis was performed considering key model parameters. Results In the cost-effectiveness analysis with exclusive-use microscopy, the RDT CareStart™ was the most cost-effective diagnostic strategy. Microscopy was the most expensive and most effective, with an additional case adequately diagnosed by microscopy costing US$ 35,550.00 in relation to CareStart™. In opposite, in the cost-effectiveness analysis with shared-use microscopy, the thick smear was extremely cost-effective. Introducing into the analytic model with shared-use microscopy a probability for individual access to the diagnosis, assuming a probability of 100% of access for a public health system user to any RDT and, hypothetically, of 85% of access to microscopy, this test saw its effectiveness reduced and was dominated by the RDT CareStart™. Conclusion The analysis of cost-effectiveness of malaria diagnosis technologies in the Brazilian Extra-Amazon Region depends on the exclusive or shared use of the microscopy. Following the assumptions of this study, shared-use microscopy would be

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis.

Science.gov (United States)

Walcott, Brian P; Khanna, Arjun; Yanamadala, Vijay; Coumans, Jean-Valery; Peterfreund, Robert A

2015-03-01

Lumbar spine surgery is typically performed under general anesthesia, although spinal anesthesia can also be used. Given the prevalence of lumbar spine surgery, small differences in cost between the two anesthetic techniques have the potential to make a large impact on overall healthcare costs. We sought to perform a cost comparison analysis of spinal versus general anesthesia for lumbar spine operations. Following Institutional Review Board approval, a retrospective cohort study was performed from 2009-2012 on consecutive patients undergoing non-instrumented, elective lumbar spine surgery for spondylosis by a single surgeon. Each patient was evaluated for both types of anesthesia, with the decision for anesthetic method being made based on a combination of physical status, anatomical considerations, and ultimately a consensus agreement between patient, surgeon, and anesthesiologist. Patient demographics and clinical characteristics were compared between the two groups. Operating room costs were calculated whilst blinded to clinical outcomes and reported in percentage difference. General anesthesia (n=319) and spinal anesthesia (n=81) patients had significantly different median operative times of 175 ± 39.08 and 158 ± 32.75 minutes, respectively (plumbar spine surgery. It has the potential to reduce operative times, costs, and possibly, complications. Further prospective evaluation will help to validate these findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

Science.gov (United States)

2010-10-01

... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

Prevalence and cost of hospital medical errors in the general and elderly United States populations.

Science.gov (United States)

Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

2013-12-01

The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

Comparison of seating, powered characteristics and functions and costs of electrically powered wheelchairs in a general population of users.

Science.gov (United States)

Dolan, Michael John; Bolton, Megan Jennifer; Henderson, Graham Iain

2017-10-26

To profile and compare the seating and powered characteristics and functions of electrically powered wheelchairs (EPWs) in a general user population including equipment costs. Case notes of adult EPW users of a regional NHS service were reviewed retrospectively. Seating equipment complexity and type were categorized using the Edinburgh classification. Powered characteristics and functions, including control device type, were recorded. 482 cases were included; 53.9% female; mean duration EPW use 8.1 years (SD 7.4); rear wheel drive 88.0%; hand joystick 94.8%. Seating complexity: low 73.2%, medium 18.0%, high 8.7%. Most prevalent diagnoses: multiple sclerosis (MS) 25.3%, cerebral palsy (CP) 18.7%, muscular dystrophy (8.5%). Compared to CP users, MS users were significantly older at first use, less experienced, more likely to have mid-wheel drive and less complex seating. Additional costs for muscular dystrophy and spinal cord injury users were 3-4 times stroke users. This is the first large study of a general EPW user population using a seating classification. Significant differences were found between diagnostic groups; nevertheless, there was also high diversity within each group. The differences in provision and the equipment costs across diagnostic groups can be used to improve service planning. Implications for Rehabilitation At a service planning level, knowledge of a population's diagnostic group and age distribution can be used to inform decisions about the number of required EPWs and equipment costs. At a user level, purchasing decisions about powered characteristics and functions of EPWs and specialised seating equipment need to be taken on a case by case basis because of the diversity of users' needs within diagnostic groups. The additional equipment costs for SCI and MD users are several times those of stroke users and add between 60 and 70% of the cost of basic provision.

Impact of connection density on regional cost differences for network operators in the Netherlands

International Nuclear Information System (INIS)

2009-04-01

The Dutch Office of Energy Regulation ('Energiekamer') has an obligation to investigate the extent to which the electricity and gas distribution businesses (DNOs) in the Netherlands face different structural environments that result in regional cost differences which, in turn, could justify tariff differences. On the basis of previous studies, Energiekamer has identified 'water crossings' and 'local taxes' as allowable regional differences. To account for them, Energiekamer has introduced an adjustment to the regulated revenues formula in order to guarantee a level-playing field to the Dutch DNOs. In addition to these factors, it has been claimed that connection density may have an impact on distribution costs and that, therefore, regulated revenues should be adjusted to compensate for regional differences in connection density between DNOs. However, so far, the research in this field has been unable to identify a sufficiently robust relationship between cost and connection density to support this claim. In order to address this issue, Energiekamer has asked Frontier Economics and Consentec to further investigate the relationship between connection density and distribution costs in the Netherlands. Therefore, our analysis has aimed at determining whether, and to what extent, connection density in the Netherlands is a significant driver of the costs of electricity and gas distribution networks. The following three questions are answered: (1) Is connection density a significant cost driver in electricity and gas networks in the Netherlands?; (2) If so, which functional form (e.g. U-shaped) does this relationship have in the Netherlands?; (3) Finally, based on the evidence collected, is the influence of connection density sufficiently well-determined to be considered a regional difference in the Dutch regulatory framework?

Outcrossings of safe regions by generalized hyperbolic processes

DEFF Research Database (Denmark)

Klüppelberg, Claudia; Rasmussen, Morten Grud

2013-01-01

We present a simple Gaussian mixture model in space and time with generalized hyperbolic marginals. Starting with Rice’s celebrated formula for level upcrossings and outcrossings of safe regions we investigate the consequences of the mean-variance mixture model on such quantities. We obtain...

A general theory to explain the relatively high cost of environmental restoration at DOE facilities

International Nuclear Information System (INIS)

Sullivan, W.H.

1995-01-01

Environmental Restoration costs for Department of Energy (DOE) facilities have been the subject of much scrutiny and concern for several years. General opinion is that DOE clean-up costs are as much as three times higher than costs for similar clean-up projects in the private sector. Consequently, DOE Environmental Restoration professionals are continually under pressure to do more with less, which, ironically, can lead to additional inefficiencies in the system. This paper proposes a general theory as to why DOE costs are higher, explains the reasons why current conditions will make it difficult to realize any pervasive or significant decreases in clean-up costs, and presents some general changes that need to take place in the DOE system in order to bring about conditions that will allow more efficient clean-up to occur. The theory is based on a simple economic model that describes the balance between the resources spent for risk avoidance and the corresponding changes in overall productivity as a function of risk. The elementary concepts illustrated with the economic model, when refined and specifically applied, have the potential to become the catalyst for significant change-change that is absolutely necessary if we truly intend to conduct environmental clean-up with the same efficiencies as private industry

Shipping emission forecasts and cost-benefit analysis of China ports and key regions' control.

Science.gov (United States)

Liu, Huan; Meng, Zhi-Hang; Shang, Yi; Lv, Zhao-Feng; Jin, Xin-Xin; Fu, Ming-Liang; He, Ke-Bin

2018-05-01

China established Domestic Emission Control Area (DECA) for sulphur since 2015 to constrain the increasing shipping emissions. However, future DECA policy-makings are not supported due to a lack of quantitive evaluations. To investigate the effects of current and possible Chinese DECAs policies, a model is presented for the forecast of shipping emissions and evaluation of potential costs and benefits of an DECA policy package set in 2020. It includes a port-level and regional-level projection accounting for shipping trade volume growth, share of ship types, and fuel consumption. The results show that without control measures, both SO 2 and particulate matter (PM) emissions are expected to increase by 15.3-61.2% in Jing-Jin-Ji, the Yangtze River Delta, and the Pearl River Delta from 2013 to 2020. However, most emissions can be reduced annually by the establishment of a DECA that depends on the size of the control area and the fuel sulphur content limit. Costs range from 0.667 to 1.561 billion dollars (control regional shipping emissions) based on current fuel price. A social cost method shows the regional control scenarios benefit-cost ratios vary from 4.3 to 5.1 with large uncertainty. Chemical transportation model combined with health model method is used to get the monetary health benefits and then compared with the results from social cost method. This study suggests that Chinese DECAs will reduce the projected emissions at a favorable benefit-cost ratio, and furthermore proposes policy combinations that provide high cost-effective benefits as a reference for future policy-making. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2014-08-31

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

Construction of road network vulnerability evaluation index based on general travel cost

Science.gov (United States)

Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

2018-03-01

With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

Design of low-cost general purpose microcontroller based neuromuscular stimulator.

Science.gov (United States)

Koçer, S; Rahmi Canal, M; Güler, I

2000-04-01

In this study, a general purpose, low-cost, programmable, portable and high performance stimulator is designed and implemented. For this purpose, a microcontroller is used in the design of the stimulator. The duty cycle and amplitude of the designed system can be controlled using a keyboard. The performance test of the system has shown that the results are reliable. The overall system can be used as the neuromuscular stimulator under safe conditions.

Studi Banding Penyusunan Laporan Keuangan Dengan Metode Historical Cost Accounting Dan General Price Level Accounting Pada Masa Inflasi

OpenAIRE

Kodrat, David Sukardi

2006-01-01

Generally, Financial Statements are based on Historical Cost Accounting (HCA) that assumes that prices are stable. Actually, there are several methods on accounting for the effect of changing prices, such as Current Cost Accounting (Replacement Cost Accounting) and Constant Dollar Accounting or General Price Level Accounting (GPLA)). GPLA will do restatement the components of financial statement to be a rupiah on a similar level of purchasing power, but without changes in accounting principle...

STUDI BANDING PENYUSUNAN LAPORAN KEUANGAN DENGAN METODE HISTORICAL COST ACCOUNTING DAN GENERAL PRICE LEVEL ACCOUNTING PADA MASA INFLASI

OpenAIRE

David Sukardi Kodrat

2006-01-01

Generally, Financial Statements are based on Historical Cost Accounting (HCA) that assumes that prices are stable. Actually, there are several methods on accounting for the effect of changing prices, such as Current Cost Accounting (Replacement Cost Accounting) and Constant Dollar Accounting or General Price Level Accounting (GPLA)). GPLA will do restatement the components of financial statement to be a rupiah on a similar level of purchasing power, but without changes in accounting principle...

Message from the Director General Final costs to completion of LHC

CERN Multimedia

Luciano Maiani

2001-01-01

In March this year a review of the costs for the LHC machine was started, which was completed by the end of August. This was a bottom-up review with each group concerned making a projection of the cost to completion of the project. Figures presented were worryingly high. In conjunction, the responses from industries to the calls for tender for essential machine components, especially the superconducting magnet assembly, were also higher than originally anticipated. A summary of this situation was presented to the Finance Committee last week and then to the Committee of Council. After the meetings a summary was prepared by the chairman of Committee of Council which I reprint below. CHAIRMAN'S SUMMARY In the 248th Meeting of the Committee of Council, the Director-General presented a preliminary estimate of the cost to completion of the LHC Project, approved in 1994 and scheduled for commissioning and operation in 2006. Repeating that the project is well advanced and technically sound, the figures presented, s...

Assessing the Economic Cost of Landslide Damage in Low-Relief Regions: Case Study Evidence from the Flemish Ardennes (Belgium)

Science.gov (United States)

Vranken, L.; Van Turnhout, P.; Van Den Eeckhaut, M.; Vandekerckhove, L.; Vantilt, G.; Poesen, J.

2012-04-01

connecting two important Belgian cities has been built and within that one project, the cost to prevent damage to railroads augmented already to at least 4 567 822 €. The value of real estate located in regions affected by landslides decreased with 15% to 35%. All these damage costs were then used to made potential damage maps. Based on the inventory of landslides, frequency of landslides' re-activation and land use, we categorized regions that are affected by landslides according to their temporal probability of landslide re-activation. This allowed us to produce a (semi-) qualitative risk map for regions that were affected by landslides in the past. This paper shows that, though generally not spectacular, landsliding in low-relief regions susceptible to landslides is a slow but continuously operating process with considerable damage allowing one to identify several medium to high landslide risk zones. As such this study provides important information for government officials, especially those in charge of spatial planning and of town and environmental planning, as it clearly informs about the costs associated with certain land use types in landslide prone areas. This information can be particularly useful for regions in which increasing demand for building land pressures government officials and (local) political leaders to expand the built environment.

Coste del cuidado informal del ictus en una población general no institucionalizada Cost of informal care for stroke victims in a non-institutionalized general population

Directory of Open Access Journals (Sweden)

Adolfo Hervás

2007-12-01

Full Text Available Antecedentes: El impacto social del ictus es importante por tratarse de una enfermedad invalidante, que causa dependencia y necesidad de cuidados informales. La importancia de la dependencia cada vez es mayor en la sociedad, pero no hay registros de los costes del cuidado informal, y se desconoce cómo valorarla. Objetivos: Calcular el coste del cuidado informal del ictus en una población general y analizarlo en función del grado de dependencia. Realizar un análisis de sensibilidad con la variable costes unitarios a partir de fuentes diversas. Material y métodos: Se estudian todos los casos diagnosticados de ictus a 31 de diciembre de 2004 (n = 95 pertenecientes a una zona básica de salud de Navarra, de los que 40 (44,4% precisan cuidados informales. Se valora la dependencia para las actividades de la vida diaria mediante los índices de Barthel (actividades básicas [ABVD] y Lawton-Brody (actividades instrumentales [AIVD]. La valoración del tiempo del cuidado informal se realiza con una aproximación de abajo a arriba (bottom-up, mediante un cuestionario de recogida de actividades diarias. Resultados: El coste del cuidado informal de los pacientes con ictus es de 21.551,28 €/año, con un rango, según el análisis de sensibilidad, entre 6.490,80 y 31.436,72 €/año. Hay diferencias estadísticamente significativas en el coste del cuidado informal según el grado de dependencia (ABVD: 24.865,2 €/año; AIVD: 10.442,9 €/año. Conclusiones: El coste del cuidado informal en la atención al ictus es elevado y crece con el nivel de dependencia.Background: Stroke has a strong social impact since it causes disability, leading to dependency and the need for informal care. Although awareness of the importance of dependency is increasing, registries of the cost of informal care are lacking and consequently the real value of this activity to society is still unknown. Objectives: To calculate the cost of informal care of stroke victims in a

STUDI BANDING PENYUSUNAN LAPORAN KEUANGAN DENGAN METODE HISTORICAL COST ACCOUNTING DAN GENERAL PRICE LEVEL ACCOUNTING PADA MASA INFLASI

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David Sukardi Kodrat

2006-01-01

Full Text Available Generally, Financial Statements are based on Historical Cost Accounting (HCA that assumes that prices are stable. Actually, there are several methods on accounting for the effect of changing prices, such as Current Cost Accounting (Replacement Cost Accounting and Constant Dollar Accounting or General Price Level Accounting (GPLA. GPLA will do restatement the components of financial statement to be a rupiah on a similar level of purchasing power, but without changes in accounting principles which using on conventional accounting. Financial statements made by GPLA are comparing to financial statements made by HCA. Both of financial statements are analysis with NOD (Number of Dollar attribute to know that financial statements are interpretative and analysis with COG (Command of Good attribute to know that financial statements are relevant. Abstract in Bahasa Indonesia : Laporan keuangan disusun berdasarkan metode Historical Cost Accounting (HCA yang menggunakan asumsi nilai tukar stabil. Beberapa metode akuntansi yang memperhitungkan perubahan nilai tukar seperti Current Cost Accounting (Replacement Cost Accounting dan Constant Dollar Accounting atau General Price Level Accounting (GPLA. GPLA menyajikan komponen laporan keuangan berdasarkan penyesuaian rupiah dengan daya beli tanpa mengubah prinsip-prinsip akuntasi konvensional. Laporan keuangan yang disusun dengan GPLA dapat diperbandingkan dengan laporan keuangan berdasarkan HCA. Dengan analisa NOD (Number of Dollar dan COG (Command Over Good attribute menunjukkan bahwa laporan keuangan berdasarkan GPLA lebih interpretatif dan lebih relevan. Kata Kunci: Laporan Keuangan, Historical Cost Accounting, General Price Level Accounting, NOD attribute, COG attribute.

China’s regional industrial energy efficiency and carbon emissions abatement costs

International Nuclear Information System (INIS)

Wang, Ke; Wei, Yi-Ming

2014-01-01

Graphical abstract: Major cities in eight economy-geography regions of China. - Highlights: • Industrial energy and emissions efficiency were evaluated for China’s major cities. • Shadow prices of CO 2 emissions were estimated for China’s major cities. • Efficiency increase potentials on energy utilization and CO 2 emissions are 19% and 17%. • N-shaped EKC exists between levels of CO 2 emissions efficiency and income. • Average industrial CO 2 emissions abatement cost for China’s major cities is 45 US$. - Abstract: Evaluating the energy and emissions efficiency, measuring the energy saving and emissions reduction potential, and estimating the carbon price in China at the regional level are considered a crucial way to identify the regional efficiency levels and efficiency promotion potentials, as well as to explore the marginal abatement costs of carbon emissions in China. This study applies a newly developed Data Envelopment Analysis (DEA) based method to evaluate the regional energy and emissions efficiencies and the energy saving and emissions reduction potentials of the industrial sector of 30 Chinese major cities during 2006–2010. In addition, the CO 2 shadow prices, i.e., the marginal abatement costs of CO 2 emissions from industrial sector of these cities are estimated during the same period. The main findings are: (i) The coast area cities have the highest total factor industrial energy and emissions efficiency, but efficiency of the west area cities are lowest, and there is statistically significant efficiency difference between these cities. (ii) Economically well-developed cities evidence higher efficiency, and there is still obviously unbalanced and inequitable growth in the nationwide industrial development of China. (iii) Fortunately, the energy utilization and CO 2 emissions efficiency gaps among different Chinese cities were decreasing since 2006, and the problem of inequitable nationwide development has started to mitigate. (iv

Effects of regional agglomeration of salmon : aquaculture on production costs

OpenAIRE

Tveterås, Ragnar

2001-01-01

During the last decade empirical evidence of regional agglomeration economies has emerged for some industries. This report argues that externalities from agglomeration are not only present in some manufacturing and service sectors, but can also occur in primary industries such as aquaculture. Econometric analyses in this literature have primarily estimated production functions on aggregated industry data. Here, cost functions are estimated on firm level observations of Norwegian salmon aquacu...

Future regional nuclear fuel cycle cooperation in East Asia: Energy security costs and benefits

International Nuclear Information System (INIS)

Hippel, David von; Hayes, Peter; Kang, Jungmin; Katsuta, Tadahiro

2011-01-01

Economic growth in East Asia has rapidly increased regional energy, and especially, electricity needs. Many of the countries of East Asia have sought or are seeking to diversify their energy sources and bolster their energy supply and/or environmental security by developing nuclear power. Rapid development of nuclear power in East Asia brings with it concerns regarding nuclear weapons proliferation associated with uranium enrichment and spent nuclear fuel management. This article summarizes the development and analysis of four different scenarios of nuclear fuel cycle management in East Asia, including a scenario where each major nuclear power user develops uranium enrichment and reprocessing of spent fuel individually, scenarios featuring cooperation in the full fuel cycle, and a scenario where reprocessing is avoided in favor of dry cask storage of spent fuel. The material inputs and outputs and costs of key fuel cycle elements under each scenario are summarized. - Highlights: → We evaluate four scenarios of regional nuclear fuel cycle cooperation in East Asia and the Pacific. → The scenarios cover fuel supply, enrichment, transport, reprocessing, and waste management. → We evaluate nuclear material flows, energy use, costs, and qualitative energy security impacts. → Regional cooperation on nuclear fuel cycle issues can help to enhance energy security. → A regional scenario in which reprocessing is rapidly phased out shows security and cost advantages.

General inspection strategy for fault diagnosis-minimizing the inspection costs

International Nuclear Information System (INIS)

Reinertsen, Rune; Wang Xiaozhong

1995-01-01

In this paper, a general inspection strategy for system fault diagnosis is presented. The procedure presented in this paper, is an improvement of methods described in papers by , and . This general strategy provides the optimal inspection procedure when the inspections require unequal effort and the minimum cut set probabilities are unequal. This feature makes the procedure described in this paper more useful for practical applications than the most recent procedure presented in the paper by Najmus-Saqib and Ishaque, which requires the minimum cut set probabilities to be equal. The inspection strategy described in this paper is based on first inspecting the basic event that will provide the maximum information gain per unit cost invested. The information gain is measured by the decrease of Shannon entropy. A detailed tutorial example is presented

A low cost general purpose portable programmable master/slave manipulative appliance

International Nuclear Information System (INIS)

Cameron, W.

1984-01-01

The TRIUMF 100 μA 500 MeV cyclotron, located at the University of British Columbia, required a low cost, portable master/slave manipulative capability for experimental beam line servicing. A programmable capability was also required for the hot cell manipulators. A general purpose unit was developed that might also have applications in light manufacturing and medical rehabilitation. The project now in prototype testing represents a modular portable robot costing less than $5000 that is lead-through-teach programmable by either a master controller or hands-on lead-through. Task programs are stored and retrieved on any 32 k personal computer. An on-board proportional integral derivative controller (Motorola 6809 based) gives discrete positioning of the six degrees of freedom 2 kg capacity end effector

A Poisson process approximation for generalized K-5 confidence regions

Science.gov (United States)

Arsham, H.; Miller, D. R.

1982-01-01

One-sided confidence regions for continuous cumulative distribution functions are constructed using empirical cumulative distribution functions and the generalized Kolmogorov-Smirnov distance. The band width of such regions becomes narrower in the right or left tail of the distribution. To avoid tedious computation of confidence levels and critical values, an approximation based on the Poisson process is introduced. This aproximation provides a conservative confidence region; moreover, the approximation error decreases monotonically to 0 as sample size increases. Critical values necessary for implementation are given. Applications are made to the areas of risk analysis, investment modeling, reliability assessment, and analysis of fault tolerant systems.

Potential Cost Savings From Reduction of Regional Variation in Medicare Spending

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Yunjie Song

2016-04-01

Full Text Available Potential cost savings estimated from reduction of regional variation in Medicare spending are considerable but questioned. This article evaluates the validity of the principal methods that have been used in the estimations of the potential savings. Three estimation approaches were identified. The first approach uses adjusted expenditures to calculate avoidable costs, but adjusted expenditures can be independent of avoidable costs, and measurement errors are not controlled. The second approach uses an outcome variable to replace its causal factors, and is not acceptable because the association between the outcomes and the causes is untestable. The final approach uses surveys to directly measure physician beliefs and patient preferences, but the sole study using this approach is weakened by sample selection biases and incomplete controls. A development of reliable measures and a switch of observation from clinic settings to geographic contexts could make the estimations more convincing.

Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs.

Science.gov (United States)

Rodgers, S; Avery, A J; Meechan, D; Briant, S; Geraghty, M; Doran, K; Whynes, D K

1999-09-01

It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. To determine whether intervention practices made savings relative to controls. An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to take part and received intensive input from five pharmacists for one year (September 1996 to August 1997) at a cost of 163,000 Pounds. Changes in prescribing patterns were investigated by comparing these practices with eight individually matched controls for both the year of the intervention and the previous year. Prescribing data (PACTLINE) were used to assess these changes. The measures used to take account of differences in the populations of the practices included the ASTRO-PU for overall prescribing and the STAR-PU for prescribing in specific therapeutic areas. Differences between intervention and control practices were subjected to Wilcoxon matched-pairs, signed-ranks tests. The median (minimum to maximum) rise in prescribing costs per ASTRO-PU was 0.85 Pound (-1.95 Pounds to 2.05 Pounds) in the intervention practices compared with 2.55 Pounds (1.74 Pounds to 4.65 Pounds) in controls (P = 0.025). Had the cost growth of the intervention group been as high as that of the controls, their total prescribing expenditure would have been around 347,000 Pounds higher. This study suggests that the use of pharmacists did control prescribing expenditure sufficiently to offset their employment costs.

Regional differences in electricity distribution costs and their consequences for yardstick regulation of access prices

International Nuclear Information System (INIS)

Filippini, M.; Wild, J.

2001-01-01

In this paper we estimate an average-cost function for a panel of 59 Swiss local and regional electricity distribution utilities as a basis for yardstick regulation of the distribution-network access prices. Shleifer (1985) proposed yardstick competition in terms of price to regulate local monopolies producing a homogeneous good. The regulated price for the individual firms depends on the average costs of identical firms. The yardstick competition concept can also be applied to firms that produce heterogeneous goods if these goods differ only in observable characteristics. To correct the yardstick for heterogeneity the regulator can use a multivariate estimation of an average-cost function. In the case of electricity distribution, the heterogeneity of output consists mainly of different characteristics of the distribution service areas. In this paper we follow Shleifer's suggestion to estimate a multivariate average-cost function that can be employed by the regulatory commission to benchmark network access prices at the distribution level. Several exogenous variables measuring the heterogeneity of the service areas were included in the cost model specification. We find that the regional differences of the service areas - e.g. area shares of forests, agricultural areas or unproductive land and population density - significantly influence electricity distribution costs

Automotive Lithium-ion Cell Manufacturing: Regional Cost Structures and Supply Chain Considerations

Energy Technology Data Exchange (ETDEWEB)

Chung, Donald [Clean Energy Manufacturing Analysis Center, Godlen, CO (United States); Elgqvist, Emma [Clean Energy Manufacturing Analysis Center, Godlen, CO (United States); Santhanagopalan, Shriram [Clean Energy Manufacturing Analysis Center, Godlen, CO (United States)

2016-04-08

Manufacturing capacity for lithium-ion batteries (LIBs)--which power many consumer electronics and are increasingly used to power electric vehicles--is heavily concentrated in east Asia. Currently, China, Japan, and Korea collectively host 88% of all LIB cell and 79% of automotive LIB cell manufacturing capacity. Mature supply chains and strong cumulative production experience suggest that most LIB cell production will remain concentrated in Asia. However, other regions--including North America--could be competitive in the growing automotive LIB cell market under certain conditions. To illuminate the factors that drive regional competitiveness in automotive LIB cell production, this study models cell manufacturing cost and minimum sustainable price, and examines development of LIB supply chains and current LIB market conditions. Modeled costs are for large format, 20-Ah stacked pouch cells with lithium-nickel-manganese-cobalt-oxide (NMC) cathodes and graphite anodes suitable for automotive application. Production volume is assumed to be at commercial scale, 600 MWh per year.

2 CFR Appendix A to Part 225 - General Principles for Determining Allowable Costs

Science.gov (United States)

2010-01-01

... based on the fundamental premises that: (1) Governmental units are responsible for the efficient and... reduce the burden associated with maintaining systems for charging administrative costs to Federal... reasonable and necessary for operating these programs, and funds are not used for general expenses required...

Historical Cost Dan General Price Level Accounting: Analisis Relevansi Indikator Keuangan

OpenAIRE

-, Meythi; Teresa, Sheffie

2012-01-01

In conventional accounting, financial statements are based on the historical cost principle that assumes that prices (monetary unit) are stable. Conventional accounting recognizes neither changes in the general price level nor changes in the specific price level. Consequently, if there are any changes in purchasing power such as in inflation period, the historical financial statement are not economically relevant and also income is usually overstated, and the fixed assets are usually understa...

Costs and expected gain in lifetime health from intensive care versus general ward care of 30,712 individual patients: a distribution-weighted cost-effectiveness analysis.

Science.gov (United States)

Lindemark, Frode; Haaland, Øystein A; Kvåle, Reidar; Flaatten, Hans; Norheim, Ole F; Johansson, Kjell A

2017-08-21

Clinicians, hospital managers, policy makers, and researchers are concerned about high costs, increased demand, and variation in priorities in the intensive care unit (ICU). The objectives of this modelling study are to describe the extra costs and expected health gains associated with admission to the ICU versus the general ward for 30,712 patients and the variation in cost-effectiveness estimates among subgroups and individuals, and to perform a distribution-weighted economic evaluation incorporating extra weighting to patients with high severity of disease. We used a decision-analytic model that estimates the incremental cost per quality-adjusted life year (QALY) gained (ICER) from ICU admission compared with general ward care using Norwegian registry data from 2008 to 2010. We assigned increasing weights to health gains for those with higher severity of disease, defined as less expected lifetime health if not admitted. The study has inherent uncertainty of findings because a randomized clinical trial comparing patients admitted or rejected to the ICU has never been performed. Uncertainty is explored in probabilistic sensitivity analysis. The mean cost-effectiveness of ICU admission versus ward care was €11,600/QALY, with 1.6 QALYs gained and an incremental cost of €18,700 per patient. The probability (p) of cost-effectiveness was 95% at a threshold of €22,000/QALY. The mean ICER for medical admissions was €10,700/QALY (p = 97%), €12,300/QALY (p = 93%) for admissions after acute surgery, and €14,700/QALY (p = 84%) after planned surgery. For individualized ICERs, there was a 50% probability that ICU admission was cost-effective for 85% of the patients at a threshold of €64,000/QALY, leaving 15% of the admissions not cost-effective. In the distributional evaluation, 8% of all patients had distribution-weighted ICERs (higher weights to gains for more severe conditions) above €64,000/QALY. High-severity admissions gained the most, and were more

Regional Variation of Cost of Care in the Last 12 Months of Life in Switzerland: Small-area Analysis Using Insurance Claims Data.

Science.gov (United States)

Panczak, Radoslaw; Luta, Xhyljeta; Maessen, Maud; Stuck, Andreas E; Berlin, Claudia; Schmidlin, Kurt; Reich, Oliver; von Wyl, Viktor; Goodman, David C; Egger, Matthias; Zwahlen, Marcel; Clough-Gorr, Kerri M

2017-02-01

Health care spending increases sharply at the end of life. Little is known about variation of cost of end of life care between regions and the drivers of such variation. We studied small-area patterns of cost of care in the last year of life in Switzerland. We used mandatory health insurance claims data of individuals who died between 2008 and 2010 to derive cost of care. We used multilevel regression models to estimate differences in costs across 564 regions of place of residence, nested within 71 hospital service areas. We examined to what extent variation was explained by characteristics of individuals and regions, including measures of health care supply. The study population consisted of 113,277 individuals. The mean cost of care during last year of life was 32.5k (thousand) Swiss Francs per person (SD=33.2k). Cost differed substantially between regions after adjustment for patient age, sex, and cause of death. Variance was reduced by 52%-95% when we added individual and regional characteristics, with a strong effect of language region. Measures of supply of care did not show associations with costs. Remaining between and within hospital service area variations were most pronounced for older females and least for younger individuals. In Switzerland, small-area analysis revealed variation of cost of care during the last year of life according to linguistic regions and unexplained regional differences for older women. Cultural factors contribute to the delivery and utilization of health care during the last months of life and should be considered by policy makers.

Allocation of Home Office Expenses to Segments and Business Unit General and Administrative Expenses to Final Cost Objectives

Science.gov (United States)

1992-02-16

3 0 B. Cost Accounting Standard 418 ..................................................... 3 1 1. D efinitio n s ...objective" as an activity for which a separate measurement of cost is desired. C. Horngren , Cost Accounting . A Managerial Emphasis 21 (5th ed. 1982...Segments and Business Unit General and Administrative Expenses to Final Cost Objectives 6. AUTHOR( S ) Stephen Thomas Lynch, Major 7. PERFORMING

Accurate Computation of Periodic Regions' Centers in the General M-Set with Integer Index Number

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Wang Xingyuan

2010-01-01

Full Text Available This paper presents two methods for accurately computing the periodic regions' centers. One method fits for the general M-sets with integer index number, the other fits for the general M-sets with negative integer index number. Both methods improve the precision of computation by transforming the polynomial equations which determine the periodic regions' centers. We primarily discuss the general M-sets with negative integer index, and analyze the relationship between the number of periodic regions' centers on the principal symmetric axis and in the principal symmetric interior. We can get the centers' coordinates with at least 48 significant digits after the decimal point in both real and imaginary parts by applying the Newton's method to the transformed polynomial equation which determine the periodic regions' centers. In this paper, we list some centers' coordinates of general M-sets' k-periodic regions (k=3,4,5,6 for the index numbers α=−25,−24,…,−1 , all of which have highly numerical accuracy.

A Generalized Minimum Cost Flow Model for Multiple Emergency Flow Routing

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Jianxun Cui

2014-01-01

Full Text Available During real-life disasters, that is, earthquakes, floods, terrorist attacks, and other unexpected events, emergency evacuation and rescue are two primary operations that can save the lives and property of the affected population. It is unavoidable that evacuation flow and rescue flow will conflict with each other on the same spatial road network and within the same time window. Therefore, we propose a novel generalized minimum cost flow model to optimize the distribution pattern of these two types of flow on the same network by introducing the conflict cost. The travel time on each link is assumed to be subject to a bureau of public road (BPR function rather than a fixed cost. Additionally, we integrate contraflow operations into this model to redesign the network shared by those two types of flow. A nonconvex mixed-integer nonlinear programming model with bilinear, fractional, and power components is constructed, and GAMS/BARON is used to solve this programming model. A case study is conducted in the downtown area of Harbin city in China to verify the efficiency of proposed model, and several helpful findings and managerial insights are also presented.

Low-Cost Quality Control and Nondestructive Evaluation Technologies for General Aviation Structures

Science.gov (United States)

Cramer, K. Elliott; Gavinsky, Bob; Semanskee, Grant

1998-01-01

NASA's Advanced General Aviation Transport Experiments (AGATE) Program has as a goal to reduce the overall cost of producing private aviation aircraft while maintaining the safety of these aircraft. In order to successfully meet this goal, it is necessary to develop nondestructive inspection techniques which will facilitate the production of the materials used in these aircraft and assure the quality necessary to maintain airworthiness. This paper will discuss a particular class of general aviation materials and several nondestructive inspection techniques that have proven effective for making these inspections. Additionally, this paper will discuss the investigation and application of other commercially available quality control techniques applicable to these structures.

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

Science.gov (United States)

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

2015-02-01

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

Hanford general employee training: A million dollar cost-beneficial program

International Nuclear Information System (INIS)

Gardner, P.R.

1991-01-01

In January, 1990, Westinghouse Hanford Company (WHC) implemented an interactive videodisc training program entitled Hanford General Employee Training (HGET). Following an introduction by the course instructor, students begin the interactive video segment of the course by taking a tour of an office building. In fact, this tour is simply a setting in which to give the student a checkout on safety, security, and quality issues. For example, at one point the guide leaves the room and the phone suddenly begins a steady ring. This is a particular alarm at WHC, and the student is challenged to respond correctly. Missed questions flag corresponding tutorials to be delivered either immediately or on completion of the tour. Instructors receive notification of weakoesses left unremedied. Development costs for a sophisticated program such as HGET were high compared to similar costs for developing equivalent traditional training. Hardware and labor totaled $900K. Annual maintenance costs, equipment plus labor, appear to be running about $200K. On the benefit side, by consolidating some seventeen previous WHC courses and more effectively managing the instructional process, HGET reduced the average student training time from over eleven hours to just under four hours. In the development and implementation of HGET a number of issues were resolved, some more successfully than others: (1) what about job security for former instructors? (2) how should the course be run on a daily basis? (we envisioned a combination of instructor and videodisc); (3) how high will the maintenance costs be? (higher than projected); etc. Many obstacles arise, most in connection with the large number of groups and personnel whose efforts had to be coordinated

Robust Guaranteed Cost Observer Design for Singular Markovian Jump Time-Delay Systems with Generally Incomplete Transition Probability

Directory of Open Access Journals (Sweden)

Yanbo Li

2014-01-01

Full Text Available This paper is devoted to the investigation of the design of robust guaranteed cost observer for a class of linear singular Markovian jump time-delay systems with generally incomplete transition probability. In this singular model, each transition rate can be completely unknown or only its estimate value is known. Based on stability theory of stochastic differential equations and linear matrix inequality (LMI technique, we design an observer to ensure that, for all uncertainties, the resulting augmented system is regular, impulse free, and robust stochastically stable with the proposed guaranteed cost performance. Finally, a convex optimization problem with LMI constraints is formulated to design the suboptimal guaranteed cost filters for linear singular Markovian jump time-delay systems with generally incomplete transition probability.

Do Cost Functions for Tracking Error Generalize across Tasks with Different Noise Levels?

Directory of Open Access Journals (Sweden)

Jonathon Sensinger

Full Text Available Control of human-machine interfaces are well modeled by computational control models, which take into account the behavioral decisions people make in estimating task dynamics and state for a given control law. This control law is optimized according to a cost function, which for the sake of mathematical tractability is typically represented as a series of quadratic terms. Recent studies have found that people actually use cost functions for reaching tasks that are slightly different than a quadratic function, but it is unclear which of several cost functions best explain human behavior and if these cost functions generalize across tasks of similar nature but different scale. In this study, we used an inverse-decision-theory technique to reconstruct the cost function from empirical data collected on 24 able-bodied subjects controlling a myoelectric interface. Compared with previous studies, this experimental paradigm involved a different control source (myoelectric control, which has inherently large multiplicative noise, a different control interface (control signal was mapped to cursor velocity, and a different task (the tracking position dynamically moved on the screen throughout each trial. Several cost functions, including a linear-quadratic; an inverted Gaussian, and a power function, accurately described the behavior of subjects throughout this experiment better than a quadratic cost function or other explored candidate cost functions (p<0.05. Importantly, despite the differences in the experimental paradigm and a substantially larger scale of error, we found only one candidate cost function whose parameter was consistent with the previous studies: a power function (cost ∝ errorα with a parameter value of α = 1.69 (1.53-1.78 interquartile range. This result suggests that a power-function is a representative function of user's error cost over a range of noise amplitudes for pointing and tracking tasks.

Initial investigation into lower-cost CT for resource limited regions of the world

Science.gov (United States)

Dobbins, James T., III; Wells, Jered R.; Segars, W. Paul; Li, Christina M.; Kigongo, Christopher J. N.

2010-04-01

This paper describes an initial investigation into means for producing lower-cost CT scanners for resource limited regions of the world. In regions such as sub-Saharan Africa, intermediate level medical facilities serving millions have no CT machines, and lack the imaging resources necessary to determine whether certain patients would benefit from being transferred to a hospital in a larger city for further diagnostic workup or treatment. Low-cost CT scanners would potentially be of immense help to the healthcare system in such regions. Such scanners would not produce state-of-theart image quality, but rather would be intended primarily for triaging purposes to determine the patients who would benefit from transfer to larger hospitals. The lower-cost scanner investigated here consists of a fixed digital radiography system and a rotating patient stage. This paper describes initial experiments to determine if such a configuration is feasible. Experiments were conducted using (1) x-ray image acquisition, a physical anthropomorphic chest phantom, and a flat-panel detector system, and (2) a computer-simulated XCAT chest phantom. Both the physical phantom and simulated phantom produced excellent image quality reconstructions when the phantom was perfectly aligned during acquisition, but artifacts were noted when the phantom was displaced to simulate patient motion. An algorithm was developed to correct for motion of the phantom and demonstrated success in correcting for 5-mm motion during 360-degree acquisition of images. These experiments demonstrated feasibility for this approach, but additional work is required to determine the exact limitations produced by patient motion.

26 CFR 1.468A-1T - Nuclear decommissioning costs; general rules (temporary).

Science.gov (United States)

2010-04-01

... accrual method of accounting that do not elect the application of section 468A are not allowed a deduction... (temporary). 1.468A-1T Section 1.468A-1T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE...-1T Nuclear decommissioning costs; general rules (temporary). (a) Introduction. Section 468A provides...

Reforming the Canadian Sales Tax System: A Regional General Equilibrium Analysis

OpenAIRE

CHUN-YAN KUO; BOB HAMILTON

1991-01-01

The paper develops a regional general equilibrium model of the Canadian economy to analyze the sectoral and regional impacts of the major changes to the Canadian sales tax system. The results indicate that replacing the federal sales tax with the goods and service tax increases real output in Canada in the long run by 1.4 percent. If the provincial sales taxes are also integrated, real output increases by a further 0.8 percent.

Actuarial modeling of cost of voluntary pension insurance of the population of the region

Directory of Open Access Journals (Sweden)

Mikhailova Svetlana Sergeevna

2013-06-01

Full Text Available In article approach to determination of net value of the contract of pension insurance for the man's and female population, considering regional demographic features is offered. Results of actuarial calculation of the size pure net - rates of individual pension insurance are presented, "sensitivity" of cost of insurance is defined by methods of statistical modeling to key parameters of a pension product for the region population.

[Can Topical Negative Pressure Therapy be Performed as a Cost-Effective General Surgery Procedure in the German DRG System?].

Science.gov (United States)

Hirche, Z; Xiong, L; Hirche, C; Willis, S

2016-04-01

Topical negative pressure therapy (TNPT) has been established for surgical wound therapy with different indications. Nevertheless, there is only sparse evidence regarding its therapeutic superiority or cost-effectiveness in the German DRG system (G-DRG). This study was designed to analyse the cost-effectiveness of TNPT in the G-DRG system with a focus on daily treatment costs and reimbursement in a general surgery care setting. In this retrospective study, we included 176 patients, who underwent TNPT between 2007 and 2011 for general surgery indications. Analysis of the cost-effectiveness involved 149 patients who underwent a simulation to calculate the reimbursement with or without TNPT by a virtual control group in which the TNP procedure was withdrawn for DRG calculation. This was followed by a calculation of costs for wound dressings and TNPT rent and material costs. Comparison between the "true" and the virtual group enabled calculation of the effective remaining surplus per case. Total reimbursement by included TNPT cases was 2,323 ,70.04 €. Costs for wound dressings and TNPT rent were 102,669.20 €. In 41 cases there was a cost-effectiveness (27.5%) with 607,422.03 € with TNP treatment, while the control group without TNP generated revenues of 442,015.10 €. Costs for wound dressings and TNPT rent were 47,376.68 €. In the final account we could generate a cost-effectiveness of 6759 € in 5 years per 149 patients by TNPT. In 108 cases there was no cost-effectiveness (72.5%). TNPT applied in a representative general surgery setting allows for wound therapy without a major financial burden. Based on the costs for wound dressings and TNPT rent, a primarily medically based decision when to use TNPT can be performed in a balanced product cost accounting. This study does not analyse the superiority of TNPT in wound care, so further prospective studies are required which focus on therapeutic superiority and cost-effectiveness. Georg Thieme

A theoretical cost optimization model of reused flowback distribution network of regional shale gas development

International Nuclear Information System (INIS)

Li, Huajiao; An, Haizhong; Fang, Wei; Jiang, Meng

2017-01-01

The logistical issues surrounding the timing and transport of flowback generated by each shale gas well to the next is a big challenge. Due to more and more flowback being stored temporarily near the shale gas well and reused in the shale gas development, both transportation cost and storage cost are the heavy burden for the developers. This research proposed a theoretical cost optimization model to get the optimal flowback distribution solution for regional multi shale gas wells in a holistic perspective. Then, we used some empirical data of Marcellus Shale to do the empirical study. In addition, we compared the optimal flowback distribution solution by considering both the transportation cost and storage cost with the flowback distribution solution which only minimized the transportation cost or only minimized the storage cost. - Highlights: • A theoretical cost optimization model to get optimal flowback distribution solution. • An empirical study using the shale gas data in Bradford County of Marcellus Shale. • Visualization of optimal flowback distribution solutions under different scenarios. • Transportation cost is a more important factor for reducing the cost. • Help the developers to cut the storage and transportation cost of reusing flowback.

HISTORIOGRAPHY GENERAL, REGIONAL AND SPECIAL STUDIES OF JUDICIAL REFORM IN RUSSIA 1864

Directory of Open Access Journals (Sweden)

Sergei Evgenievich Strakhov

2014-10-01

Full Text Available In today's world, a crucial role is played by the judiciary. In the period lasting judicial reform, it is important to explore this institution not only at the present stage, but also to trace the history of its development, including - through analysis and synthesis of existing studies of the judiciary and judicial reforms.The purpose of this study - to explore the historiography of general, special and regional studies of judicial reform of1864 inRussia, to classify research on history and on the subject of the study.Scientific, theoretical and practical significance of the work lies in the fact that the study of this topic will summarize the significant weight of the studies of the judicial reform of 1864 and classified by facilitating orientation interested in individuals in the study subjects.The author uses historical, comparative, hermeneutical, mathematical methods, as well as general methods of scientific research.The author analyzes the historiography of general, special and regional studies of the judicial reform of1864 inRussia, introducing a classification of such studies in chronological order (pre-revolutionary, Soviet and modern stages and subject matter (common - affecting all aspects of judicial reform, special - dedicated to a particular aspect (legal agencies, prosecutors, legal, etc. and regional - dedicated to judicial reform, or some aspects of it in some regions of Russia.The results of this study are scientific and practical value, because they can be useful for teaching students - in industry disciplines "judiciary", "advocacy", "notary public", "public prosecutor's supervision" and general theoretical "History of State and Law," "History of the fatherland" ; in science - by picking up information about the historiography of the judicial reform, and in practice - said work can serve as a guide to research judicial reform, which may be useful to practitioners of judicial and investigative bodies, as well as - prosecutors

[A totally implantable venous access device. Implantation in general or local anaesthesia? A retrospective cost analysis].

Science.gov (United States)

Schuld, J; Richter, S; Moussavian, M R; Kollmar, O; Schilling, M K

2009-08-01

Implantation of venous access port systems can be performed in local or general anesthesia. In spite of the increasing rate of interventionally implanted systems, the surgical cut-down represents a safe alternative. Thus, the question arises whether--in context to the increasing health-economic pressure--open implantation in general anesthesia is still a feasible alternative to implantation in local anesthesia regarding OR efficiency and costs. In a retrospective analysis, 993 patients receiving a totally implantable venous access device between 2001 and 2007 were evaluated regarding OR utilization, turnover times, intraoperative data and costs. Implantations in local (LA) and general anesthesia (GA) were compared. GA was performed in 762 cases (76.6 %), LA was performed in 231 patients (23.3 %). Mean operation time was similar in both groups (LA 47.27 +/- 1.40 min vs. GA 45.41 +/- 0.75 min, p = 0.244). Patients receiving local anesthesia had a significantly shorter stay in the OR unit (LA 95.9 +/- 1.78 min vs. GA 105.92 +/- 0.92 min; p cut (LA 39.57 +/- 0.69 min vs. GA 50.46 +/- 0.52 min; p material costs were significantly lower in the LA group compared with the GA group (LA: 400.72 +/- 8.25 euro vs. GA: 482.86 +/- 6.23 euro; p systems in local anesthesia is superior in comparison to the implantation under general anesthesia regarding procedural times in the OR unit and costs. With the same operation duration, but less personnel and material expenditure, implantation in local anesthesia offers a potential economic advantage by permitting faster changing times. Implantation in GA only should be performed at a special request by the patient or in difficult venous conditions. Georg Thieme Verlag Stuttgart.New York.

Inventory of past DOE land disturbance, Yucca Mountain, Nevada, and estimated general reclamation costs

International Nuclear Information System (INIS)

1989-04-01

Since 1976, DOE preliminary investigations for a high level nuclear waste repository at Yucca Mountain, Nevada, have caused widespread disturbances of the landscape. This report addresses the areal extent of those disturbances that have accrued up to June 1988, and identifies expected associated reclamation costs. It was first necessary to identify disturbances, next to classify them for reclamation purposes, and, then, to assign general reclamation costs. The purposes of the analysis were: (1) to establish the amount of disturbance that already exists in the area of Yucca Mountain in order to identify alterations of the landscape that comprise the existing baseline conditions; (2) to identify estimated general reclamation costs for repair of the disturbances; (3) to provide information needed to establish disturbance models, and eventually environmental impact models, that can be applied to future DOE activities during Site Characterization and later phases of repository development, if they occur, and (4) to provide indicators of the needs for reclamation of future disturbances created by DOE's Site Characterization program. Disturbances were estimated using measurements from June 1988, large scale color aerial photography. Two reconnaissance site visits were also conducted. The identified disturbance totals by type are displayed in tabular form in the appendices. 84 refs., 2 figs., 9 tabs

General practitioner participation in intranatal care in the northern region in 1983.

OpenAIRE

Marsh, G N; Cashman, H A; Russell, I T

1985-01-01

In 1983 a quarter of general practitioners in the Northern region of England cared for obstetric deliveries and half of these for a minimum of 10 deliveries a year. Most expected their intranatal work to remain at the same level or increase in the next 10 years. Most participating general practitioners did their own forceps deliveries and initiated inductions. Most out of hours deliveries were attended by the mother's own general practitioner or a partner. A quarter of all respondents had car...

Comparison of Turkey’s Geographical Regions in terms of Stand-Alone PV System Design and Cost Parameters

Directory of Open Access Journals (Sweden)

Nevzat Onat

2017-01-01

Full Text Available Stand-alone photovoltaic (SAPV systems are widely used in rural areas where there is no national grid or as a precaution against power outages. In this study, technical and economic analysis of a SAPV system was carried out using meteorological data for 75 province centers in seven geographical regions of Turkey. Obtained results for each province center were separated by geographical area. The averages of the centers for each region are taken as output. A calculation algorithm based on MsExcel has been established for these operations. The analyses made with the developed algorithm are repeated for five different scenarios that they cover periods of time when a constant strong load is active for all seasons (winter, spring, summer, and autumn and all year round. The developed algorithm calculates the life-cycle cost, the unit energy cost, the electrical capacity utilization rate, the amount of generated/excess energy per month, the initial investment/replacement, and operating and maintenance (O&M costs of each element. As a result, geographical regions of Turkey are compared in terms of these outputs graphically. Further investigations may include the sale of excess energy generated, small-scale PV system cost factors parallel to the grid, and the effects of government incentives.

A Cost-based Explanation of Gradual, Regional Internationalization of Multinationals on Social Networking Sites

DEFF Research Database (Denmark)

Pogrebnyakov, Nicolai

2017-01-01

This paper examines firm internationalization on social networking sites (SNS). It systematically examines costs faced by an internationalizing firm and how firms react to these costs according to “distance-dependent” (gradual and regional) and “distance-invariant” (born-global) explanations...... of internationalization. Data on 5827 country pages of 240 multinational firms on Facebook, the most popular SNS today, is used. Creating a foreign country-specific Facebook page is considered the SNS equivalent of opening a physical subsidiary in that country. The data show that multinationals exhibit...

A worldwide review of the cost of nuclear power

International Nuclear Information System (INIS)

Lecomte, M.; Mario, N.; Vignon, D.

2014-01-01

The 'true cost' of nuclear energy is a subject of great controversy, especially when considering capital costs of recent projects which opponents to this technology claim to be out of control. In order to provide an objective assessment of nuclear competitiveness, a systematic review of nuclear costs as estimated by stakeholders on a worldwide basis (parliamentary commissions, general accounting offices, academics from universities, non-governmental organizations [either promoting nuclear, or nonnuclear energy], utilities and vendors) was done. Based on these data, levelised costs of electricity (LCOE) were calculated, for different technologies and different regional areas. A breakdown between the key factors (pre-construction and owner costs, Capex, Opex, spent fuel management, dismantling and decommissioning) was provided. The study generally concludes that nuclear energy remains competitive, although costs of advanced technologies soared compared to Gen II. It also demonstrates the benefit of steady and ongoing nuclear programs compared to construction of single projects from time to time. (authors)

Domain-General Brain Regions Do Not Track Linguistic Input as Closely as Language-Selective Regions.

Science.gov (United States)

Blank, Idan A; Fedorenko, Evelina

2017-10-11

Language comprehension engages a cortical network of left frontal and temporal regions. Activity in this network is language-selective, showing virtually no modulation by nonlinguistic tasks. In addition, language comprehension engages a second network consisting of bilateral frontal, parietal, cingulate, and insular regions. Activity in this "multiple demand" (MD) network scales with comprehension difficulty, but also with cognitive effort across a wide range of nonlinguistic tasks in a domain-general fashion. Given the functional dissociation between the language and MD networks, their respective contributions to comprehension are likely distinct, yet such differences remain elusive. Prior neuroimaging studies have suggested that activity in each network covaries with some linguistic features that, behaviorally, influence on-line processing and comprehension. This sensitivity of the language and MD networks to local input characteristics has often been interpreted, implicitly or explicitly, as evidence that both networks track linguistic input closely, and in a manner consistent across individuals. Here, we used fMRI to directly test this assumption by comparing the BOLD signal time courses in each network across different people ( n = 45, men and women) listening to the same story. Language network activity showed fewer individual differences, indicative of closer input tracking, whereas MD network activity was more idiosyncratic and, moreover, showed lower reliability within an individual across repetitions of a story. These findings constrain cognitive models of language comprehension by suggesting a novel distinction between the processes implemented in the language and MD networks. SIGNIFICANCE STATEMENT Language comprehension recruits both language-specific mechanisms and domain-general mechanisms that are engaged in many cognitive processes. In the human cortex, language-selective mechanisms are implemented in the left-lateralized "core language network

Generalized least squares and empirical Bayes estimation in regional partial duration series index-flood modeling

DEFF Research Database (Denmark)

Madsen, Henrik; Rosbjerg, Dan

1997-01-01

parameters is inferred from regional data using generalized least squares (GLS) regression. Two different Bayesian T-year event estimators are introduced: a linear estimator that requires only some moments of the prior distributions to be specified and a parametric estimator that is based on specified......A regional estimation procedure that combines the index-flood concept with an empirical Bayes method for inferring regional information is introduced. The model is based on the partial duration series approach with generalized Pareto (GP) distributed exceedances. The prior information of the model...

Comparative Cost Study by Southeastern Regional Association of Physical Plant Administrators of Universities and Colleges Standards Committee.

Science.gov (United States)

Duke Univ., Durham, NC.

Presented in this document are data pertaining to maintenance and operations costs at colleges and universities in the southeastern region of the U.S. The major accounts included in the cost analysis are: (1) physical plant administration, (2) building maintenance, (3) custodial services, (4) utilities, (5) landscape and grounds maintenance, and…

The cost of geothermal energy in the western US region:a portfolio-based approach a mean-variance portfolio optimization of the regions' generating mix to 2013.

Energy Technology Data Exchange (ETDEWEB)

Beurskens, Luuk (ECN-Energy Research Centre of the Netherland); Jansen, Jaap C. (ECN-Energy Research Centre of the Netherlands); Awerbuch, Shimon Ph.D. (.University of Sussex, Brighton, UK); Drennen, Thomas E.

2005-09-01

Energy planning represents an investment-decision problem. Investors commonly evaluate such problems using portfolio theory to manage risk and maximize portfolio performance under a variety of unpredictable economic outcomes. Energy planners need to similarly abandon their reliance on traditional, ''least-cost'' stand-alone technology cost estimates and instead evaluate conventional and renewable energy sources on the basis of their portfolio cost--their cost contribution relative to their risk contribution to a mix of generating assets. This report describes essential portfolio-theory ideas and discusses their application in the Western US region. The memo illustrates how electricity-generating mixes can benefit from additional shares of geothermal and other renewables. Compared to fossil-dominated mixes, efficient portfolios reduce generating cost while including greater renewables shares in the mix. This enhances energy security. Though counter-intuitive, the idea that adding more costly geothermal can actually reduce portfolio-generating cost is consistent with basic finance theory. An important implication is that in dynamic and uncertain environments, the relative value of generating technologies must be determined not by evaluating alternative resources, but by evaluating alternative resource portfolios. The optimal results for the Western US Region indicate that compared to the EIA target mixes, there exist generating mixes with larger geothermal shares at equal-or-lower expected cost and risk.

Part B Excess Cost Quick Reference Document

Science.gov (United States)

Ball, Wayne; Beridon, Virginia; Hamre, Kent; Morse, Amanda

2011-01-01

This Quick Reference Document has been prepared by the Regional Resource Center Program ARRA/Fiscal Priority Team to aid RRCP State Liaisons and other (Technical Assistance) TA providers in understanding the general context of state questions surrounding excess cost. As a "first-stop" for TA providers in investigating excess cost…

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

Science.gov (United States)

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

Photovoltaic systems: A cost competitive option to supply energy to off-grid agricultural communities in arid regions

International Nuclear Information System (INIS)

Qoaider, Louy; Steinbrecht, Dieter

2010-01-01

The main objective of this work is to investigate the economic feasibility of photovoltaic technology to supply the entire energy demands to off-grid irrigated-farming-based communities in the arid regions. This aims at helping these communities to find practical solutions to cope with the rapid rising electricity generation costs, mainly by diesel generators (gensets). The genset electricity costs are typically affected by the high fossil fuel prices, the fuel transport costs and the intensive operation and maintenance (O and M) requirements. The work was conducted on a representative site from which conclusions could be drawn for similar regions. The case study was performed in the New Kalabsha Village in the Lake Nasser Region (LNR) in southern Egypt. The work involved the technical design and the calculation of the life cycle costs (LCC) of a PV system, which is able to supply the village with its entire energy demand. The PV generator was sized in such a way to daily pump 111 000 m 3 of lake water to irrigate 1260 ha acreage plots and to electrify the adjacent village's households. The required pumps were designed to pump the fluctuating lake's water for a maximum differential head of 17 m in four different locations. Consequently, water from the four pumping stations flows freely by gravity forces to the different plots through overhead open canals. The electricity generation costs and the performance of the designed PV generator were compared with those of an equivalent diesel generator (genset) in order to prove its competitiveness. With this regard, the real market value of the diesel fuel of 86.55 c Euro l -1 was considered for calculating the costs of genset generated electricity. The results showed that the genset electricity unit costs 39 c Euro kW h -1 while a unit of PV electricity costs only 13 c Euro kW h -1 for the equivalent system size and project lifetime. Furthermore, the subsidised genset electricity cost was calculated to be 12 c Euro kW h

A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

LENUS (Irish Health Repository)

Naughton, C

2011-06-01

Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

Taxes, cost and demand shifters as determinants in the regional gasoline price formation process: Evidence from Spain

International Nuclear Information System (INIS)

Bello, Alejandro; Contín-Pilart, Ignacio

2012-01-01

This paper examines the pass-through of regional tax changes and spot price variations to regional gasoline prices in Spain. It also analyzes the impact of all major cost and demand shifters that contribute to regional gasoline price formation. To address these research issues, a reduced form price equation using monthly time-series cross-sectional (TSCS) data from January 2004 through December 2008 is estimated. Strong and consistent evidence of full shifting of regional tax changes to regional gasoline prices is found. Gasoline spot price changes are more than proportionally passed through to retail prices. In addition, the empirical evidence shows, on the one hand, that regional gasoline price differences before taxes continue to be quite narrow and, on the other hand, that there is still a margin for larger gasoline price differences among regions. This suggest that “traditional practices” from the monopoly era (i.e. relatively uniform regional gasoline prices) persist after the market has been liberalized, which may have been facilitated by the strong and uniform presence of the major Spanish-based refining companies in the retail sector over the whole country. - Highlights: ► The paper analyzes the impact of all major demand and cost shifters that contribute to regional gasoline price formation. ► It shows that the relatively uniform regional gasoline prices persist after the Spanish gasoline market has been liberalized. ► It shows that regional tax changes are fully passed on to regional gasoline prices. ► It also shows that gasoline spot price changes are fully passed on to consumer prices.

Cost justification of clinical pharmacy services on a general surgery team: focus on diagnosis-related group cases.

Science.gov (United States)

Bertch, K E; Hatoum, H T; Willett, M S; Witte, K W

1988-11-01

We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.

Science.gov (United States)

Elsamadicy, Aladine A; Yang, Siyun; Sergesketter, Amanda R; Ashraf, Bilal; Charalambous, Lefko; Kemeny, Hanna; Ejikeme, Tiffany; Ren, Xinru; Pagadala, Promila; Parente, Beth; Xie, Jichun; Lad, Shivanand P

2017-09-29

The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012. We collected total, outpatient, and pain prescription costs three years prior to CRPS diagnosis (baseline), at year of CRPS diagnosis, and eight-year post-CRPS diagnosis. A longitudinal multivariate analysis was used to model the estimated total and pain prescription cost ratios comparing patients diagnosed before and after CRPS. We included 35,316 patients with a newly indexed diagnosis of CRPS (Type I: n = 18,703, Type II: n = 14,599, Unspecified: n = 2014). Baseline characteristics were similar between the CRPS cohorts. Compared to two- and three-year baseline costs, one-year prior to diagnosis for all CRPS patients yielded the highest interquartile median [IQR] costs: total costs $7904[$3469, $16,084]; outpatient costs $6706[$3119, $12,715]; and pain prescription costs $1862[$147, $7649]. At the year of CRPS diagnosis, the median [IQR] costs were significantly higher than baseline costs: total costs $8508[$3943, $16,666]; outpatient costs $7251[$3527, $13,568]; and pain prescription costs $2077[$140, $8856]. Over the eight-year period after CRPS diagnosis, costs between all the years were similar, ranging from the highest (one-year) to lowest (seven-years), $4845 to $3888. The median total cumulative cost 8-years after CRPS diagnosis was $43,026 and $12,037 for pain prescription costs. [Correction added on 06 November 2017 after first online publication: the preceding sentence has been updated to demonstrate the median cumulative cost in replacement of the

Generalized hedgehog ansatz and Gribov copies in regions with nontrivial topologies

Science.gov (United States)

Canfora, Fabrizio; Salgado-Rebolledo, Patricio

2013-02-01

In this paper the arising of Gribov copies both in Landau and Coulomb gauges in regions with nontrivial topologies but flat metric, (such as closed tubes S1×D2, or R×T2) will be analyzed. Using a novel generalization of the hedgehog ansatz beyond spherical symmetry, analytic examples of Gribov copies of the vacuum will be constructed. Using such ansatz, we will also construct the elliptic Gribov pendulum. The requirement of absence of Gribov copies of the vacuum satisfying the strong boundary conditions implies geometrical constraints on the shapes and sizes of the regions with nontrivial topologies.

Regional Transmission Planning: A review of practices following FERC Order Nos. 890 and 1000

Energy Technology Data Exchange (ETDEWEB)

Eto, Joseph H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gallo, Guilia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-11-15

Federal Energy Regulatory Commission (FERC) Order Nos. 890 and 10001 established requirements that transmission planning regions must follow in regional transmission planning and allocating the costs of new transmission facilities. Order No. 890, issued in 2007, outlined general requirements for local as well as regional transmission planning practices and procedures. Order No. 1000, issued in 2011, laid out specific requirements for: (1) regional transmission planning; (2) consideration of transmission needs driven by public policy requirements; (3) non-incumbent transmission development; (4) interregional transmission coordination; and (5) cost allocation for transmission facilities that have been selected in a regional transmission plan for purposes of cost allocation. This report reviews how these FERC orders are being implemented by the 12 transmission planning regions recognized by FERC.

Trojan Decommissioning Project Cost Performance

International Nuclear Information System (INIS)

Michael B. Lackey

2000-01-01

The Trojan nuclear plant (Trojan) was an 1160-MW(electric) four-loop pressurized water reactor located in Rainier, Oregon. The plant was permanently shut down in 1993 after ∼17 yr of commercial operation. The early plant closure was an economic decision. The key factors in the closure analysis were escalation of inspection and repair costs associated with steam generator tube cracking and the projected availability of inexpensive replacement power in the Pacific Northwest region of the United States. Since the plant closure, Portland General Electric (PGE) has been actively engaged in decommissioning. The Trojan Decommissioning Project currently has a forecast at completion of $429.7 million (all costs are in millions of 1997 dollars, unless otherwise noted). The cost performance of the Trojan Decommissioning Project to date is addressed, as well as the tools that are in place to provide cost control through completion of decommissioning

General Equilibrium in a Segmented Market Economy with Convex Transaction Cost: Existence, Efficiency, Commodity and Fiat Money

OpenAIRE

Starr, Ross M.

2002-01-01

This study derives the monetary structure of transactions, the use of commodity or fiat money, endogenously from transaction costs in a segmented market general equilibrium model. Market segmentation means there are separate budget constraints for each transaction: budgets balance in each transaction separately. Transaction costs imply differing bid and ask (selling and buying) prices. The most liquid instruments are those with the lowest proportionate bid/ask spread in equilibrium. Exist...

39 CFR 230.25 - Who pays the costs incurred when the Office of Inspector General responds to a demand for...

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Who pays the costs incurred when the Office of....25 Who pays the costs incurred when the Office of Inspector General responds to a demand for documents or testimony? (a) Unless determined by 28 U.S.C. 1821 or other applicable statute, the costs of...

An analysis of the 'costs and effectiveness' of post-mastectomy local-regional radiation therapy

International Nuclear Information System (INIS)

Marks, L.B.; Prosnitz, L.R.; Hardenbergh, P.H.; Winer, E.T.

1997-01-01

Purpose: To estimate the 'cost/effectiveness' ratio for post-mastectomy local-regional radiation therapy (LR-XRT) for patients with breast cancer. As the risk of local-regional recurrence (LRR) is related to the number of positive axillary lymph nodes, the cost/effectiveness ratio of LR-XRT was assessed for a variable number of positive axillary nodes. For overall survival (OS), the cost per additional life-year is estimated as a function of follow-up duration. Methods/Assumptions: Literature data indicate that the risk of LRR is related to the number of positive axillary nodes (e.g. Fowble, Kuske). For example, the LRR rate is ∼10% for patients with negative nodes, increasing to ∼40% for patients with ≥4 positive nodes. Such data are used to linearly relate the number of positive nodes with the risk of LRR. Additional assumptions include: RT reduces the risk of LRR by 67%; local recurrences are treated with exision/biopsy, LR-XRT and systemic chemotherapy; half of the local recurrences are controlled locally and half will require additional salvage treatment with surgery or chemotherapy. The 5, 10 and 15 yr improvements in OS provided by LR-XRT are estimated to be 3, 7, and 10%, respectively, based on the literature (Overgaard, Ragaz, Klefstrom, Rutqvist). For each year following LR-XRT, the accrued life-years gained are estimated from the published survival curves. Professional and technical charges are used as a surrogate for costs, as follows (in thousands): LR-XRT-15; evaluation of recurrence-2; biopsy plus pathology-1; resection plus pathology-7, chemotherapy-10. Results: The cost per LRR prevented with the addition of routine post-mastectomy LR-XRT is shown, as a function of the number of positive axillary nodes. The cost per additional life-year gained with LR-XRT, as a function of follow-up duration, is shown. With increasing follow-up, the cost per life-year gained decreases as the additional life-years accrue. Conclusions: The cost per LRR

Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.

Science.gov (United States)

Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

2009-01-01

To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.

General practitioner participation in intranatal care in the northern region in 1983.

Science.gov (United States)

Marsh, G N; Cashman, H A; Russell, I T

1985-03-30

In 1983 a quarter of general practitioners in the Northern region of England cared for obstetric deliveries and half of these for a minimum of 10 deliveries a year. Most expected their intranatal work to remain at the same level or increase in the next 10 years. Most participating general practitioners did their own forceps deliveries and initiated inductions. Most out of hours deliveries were attended by the mother's own general practitioner or a partner. A quarter of all respondents had cared for planned and unplanned home births. Few were happy about attending them, but most would provide planned home care if urged to do so.

System-wide impacts of environmental cost factors

International Nuclear Information System (INIS)

Rogers, M.; Kennedy, T.; Finnell, J.; Hoelscher, J.

1992-01-01

This paper presents a continuum of approaches to considering environmental externalities in the utility resource selection process. While photovoltaic (PV) technologies can play a role in reducing emissions, they are generally not cost-competitive with conventional technologies, even when cost estimates for environmental damages are introduced. Several approaches are explored to determine whether PV becomes more competitive when emission reduction strategies are considered on a regional basis. Finally, preliminary analysis was performed with the Midas utility planning model to develop emission credits based on PV's ability to displace emissions on a net system basis

Modeling a farm population to estimate on-farm compliance costs and environmental effects of a grassland extensification scheme at the regional scale

DEFF Research Database (Denmark)

Uthes, Sandra; Sattler, Claudia; Piorr, Annette

2010-01-01

We used a farm-level modeling approach to estimate on-farm compliance costs and environmental effects of a grassland extensification scheme in the district of Ostprignitz-Ruppin, Germany. The behavior of the regional farm population (n = 585) consisting of different farm types with different...... and environmental effects were heterogeneous in space and farm types as a result of different agricultural production and site characteristics. On-farm costs ranged from zero up to almost 1500 Euro/ha. Such high costs occurred only in a very small part of the regional area, whereas the majority of the grassland had...... low on-farm costs below 50 Euro/ha. Environmental effects were moderate and greater on high-yield than on low-yield grassland. The low effectiveness combined with low on-farm costs in large parts of the region indicates that the scheme is not well targeted. The soft scheme design results from...

Clean air benefits and costs in the GVRD [Greater Vancouver Regional District

International Nuclear Information System (INIS)

Gislason, G.; Martin, J.; Williams, D.; Caton, B.; Rich, J.; Rojak, S.; Robinson, J.; Stuermer, A. von

1994-01-01

Air pollution is a major concern in the Greater Vancouver Regional District in British Columbia. An analysis was conducted to assess the costs and benefits of an innovative plan to reduce the emissions of five primary pollutants in the GVRD: nitrogen oxides (NOx), sulfur oxides (SOx), volatile organic compounds (VOCs), particulates, and CO. The study adopts a damage function approach in which the benefits of reduced emissions are given by the averted damages to human health, crops, and so on. Under a base case scenario, motor vehicle emission controls and additional measures proposed in the region's air quality management plan (AQMP) are projected to lead to emission reductions of 873,000 tonnes in the GVRD by the year 2020, compared to the emission level projected without intervention. The AQMP is projected to avert over its life some 2,800 premature deaths, 33,000 emergency room visits, 13 million restricted activity days, and 5 million symptoms. Crop losses due to ozone are projected to decrease by 1-4%/y over the next several decades due to the AQMP. Damage averted to materials and property per tonne of pollutant reduced ranges from $30 for VOC to $180 for particulates. Under base-case conservative assumptions, the AQMP generates $5.4 billion in benefits and $3.8 billion in costs, nearly 2/3 of which are paid by the industrial and commercial sectors. 1 tab

A General Model for Cost Estimation in an Exchange

Directory of Open Access Journals (Sweden)

Benzion Barlev

2014-03-01

Full Text Available Current Generally Accepted Accounting Principles (GAAP state that the cost of an asset acquired for cash is the fair value (FV of the amount surrendered, and that of an asset acquired in a non-monetary exchange is the FV of the asset surrendered or, if it is more “clearly evident,” the FV of the acquired asset. The measurement method prescribed for a non-monetary exchange ignores valuable information about the “less clearly evident” asset. Thus, we suggest that the FV in any exchange be measured by the weighted average of the exchanged assets’ FV estimations, where the weights are the inverse of the variances’ estimations. This alternative valuation process accounts for the uncertainty involved in estimating the FV of each of the asset in the exchange. The proposed method suits all types of exchanges: monetary and non-monetary. In a monetary transaction, the weighted average equals the cash paid because the variance of its FV is nil.

Project cost estimation techniques used by most emerging building ...

African Journals Online (AJOL)

consisted of five distinct types of contractors, general builders, civil engineers, electricians ... Mmboswobeni Watson Ladzani, Department of Business Management, University of South .... final cost of a proposed project for a given work scope. Thus, by .... Since the test statistic does not exceed the critical region, the null.

The Distinction between Direct and General Costs with Regard to the Deduction of Input VAT - The Case of Acquisition, Holding and Sale of Shares

DEFF Research Database (Denmark)

Jensen, Dennis Ramsdahl; Stensgaard, Henrik

2012-01-01

of distinguishing between direct and general costs. On the other hand the aim is to describe and analyse the law as it stands regarding the treatment of shares in the EU VAT system, with a special focus on the right to deduct input VAT on costs re-lating to transactions in shares. As a part of this analysis the aim......In revealing the conditions for the deduction of input VAT, the essential questions concern the nature of the so-called ‘direct and immediate link’ test and thus also the criteria for the important distinction between direct costs and general costs. The ‘direct and immediate link’ test...... is of general importance to all types of costs, but judged from the case law of the ECJ it has especially materialised itself when it comes to costs related to the acquisition, holding or sales of shares. The purpose of this article is therefore twofold. On the one hand it deals with the difficult question...

Regional disparity and cost-effective SO2 pollution control in China: A case study in 5 mega-cities

International Nuclear Information System (INIS)

Kanada, Momoe; Dong, Liang; Fujita, Tsuyoshi; Fujii, Minoru; Inoue, Tsuyoshi; Hirano, Yujiro; Togawa, Takuya; Geng, Yong

2013-01-01

With rapid development, increasing sulfur dioxide (SO 2 ) emission becomes a key environmental issue in China. To respond to this challenge, the Chinese government established a top-down scheme to reduce its SO 2 emissions. However, regional disparity and the associated cost differences brought uncertainties to the policy effectiveness and efficiency. Few studies focus on this field. Therefore, this study tries to fill such a gap by investigating the differences of SO 2 emissions, reduction potential, and cost-effectiveness through use of the GAINS-China model in five mega-cities in China, namely, Beijing, Shanghai, Tianjin, Chongqing, and Hong Kong. A scenario analysis approach is employed, focusing on two technologies named flue gas desulfurization (FGD) and limestone injection (LINJ). Results demonstrated that a large SO 2 reduction potential exists, as well as a great disparity, among the five mega-cities. Chongqing had the largest reduction potential with lowest unit cost, while Beijng and Hong Kong showed the lowest reduction potential with higher unit cost. In Beijing and Shanghai, FGD and LINJ in the power generation sector had the larger reduction potential with the highest cost-effectiveness. However, in Chongqing, the industry sectors also had large reduction potentials. Finally, appropriate SO 2 control strategies and policies are raised by considering the local realities. - Highlights: • The cost-effectiveness of SO 2 control policy was analyzed in five mega-cities in China. • Reduction potential and cost-effectiveness were closely linked to regional disparity. • Beijing and Hong Kong showed lower reduction potential and higher marginal reduction cost. • Chongqing showed the largest reduction potential and the lowest marginal reduction cost

Minimum-Cost Reachability for Priced Timed Automata

DEFF Research Database (Denmark)

Behrmann, Gerd; Fehnker, Ansgar; Hune, Thomas Seidelin

2001-01-01

This paper introduces the model of linearly priced timed automata as an extension of timed automata, with prices on both transitions and locations. For this model we consider the minimum-cost reachability problem: i.e. given a linearly priced timed automaton and a target state, determine...... the minimum cost of executions from the initial state to the target state. This problem generalizes the minimum-time reachability problem for ordinary timed automata. We prove decidability of this problem by offering an algorithmic solution, which is based on a combination of branch-and-bound techniques...... and a new notion of priced regions. The latter allows symbolic representation and manipulation of reachable states together with the cost of reaching them....

Air Cargo Development in the Regional Airports of the Baltic Sea Region Through Road Feeder Services

Directory of Open Access Journals (Sweden)

Beifert Anatoli

2015-06-01

Full Text Available As issued in the Competition Policy Brief on the new state aid rules for a competitive aviation industry by the Competition Directorate-General of the European Commission in February 20141, it will be more difficult for unprofitable airports, to obtain financial public subsidies on EU, national or regional level. Although the positive impact of small airports on the regional development and general accessibility was mentioned, still the operating aid to the airports shall be cut out over a maximum of 10 years. It has been further stated that the vast majority of small and regional airports experience problems to cover their running operative costs, as a result from an intensive market competition and overlapping of airports’ catchment areas preventing even some promising airports from growth. Public subsidies are mostly used by the airport management for infrastructural investments, to cover operating losses or to attract price-sensitive airlines. Herewith, among other things, the EU Commission is pointing out at the lack of cooperation structures and network strategies among the regional airports and at rather isolated and individual approach during elaboration of the airport development scenarios. However, the Competition Policy Brief permits public aid to regional airports, among other things if there is sufficient transports need to establish transition periods for small airports; the need for more flexibility of the regional airports in the remote areas has been underlined. The EU Commission is expecting herewith not to close the regional airports, but to stimulate them to operate on cost efficient and profitable basis, and that only the most inefficient airports will be closed.

Managing female urinary incontinence: A regional prospective analysis of cost-utility ratios (curs and effectiveness

Directory of Open Access Journals (Sweden)

Elisabetta Costantini

2014-06-01

Full Text Available Introduction: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. Materials and methods: A prospective cohort study of women who were consecutively referred by general practitioners (GPs to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy for stress and/or urgency incontinence by examining costs and quality-adjusted life years. Results: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81 were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS; Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. Conclusions: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.

Regional or general anesthesia for fast-track hip and knee replacement - what is the evidence?

DEFF Research Database (Denmark)

Kehlet, Henrik; Aasvang, Eske Kvanner

2015-01-01

Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding...... and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non......-randomized epidemiological database cohort studies. In contrast, the data from newer randomized trials are conflicting, and recent studies using modern general anesthetic techniques may potentially support the use of general versus spinal anesthesia. In summary, the lack of properly designed large randomized controlled...

THE COST OF CREDIBILITY: THE COMPANY OF GENERAL FARMS AND FISCAL STAGNATION IN EIGHTEENTH-CENTURY FRANCE

Directory of Open Access Journals (Sweden)

Noel D. Johnson

2006-01-01

Full Text Available The Company of General Farms, a quasi-private collector of about half the French taxes in the eighteenth century, was one of the largest lenders to the Crown. The relationship between the Crown and General Farms fits the model of sovereign debt as a contingent claim. Lending is sustained in contingent claims models if the lender credibly commits to withhold funds from the sovereign if he defaults. The General Farms maintained this commitment with amonopsony of the Crown's access to taxes and borrowed funds. When revolution threatened, the monopsony stood between the Crown and reform of the fiscal system. The history of the Company of General Farms shows how a contingent claims equilibrium can raise the cost of legitimate reform.

Stratospheric Ozone Distribution and Tropospheric General Circulation: Interconnections in the UTLS Region

Science.gov (United States)

Barodka, S.; Krasovsky, A.; Shalamyansky, A.

2014-12-01

The height of the tropopause, which divided the stratosphere and the troposphere, is a result of two rival categories of processes: the tropospheric vertical convection and the radiative heating of the stratosphere resulting from the ozone cycle. Hence, it is natural that tropospheric and stratospheric phenomena can have effect each other in manifold processes of stratosphere-troposphere interactions. In the present study we focus our attention to the "top-down" side of the interaction: the impact of stratospheric ozone distribution on the features of tropospheric circulation and the associated weather patterns and regional climate conditions. We proceed from analyzes of the observational data performed at the A.I. Voeikov Main Geophysical Observatory, which suggest a distinct correlation between stratospheric ozone distribution, synoptic formations and air-masses boundaries in the upper troposphere and the temperature field of the lower stratosphere [1]. Furthermore, we analyze local features of atmospheric general circulation and stratospheric ozone distribution from the atmospheric reanalyses and general circulation model data, focusing our attention to instantaneous positions of subtropical and polar stationary atmospheric fronts, which define regional characteristics of the general circulation cells in the troposphere and separate global tropospheric air-masses, correspond to distinct meteorological regimes in the TOC field [2, 3]. We assume that by altering the tropopause height, stratospheric ozone-related processes can have an impact on the location of the stationary atmospheric fronts, thereby exerting influence on circulation processes in troposphere and lower stratosphere. For midlatitudes, the tropopause height controls the position of the polar stationary front, which has a direct impact on the trajectory of motion of active vortices on synoptic tropospheric levels, thereby controlling weather patterns in that region and the regional climate. This

PRODUCTION COSTS AND PROFITABILITY OF ‘NIAGARA ROSADA’ TABLE GRAPE GROWN IN DIFFERENT REGIONS OF SÃO PAULO STATE

Directory of Open Access Journals (Sweden)

FERNANDO PEREZ CAPPELLO

2017-10-01

Full Text Available ABSTRACT Niagara Rosada is the main cultivar of table grapes produced in São Paulo state. Its production is concentrated mainly in the regions of Campinas, Itapetininga and Jales, where it is grown under different production systems. The aim of this study was to analyze the economic viability of cv. Niagara Rosada at main regions producers of São Paulo State. Therefore, case studies were made with grape growers for each region to assess the production cost and calculate profitability. In the Campinas region, for two cycles per year, the main crop and the second crop were evaluated, and the Total Cost (TC obtained was US$ 0.81/Kg, with US$ 0.23/Kg of Total Net Revenue (TNR. Considering only the main crop, the decrease of grape production increased the production cost and reduced profitability, the TC reached was US$ 0.93/Kg and TNR US$ 0.08/Kg. In the Itapetininga region, for two cycles per year, in main crop the TC was US$ 0.68/Kg and the TNR was US$ 0.32/Kg. Meanwhile, in the second crop, the lower productivity increased TC to US$ 1.05/Kg, but the higher price caused a TNR of US$ 0.38/Kg. In the Jales region, only one cycle per year, TC was increased to US$ 1.21/Kg, however, the high selling prices in the off-season in São Paulo State resulted in TNR of US$ 0.43/Kg. According to the results, the production of cv. Niagara Rosada in different regions of São Paulo State is profitable and has a positive return for family agriculture. Nevertheless, each region has its own characteristics in terms of production and commercialization of table grapes.

Nuclear power costs in the build, operate, transfer approach

International Nuclear Information System (INIS)

Aybers, M.N.; Sahin, B.

1990-01-01

The costs of nuclear power are discussed with special reference to the economic problems faced by developing countries, and the relative merit of a new accounting approach, viz., the build, operate, transfer contract model, which was proposed in Turkey for the Akkuyu nuclear power project, is illustrated. In this context, the general methodology of calculating nuclear power costs is summarized and a capital cost analysis for a 986 MW pressurized water reactor plant is given in terms of constant monetary units for the above contract model and the turnkey contract model. Adjustment of the costs taking into account regional conditions such as inflation and higher interest rates is also indicated. (orig.) [de

Regional cost-effectiveness in transboundary water quality management for the Baltic Sea

DEFF Research Database (Denmark)

Hasler, Berit; Smart, James Christopher Rudd; Fonnesbech-Wulff, Anders

In 2007 HELCOM launched a plan for transboundary management of the Baltic Sea. This plan, called the Baltic Sea Action Plan (BSAP), aims amongst other things, to reduce eutrophication in the different regions of the Baltic Sea by reducing incoming nutrient loads from all discharging drainage basins...... difficult to achieve, and that additional abatement measures are likely to be required to fulfil these targets. The minimised total cost of delivering the achievable load reductions across the 9 Baltic littoral countries is estimated to be 4.69 billion Euros, annually, with substantial differences...

Regional-employment impact of rapidly escalating energy costs. [Riverside-San Bernardino SMSA

Energy Technology Data Exchange (ETDEWEB)

Kolk, D X

1983-04-01

This paper presents a methodology for incorporating price-induced technological substitution into a regional input-output forecasting model. The model was used to determine the employment impacts of rapidly escalating energy costs on the Riverside-San Bernardino (California) SMSA. The results indicate that the substitution effect between energy and other goods was dominated by the income effect. A reallocation of consumer expenditures from labor-intensive to energy-intensive goods occurred, resulting in a two- to threefold increase in the unemployment rate among low-skilled individuals. 18 references, 5 tables.

Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region.

Science.gov (United States)

Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B; Dusetzina, Stacie B

This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12-14 visits. . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Sulfur Emissions, Abatement Technologies and Related Costs for Europe in the RAINS Model Database

OpenAIRE

Cofala, J.; Syri, S.

1998-01-01

This paper describes the part of the Regional Pollution Information and Simulation (RAINS) model dealing with the potential and costs controlling emissions of sulfur dioxide. The paper describes the selected aggregation level of the emission generating activities and reviews the major options for controlling SO2 emissions. An algorithm for estimating emission control costs is presented. The cost calculation distinguishes 'general'(i.e., valid for all countries) and 'country-specific' paramete...

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens.

Science.gov (United States)

Phillips, Victoria L; Byrd, Anwar L; Adeel, Saira; Peng, Limin; Smiley, Dawn D; Umpierrez, Guillermo E

2017-01-01

The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect on costs is unknown. We conducted a post hoc analysis of the RABBIT Surgery trial to examine whether total inpatient costs per day for general surgery patients with T2DM treated with BBI ( n  = 103) differed from those for patients with T2DM treated with SSI ( n  = 99) regimens. Data were collected from patient clinical and hospital billing records. Charges were adjusted to reflect hospital costs. General linearized models were used to estimate the risk-adjusted effects of BBI versus SSI treatment on average total inpatient costs per day. Risk-adjusted average total inpatient costs per day were $US5404. Treatment with BBI compared with SSI reduced average total inpatient costs per day by $US751 (14%; 95% confidence interval [CI] 20-4). Being treated in a university medical centre, being African American or having a bowel procedure or higher-volume pharmacy use significantly reduced costs per day. In general surgery patients with T2DM, a BBI regimen significantly reduced average total hospital costs per day compared with an SSI regimen. BBI has been shown to improve outcomes in a randomized controlled trial. Those results, combined with our findings regarding savings, suggest that hospitals should consider adopting BBI regimens in patients with T2DM undergoing surgery.

Developing a closed-form cost expression for an (R,s,nQ) policy where the demand process is compound generalized Erlang

DEFF Research Database (Denmark)

Larsen, Christian; Kiesmüller, Gudrun P.

We derive a closed-form cost expression for an (R,s,nQ) inventory control policy where all replenishment orders have a constant lead-time, unfilled demand is backlogged and inter-arrival times of order requests are generalized Erlang distributed.......We derive a closed-form cost expression for an (R,s,nQ) inventory control policy where all replenishment orders have a constant lead-time, unfilled demand is backlogged and inter-arrival times of order requests are generalized Erlang distributed....

Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

Science.gov (United States)

Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

2009-01-01

Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

Determination of chest x-ray cost using activity based costing approach at Penang General Hospital, Malaysia.

Science.gov (United States)

Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Saleem, Fahad; Ahmad, Nafees

2012-01-01

Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure. Human resource cost was calculated by multiplying the mean time spent by employees doing specific activity to their per-minute salaries. The costs of consumables and clinical equipments were obtained from the procurement section of the Radiology Department. The cost of the building was calculated by multiplying the area of space used by the chest X-ray facility with the unit cost of public building department. Moreover, straight-line deprecation with a discount rate of 3% was assumed for calculation of equivalent annual costs for building and machines. Cost of electricity was calculated by multiplying number of kilo watts used by electrical appliance in the year 2010 with electricity tariff for Malaysian commercial consumers (MYR 0.31 per kWh). Five activities were identified which were required to develop one chest X-ray film. Human resource, capital, consumable and electricity cost was MYR 1.48, MYR 1.98, MYR 2.15 and MYR 0.04, respectively. Total cost of single chest X-ray was MYR 5.65 (USD 1.75). By applying ABC approach, we can have more detailed and precise estimate of cost for specific activity or service. Choice of repeating a chest X-ray can be based on our findings, when cost is a limiting factor.

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali.

Science.gov (United States)

Maccario, Roberta; Rouhani, Saba; Drake, Tom; Nagy, Annie; Bamadio, Modibo; Diarra, Seybou; Djanken, Souleymane; Roschnik, Natalie; Clarke, Siân E; Sacko, Moussa; Brooker, Simon; Thuilliez, Josselin

2017-06-12

The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali

Directory of Open Access Journals (Sweden)

Roberta Maccario

2017-06-01

Full Text Available Abstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN, and Intermittent Parasite Clearance in schools (IPCs in southern Mali. Methods Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children. A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. Results The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41 with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%, $5.53 (53.3% and $2.72 (26.2% per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. Conclusions A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

Evaluation of proposed casemix criteria as a basis for costing patients in the adult general intensive care unit.

Science.gov (United States)

Stevens, V G; Hibbert, C L; Edbrooke, D L

1998-10-01

This study analyses the relationship between the actual patient-related costs of care calculated for 145 patients admitted sequentially to an adult general intensive care unit and a number of factors obtained from a previously described consensus of opinion study. The factors identified in the study were suggested as potential descriptors for the casemix in an intensive care unit that could be used to predict the costs of care. Significant correlations between the costs of care and severity of illness, workload and length of stay were found but these failed to predict the costs of care with sufficient accuracy to be used in isolation to define isoresource groups in the intensive care unit. No associations between intensive care unit mortality, reason for admission and intensive and unit treatments and costs of care were found. Based on these results, it seems that casemix descriptors and isoresource groups for the intensive care unit that would allow costs to be predicted cannot be defined in terms of single factors.

Water quality management and climate change mitigation: cost-effectiveness of joint implementation in the Baltic Sea region

DEFF Research Database (Denmark)

Nainggolan, Doan; Hasler, Berit; Andersen, Hans Estrup

2018-01-01

of contrasting strategies: single environmental objective management versus joint implementation strategy. The results show that implementing land-based measures with a sole focus on water quality (to meet the HELCOM's 2013 Baltic Sea Action Plan nutrient abatement targets) can produce climate change mitigation......This paper explores the scope for simultaneously managing nutrient abatement and climate change mitigation in the Baltic Sea (BS) region through the implementation of a selection of measures. The analysis is undertaken using a cost-minimisation model for the entire BS region, the BALTCOST model....... In the present research, the model has been extended to include greenhouse gas (GHG) emissions effects, enabling us to analyse the tradeoffs between cost-effective GHG and nutrient load reductions. We run the model for four different scenarios in order to compare the environmental and economic consequences...

A general approach to total repair cost limit replacement policies

Directory of Open Access Journals (Sweden)

F. Beichelt

2014-01-01

Full Text Available A common replacement policy for technical systems consists in replacing a system by a new one after its economic lifetime, i.e. at that moment when its long-run maintenance cost rate is minimal. However, the strict application of the economic lifetime does not take into account the individual deviations of maintenance cost rates of single systems from the average cost development. Hence, Beichet proposed the total repair cost limit replacement policy: the system is replaced by a new one as soon as its total repair cost reaches or exceeds a given level. He modelled the repair cost development by functions of the Wiener process with drift. Here the same policy is considered under the assumption that the one-dimensional probability distribution of the process describing the repair cost development is given. In the examples analysed, applying the total repair cost limit replacement policy instead of the economic life-time leads to cost savings of between 4% and 30%. Finally, it is illustrated how to include the reliability aspect into the policy.

A minisum model with forbidden regions for locating a semi-desirable facility in the plane

DEFF Research Database (Denmark)

Brimberg, Jack; Juel, Henrik

-desirable facility which accounts for the service costs by a standard minisum objective with arbitrary travel distance function. The social costs are imputed by specifying around each demand point or population center a convex forbidden region, also defined by an arbitrary distance metric, in which the new facility...... may not be located. A general solution algorithm is suggested, and the methodology applied to circular forbidden regions and special travel distance functions....

Manufacturing cost analysis of a parabolic dish concentrator (General Electric design) for solar thermal electric power systems in selected production volumes

Science.gov (United States)

1981-01-01

The manufacturing cost of a General Electric 12 meter diameter concentrator was estimated. This parabolic dish concentrator for solar thermal system was costed in annual production volumes of 100 - 1,000 - 5,000 - 10,000 - 50,000 100,000 - 400,000 and 1,000,000 units. Presented for each volume are the costs of direct labor, material, burden, tooling, capital equipment and buildings. Also presented is the direct labor personnel and factory space requirements. All costs are based on early 1981 economics.

An Analysis of the Romanian General Accounting Plan. Opportunities for Adaptation to the Activity-Based Costing (ABC Method

Directory of Open Access Journals (Sweden)

Irina-Alina Preda

2008-11-01

Full Text Available In this article, we analyze the causes that have led to the improvement of the Romanian general accounting plan according to the Activity- Based Costing (ABC method. We explain the advantages presented by the dissociated organization of management accounting, in contrast with the tabular- statistical form. The article also describes the methodological steps to be taken in the process of recording book entries, according to the Activity-Based Costing (ABC method in Romania.

Social incidence and economic costs of carbon limits; A computable general equilibrium analysis for Switzerland

Energy Technology Data Exchange (ETDEWEB)

Stephan, G.; Van Nieuwkoop, R.; Wiedmer, T. (Institute for Applied Microeconomics, Univ. of Bern (Switzerland))

1992-01-01

Both distributional and allocational effects of limiting carbon dioxide emissions in a small and open economy are discussed. It starts from the assumption that Switzerland attempts to stabilize its greenhouse gas emissions over the next 25 years, and evaluates costs and benefits of the respective reduction programme. From a methodological viewpoint, it is illustrated how a computable general equilibrium approach can be adopted for identifying economic effects of cutting greenhouse gas emissions on the national level. From a political economy point of view it considers the social incidence of a greenhouse policy. It shows in particular that public acceptance can be increased and economic costs of greenhouse policies can be reduced, if carbon taxes are accompanied by revenue redistribution. 8 tabs., 1 app., 17 refs.

The first nationwide evaluation of robotic general surgery: a regionalized, small but safe start.

Science.gov (United States)

Wormer, Blair A; Dacey, Kristian T; Williams, Kristopher B; Bradley, Joel F; Walters, Amanda L; Augenstein, Vedra A; Stefanidis, Dimitrios; Heniford, B Todd

2014-03-01

The purpose of this study was to evaluate the outcomes of the most commonly performed robotic-assisted general surgery (RAGS) procedures in a nationwide database and compare them with their laparoscopic counterparts. The Nationwide Inpatient Sample was queried from October 2008 to December 2010 for patients undergoing elective, abdominal RAGS procedures. The two most common, robotic-assisted fundoplication (RF) and gastroenterostomy without gastrectomy (RG), were individually compared with the laparoscopic counterparts (LF and LG, respectively). During the study, 297,335 patients underwent abdominal general surgery procedures, in which 1,809 (0.6 %) utilized robotic-assistance. From 2009 to 2010, the incidence of RAGS nearly doubled from 573 to 1128 cases. The top five RAGS procedures by frequency were LG, LF, laparoscopic lysis of adhesions, other anterior resection of rectum, and laparoscopic sigmoidectomy. Eight of the top ten RAGS were colorectal or foregut operations. RG was performed in 282 patients (0.9 %) and LG in 29,677 patients (99.1 %). When comparing RG with LG there was no difference in age, gender, race, Charlson comorbidity index (CCI), postoperative complications, or mortality; however, length of stay (LOS) was longer in RG (2.5 ± 2.4 vs. 2.2 ± 1.5 days; p < 0.0001). Total cost for RG was substantially higher ($60,837 ± 28,887 vs. $42,743 ± 23,366; p < 0.0001), and more often performed at teaching hospitals (87.2 vs. 50.9 %; p < 0.0001) in urban areas (100 vs. 93.0 %; p < 0.0001). RF was performed in 272 patients (3.5 %) and LF in 7,484 patients (96.5 %). RF patients were more often male compared with LF (38.2 vs. 32.3 %; p < 0.05); however, there was no difference in age, race, CCI, LOS, or postoperative complications. RF was more expensive than LF ($37,638 ± 21,134 vs. $32,947 ± 24,052; p < 0.0001), and more often performed at teaching hospitals (72.4 vs. 54.9 %; p < 0.0001) in urban areas (98.5 vs. 88.7 %; p < 0.0001). This nationwide

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

Science.gov (United States)

Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

2013-01-01

With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (Phospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.

Costs and indices for domestic oil and gas field equipment and production operations, 1992--1995

International Nuclear Information System (INIS)

1996-08-01

This report presents estimated costs and cost indices for domestic oil and natural gas field equipment and production operations for 1992, 1993, 1994, and 1995. The costs of all equipment and services are those in effect during June of each year. The sum (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measured do not capture changes in industry-wide costs exactly because of annual variations in the ratio of the total number of oil wells to the total number of gas wells. The detail provided in this report is unavailable elsewhere. The body of this report contains summary tables, and the appendices contain detailed tables

A minisum model with forbidden regions for locating a semi-desirable facility in the plane

DEFF Research Database (Denmark)

Juel, Henrik; Brimberg, Jack

1998-01-01

-desirable facility that accounts for the service costs by a standard minisum objective with arbitrary travel distance function. The social costs are imputed by specifying around each demand point or population center a convex forbidden region, also defined by an arbitrary distance metric, in which the new facility...... may not be located. A general solution algorithm is suggested, and the methodology is applied to circular forbidden regions and special travel distance functions....

Physical activity coaching by Australian Exercise Physiologists is cost effective for patients referred from general practice.

Science.gov (United States)

Ewald, Ben; Stacey, Fiona; Johnson, Natalie; Plotnikoff, Ronald C; Holliday, Elizabeth; Brown, Wendy; James, Erica L

2018-02-01

Interventions to promote physical activity for sedentary patients seen in general practice may be a way to reduce the burden of chronic disease. Coaching by an exercise physiologist is publicly funded in Australia, but cost effectiveness has not been documented. In a three-arm randomised controlled trial, face-to-face coaching and telephone coaching over 12 weeks were compared with a control group using the outcome of step count for one week at baseline, three months and twelve months. Program costs and time-based costs were considered. Quality of life was measured as a secondary outcome. At 12 months, the intervention groups were more active than controls by 1,002 steps per day (95%CI 244, 1,759). This was achieved at a cost of AUD$245 per person. There was no change in reported quality of life or utility values. Coaching achieved a modest increase in activity equivalent to 10 minutes walking per day, at a cost of AUD$245 per person. Face-to-face and telephone counselling were both effective. Implication for public health: Persistence of increases nine months after the end of coaching suggests it creates long-term change and is a good value health intervention. © 2017 The Authors.

Marginal abatement cost curves in general equilibrium: The influence of world energy prices

International Nuclear Information System (INIS)

Klepper, Gernot; Peterson, Sonja

2006-01-01

Marginal abatement cost curves (MACCs) are a favorite instrument to analyze international emissions trading. This paper focuses on the question of how to define MACCs in a general equilibrium context where the global abatement level influences energy prices and in turn national MACCs. We discuss the mechanisms theoretically and then use the CGE model DART for quantitative simulations. The result is, that changes in energy prices resulting from different global abatement levels do indeed affect national MACCs. Also, we compare different possibilities of defining MACCs-of which some are robust against changes in energy prices while others vary considerably. (author)

Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures.

Science.gov (United States)

Burnett, Heather F; Lambley, Rosemary; West, Stephanie K; Ungar, Wendy J; Mireskandari, Kamiar

2015-11-01

The inability of some children to tolerate detailed eye examinations often necessitates general anaesthesia (GA). The objective was to assess the incremental cost effectiveness of paediatric eye examinations carried out in an outpatient sedation unit compared with GA. An episode of care cost-effectiveness analysis was conducted from a societal perspective. Model inputs were based on a retrospective cross-over cohort of Canadian children aged Costs ($CAN), adverse events and number of successful procedures were modelled in a decision analysis with one-way and probabilistic sensitivity analysis. The mean cost per patient was $406 (95% CI $401 to $411) for EUS and $1135 (95% CI $1125 to $1145) for EUA. The mean number of successful procedures per patient was 1.39 (95% CI 1.34 to 1.42) for EUS and 2.06 (95% CI 2.02 to 2.11) for EUA. EUA was $729 more costly on average than EUS (95% CI $719 to $738) but resulted in an additional 0.68 successful procedures per child. The result was robust to varying the cost assumptions. Cross-over designs offer a powerful way to assess costs and effectiveness of two interventions because patients serve as their own control. This study demonstrated significant savings when ophthalmological exams were carried out in a hospital outpatient clinic, although with slightly fewer procedures completed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service.

LENUS (Irish Health Repository)

Ahmed, M

2012-01-01

Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs.

The generalized model of organization and planning of regional gas supply monitoring

Directory of Open Access Journals (Sweden)

Maria V. Shevchenko

2015-12-01

Full Text Available At the moment, gas is one of the most promising types of fuel in Ukraine. In this regard, the problems associated with its transportation in the regional system of gas supply are relevant. Now it is not completely solved and needs detailed study the problem of monitoring the regional gas supply system. Aim: The aim of the study is to improve the efficiency of the regional gas supply system at the expense of the organization and planning of gas transport monitoring and, in the future, the synthesis of the monitoring system of regional gas supply. Materials and Methods: The generalized model of organization and planning of monitoring regional gas suppliers were developed to achieve this goal. It allows making decisions on the organization of the monitoring system. In addition, this model makes it possible to plan under conditions of multicriteriality and uncertainty of the source data. Results: The basic criteria and constraints for solving the problem of organizing and planning the monitoring system of regional gas supply are proposed in this work. The corresponding computations were made to confirm the assumptions. The calculations were carried out in context of uncertainty of input data using a set of methods for the analysis of hierarchies, exhaustive search, as well as the methods of decision making in context of uncertainty.

Hospital Costs of Foreign Non-Resident Patients: A Comparative Analysis in Catalonia, Spain.

Science.gov (United States)

Arroyo-Borrell, Elena; Renart-Vicens, Gemma; Saez, Marc; Carreras, Marc

2017-09-14

Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15-24 and 35-44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs.

Performing an Environmental Tax Reform in a regional Economy. A Computable General Equilibrium

NARCIS (Netherlands)

Andre, F.J.; Cardenete, M.A.; Velazquez, E.

2003-01-01

We use a Computable General Equilibrium model to simulate the effects of an Environmental Tax Reform in a regional economy (Andalusia, Spain).The reform involves imposing a tax on CO2 or SO2 emissions and reducing either the Income Tax or the payroll tax of employers to Social Security, and

Matching comprehensive health insurance reimbursements to their real costs: the case of antenatal care visits in a region of Peru.

Science.gov (United States)

Cobos Muñoz, Daniel; Hansen, Kristian Schultz; Terris-Prestholt, Fern; Cianci, Fiona; Pérez-Lu, José Enrique; Lama, Aldo; García, Patricia J

2015-01-01

Prepaid contributory systems are increasingly being recognized as key mechanisms in achieving universal health coverage in low and middle-income countries. Peru created the Seguro Integral de Salud (SIS) to increase health service use amongst the poor by removing financial barriers. The SIS transfers funds on a fee-for-service basis to the regional health offices to cover recurrent cost (excluding salaries) of pre-specified packages of interventions. We aim to estimate the full cost of antenatal care (ANC) provision in the Ventanilla District (Callao-Peru) and to compare the actual cost to the reimbursement rates provided by SIS. The economic costs of ANC provision in 2011 in 8 of the 15 health centres in Ventanilla District were estimated from a provider perspective and the actual costs of those services covered by the SIS fee of $3.8 for each ANC visit were calculated. A combination of step-down and bottom-up costing methodologies was used. Sensitivity analysis was conducted to test the uncertainty around estimated parameters and model assumptions. Results are reported in 2011 US$. The total economic cost of ANC provision in all 8 health centres was $569,933 with an average cost per ANC visit of $31.3 (95 % CI $29.7-$33.5). Salaries comprised 74.4 % of the total cost. The average cost of the services covered by the SIS fee was $3.4 (95 % CI $3.0-$3.8) per ANC visit. Sensitivity analysis showed that the probability of the cost of an ANC visit being above the SIS reimbursed fee is 1.4 %. Our analysis suggests that the fee reimbursed by the SIS will cover the cost that it supposed to cover. However, there are significant threats to medium and longer term sustainability of this system as fee transfers represent a small fraction of the total cost of providing ANC. Increasing ANC coverage requires the other funding sources of the Regional Health Office (DIRESA) to adapt to increasing demand.

Negative royalty in duopoly and definition of license fee: general demand and cost functions

OpenAIRE

Hattori, Masahiko; Tanaka, Yasuhito

2017-01-01

We examine the relationship between the definition of license fee and a possibility of negative royalty in a duopoly with an outside innovator which has an option to enter the market and imposes a combination of a royalty per output and a fixed fee under general demand and cost functions. We consider two scenarios about determination of license fee. One is a scenario which does not assume entry of the innovator, and the other is a scenario which takes a possibility of entry of the innovator i...

The implications of regional and national demographic projections for future GMS costs in Ireland through to 2026.

LENUS (Irish Health Repository)

Conway, Aisling

2014-10-21

As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing. The GMS scheme covers approximately 37% of the Irish population in 2011 and entitles them, inter alia, to free prescription drugs and appliances. This paper projects the effects of future changes in population, coverage, claims rates and average claims cost on GMS costs in Ireland.

Prescription Patterns and the Cost of Migraine Treatments in German General and Neurological Practices.

Science.gov (United States)

Jacob, Louis; Kostev, Karel

2017-07-01

The aim of this study was to analyze prescription patterns and the cost of migraine treatments in general practices (GPs) and neurological practices (NPs) in Germany. This study included 43,149 patients treated in GPs and 13,674 patients treated in NPs who were diagnosed with migraine in 2015. Ten different families of migraine therapy were included in the analysis: triptans, analgesics, anti-emetics, beta-blockers, antivertigo products, gastroprokinetics, anti-epileptics, calcium channel blockers, tricyclic antidepressants, and other medications (all other classes used in the treatment of migraine including homeopathic medications). The share of migraine therapies and their costs were estimated for GPs and NPs. The mean age was 44.4 years in GPs and 44.1 years in NPs. Triptans and analgesics were the 2 most commonly prescribed families of drugs in all patients and in the 9 specific subgroups. Interestingly, triptans were more commonly prescribed in NPs than in GPs (30.9% to 55.0% vs. 30.0% to 44.7%), whereas analgesics were less frequently given in NPs than in GPs (11.5% to 17.2% vs. 35.3% to 42.4%). Finally, the share of patients who received no therapy was higher in NPs than in GPs (33.9% to 58.4% vs. 27.5% to 37.9%). The annual cost per patient was €66.04 in GPs and €94.71 in NPs. Finally, the annual cost per patient increased with age and was higher in women and in individuals with private health insurance coverage than in men and individuals with public health insurance coverage. Triptans and analgesics were the 2 most commonly prescribed drugs for the treatment of migraine. Furthermore, approximately 30% to 40% of patients did not receive any therapy. Finally, the annual cost per patient was higher in NPs than in GPs. © 2016 World Institute of Pain.

Costs and indices for domestic oil and gas field equipment and production operations 1990 through 1993

Energy Technology Data Exchange (ETDEWEB)

1994-07-08

This report presents estimated costs and indice for domestic oil and gas field equipment and production operations for 1990, 1991, 1992, and 1993. The costs of all equipment and serives were those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of oil wells to gas wells. The body of the report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (costs and lease availability) have significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas production equipment and operations.

Costs and indices for domestic oil and gas field equipment and production operations 1990 through 1993

International Nuclear Information System (INIS)

1994-01-01

This report presents estimated costs and indice for domestic oil and gas field equipment and production operations for 1990, 1991, 1992, and 1993. The costs of all equipment and serives were those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of oil wells to gas wells. The body of the report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (costs and lease availability) have significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas production equipment and operations

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

Directory of Open Access Journals (Sweden)

Lue-Ping Zhao

Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

7 CFR 249.12 - SFMNP costs.

Science.gov (United States)

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false SFMNP costs. 249.12 Section 249.12 Agriculture....12 SFMNP costs. (a) General. (1) Composition of allowable costs. In general, a cost item will be... administration and operation of the SFMNP. Allowable SFMNP costs may be classified as follows: (i) Food costs and...

Liquefied Natural Gas as an alternative fuel: a regional-level social cost-benefit appraisal

OpenAIRE

Moreira, Paulo Pires; Caetano, Fernando J. P.

2017-01-01

The impact from traditional marine fuels has the potential of causing health and non-health damages and contributes to climate change. Here, the introduction of Liquefied Natural Gas (LNG) as an energy end-use fuel for marine purposes is analysed. The aim of this study is to verify LNG’s policy implementation feasibility as a step-change for a low carbon perspective for shipping by means of developing a social cost-benefit analysis on a regional basis. Emissions from the Portuguese merchant f...

Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

Science.gov (United States)

Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

2018-01-18

Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and  Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases.  Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.

Improving the thermal integrity of new single-family detached residential buildings: Documentation for a regional database of capital costs and space conditioning load savings

International Nuclear Information System (INIS)

Koomey, J.G.; McMahon, J.E.; Wodley, C.

1991-07-01

This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole

Assessment of healthcare measures, healthcare resource use, and cost of care among severe hemophilia A patients in Mumbai region of India.

Science.gov (United States)

Jadhav, U; Mukherjee, K

2017-10-23

In India, the low public health priority given to rare disorders such as hemophilia hinders their management and optimal care, leading to relatively poor health outcomes. This study aims to profile the multidimensional health status of patients with severe hemophilia A, and its association with the use of healthcare resources and the cost of care in Mumbai region of India. A cross-sectional, single-center study was conducted during January-May 2011, among 160 patients diagnosed with severe hemophilia A in Mumbai region of India. Their health status was documented using the Hemophilia Utilization Group Study's validated instrument of Functional Health Status Measure (FHS) and a single item of Self-care Measure. Of 160 patients, 55% (n = 88) scored on the lower side on the FHS, with an average score of 6.65 ± 2.85. The use of healthcare resources and cost of treatment were considerable for patients with a lower mean rank score on the FHS and a higher mean rank score on the self-care measure. The consumption of clotting factor concentrates (CFCs), number of visits to a health facility and incidence of inpatient episodes were significantly associated with a relatively low score on the FHS. Similarly, a higher cost of treatment, in terms of the cost of CFCs, direct cost, emergency room cost, and indirect cost, were significantly associated with a lower score on the FHS. The health status of patients with severe hemophilia A is compromised and has a significant impact on the use of healthcare resources and the cost of treatment.

A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

Science.gov (United States)

Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

2016-12-15

How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO 2 ) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10 6 compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases. Copyright �

An analysis of electric utility embedded power supply costs

International Nuclear Information System (INIS)

Kahal, M.; Brown, D.

1998-01-01

There is little doubt that for the vast majority of electric utilities the embedded costs of power supply exceed market prices, giving rise to the stranded cost problem. Beyond that simple generalization, there are a number of crucial questions, which this study attempts to answer. What are the regional patterns of embedded cost differences? To what extent is the cost problem attributable to nuclear power? How does the cost of purchased power compare to the cost of utility self-generation? What is the breakdown of utility embedded generation costs between operating costs - which are potentially avoidable--and ownership costs, which by definition are ''sunk'' and therefore not avoidable? How will embedded generation costs and market prices compare over time? These are the crucial questions for states as they address retail-restructuring proposal. This study presents an analysis of generation costs, which addresses these key questions. A computerized costing model was developed and applied using FERC Form 1 data for 1995. The model analyzed embedded power supply costs (i.e.; self-generation plus purchased power) for two groups of investor-owned utilities, 49 non-nuclear vs. 63 nuclear. These two subsamples represent substantially the entire US investor-owned electric utility industry. For each utility, embedded cost is estimated both at busbar and at meter

[Total knee and hip prosthesis: variables associated with costs].

Science.gov (United States)

Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

2013-01-01

The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. To determine the influence of a number of variables on the costs of total knee and hip arthroplasty surgery during the hospital stay and during the one-year post-discharge. A prospective multi-center study was performed in 15 hospitals from three Spanish regions. Relationships between the independent variables and the costs of hospital stay and postdischarge follow-up were analyzed by using multilevel models in which the "hospital" variable was used to group cases. Independent variables were: age, sex, body mass index, preoperative quality of life (SF-12, EQ-5 and Womac questionnaires), surgery (hip/knee), Charlson Index, general and local complications, number of beds and economic-institutional dependency of the hospital, the autonomous region to which it belongs, and the presence of a caregiver. The cost of hospital stay, excluding the cost of the prosthesis, was 4,734 Euros, and the post-discharge cost was 554 Euros. With regard to hospital stay costs, the variance among hospitals explained 44-46% of the total variance among the patients. With regard to the post-discharge costs, the variability among hospitals explained 7-9% of the variance among the patients. There is considerable potential for reducing the hospital stay costs of these patients, given that more than 44% of the observed variability was not determined by the clinical conditions of the patients but rather by the behavior of the hospitals.

A General Method to Estimate Earthquake Moment and Magnitude using Regional Phase Amplitudes

Energy Technology Data Exchange (ETDEWEB)

Pasyanos, M E

2009-11-19

This paper presents a general method of estimating earthquake magnitude using regional phase amplitudes, called regional M{sub o} or regional M{sub w}. Conceptually, this method uses an earthquake source model along with an attenuation model and geometrical spreading which accounts for the propagation to utilize regional phase amplitudes of any phase and frequency. Amplitudes are corrected to yield a source term from which one can estimate the seismic moment. Moment magnitudes can then be reliably determined with sets of observed phase amplitudes rather than predetermined ones, and afterwards averaged to robustly determine this parameter. We first examine in detail several events to demonstrate the methodology. We then look at various ensembles of phases and frequencies, and compare results to existing regional methods. We find regional M{sub o} to be a stable estimator of earthquake size that has several advantages over other methods. Because of its versatility, it is applicable to many more events, particularly smaller events. We make moment estimates for earthquakes ranging from magnitude 2 to as large as 7. Even with diverse input amplitude sources, we find magnitude estimates to be more robust than typical magnitudes and existing regional methods and might be tuned further to improve upon them. The method yields a more meaningful quantity of seismic moment, which can be recast as M{sub w}. Lastly, it is applied here to the Middle East region using an existing calibration model, but it would be easy to transport to any region with suitable attenuation calibration.

Empathic concern drives costly altruism

Science.gov (United States)

FeldmanHall, Oriel; Dalgleish, Tim; Evans, Davy; Mobbs, Dean

2015-01-01

Why do we self-sacrifice to help others in distress? Two competing theories have emerged, one suggesting that prosocial behavior is primarily motivated by feelings of empathic other-oriented concern, the other that we help mainly because we are egoistically focused on reducing our own discomfort. Here we explore the relationship between costly altruism and these two sub-processes of empathy, specifically drawing on the caregiving model to test the theory that trait empathic concern (e.g. general tendency to have sympathy for another) and trait personal distress (e.g. predisposition to experiencing aversive arousal states) may differentially drive altruistic behavior. We find that trait empathic concern – and not trait personal distress – motivates costly altruism, and this relationship is supported by activity in the ventral tegmental area, caudate and subgenual anterior cingulate, key regions for promoting social attachment and caregiving. Together, this data helps identify the behavioral and neural mechanisms motivating costly altruism, while demonstrating that individual differences in empathic concern-related brain responses can predict real prosocial choice. PMID:25462694

Costs of employee turnover

Directory of Open Access Journals (Sweden)

Jiří Duda

2013-01-01

Full Text Available The aim of this paper is to establish a general methodology for calculating the costs incurred by employee turnover. This paper deals with identification of costs incurred by the departure of an employee, and does not deal with the cost of recruitment of a new employee. Economic calculations are adjusted to the tax policy in the Czech Republic. The costs of employee turnover (according to Bliss, 2012 include the costs of substitution of the unoccupied position, costs of conducting the exit interview and termination of the contract. The cost of an executive’s time to understand the causes of leaving and costs of the leaving employee’s training were also determined. Important factors in the costs of employee turnover also include the loss of knowledge and possibly also a loss of customers. Costs of lost employee and department productiveness represent an important part of the costs of employee turnover, as well. For all of these costs there have been proposed general calculations formulas.

Governance, corruption, and trade in the Asia Pacific region

OpenAIRE

Abe, Kazutomo; Wilson, John S.

2008-01-01

This paper examines the impact of reducing corruption and improving transparency to lower trade costs in the Asia Pacific Economic Cooperation region. The authors find, based on a computable general equilibrium model, significant potential trade and welfare gains for Asia Pacific Economic Cooperation members, with increased transparency and lower levels of corruption. Results suggest that ...

Regional Marginal Abatement Cost Curves for NOx

Data.gov (United States)

U.S. Environmental Protection Agency — Data underlying the figures included in the manuscript "Marginal abatement cost curve for NOx incorporating controls, renewable electricity, energy efficiency and...

Metabolic Compensation of Fitness Costs Is a General Outcome for Antibiotic-Resistant Pseudomonas aeruginosa Mutants Overexpressing Efflux Pumps.

Science.gov (United States)

Olivares Pacheco, Jorge; Alvarez-Ortega, Carolina; Alcalde Rico, Manuel; Martínez, José Luis

2017-07-25

It is generally assumed that the acquisition of antibiotic resistance is associated with a fitness cost. We have shown that overexpression of the MexEF-OprN efflux pump does not decrease the fitness of a resistant Pseudomonas aeruginosa strain compared to its wild-type counterpart. This lack of fitness cost was associated with a metabolic rewiring that includes increased expression of the anaerobic nitrate respiratory chain when cells are growing under fully aerobic conditions. It was not clear whether this metabolic compensation was exclusive to strains overexpressing MexEF-OprN or if it extended to other resistant strains that overexpress similar systems. To answer this question, we studied a set of P. aeruginosa mutants that independently overexpress the MexAB-OprM, MexCD-OprJ, or MexXY efflux pumps. We observed increased expression of the anaerobic nitrate respiratory chain in all cases, with a concomitant increase in NO 3 consumption and NO production. These efflux pumps are proton/substrate antiporters, and their overexpression may lead to intracellular H + accumulation, which may in turn offset the pH homeostasis. Indeed, all studied mutants showed a decrease in intracellular pH under anaerobic conditions. The fastest way to eliminate the excess of protons is by increasing oxygen consumption, a feature also displayed by all analyzed mutants. Taken together, our results support metabolic rewiring as a general mechanism to avoid the fitness costs derived from overexpression of P. aeruginosa multidrug efflux pumps. The development of drugs that block this metabolic "reaccommodation" might help in reducing the persistence and spread of antibiotic resistance elements among bacterial populations. IMPORTANCE It is widely accepted that the acquisition of resistance confers a fitness cost in such a way that in the absence of antibiotics, resistant populations will be outcompeted by susceptible ones. Based on this assumption, antibiotic cycling regimes have been

Economic efficiency and cost implications of habitat conservation: An example in the context of the Edwards Aquifer region

Science.gov (United States)

Gillig, Dhazn; McCarl, Bruce A.; Jones, Lonnie L.; Boadu, Frederick

2004-04-01

Groundwater management in the Edwards Aquifer in Texas is in the process of moving away from a traditional right of capture economic regime toward a more environmentally sensitive scheme designed to preserve endangered species habitats. This study explores economic and environmental implications of proposed groundwater management and water development strategies under a proposed regional Habitat Conservation Plan. Results show that enhancing the habitat by augmenting water flow costs $109-1427 per acre-foot and that regional water development would be accelerated by the more extreme possibilities under the Habitat Conservation Plan. The findings also indicate that a water market would improve regional welfare and lower water development but worsen environmental attributes.

Internalisation of external cost in the power generation sector: Analysis with Global Multi-regional MARKAL model

International Nuclear Information System (INIS)

Rafaj, Peter; Kypreos, Socrates

2007-01-01

The Global MARKAL-Model (GMM), a multi-regional 'bottom-up' partial equilibrium model of the global energy system with endogenous technological learning, is used to address impacts of internalisation of external costs from power production. This modelling approach imposes additional charges on electricity generation, which reflect the costs of environmental and health damages from local pollutants (SO 2 , NO x ) and climate change, wastes, occupational health, risk of accidents, noise and other burdens. Technologies allowing abatement of pollutants emitted from power plants are rapidly introduced into the energy system, for example, desulphurisation, NO x removal, and CO 2 scrubbers. The modelling results indicate substantial changes in the electricity production system in favour of natural gas combined cycle, nuclear power and renewables induced by internalisation of external costs and also efficiency loss due to the use of scrubbers. Structural changes and fuel switching in the electricity sector result in significant reduction of emissions of both local pollution and CO 2 over the modelled time period. Strong decarbonisation impact of internalising local externalities suggests that ancillary benefits can be expected from policies directly addressing other issues then CO 2 mitigation. Finally, the detailed analysis of the total generation cost of different technologies points out that inclusion of external cost in the price of electricity increases competitiveness of non-fossil generation sources and fossil power plants with emission control

Break-Even Cost for Residential Photovoltaics in the United States: Key Drivers and Sensitivities

Energy Technology Data Exchange (ETDEWEB)

Denholm, P.; Margolis, R. M.; Ong, S.; Roberts, B.

2009-12-01

Grid parity--or break-even cost--for photovoltaic (PV) technology is defined as the point where the cost of PV-generated electricity equals the cost of electricity purchased from the grid. Break-even cost is expressed in $/W of an installed system. Achieving break-even cost is a function of many variables. Consequently, break-even costs vary by location and time for a country, such as the United States, with a diverse set of resources, electricity prices, and other variables. In this report, we analyze PV break-even costs for U.S. residential customers. We evaluate some key drivers of grid parity both regionally and over time. We also examine the impact of moving from flat to time-of-use (TOU) rates, and we evaluate individual components of the break-even cost, including effect of rate structure and various incentives. Finally, we examine how PV markets might evolve on a regional basis considering the sensitivity of the break-even cost to four major drivers: technical performance, financing parameters, electricity prices and rates, and policies. We find that local incentives rather than ?technical? parameters are in general the key drivers of the break-even cost of PV. Additionally, this analysis provides insight about the potential viability of PV markets.

A general approach to regularizing inverse problems with regional data using Slepian wavelets

Science.gov (United States)

Michel, Volker; Simons, Frederik J.

2017-12-01

Slepian functions are orthogonal function systems that live on subdomains (for example, geographical regions on the Earth’s surface, or bandlimited portions of the entire spectrum). They have been firmly established as a useful tool for the synthesis and analysis of localized (concentrated or confined) signals, and for the modeling and inversion of noise-contaminated data that are only regionally available or only of regional interest. In this paper, we consider a general abstract setup for inverse problems represented by a linear and compact operator between Hilbert spaces with a known singular-value decomposition (svd). In practice, such an svd is often only given for the case of a global expansion of the data (e.g. on the whole sphere) but not for regional data distributions. We show that, in either case, Slepian functions (associated to an arbitrarily prescribed region and the given compact operator) can be determined and applied to construct a regularization for the ill-posed regional inverse problem. Moreover, we describe an algorithm for constructing the Slepian basis via an algebraic eigenvalue problem. The obtained Slepian functions can be used to derive an svd for the combination of the regionalizing projection and the compact operator. As a result, standard regularization techniques relying on a known svd become applicable also to those inverse problems where the data are regionally given only. In particular, wavelet-based multiscale techniques can be used. An example for the latter case is elaborated theoretically and tested on two synthetic numerical examples.

Green-E general program and public information support program report, August 1, 1999 - September 30, 2000

Energy Technology Data Exchange (ETDEWEB)

Brown, Kirk

2000-09-30

Green-E Program support from the Dept. of Energy augmented the costs of implementing the objectives of the Green-E Renewable Electricity Project; general program implementation; regional adaptation; developing strategic partnerships; and public information/education/outreach.

Nuclear power regional analysis

International Nuclear Information System (INIS)

Parera, María Delia

2011-01-01

In this study, a regional analysis of the Argentine electricity market was carried out considering the effects of regional cooperation, national and international interconnections; additionally, the possibilities of insertion of new nuclear power plants in different regions were evaluated, indicating the most suitable areas for these facilities to increase the penetration of nuclear energy in national energy matrix. The interconnection of electricity markets and natural gas due to the linkage between both energy forms was also studied. With this purpose, MESSAGE program was used (Model for Energy Supply Strategy Alternatives and their General Environmental Impacts), promoted by the International Atomic Energy Agency (IAEA). This model performs a country-level economic optimization, resulting in the minimum cost for the modelling system. Regionalization executed by the Wholesale Electricity Market Management Company (CAMMESA, by its Spanish acronym) that divides the country into eight regions. The characteristics and the needs of each region, their respective demands and supplies of electricity and natural gas, as well as existing and planned interconnections, consisting of power lines and pipelines were taken into account. According to the results obtained through the model, nuclear is a competitive option. (author) [es

Regional differences of outpatient physician supply as a theoretical economic and empirical generalized linear model.

Science.gov (United States)

Scholz, Stefan; Graf von der Schulenburg, Johann-Matthias; Greiner, Wolfgang

2015-11-17

Regional differences in physician supply can be found in many health care systems, regardless of their organizational and financial structure. A theoretical model is developed for the physicians' decision on office allocation, covering demand-side factors and a consumption time function. To test the propositions following the theoretical model, generalized linear models were estimated to explain differences in 412 German districts. Various factors found in the literature were included to control for physicians' regional preferences. Evidence in favor of the first three propositions of the theoretical model could be found. Specialists show a stronger association to higher populated districts than GPs. Although indicators for regional preferences are significantly correlated with physician density, their coefficients are not as high as population density. If regional disparities should be addressed by political actions, the focus should be to counteract those parameters representing physicians' preferences in over- and undersupplied regions.

Assessing the full costs of water, liquid waste, energy and solid waste infrastructure in the Fraser Valley Regional District (FVRD)

International Nuclear Information System (INIS)

Pollard, D.

2001-01-01

This document presents a newly drafted growth strategy developed by the Fraser Valley Regional District (FVRD) in British Columbia. It guides the sustainable growth, change and development of the region for the next 25 years and deals with air pollution, water quality, traffic congestion, affordable housing, employment, energy use, parks and green space. In particular, this case study develops a method to apply full cost accounting (FCA) to a growth strategy. FCA is the most appropriate way to approach a sustainable strategy because it considers economic, social and environmental issues. The study also includes the development of a software tool consisting of an ACCESS database and an ARCVIEW GIS file for compiling and analyzing detailed infrastructure profiles which can be used to assess the full costs of different growth scenarios. The following four issue categories of environmental and economic indicators of FVRD performance were addressed: solid waste, water and wastewater, energy, and infrastructure costs. Each issue category was then used to establish a set of 5 performance indicators that can be measured and assessed over time. These included solid waste, water consumption, wastewater, energy consumption and air emissions. The database and methodology developed for this project is suitable for other regions. The software can be viewed by contacting the Sheltair Group Resource Consultants Inc. in Vancouver

Cost-effectiveness of trachoma control in seven world regions.

NARCIS (Netherlands)

Baltussen, R.M.P.M.; Sylla, M.; Frick, K.D.; Mariotti, S.P.

2005-01-01

BACKGROUND/AIMS: The fight against blinding trachoma is being addressed with an integrated strategy of surgery, antibiotics, hygiene promotion, and environmental improvement-the SAFE strategy, but its cost-effectiveness is largely unknown. This paper estimates the cost effectiveness of surgery and

Sectoral and regional expansion of emissions trading

Energy Technology Data Exchange (ETDEWEB)

Boehringer, Christoph; Bouwe, Dijkstra; Rosendahl, Knut Einar

2011-07-01

We consider an international emissions trading scheme with partial sectoral and regional coverage. Sectoral and regional expansion of the trading scheme is beneficial in aggregate, but not necessarily for individual countries. We simulate international CO{sub 2} emission quota markets using marginal abatement cost functions and the Copenhagen 2020 climate policy targets for selected countries that strategically allocate emissions in a bid to manipulate the quota price. Quota exporters and importers generally have conflicting interests about admitting more countries to the trading coalition, and our results indicate that some countries may lose substantially when the coalition expands in terms of new countries. For a given coalition, expanding sectoral coverage makes most countries better off, but some countries (notably the USA and Russia) may lose out due to loss of strategic advantages. In general, exporters tend to have stronger strategic power than importers.(Author)

Variation in the costs of delivering routine immunization services in Peru.

Science.gov (United States)

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

Designing a low-cost effective network for monitoring large scale regional seismicity in a soft-soil region (Alsace, France)

Science.gov (United States)

Bès de Berc, M.; Doubre, C.; Wodling, H.; Jund, H.; Hernandez, A.; Blumentritt, H.

2015-12-01

The Seismological Observatory of the North-East of France (ObSNEF) is developing its monitoring network within the framework of several projects. Among these project, RESIF (Réseau sismologique et géodésique français) allows the instrumentation of broad-band seismic stations, separated by 50-100 km. With the recent and future development of geothermal industrial projects in the Alsace region, the ObSNEF is responsible for designing, building and operating a dense regional seismic network in order to detect and localize earthquakes with both a completeness magnitude of 1.5 and no clipping for M6.0. The realization of the project has to be done prior to the summer 2016Several complex technical and financial constraints constitute such a projet. First, most of the Alsace Région (150x150 km2), particularly the whole Upper Rhine Graben, is a soft-soil plain where seismic signals are dominated by a high frequency noise level. Second, all the signals have to be transmitted in near real-time. And finally, the total cost of the project must not exceed $450,000.Regarding the noise level in Alsace, in order to make a reduction of 40 dB for frequencies above 1Hz, we program to instrument into 50m deep well with post-hole sensor for 5 stations out of 8 plane new stations. The 3 remaining would be located on bedrock along the Vosges piedmont. In order to be sensitive to low-magnitude regional events, we plan to install a low-noise short-period post-hole velocimeter. In order to avoid saturation for high potentiel local events (M6.0 at 10km), this velocimeter will be coupled with a surface strong-motion sensor. Regarding the connectivity, these stations will have no wired network, which reduces linking costs and delays. We will therefore use solar panels and a 3G/GPRS network. The infrastructure will be minimal and reduced to an outdoor box on a secured parcel of land. In addition to the data-logger, we will use a 12V ruggedized computer, hosting a seed-link server for near

Regional risk assessment of environmental contamination from oil pipelines

International Nuclear Information System (INIS)

Pelmulder, S.D.; Eguchi, R.T.

1991-01-01

This paper presents a methodology for assessing the risk of environmental contamination from oil pipeline leaks due to earthquakes. Risk is measured both as volume of oil released and remediation cost. The methodology was developed for use on a regional scale and thus relies on a limited amount of input data. Monte Carlo techniques are used to simulate earthquake events, while a deterministic model is used to estimate the volume of oil released at a particular site. A library of cost models is used to estimate the contamination and resulting remediation cost based on the volume of oil released and the general site conditions. This methodology has been implemented in a computer program, OILOSS, and the results are presented as annual frequency of exceedence curves for volume of oil released and cost of remediation

PENETAPAN TARGET TERHADAP STICKINESS COST

Directory of Open Access Journals (Sweden)

Windyastuti Windyastuti

2017-03-01

Full Text Available This study aimed to analyze the influence of manager targeting to the stickiness cost. The research data was amanufacturing company’s financial statements during 1999-2011 published at BEI. The research data includedcost of sales, administration and general, net sales and Price Earnings Ratio (PER. This study used adynamic panel data regression analysis. The results showed that cost of sales, administration and general weresticky. Furthermore, manager targeting caused the stickiness degree of sales, administration and general costlower. Manager targeting changed the manager’s behavior. When the net sales declined, manager reduced theresource use drastically so the cost of sales, administration and general also decreased drastically.

Generalized query-based active learning to identify differentially methylated regions in DNA.

Science.gov (United States)

Haque, Md Muksitul; Holder, Lawrence B; Skinner, Michael K; Cook, Diane J

2013-01-01

Active learning is a supervised learning technique that reduces the number of examples required for building a successful classifier, because it can choose the data it learns from. This technique holds promise for many biological domains in which classified examples are expensive and time-consuming to obtain. Most traditional active learning methods ask very specific queries to the Oracle (e.g., a human expert) to label an unlabeled example. The example may consist of numerous features, many of which are irrelevant. Removing such features will create a shorter query with only relevant features, and it will be easier for the Oracle to answer. We propose a generalized query-based active learning (GQAL) approach that constructs generalized queries based on multiple instances. By constructing appropriately generalized queries, we can achieve higher accuracy compared to traditional active learning methods. We apply our active learning method to find differentially DNA methylated regions (DMRs). DMRs are DNA locations in the genome that are known to be involved in tissue differentiation, epigenetic regulation, and disease. We also apply our method on 13 other data sets and show that our method is better than another popular active learning technique.

The hidden cost of chronic fatigue to patients and their families

Directory of Open Access Journals (Sweden)

Donaldson Ana

2010-03-01

Full Text Available Abstract Background Nearly 1 in 10 in the population experience fatigue of more than six months at any one time. Chronic fatigue is a common reason for consulting a general practitioner, and some patients report their symptoms are not taken seriously enough. A gap in perceptions may occur because doctors underestimate the impact of fatigue on patients' lives. The main aim of the study is to explore the economic impact of chronic fatigue in patients seeking help from general practitioners and to identify characteristics that explain variations in costs. Methods The design of study was a survey of patients presenting to general practitioners with unexplained chronic fatigue. The setting were 29 general practice surgeries located in the London and South Thames regions of the English National Health Service. Use of services over a six month period was measured and lost employment recorded. Regression models were used to identify factors that explained variations in these costs. Results The mean total cost of services and lost employment across the sample of 222 patients was £3878 for the six-month period. Formal services accounted for 13% of this figure, while lost employment accounted for 61% and informal care for 26%. The variation in the total costs was significantly related to factors linked to the severity of the condition and social functioning. Conclusions The economic costs generated by chronic fatigue are high and mostly borne by patients and their families. Enquiry about the functional consequences of fatigue on the social and occupational lives of patients may help doctors understand the impact of fatigue, and make patients feel better understood.

Costs and indices for domestic oil and gas field equipment and production operations 1994 through 1997

International Nuclear Information System (INIS)

1998-03-01

This report presents estimated costs and cost indices for domestic oil and natural gas field equipment and production operations for 1994, 1995, 1996, and 1997. The costs of all equipment and services are those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of the total number of oil wells to the total number of gas wells. The detail provided in this report is unavailable elsewhere. The body of this report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (compliance costs and lease availability) have a significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas equipment and production operations

Body Condition Scores and Evaluation of Feeding Habits of Dogs and Cats at a Low Cost Veterinary Clinic and a General Practice

Directory of Open Access Journals (Sweden)

Stephanie A. Sapowicz

2016-01-01

Full Text Available This study assessed body condition scores (BCS and feeding habits for dogs and cats. Eighty-six cats and 229 dogs (and their owners were enrolled from 2 clinics: a low cost clinic (n=149 and a general practice (n=166. BCS and body weight were recorded. Owners completed a survey which included animal age, sex, and breed; owner demographics; and feeding practices (e.g., diet, rationale for feeding practices. Owners from the low cost clinic had a significantly lower income (P<0.001 and education (P<0.001 compared to those from the general practice. Animals from the low cost clinic were younger (P<0.001 and dogs were less likely to be neutered (P<0.001. Overweight prevalence was 55% overall (P=0.083, with a significantly higher prevalence in the general practice for cats (44% versus 66%; P=0.046, but not for dogs (58% versus 53%; P=0.230. Multivariate analysis showed that only neuter status was significantly associated with BCS (P=0.004. Veterinarians were the most common source of nutritional information, though lack of accurate nutrition knowledge was common among all participants. These findings support the need for enhanced communication about optimal BCS and nutrition regardless of socioeconomic status.

Evaluating economic costs and benefits of climate resilient livelihood strategies

Directory of Open Access Journals (Sweden)

S. Liu

2016-01-01

Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.

Economic Cost Analysis Related to Complications in General and Digestive Surgery.

Science.gov (United States)

Gomez-Rosado, Juan-Carlos; Salas-Turrens, Jose; Olry-de-Labry-Lima, Antonio

2018-04-21

The aim was to assess the impact on economic costs and length of stay (LOS) of postoperative complications. 5,822 records from BMDS (2014-2015) are included. A descriptive, univariate and multivariate study evaluated the correlation between complications, Clavien-Dindo grade and vacation periods with LOS and economic costs, based on a full-cost model, aggregated by DRG. Mean cost per stay was €676.71, and €4,309.02 per episode. Complications appeared in 639 patients (11%). Admission to ICU was required in 203 patients, re-operation in 134 and re-admission in 243, while 66 patients died (1.1%). Complications caused significantly longer LOS (20.08 vs 5.48 days) and higher economic cost (€11,670.31 vs €3,354.12); infectious complications were the most frequent and respiratory the most expensive (€20,428.53), together with ICU admission (€20,242.66). Clavien-Dindo grade correlated with greater LOS and costs (except gradev). During vacation periods, complications and LOS are increased, but costs of these complications and LOS did not differ significantly from complications detected in non-vacation periods. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of different types of anaesthesia (regional vs general) on serum NO and TNF-α levels in surgical patients

International Nuclear Information System (INIS)

Li Hong

2006-01-01

Objective: To study the effect of anesthesia on changes of serum NO and TNF-α levels in surgical patients. Methods: Serum NO (with biochemical method) and TNF-α (with RIA) levels were determined for 3 times in 31 patients operated under regional anesthesia and 31 patients operated under general anesthesia (both for benign gastric ulcer). The levels were measured before induction of anesthesia, at the beginning of operation, and 1 hr later. Results: In patients under regional anesthesia, both the NO and TNF-α levels increased significantly at the beginning of operation and, 1 hr later, though dropped, remained significantly higher than the levels before induction (P<0.05). NO significant changes of the levels were observed in patients under general anesthesia throughout the operation, and the levels were, as a whole, significantly lower than the levels under regional anesthesia (P<0.05). Conclusion: General anesthesia (combined intravenous and inhalation) could abolish the increase of serum NO and TNF-α levels duning operation. (authors)

Low-cost general purpose spectral display unit using an IBM PC

International Nuclear Information System (INIS)

Robinson, S.L.

1985-10-01

Many physics experiments require acquisition and analysis of spectral data. commercial minicomputer-based multichannel analyzers collect detected counts at various energies, create a histogram of the counts in memory, and display the resultant spectra. They acquire data and provide the user-to-display interface. The system discussed separates functions into the three modular components of data acquisition, storage, and display. This decoupling of functions allows the experimenter to use any number of detectors for data collection before forwarding up to 64 spectra to the display unit, thereby increasing data throughput over that available with commercial systems. An IBM PC was chosen for the low-cost, general purpose display unit. Up to four spectra may be displayed simultaneously in different colors. The histogram saves 1024 channels per detector, 640 of which may be distinctly displayed per spectra. The IEEE-488 standard provides the data path between the IBM PC and the data collection unit. Data is sent to the PC under interrupt control, using direct memory access. Display manipulations available via keyboard are also discussed

Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial

NARCIS (Netherlands)

Korthals-de Bos, Ingeborg B. C.; Hoving, Jan L.; van Tulder, Maurits W.; Rutten-van Mölken, Maureen P. M. H.; Adèr, Herman J.; de Vet, Henrica C. W.; Koes, Bart W.; Vondeling, Hindrik; Bouter, Lex M.

2003-01-01

OBJECTIVE: To evaluate the cost effectiveness of physiotherapy, manual therapy, and care by a general practitioner for patients with neck pain. DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Primary care. PARTICIPANTS: 183 patients with neck pain for at least two weeks

Costs of the 'Hartslag Limburg' community heart health intervention

Directory of Open Access Journals (Sweden)

Ruland Erik

2006-03-01

Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very

Regional analysis of the nuclear-electricity; Analisis regional de la nucleoelectricidad

Energy Technology Data Exchange (ETDEWEB)

Parera, M. D., E-mail: dparera@cnea.gov.ar [CNEA, Gerencia de Planificacion, Coordinacion y Control, Subgerencia de Planificacion Estrategica, Av. Gral. Paz 1499, B1650KNA San Martin, Buenos Aires (Argentina)

2011-11-15

In this study was realized a regional analysis of the Argentinean electric market contemplating the effects of regional cooperation, the internal and international interconnections; and the possibilities of insert of new nuclear power stations were evaluated in different regions of the country, indicating the most appropriate areas to carry out these facilities to increase the penetration of the nuclear energy in the national energy matrix. Also was studied the interconnection of the electricity and natural gas markets, due to the existent linking among both energy forms. With this purpose the program Message (Model for energy supply strategy alternatives and their general environmental impacts) was used, promoted by the International Atomic Energy Agency. This model carries out an economic optimization level country, obtaining the minimum cost as a result for the modeling system. The division for regions realized by the Compania Administradora del Mercado Mayorista Electrico (CAMMESA) was used, which divides to the country in eight regions. They were considered the characteristics and necessities of each one of them, their respective demands and offers of electric power and natural gas, as well as their existent and projected interconnections, composed by the electric lines and gas pipes. According to the results obtained through the model, the nuclear-electricity is a competitive option. (Author)

Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

Science.gov (United States)

Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

2014-01-01

Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This

CT-guided percutaneous radiofrequency ablation of hepatic malignancies located in unusual regions under general anesthesia

International Nuclear Information System (INIS)

Pan Jie; Chen Shaohui; Lu Xin; Mao Yilei; Sang Xinting; Chen Fang; Li Yumei; Huang Yuguang; Jin Zhengyu

2010-01-01

Objective: To discuss the feasibility of CT-guided percutaneous radiofrequency ablation (RFA) of liver malignancies located in unusual regions under general anesthesia, and to assess its clinical value. Methods: Eighteen patients with a total of 26 malignant hepatic lesions were enrolled in this study. The lesions were located at diaphragmatic surface, hepatic hilum, hepatic subcapsular site,side of inferior vena cava, side of gallbladder or near by colon. Transcatheter arterial chemoembolization was performed in all patients, which was followed by CT-guided percutaneous RFA under general anesthesia. The time used for puncturing and the time used for putting the needles to the scheduled sites were recorded. A follow-up for 115 months was conducted. The complications and the therapeutic results were observed. Results: For all patients,the procedure of puncture and needle placement was completed in 1-3 minutes. A total of 35 RFA procedures were conducted for 26 lesions. No severe complications occurred. Complete necrosis was observed in 20 tumors and partial necrosis in 6 tumors. Conclusion: The result of this study indicates that CT-guided percutaneous RFA under general anesthesia is a feasible technique for the treatment of liver malignancies located at unusual regions. This technique is very helpful for reducing the manipulating difficulty and lowing the complication risk of RFA procedures. (authors)

Cost-effectiveness analysis of cervical cancer prevention based on a rapid human papillomavirus screening test in a high-risk region of China.

Science.gov (United States)

Levin, Carol E; Sellors, John; Shi, Ju-Fang; Ma, Li; Qiao, You-lin; Ortendahl, Jesse; O'Shea, Meredith K H; Goldie, Sue J

2010-09-01

This study assessed the cost-effectiveness of a new, rapid human papillomavirus (HPV)-DNA screening test for cervical cancer prevention in the high-risk region of Shanxi, China. Using micro-costing methods, we estimated the resources needed to implement preventive strategies using cervical cytology or HPV-DNA testing, including the Hybrid Capture 2 (hc2) test (QIAGEN Corp., Gaithersburg, MD) and the rapid HPV-DNA careHPV test (QIAGEN). Data were used in a previously published model and empirically calibrated to country-specific epidemiological data. Strategies differed by initial test, targeted age, frequency of screening, number of clinic visits required (1, 2 or 3) and service delivery setting (national, county and township levels). Outcomes included lifetime risk of cancer, years of life saved (YLS), lifetime costs and incremental cost-effectiveness ratios (cost per YLS). For all screening frequencies, the most efficient strategy used 2-visit rapid HPV-DNA testing at the county level, including screening and diagnostics in the first visit, and treatment in the second visit. Screening at ages 35, 40 and 45 reduced cancer risk by 50% among women compliant with all 3 screening rounds, and was US$ 150 per YLS, compared with this same strategy applied twice per lifetime. This would be considered very cost-effective evaluated against China's per-capita gross domestic product (US$ 1,702). By enhancing the linkage between screening and treatment through a reduced number of visits, rapid HPV-DNA testing 3 times per lifetime is more effective than traditional cytology, and is likely to be cost-effective in high-risk regions of China.

Economic growth, regional disparities and energy demand in China

International Nuclear Information System (INIS)

Sheng, Yu; Shi, Xunpeng; Zhang, Dandan

2014-01-01

Using the panel data of 27 provinces between 1978 and 2008, we employed a instrumental regression technique to examine the relationship between economic growth, energy demand/production and the related policies in China. The empirical results show that forming a cross-province integrated energy market will in general reduce the response of equilibrium user costs of energy products to their local demand and production, through cross-regional energy transfer (including both energy trade and cross-regional reallocation). In particular, reducing transportation costs and improving marketization level are identified as two important policy instruments to enhance the role of energy market integration. The findings support the argument for a more competitive cross-province energy transfer policies and calls for more developed energy connectivity and associate institutional arrangements within China. These policy implications may also be extended to the East Asia Summit region where energy market integration is being actively promoted. - Highlights: • Development driving energy demand has different impacts on energy prices than others. • EMI will reduce the response of equilibrium energy prices to local demand and production. • Reducing transportation costs and improving marketization level enhance the role of EMI. • More market competition and better physical and institutional connectivity are better. • Policy implications to China may be extended to the East Asia Summit region

48 CFR 31.205-12 - Economic planning costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Economic planning costs... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-12 Economic planning costs. Economic planning costs are the costs of general long-range...

General Ultrasound Imaging

Medline Plus

Full Text Available ... This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Discuss the fees associated with your prescribed procedure with your doctor, ...

42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

Prospective casemix-based funding, analysis and financial impact of cost outliers in all-patient refined diagnosis related groups in three Belgian general hospitals.

Science.gov (United States)

Pirson, Magali; Martins, Dimitri; Jackson, Terri; Dramaix, Michèle; Leclercq, Pol

2006-03-01

This study examined the impact of cost outliers in term of hospital resources consumption, the financial impact of the outliers under the Belgium casemix-based system, and the validity of two "proxies" for costs: length of stay and charges. The cost of all hospital stays at three Belgian general hospitals were calculated for the year 2001. High resource use outliers were selected according to the following rule: 75th percentile +1.5 xinter-quartile range. The frequency of cost outliers varied from 7% to 8% across hospitals. Explanatory factors were: major or extreme severity of illness, longer length of stay, and intensive care unit stay. Cost outliers account for 22-30% of hospital costs. One-third of length-of-stay outliers are not cost outliers, and nearly one-quarter of charges outliers are not cost outliers. The current funding system in Belgium does not penalize hospitals having a high percentage of outliers. The billing generated by these patients largely compensates for costs generated. Length of stay and charges are not a good approximation to select cost outliers.

National Research Council Dialogue to Assess Progress on NASA's Systems Engineering Cost/Risk Analysis Capability Roadmap Development: General Background and Introduction

Science.gov (United States)

Regenie, Victoria

2005-01-01

Contents include the following: General Background and Introduction of Capability. Roadmaps for Systems Engineering Cost/Risk Analysis. Agency Objectives. Strategic Planning Transformation. Review Capability Roadmaps and Schedule. Review Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden.

Science.gov (United States)

Virta, Lena; Joranger, Pål; Brox, Jens Ivar; Eriksson, Rikard

2012-02-10

Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. 204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.

Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

Directory of Open Access Journals (Sweden)

Virta Lena

2012-02-01

Full Text Available Abstract Background Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. Methods The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. Results 204 (103 women patients, mean age 48 (SD 11 years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16% remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389 during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. Conclusions The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.

A General Catalytic Method for Highly Cost- and Atom-Efficient Nucleophilic Substitutions.

Science.gov (United States)

Huy, Peter H; Filbrich, Isabel

2018-05-23

A general formamide-catalyzed protocol for the efficient transformation of alcohols into alkyl chlorides, which is promoted by substoichiometric amounts (down to 34 mol %) of inexpensive trichlorotriazine (TCT), is introduced. This is the first example of a TCT-mediated dihydroxychlorination of an OH-containing substrate (e.g., alcohols and carboxylic acids) in which all three chlorine atoms of TCT are transferred to the starting material. The consequently enhanced atom economy facilitates a significantly improved waste balance (E-factors down to 4), cost efficiency, and scalability (>50 g). Furthermore, the current procedure is distinguished by high levels of functional-group compatibility and stereoselectivity, as only weakly acidic cyanuric acid is released as exclusive byproduct. Finally, a one-pot protocol for the preparation of amines, azides, ethers, and sulfides enabled the synthesis of the drug rivastigmine with twofold S N 2 inversion, which demonstrates the high practical value of the presented method. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Comparative cost analysis of generalized anxiety disorder and major depressive disorder patients in secondary care from a national hospital registry in Finland.

Science.gov (United States)

Kujanpää, Tero; Ylisaukko-Oja, Tero; Jokelainen, Jari; Linna, Miika; Timonen, Markku

2014-07-01

Major depressive disorder (MDD) has shown to cause high costs to society. Earlier research indicates that generalized anxiety disorder (GAD) also causes high costs, but only limited data is available in varying settings. To analyse the secondary care costs of GAD compared with those of MDD. Retrospective database analysis from Finnish Hospital Discharge Registers (FHDR). All GAD and MDD patients diagnosed between 1 January 2007 and 31 December 2007 in FHDR were recorded and individual-level secondary care costs during a 48-month follow-up period were measured. The total mean cost of GAD with history of MDD or some other anxiety disorder was significantly higher than that of MDD with history of GAD or some other anxiety disorder during the 48-month follow-up period. The costs of pure GAD were comparable with those of pure MDD, but after adjusting for age and sex, the costs of pure MDD were higher than those of pure GAD. The economic burden of individual GAD patients is comparable with that of MDD patients in secondary care.

General interest and investment. Long-term marginal cost and pricing at Electricite de France (1948-1949)

International Nuclear Information System (INIS)

Yon, Guillaume

2014-01-01

The paper investigates the construction of a concept in economic theory, long-term marginal cost pricing. It does so by exploring the work done within electricite de France in 1948-1949 by a group of engineer-economists who came out with the notion while they were engaged in completely remaking the pricing policy of the new public monopoly. I will show that the concept envisages a large-scale reorganization of the national power generation capacity in order to enact a certain conception of the general interest in the electric sector

Regional Intergration and Migration: An Economic Geography Model with Hetergenous Labour Force

OpenAIRE

Nicola D. Coniglio

2002-01-01

This paper aims to analyse the effect of deepening regional integration on the incentive for factors of production, in particular labour, to spatially relocate. We adopt a general equilibrium, economic-geography model built on Krugman (1991) allowing for skill heterogeneity in the manufacturing sector. At a given level of trade costs, due to the productivity premium associated with the concentration of high-skilled workers in one region, this type of worker will be more willing to migrate tha...

Cost-effectiveness of i-Sleep, a guided online CBT intervention, for patients with insomnia in general practice: protocol of a pragmatic randomized controlled trial.

Science.gov (United States)

van der Zweerde, Tanja; Lancee, Jaap; Slottje, Pauline; Bosmans, Judith; Van Someren, Eus; Reynolds, Charles; Cuijpers, Pim; van Straten, Annemieke

2016-04-02

Insomnia is a highly prevalent disorder causing clinically significant distress and impairment. Furthermore, insomnia is associated with high societal and individual costs. Although cognitive behavioural treatment for insomnia (CBT-I) is the preferred treatment, it is not used often. Offering CBT-I in an online format may increase access. Many studies have shown that online CBT for insomnia is effective. However, these studies have all been performed in general population samples recruited through media. This protocol article presents the design of a study aimed at establishing feasibility, effectiveness and cost-effectiveness of a guided online intervention (i-Sleep) for patients suffering from insomnia that seek help from their general practitioner as compared to care-as-usual. In a pragmatic randomized controlled trial, adult patients with insomnia disorder recruited through general practices are randomized to a 5-session guided online treatment, which is called "i-Sleep", or to care-as-usual. Patients in the care-as-usual condition will be offered i-Sleep 6 months after inclusion. An ancillary clinician, known as the psychological well-being practitioner who works in the GP practice (PWP; in Dutch: POH-GGZ), will offer online support after every session. Our aim is to recruit one hundred and sixty patients. Questionnaires, a sleep diary and wrist actigraphy will be administered at baseline, post intervention (at 8 weeks), and at 6 months and 12 months follow-up. Effectiveness will be established using insomnia severity as the main outcome. Cost-effectiveness and cost-utility (using costs per quality adjusted life year (QALY) as outcome) will be conducted from a societal perspective. Secondary measures are: sleep diary, daytime consequences, fatigue, work and social adjustment, anxiety, alcohol use, depression and quality of life. The results of this trial will help establish whether online CBT-I is (cost-) effective and feasible in general practice as compared

Generalized Lorentz transformation in the general relativity theory and the behaviour of some physical quantities at the boundary of R and T regions

International Nuclear Information System (INIS)

Nekrasov, A.G.; Mikhal'chuk, A.A.

1978-01-01

Transition between diagonal metrics is considered. The transformations are written in the generalized Lorentz form. On the basis of the thus introduced form of transformations of coordinates the transformations for velocity, acceleration, force, momentum, energy and energy-momentum tensor components have been obtained. The resultant relationships are used for the estimation of physical values at the R and T region boundaries

Production cost methods and data

Science.gov (United States)

Jeffe, R. E.; Fujita, T.

1975-01-01

The general gas cost equation for utility financing is presented. Modifications and assumptions made in order to apply the cost equation to hydrogen production are described. Cost data are given for various methods of hydrogen production. The cost matrix procedure is briefly discussed.

Determination of optimum insulation thicknesses of the external walls and roof (ceiling) for Turkey's different degree-day regions

International Nuclear Information System (INIS)

Sisman, Nuri; Kahya, Emin; Aras, Nil; Aras, Haydar

2007-01-01

The external walls and roof of a building are the interface between its interior and the outdoor environment. Insulation of the external walls and roof is the most cost-effective way of controlling the outside elements to make homes more comfortable. Although insulation is generally accepted as a factor increasing the building costs, with the calculations we have shown that this is not the case. Fuel consumption and operational costs are reduced by increasing the thickness of the external walls and roof (ceiling), despite an increase in the investment costs. According to Turkish Standard Number 825 (TS 825), there are four different degree-day (DD) regions, and the required heat loads for the buildings in these regions exhibit large differences. Therefore, a method based on costs is needed for the determination of optimum insulation thicknesses of different DD regions. In this study, optimum insulation thicknesses for different DD regions of Turkey, namely, Izmir (DD: 1450), Bursa (DD: 2203), Eskisehir (DD: 3215) and Erzurum (DD: 4856), have been determined for a lifetime of N years, maximizing the present worth value of annual energy savings for insulated external walls

Improving the Quality of the Deteriorated Regions of Multicrystalline Silicon Ingots during General Solar Cell Processes

International Nuclear Information System (INIS)

Wu Shan-Shan; Wang Lei; Yang De-Ren

2011-01-01

The behavior of wafers and solar cells from the border of a multicrystalline silicon (mc-Si) ingot, which contain deteriorated regions, is investigated. It is found that the diffusion length distribution of minority carriers in the cells is uniform, and high efficiency of the solar cells (about 16%) is achieved. It is considered that the quality of the deteriorated regions could be improved to be similar to that of adjacent regions. Moreover, it is indicated that during general solar cell fabrication, phosphorus gettering and hydrogen passivation could significantly improve the quality of deteriorated regions, while aluminum gettering by RTP could not. Therefore, it is suggested that the border of a mc-Si ingot could be used to fabricate high efficiency solar cells, which will increase mc-Si utilization effectively. (condensed matter: structure, mechanical and thermal properties)

Application of a generalized Leibniz rule for calculating electromagnetic fields within continuous source regions

International Nuclear Information System (INIS)

Silberstein, M.

1991-01-01

In deriving the electric and magnetic fields in a continuous source region by differentiating the vector potential, Yaghjian (1985) explains that the central obstacle is the dependence of the integration limits on the differentiation variable. Since it is not mathematically rigorous to assume the curl and integral signs are interchangeable, he uses an integration variable substitution to circumvent this problematic dependence. Here, an alternative derivation is presented, which evaluates the curl of the vector potential volume integral directly, retaining the dependence of the limits of integration on the differentiation variable. It involves deriving a three-dimensional version of Leibniz' rule for differentiating an integral with variable limits of integration, and using the generalized rule to find the Maxwellian and cavity fields in the source region. 7 refs

Integral Cost-Benefit Analysis of Maglev Rail Projects Under Market Imperfections

Directory of Open Access Journals (Sweden)

J. Paul Elhorst

2008-07-01

Full Text Available This article evaluates a new mode of high speed ground transportation, the magnetic levitation rail system (Maglev. The outcomes of this evaluation provide policy information on the interregional redistribution of employment and population and the national welfare improvement of two Dutch urban-conglomeration and two Dutch core-periphery projects. This article also compares the results of an integral cost- benefit analysis with those of a conventional cost-benefit analysis and concludes that the additional economic benefits due to market imperfections vary from –1% to +38% of the direct transport benefits, depending on the type of regions connected and the general condition of the economy.

24 CFR 908.108 - Cost.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Cost. 908.108 Section 908.108..., RENTAL VOUCHER, AND MODERATE REHABILITATION PROGRAMS § 908.108 Cost. (a) General. The costs of the... computer hardware or software, or both, the cost of contracting for those services, or the cost of...

[Regional anaesthesia as advantage in competition between hospitals. Strategic market analysis].

Science.gov (United States)

Heller, A R; Bauer, K R; Eberlein-Gonska, M; Albrecht, D M; Koch, T

2009-05-01

The German Social Act V section sign 12 is aimed towards competition, efficiency and quality in healthcare. Because surgical departments are billing standard diagnosis-related group (DRG) case costs to health insurance companies, they claim best value for money for internal services. Thus, anaesthesia concepts are being closely scrutinized. The present analysis was performed to gain economic arguments for the strategic positioning of regional anaesthesia procedures into clinical pathways. Surgical procedures, which in 2005 had a relevant caseload in Germany, were chosen in which regional anaesthesia procedures (alone or in combination with general anaesthesia) could routinely be used. The structure of costs and earnings for hospital services, split by types and centres of cost, as well as by underlying procedures are contained in the annually updated public accessible dataset (DRG browser) of the German Hospital Reimbursement Institute (InEK). For the year 2005 besides own data, national anaesthesia staffing costs are available from the German Society of Anaesthesiology (DGAI). The curve of earnings per DRG can be calculated from the 2005 InEK browser. This curve intersects by the cost curve at the point of national mean length of stay. The cost curve was calculated by process-oriented distribution of cost centres over the length of stay and allows benchmarking within the national competitive environment. For comparison of process times data from our local database were used. While the InEK browser lacks process times, the cost positions 5.1-5.3 (staffing costs anaesthesia) and the national structure adjusted anaesthesia staffing costs 2005 as published by the DGAI, were used to calculate nationwide mean available anaesthesia times which were compared with own process times. Within the portfolio diagram of lengths of stay for each DRG and process times most procedures are located in the economic lower left, in particular those with high case mix (length of stay and

Effects of category-specific costs on neural systems for perceptual decision-making

DEFF Research Database (Denmark)

Fleming, Stephen M; Whiteley, Louise Emma; Hulme, Oliver James

2010-01-01

Perceptual judgments are often biased by prospective losses, leading to changes in decision criteria. Little is known about how and where sensory evidence and cost information interact in the brain to influence perceptual categorization. Here we show that prospective losses systematically bias...... functions enact a particular task set that is communicated to visual regions. Across subjects, greater shifts in decision criteria were associated with greater activation of the anterior cingulate cortex (ACC). Our results support a hypothesis that costs bias an intermediate representation between...... perception and action, expressed via general effects on frontal cortex, and selective effects on extrastriate cortex. These findings indicate that asymmetric costs may affect a neural implementation of perceptual decision making in a similar manner to changes in category expectation, constituting a step...

Analysis of energy efficiency and energy consumption costs: a case study for regional wastewater treatment plant in Malaysia

Directory of Open Access Journals (Sweden)

Nor Azuana Ramli

2017-03-01

Full Text Available The objective of this study is to analyze the possibilities of increasing energy efficiency in the central region wastewater treatment plant by focusing on two aspects: biogas production and prediction of energy production. The analysis is based on one of the biggest central region wastewater treatment plants in Malaysia. After studying the energy efficiency, which consists of optimization of energy consumption and enhancing gas generation, the prediction of power consumption is performed using an autoregressive integrated moving average (ARIMA model. The prediction results are compared with the linear regression method. Comparison shows that even though the total cost of savings is greater by using linear regression, the prediction through ARIMA is more accurate and has smaller root mean square error. The implementation of these two aspects managed to increase energy efficiency by 10% of energy recovery that could further reduce electricity cost and reduction of sludge cake disposal off site. The study recommends other aspects, such as modification in setting up the frequency of variable speed drive for aerators and blowers and optimizing number of feeds into train unit processes within aeration tanks in increasing energy efficiency.

DERAJAT COST STICKINESS SEKTOR PERBANKAN DAN PERTUMBUHAN EKONOMI

Directory of Open Access Journals (Sweden)

Windyastuti Windyastuti

2017-03-01

Full Text Available This study aimed to analyze the effects of the growth on the stickiness cost in banking sector. The research datawas banking financial statements during 2001-2013 published at the Indonesian Capital Market Directory.The data included administration and general cost, bank’s Income and growth. This study used a dynamicpanel data regression with ordinary least square (OLS estimation method. The results showed that cost ofadministration and general was sticky. Furthermore, the growth increased stickiness cost of administrationand general. The growth changed behavior of bank managers. When the growth increased, the bank managersincreased the amount of resources then administration and the general cost also increased although at the sametime banking income declined.

Costly location in Hotelling duopoly

NARCIS (Netherlands)

Hinloopen, J.; Martin, S.

We introduce a cost of location into Hotelling's (1929) spatial duopoly model. We derive the general conditions on the cost-of-location function under which a pure strategy price-location Nash equilibrium exists. With linear transportation cost and a suitably specified cost of location that rises

Costly location in Hotelling duopoly

NARCIS (Netherlands)

Hinloopen, J.; Martin, S.

2013-01-01

We introduce a cost of location into Hotelling’s (1929) spatial duopoly. We derive the general conditions on the cost-of-location function under which a pure strategy price-location Nash equilibrium exists. With linear transportation cost and a suitably specified cost of location that rises toward

CCS in the North Sea region: A comparison on the cost-effectiveness of storing CO2 in the Utsira formation at regional and national scales

DEFF Research Database (Denmark)

Strachan, N.; Hoefnagels, R.; Ramirez, A.

2011-01-01

The potential scale of carbon dioxide capture and storage (CCS) under long-term decarbonisation scenarios means that analysis on the contribution of large international CO2 storage reservoirs is critical. This paper compares the potentially key role of CCS within cost-optimizing energy systems...... formation as a common North Sea CO2 storage resource. A robust finding is that low carbon electricity is a primary decarbonisation pathway and that CCS plays a key role (32–40%) within this portfolio. This paper confirms that the overall driver of the amount of CCS utilized is the climate policy...... the CO2 storage cost curve, with the Netherlands and the UK being the largest contributors, followed by transboundary flows of CO2 from other countries. However, overall regional CCS flows may be larger (for example under low fossil fuel prices) than the estimated (and uncertain) maximum annual injection...

20 CFR 225.40 - General.

Science.gov (United States)

2010-04-01

... DETERMINATIONS Cost-of-Living Increases § 225.40 General. A cost-of-living increase is an automatic increase in a... determines the percentage amount of any cost-of-living increase paid by the Board. ...

Cost of stroke

DEFF Research Database (Denmark)

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

2015-01-01

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

A low-cost general purpose spectral display unit using an IBM PC

International Nuclear Information System (INIS)

Robinson, S.L.

1986-01-01

Many physics experiments require acquisition and analysis of spectral data. Commercial minicomputer-based multichannel analyzers collect detected counts at various energies, create a histogram of the counts in memory, and display the resultant spectra. They acquire data and provide the user-to-display interface. The system discussed separates functions into the three modular components of data acquisition, storage, and display. This decoupling of functions allows the experimenter to use any number of detectors for data collection before forwarding up to 64 spectra to the display unit, thereby increasing data throughput over that available with commercial systems. An IBM PC was chosen for the low-cost, general purpose display unit. Up to four spectra may be displayed simultaneously in different colors. The histogram saves 1024 channels per detector, 640 of which may be distinctly displayed per spectra. The IEEE-488 standard provides the data path between the IBM PC and the data collection unit. Data is sent to the PC under interrupt control, using direct memory access. Display manipulations available via keyboard are also discussed

Regional Redistribution and Migration

DEFF Research Database (Denmark)

Manasse, Paolo; Schultz, Christian

We study a model with free migration between a rich and a poor region. Since there is congestion, the rich region has an incentive to give the poor region a transfer in order to reduce immigration. Faced with free migration, the rich region voluntarily chooses a transfer, which turns out...... to be equal to that a social planner would choose. Provided migration occurs in equilibrium, this conclusion holds even in the presence of moderate mobility costs. However, large migration costs will lead to suboptimal transfers in the market solution...

The impact of geography on energy infrastructure costs

International Nuclear Information System (INIS)

Zvoleff, Alex; Kocaman, Ayse Selin; Huh, Woonghee Tim; Modi, Vijay

2009-01-01

Infrastructure planning for networked infrastructure such as grid electrification (or piped supply of water) has historically been a process of outward network expansion, either by utilities in response to immediate economic opportunity, or in response to a government mandate or subsidy intended to catalyze economic growth. While significant progress has been made in access to grid electricity in Asia, where population densities are greater and rural areas tend to have nucleated settlements, access to grid electricity in Sub-Saharan Africa remains low; a problem generally ascribed to differences in settlement patterns. The discussion, however, has remained qualitative, and hence it has been difficult for planners to understand the differing costs of carrying out grid expansion in one region as opposed to another. This paper describes a methodology to estimate the cost of local-level distribution systems for a least-cost network, and to compute additional information of interest to policymakers, such as the marginal cost of connecting additional households to a grid as a function of the penetration rate. We present several large datasets of household locations developed from satellite imagery, and examine them with our methodology, providing insight into the relationship between settlement pattern and the cost of rural electrification.

Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

Science.gov (United States)

Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Saisto, Terhi

2015-05-01

Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well-being and costs of group psychoeducation and conventional care for fear of childbirth. Randomized controlled trial. A total of 371 nulliparous women scoring over the 95th centile in the Wijma Delivery Expectancy Questionnaire (W-DEQ) during the first trimester. Finland, data from obstetrical patient records and questionnaires. Randomization to group psychoeducation with relaxation (six sessions during pregnancy, one after childbirth, n = 131), or surveillance and referral on demand (n = 240). All costs in maternity care during pregnancy, delivery and postnatally according to Diagnoses Related Groups. Life satisfaction and general well-being 3 months after childbirth (by a Satisfaction with Life Scale and Well-being Visual Analogue Scale). The groups did not differ in total direct costs (€3786/woman in psychoeducative group and €3830/woman in control group), nor in life satisfaction or general well-being. Although only 76 (30%) of the women assigned to the surveillance were referred to special maternity care and 36 (15%) attended advanced prenatal classes, costs in the psychoeducation group did not exceed the costs of the controls, mostly because of the greater number of uncomplicated vaginal deliveries (63% vs. 47%, p = 0.005). Through an association with safer childbirth and equal well-being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Health effects of the Chernobyl disaster: illness or illness behavior? A comparative general health survey in two former Soviet regions

NARCIS (Netherlands)

Havenaar, J.; Rumyantzeva, G.; Kasyanenko, A.; Kaasjager, K.; Westermann, Anneke; van den Brink, W.; van den Bout, J.; Savelkoul, J.

1997-01-01

Results are described of a general health survey (n = 3044) that was conducted 6.5 years after the Chernobyl accident in 1986 in a seriously contaminated region in Belarus and a socioeconomically comparable, but unaffected, region in the Russian Federation. The purpose of the study was to

Nuclear power costs

International Nuclear Information System (INIS)

1963-01-01

A report prepared by the IAEA Secretariat and presented to the seventh session of the Agency's General Conference says that information on nuclear power costs is now rapidly moving from the domain of uncertain estimates to that of tested factual data. As more and more nuclear power stations are being built and put into operation, more information on the actual costs incurred is becoming available. This is the fourth report on nuclear power costs to be submitted to the IAEA General Conference. The report last year gave cost information on 38 nuclear power projects, 17 of which have already gone into operation. Certain significant changes in the data given last year are included-in the present report; besides, information is given on seven new plants. The report is divided into two parts, the first on recent developments and current trends in nuclear power costs and the second on the use of the cost data for economic comparisons. Both stress the fact that the margin of uncertainty in the basic data has lately been drastically reduced. At the same time, it is pointed out, some degree of uncertainty is inherent in the assumptions made in arriving at over-all generating cost figures, especially when - as is usually the case - a nuclear plant is part of an integrated power system

Time and cost analysis: pediatric dental rehabilitation with general anesthesia in the office and the hospital settings.

Science.gov (United States)

Rashewsky, Stephanie; Parameswaran, Ashish; Sloane, Carole; Ferguson, Fred; Epstein, Ralph

2012-01-01

Pediatric dental patients who cannot receive dental care in the clinic due to uncooperative behavior are often referred to receive dental care under general anesthesia (GA). At Stony Brook Medicine, dental patients requiring treatment with GA receive dental care in our outpatient facility at the Stony Brook School of Dental Medicine (SDM) or in the Stony Brook University Hospital ambulatory setting (SBUH). This study investigates the time and cost for ambulatory American Society of Anesthesiologists (ASA) Class I pediatric patients receiving full-mouth dental rehabilitation using GA in these 2 locations, along with a descriptive analysis of the patients and dental services provided. In this institutional review board-approved cross-sectional retrospective study, ICD-9 codes for dental caries (521.00) were used to collect patient records between July 2009 and May 2011. Participants were limited to ASA I patients aged 36-60 months. Complete records from 96 patients were reviewed. There were significant differences in cost, total anesthesia time, and recovery room time (P average total time (anesthesia end time minus anesthesia start time) to treat a child at SBUH under GA was 222 ± 62.7 minutes, and recovery time (time of discharge minus anesthesia end time) was 157 ± 97.2 minutes; the average total cost was $7,303. At the SDM, the average total time was 175 ± 36.8 minutes, and recovery time was 25 ± 12.7 minutes; the average total cost was $414. After controlling for anesthesia time and procedures, we found that SBUH cost 13.2 times more than SDM. This study provides evidence that ASA I pediatric patients can receive full-mouth dental rehabilitation utilizing GA under the direction of dentist anesthesiologists in an office-based dental setting more quickly and at a lower cost. This is very promising for patients with the least access to care, including patients with special needs and lack of insurance.

General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis.

Science.gov (United States)

Tsiachristas, Apostolos; McDaid, David; Casey, Deborah; Brand, Fiona; Leal, Jose; Park, A-La; Geulayov, Galit; Hawton, Keith

2017-10-01

costs of psychosocial assessments were £228 for adults and £392 for individuals younger than 18 years. If our findings are extrapolated to England, the estimated overall annual cost of general hospital management of self-harm is £162 million per year. More use of psychosocial assessment and other preventive measures, especially for young people and against self-poisoning, could potentially lower future costs at a time of major cost pressures in the NHS. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research, Care Oxford at Oxford Health NHS Foundation Trust, and Department of Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

33 CFR 214.11 - Costs.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Costs. 214.11 Section 214.11... SUPPLIES OF DRINKING WATER § 214.11 Costs. Costs incurred by the Corps of Engineers in furnishing emergency... by the community generally will not be required. Costs of necessary measures for the decontamination...

7 CFR 330.107 - Costs.

Science.gov (United States)

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Costs. 330.107 Section 330.107 Agriculture Regulations...; GARBAGE General Provisions § 330.107 Costs. All costs (including those incurred under § 330.106 of this... usual places of duty shall be furnished without cost to the person requesting the services, unless a...

OPERATIONAL COSTS OF CANAL COMPANIES AND IRRIGATION DISTRICTS IN THE INTERMOUNTAIN REGION

OpenAIRE

Wilkins-Wells, John; Lagae, Hubert J.; Anderson, Raymond L.; Anwer, Muhammad Sarfraz

1999-01-01

This study reports on the trends of operational costs of farmer owned and operated irrigation enterprises (irrigation districts and canal companies) in five intermountain states. Administrative costs have risen faster then operation and maintenance costs. While salaries of employees have not risen significantly over time, legal costs have greatly escalated.

“No generics, Doctor!” The perspective of general practitioners in two French regions

Directory of Open Access Journals (Sweden)

Béatrice Riner

2017-11-01

Full Text Available Abstract Background Generic medicines are essential to controlling health expenditures. Their market share is still small in France. The discourse and practices of prescribers may play a major role in their use. The purpose of this study was to explore the knowledge, attitudes and practices of general practitioners (GPs toward generic medicines in two French regions with the lowest penetration rate of these products. Methods An observational study was carried out from October 2015 to February 2016 in Guadeloupe and Martinique. The first qualitative phase involved a diversified sample of 14 GPs who underwent semi-structured interviews. The second phase involved a random sample of 316 GPs (response rate = 74% who were administered a structured questionnaire developed from the results of the first phase. Results Seventy-eight percent of the participants defined a generic drug as a drug containing an active substance identical to a brand-name drug, but only 11% considered generic drugs to be equivalent to brand-name drugs, and the same proportion believed that the generic drugs were of doubtful quality. The primary recognized advantage of generic medicines was their lower cost (82%. The main drawbacks cited were the variability of their presentation (44%, the confusion that they caused for some patients (47%, frequent allegations of adverse side effects (37% and a lack of efficacy (24%, and frequent refusal by patients (26%. Seventy-four percent of the participants stated that they adapted their prescribing practices to the situation, and of this group, 47% prescribed the originator product simply on demand. Conclusion Most surveyed GPs were not hostile towards generic medicines. They were caught between the requirements of health insurance regimes and the opposition of numerous users and suggested that the patient information provided by health authorities should be improved and that drug composition and packaging should be made uniform.

The cost of installing central heating. Comparison of Norway and Sweden. Final version; Kostnader ved installasjon av vannbaaren varme. Sammenlikning av Norge og Sverige. Endelig versjon

Energy Technology Data Exchange (ETDEWEB)

Haarberg, Karl Johan; Elnan, Kaare; Essen, Jan von; Hovden, Agnete; Ekvall, Thomas; Melbaeck, Johan

2010-10-22

The objective of the cost study is to examine costs and cost differences associated with the installation of various technical solutions for water heating in various buildings in Norway and Sweden - regionally and nationally. In addition, the cost study intended to point out any barriers to the increased prevalence of central heating, as well as proposals for measures to remove such. Finally, the cost study in general and in particular barriers placed in a larger environment and climate perspective. (AG)

A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.

Science.gov (United States)

Jameson, K; Averley, P A; Shackley, P; Steele, J

2007-09-22

To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment. Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis. Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was pound245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters. The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

Clinicians' adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions

Directory of Open Access Journals (Sweden)

Perrier Lionel

2012-03-01

Full Text Available Abstract Background Although the management of sarcoma is improving, non adherence to clinical practice guidelines (CPGs remains high, mainly because of the low incidence of the disease and the variety of histological subtypes. Since little is known about the health economics of sarcoma, we undertook a cost-effectiveness analysis (within the CONnective TIssue CAncer NETwork, CONTICANET comparing costs and outcomes when clinicians adhered to CPGs and when they did not. Methods Patients studied had a histological diagnosis of sarcoma, were older than 15 years, and had been treated in the Rhône-Alpes region of France (in 2005/2006 or in the Veneto region of Italy (in 2007. Data collected retrospectively for the three years after diagnosis were used to determine relapse free survival and health costs (adopting the hospital's perspective and a microcosting approach. All costs were expressed in euros (€ at their 2009 value. A 4% annual discount rate was applied to both costs and effects. The incremental cost-effectiveness ratio (ICER was expressed as cost per relapse-free year gained when management was compliant with CPGs compared with when it was not. To capture uncertainty surrounding ICER, a probabilistic sensitivity analysis was performed based on a non-parametric bootstrap method. Results A total of 219 patients were included in the study. Compliance with CPGs was observed for 118 patients (54%. Average total costs reached 23,571 euros when treatment was in accordance with CPGs and 27,313 euros when it was not. In relation to relapse-free survival, compliance with CPGs strictly dominates non compliance, i.e. it is both less costly and more effective. Taking uncertainty into account, the probability that compliance with CPGs still strictly dominates was 75%. Conclusions Our findings should encourage physicians to increase their compliance with CPGs and healthcare administrators to invest in the implementation of CPGs in the management of

Nanoparticle risk management and cost evaluation: a general framework

Science.gov (United States)

Fleury, Dominique; Bomfim, João A. S.; Metz, Sébastien; Bouillard, Jacques X.; Brignon, Jean-Marc

2011-07-01

Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

Nanoparticle risk management and cost evaluation: a general framework

International Nuclear Information System (INIS)

Fleury, Dominique; Metz, Sebastien; Bouillard, Jacques X; Brignon, Jean-Marc; Bomfim, Joao A S

2011-01-01

Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

First regional CSM program planned.

Science.gov (United States)

1982-09-01

6 countries in the English-speaking Caribbean (Antigua, Barbados, Dominica, St. Kitts/Nevis, St. Lucia, and St. Vincent) are scheduled to form the 1st regional contraceptive social marketing program. The program will be under the auspices of the Barbados Family Planning Association. By combining resources, contraceptive social marketing should be able to effectively augment family planning activities in smaller countries where individual programs wuld be too costly. The regional program will also determine whether program elements from 1 country in a region are relevant in other countries. The Caribbean region as a whole has experienced a general decline in both crude birth rates and fertility rates during the past 15 years; however, adolescent fertility rates remain high and an average of 46% of the populations of Caribbean countries are under 15 years of age. Although heavy emigration has traditionally curbed population increases, new restrictive immigration laws are expected. Further increases in the working age population will contribute to already high unemployment rates and hinder economic development. The 6 countries selected for the social marketing program are receptive to innovative family planning approaches and have the basic marketing infrastructure required. Community-based distribution programs already in operation in these countries distribute condoms, oral contraceptives, and barrier methods. The success of these programs has plateaued, and there is a need for delivery systems capable of reaching broader segments of the population. The social marketing program will be phased in to ensure local acceptance among national leaders and consumers. The regional program hopes to borrow elements from Jamaica's contraceptive social marketing program to avoid the costs involved in starting a program from scratch. A major innovation will be the use of mass media advertising for contraceptives.

The effect of pricing level to the loss of welfare costs (case study: Indonesia region II water company)

Science.gov (United States)

K, B. Rosalina E. W.; Gravitiani, E.; Raharjo, M.; Mulyaningsih, T.

2018-03-01

Climate change makes the water balance composition being unstable, both quality and quantity. As a company which responsible for water management, Regional Drinking Water Company (abbreviated as PDAM) is often unable to solve the problem. Welfare costs are indicators to evaluate the economic efficiency. This study aims to calculate the welfare cost of the people lost due to the price determination of PDAM Indonesia in region II with deadweight loss (DWL) approach, so it can provide information to pricing regulator, pricing decision makers and for coIDRorate management. DWL is a loss of economic efficiency that can occur when equilibrium for a good or a service is not achieved, caused by monopoly pricing of artificial scarcity, an externality, a tax or subsidy, or a binding price ceiling or price floor such as a minimum wage. Results showed that the pricing rules set by PDAM yielded different DWL, depending on margin set by the company DWL PDAM ranges between IDR 260,485.66/M3 to IDR 127,486,709.86/M3 which is actually shared to improve the welfare of customers, other communities, and PDAM itself. Data analysis used PDAM performance in 2015 that have not Good CoIDRorate Governance Management and Efficiency.

Effects of different types of anaesthesia (regional vs general) on serum IL-6, IL-8 and M-CSF levels in surgical patients

International Nuclear Information System (INIS)

Xiao Jiawang

2009-01-01

Objective: To study the effect of anesthesia(regional vs general) on serum IL-6, IL-8 and M-CSF levels in surgical patients. Methods: Serum IL-6, IL-8 and M-CSF levels were determined with RIA 3 times in 34 patients operated under ragional anesthesia and 34 patients operted under general anesthesia (both for benign gastral ulcer). The levels were measured before induction of anesthesia, at beginning of operation and 1 hr later. Results: In patients under regional anesthesia, the IL-6, IL-8 and M-CSF levels increased significantly at the beginning of operation and 1 hr later. Though dropped remained significantly higher than the levels before induction (P<0.05); No significant change of the levels were obsorved in patients under general anesthesia through the operation, and the levels were as a whole significantly lower than the levels under regional anesthesia (P<0.05). Conclusion: General anesthesia (combined intravenous and inhalation) could abolish increases of serum IL-6, IL-8 and M-CSF levels during operation must be of clinical values. (authors)

24 CFR 583.135 - Administrative costs.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Administrative costs. 583.135... Administrative costs. (a) General. Up to five percent of any grant awarded under this part may be used for the purpose of paying costs of administering the assistance. (b) Administrative costs. Administrative costs...

42 CFR 457.1015 - Cost-effectiveness.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

Cost Surface-Derived Least-Cost Paths: A Case Study from Iron Age Orkney

Directory of Open Access Journals (Sweden)

Brian Rahn

2005-12-01

Full Text Available In recent years, GIS landscape models have begun to move towards more sophisticated techniques for representing the land surface in order to analyse site territories, pathways and travel costs. Many of the major commercial GIS packages now offer the ability to generate anisotropic cost surfaces. In addition, recent papers have proposed methodologies for generating cost surfaces to model social preferences affecting travel (Lee and Stucky 1998; Llobera 2000. In terms of practical applications, however, GIS models of catchment areas and paths between sites continue to be dominated by those constructed on the basis of slope alone. In parallel with this, regional analyses of site location, with few exceptions, have been undertaken either within large land masses, largely ignoring the effects of rivers, lakes and the sea on travel costs and affordances, or within single islands, neglecting travel to other neighbouring islands or the mainland. The reasons for this appear to be twofold: first, there is little information available on travel costs and travel rates using pre-industrial transportation technology, beyond very general statements; second, critical analysis of what constitutes an 'acceptable' travel distance is lacking, especially in situations where both water and land transport are possibilities. This article presents some preliminary results from a research project examining the location and distribution of Middle Iron Age sites (brochs in the landscape of Orkney, Northern Scotland. It employs a terrain model, taking into account differing friction values for land and water surfaces, as well as the nature of the shoreline (cliffs, beaches and how this affects access from land to sea and vice versa. It also attempts to model pathways between sites following three friction models: lowest-energy, lowest-visibility (hidden and highest-visibility (exposed.

Navigating financial and supply reliability tradeoffs in regional drought management portfolios

Science.gov (United States)

Zeff, Harrison B.; Kasprzyk, Joseph R.; Herman, Jonathan D.; Reed, Patrick M.; Characklis, Gregory W.

2014-06-01

Rising development costs and growing concerns over environmental impacts have led many communities to explore more diversified water management strategies. These "portfolio"-style approaches integrate existing supply infrastructure with other options such as conservation measures or water transfers. Diversified water supply portfolios have been shown to reduce the capacity and costs required to meet demand, while also providing greater adaptability to changing hydrologic conditions. However, this additional flexibility can also cause unexpected reductions in revenue (from conservation) or increased costs (from transfers). The resulting financial instability can act as a substantial disincentive to utilities seeking to implement more innovative water management techniques. This study seeks to design portfolios that employ financial tools (e.g., contingency funds and index insurance) to reduce fluctuations in revenues and costs, allowing these strategies to achieve improved performance without sacrificing financial stability. This analysis is applied to the development of coordinated regional supply portfolios in the "Research Triangle" region of North Carolina, an area comprising four rapidly growing municipalities. The actions of each independent utility become interconnected when shared infrastructure is utilized to enable interutility transfers, requiring the evaluation of regional tradeoffs in up to five performance and financial objectives. Diversified strategies introduce significant tradeoffs between achieving reliability goals and introducing burdensome variability in annual revenues and/or costs. Financial mitigation tools can mitigate the impacts of this variability, allowing for an alternative suite of improved solutions. This analysis provides a general template for utilities seeking to navigate the tradeoffs associated with more flexible, portfolio-style management approaches.

Does anaesthesia cause postoperative cognitive dysfunction? : a randomised study of regional versus general anaesthesia in 438 elderly patients

NARCIS (Netherlands)

Rasmussen, L.S.; Johnson, T.; Kuipers, H.M.; Kristensen, D.; Siersma, V.D.; Vila, P.; Jolles, J.; Papaioannou, A.; Abildstrom, H.; Silverstein, J.H.; Bonal, J.A.; Raeder, J.; Nielsen, I.K.; Korttila, K.; Munoz, L.; Dodds, C.; Hanning, C.D.; Moller, J.T.

2003-01-01

Keywords:anesthesia;cognitive function;complications;postoperative period;regional anesthesia;surgery Background: Postoperative cognitive dysfunction (POCD) is a common complication after cardiac and major non-cardiac surgery with general anaesthesia in the elderly. We hypothesized that the

Developing a closed-form cost expression for an (R, s, nQ) policy where the demand process is compound generalized Erlang

DEFF Research Database (Denmark)

Larsen, Christian; Kiesmüller, G.P

2007-01-01

We derive a closed-form cost expression for an (R,s,nQ) inventory control policy where all replenishment orders have a constant lead-time, unfilled demand is back-logged and inter-arrival times of order requests are generalized Erlang distributed. For given values of Q and R we show how to compute...

Geographical Pattern and Environmental Correlates of Regional-Scale General Flowering in Peninsular Malaysia

Science.gov (United States)

Numata, Shinya; Yasuda, Masatoshi; Suzuki, Ryo O.; Hosaka, Tetsuro; Noor, Nur Supardi Md.; Fletcher, Christine D.; Hashim, Mazlan

2013-01-01

In South-East Asian dipterocarp forests, many trees synchronize their reproduction at the community level, but irregularly, in a phenomenon known as general flowering (GF). Several proximate cues have been proposed as triggers for the synchronization of Southeast Asian GF, but the debate continues, as many studies have not considered geographical variation in climate and flora. We hypothesized that the spatial pattern of GF forests is explained by previously proposed climatic cues if there are common cues for GF among regions. During the study, GF episodes occurred every year, but the spatial occurrence varied considerably from just a few forests to the whole of Peninsular Malaysia. In 2001, 2002 and 2005, minor and major GF occurred widely throughout Peninsular Malaysia (GF2001, GF2002, and GF2005), and the geographical patterns of GF varied between the episodes. In the three regional-scale GF episodes, most major events occurred in regions where prolonged drought (PD) had been recorded prior, and significant associations between GF scores and PD were found in GF2001 and GF2002. However, the frequency of PD was higher than that of GF throughout the peninsula. In contrast, low temperature (LT) was observed during the study period only before GF2002 and GF2005, but there was no clear spatial relationship between GF and LT in the regional-scale episodes. There was also no evidence that last GF condition influenced the magnitude of GF. Thus, our results suggest that PD would be essential to trigger regional-scale GF in the peninsula, but also that PD does not fully explain the spatial and temporal patterns of GF. The coarse relationships between GF and the proposed climatic cues may be due to the geographical variation in proximate cues for GF, and the climatic and floristic geographical variations should be considered to understand the proximate factors of GF. PMID:24260159

TRANSACTION COSTS WITHIN THE INDIVIDUAL AND COOPERATIVE APPLE PRODUCERS IN PRESPA REGION, THE REPUBLIC OF MACEDONIA

Directory of Open Access Journals (Sweden)

Aleksandra ANGELOSKA

2018-02-01

Full Text Available Apple production in the Republic of Macedonia is an important sector that highly contributes to theeconomy in terms of employment and income, especially for the small farmers in Prespa Region. Despitecooperatives’ efforts and governmental support to attract members through the provision of inputs,technical advices and other incentives to farmers, membership adherence is low and slow. The TransactionCost Economics Theory (TCE provided the basis for this study where the choice is conditioned by relativecomparative advantage in terms of lower transaction costs. Based on the research, following conclusions are underlined: a. from the perspective of farmers andthe cooperatives there are factors that positively influence the choice of cooperative membership; b. fromthe cooperative’s side, some of the positive influences are its regular flow of price information, constanttechnical advices and secured market; c for farmers who aim at increasing production and improving theirincomes, membership to cooperative signifies security of accessing cheaper inputs especially chemicalfertiliser, security of market for the produced apples and higher frequency of transaction cost. Farmers’choices are not exclusive to one type of structure or the other. Farmers can transact with the cooperative andtrader at the same time, influenced by the differences in the price among the “Idared” and “varieties”. Bothof them, members and non-members are limited connected to the “middlemen” in choice of transactions.

34 CFR 300.16 - Excess costs.

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Excess costs. 300.16 Section 300.16 Education... DISABILITIES General Definitions Used in This Part § 300.16 Excess costs. Excess costs means those costs that... for an example of how excess costs must be calculated.) (Authority: 20 U.S.C. 1401(8)) ...

Development of Innovative Technology to Provide Low-Cost Surface Atmospheric Observations in Data Sparse Regions

Science.gov (United States)

Kucera, Paul; Steinson, Martin

2017-04-01

Accurate and reliable real-time monitoring and dissemination of observations of surface weather conditions is critical for a variety of societal applications. Applications that provide local and regional information about temperature, precipitation, moisture, and winds, for example, are important for agriculture, water resource monitoring, health, and monitoring of hazard weather conditions. In many regions of the World, surface weather stations are sparsely located and/or of poor quality. Existing stations have often been sited incorrectly, not well-maintained, and have limited communications established at the site for real-time monitoring. The University Corporation for Atmospheric Research (UCAR)/National Center for Atmospheric Research (NCAR), with support from USAID, has started an initiative to develop and deploy low-cost weather instrumentation in sparsely observed regions of the world. The project is focused on improving weather observations for environmental monitoring and early warning alert systems on a regional to global scale. Instrumentation that has been developed use innovative new technologies such as 3D printers, Raspberry Pi computing systems, and wireless communications. The goal of the project is to make the weather station designs, software, and processing tools an open community resource. The weather stations can be built locally by agencies, through educational institutions, and residential communities as a citizen effort to augment existing networks to improve detection of natural hazards for disaster risk reduction. The presentation will provide an overview of the open source weather station technology and evaluation of sensor observations for the initial networks that have been deployed in Africa.

Leaders or Loners? How Do the BRICS Countries and their Regions Vote in the UN General Assembly

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Renan Holanda Montenegro

2017-08-01

Full Text Available The so-called emerging powers, including the BRICS nations (Brazil, Russia, India, China and South Africa, typically present themselves as natural leaders of their regions. Although physical size confers them the status of regional powers, their role as leaders depends on the consensual acceptance of their would-be followers. Can it be affirmed then that the countries under the influence of the BRICS show convergent positions? Can the five BRICS be considered de facto leaders of their regions? This article sets out to answer these questions by analysing the behaviour of the BRICS and their regional partners in the United Nations General Assembly (UNGA. The research design replicates the data from Voeten (2013 in order to compare the average affinity between each of the BRICS countries and their regions in the votes of the UNGA from 1992 to 2014. The data indicate a high level of regional cohesion for Brazil, China and South Africa when compared to Russia and India. The findings corroborate the literature in relation to Brazil and South Africa but conflict with what has been produced on the regional leadership of Russia, India and China.

Cost comparison between private and public collection of residual household waste: multiple case studies in the Flemish region of Belgium.

Science.gov (United States)

Jacobsen, R; Buysse, J; Gellynck, X

2013-01-01

The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticed in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private. Copyright © 2012 Elsevier Ltd. All rights reserved.

U.S. Solar Photovoltaic System Cost Benchmark: Q1 2017

Energy Technology Data Exchange (ETDEWEB)

Fu, Ran [National Renewable Energy Lab. (NREL), Golden, CO (United States); Feldman, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States); Woodhouse, Mike [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ardani, Kristen [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-09-01

This report benchmarks U.S. solar photovoltaic (PV) system installed costs as of the first quarter of 2017 (Q1 2017). We use a bottom-up methodology, accounting for all system and projectdevelopment costs incurred during the installation to model the costs for residential, commercial, and utility-scale systems. In general, we attempt to model the typical installation techniques and business operations from an installed-cost perspective. Costs are represented from the perspective of the developer/installer; thus, all hardware costs represent the price at which components are purchased by the developer/installer, not accounting for preexisting supply agreements or other contracts. Importantly, the benchmark also represents the sales price paid to the installer; therefore, it includes profit in the cost of the hardware, 1 along with the profit the installer/developer receives, as a separate cost category. However, it does not include any additional net profit, such as a developer fee or price gross-up, which is common in the marketplace. We adopt this approach owing to the wide variation in developer profits in all three sectors, where project pricing is highly dependent on region and project specifics such as local retail electricity rate structures, local rebate and incentive structures, competitive environment, and overall project or deal structures. Finally, our benchmarks are national averages weighted by state installed capacities.

48 CFR 231.205 - Selected costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Selected costs. 231.205... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 231.205 Selected costs. ...

Advanced Propulsion System Studies for General Aviation Aircraft

Science.gov (United States)

Eisenberg, Joseph D. (Technical Monitor); German, Jon

2003-01-01

This final report addresses the following topics: Market Impact Analysis (1) assessment of general aviation, including commuter/regional, aircraft market impact due to incorporation of advanced technology propulsion system on acquisition and operating costs, job creation and/or manpower demand, and future fleet size; (2) selecting an aircraft and engine for the study by focusing on the next generation 19-passenger commuter and the Williams International FJ44 turbofan engine growth. Propulsion System Analysis Conducted mission analysis studies and engine cycle analysis to define a new commuter mission and required engine performance, define acquisition and operating costs and, select engine configuration and initiated preliminary design for hardware modifications required. Propulsion System Benefits (1) assessed and defined engine emissions improvements, (2) assessed and defined noise reduction potential and, (3) conducted a cost analysis impact study. Review of Relevant NASA Programs Conducted literature searches using NERAC and NASA RECON services for related technology in the emissions and acoustics area. Preliminary Technology Development Plans Defined plan to incorporate technology improvements for an FJ44-2 growth engine in performance, emissions, and noise suppression.

[Study on HIV-1 subtype among elderly male clients and female sex workers of low-cost venues in Guangxi Zhuang Autonomous Region, China].

Science.gov (United States)

Deng, Y Q; Li, J J; Fang, N Y; Wang, B; Wang, J W; Liang, S S; Shen, Z Y; Lan, G H; Zhang, H M; Wu, X H; Lu, H X; Ge, X M

2017-03-10

Objective: To understand HIV-1 subtype characteristics and transmission clusters in elderly male clients and female sex workers (FSWs) of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, China. Methods: A cross sectional survey was conducted in FSWs and elderly male clients (≥50 years) of low-cost commercial sex venues in 4 cities and 9 counties in Guangxi Zhuang Autonomous Region by convenient sampling in 2012. The blood sample was collected from each case for HIV-1 antibody detection. The pol gene fragments were amplified and sequenced from viral RNA template extracted from plasma samples. The phylogenetic tree was constructed and the subtypes were identified. Results: A total of 4 048 elderly male clients and 784 FSWs were surveyed, and 116 HIV-1 infections were detected, the positive rate was 2.5% (103/4 048) in the clients and 1.7% (13/784) in FSWs. The gene amplification and sequencing of HIV-1 detected in 84 blood samples indicated that 53 pol gene sequences were successfully determined (48 blood samples from elderly male clients and 5 blood samples from FSWs). Among 53 pol sequences, 48(90.6% ), 4(7.5% ), and 1(1.9% ) sequences were identified as CRF01_AE, CRF08_BC, and CRF07_BC, respectively. Two transmission clusters were identified among CRF01_AE, including 4 sub-clusters. One transmission cluster was identified among CRF08_BC. The transmission cluster or sub-cluster were from the infected individuals at same low-cost commercial sex venue, or different low-cost commercial sex venues in the same town, or same place, or adjacent villages and towns. Conclusions: CRF01_AE was the predominant HIV-1 subtype among elderly male clients and FSWs of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, circulating in same venue or adjacent villages and towns. The HIV-1 positive male clients and FSWs might play an important role in the spread of the strains.

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 570.110 Section 570.110 Federal Acquisition Regulations System... PROPERTY General 570.110 Cost or pricing data and information other than cost or pricing data. (a) The...

Forecasting how residential urban form affects the regional carbon savings and costs of retrofitting and decentralized energy supply

International Nuclear Information System (INIS)

Hargreaves, Anthony; Cheng, Vicky; Deshmukh, Sandip; Leach, Matthew; Steemers, Koen

2017-01-01

Highlights: • An innovative model for testing combinations of spatial planning and decentralised energy supply. • An improved method of modelling the spatial variability of energy consumption per dwelling type. • Shows how spatial planning would affect the future carbon reduction of decentralised supply. • Forecasts the future carbon reduction and costs of retrofitting and decentralised supply. • A method of forecasting how residential space would affect the suitability of decentralised supply. - Abstract: Low carbon energy supply technologies are increasingly used at the building and community scale and are an important part of the government decarbonisation strategy. However, with their present state of development and costs, many of these decentralised technologies rely on public subsidies to be financially viable. It is questionable whether they are cost effective compared to other ways of reducing carbon emissions, such as decarbonisation of conventional supply and improving the energy efficiency of dwellings. Previous studies have found it difficult to reliably estimate the future potential of decentralised supply because this depends on the available residential space which varies greatly within a city region. To address this problem, we used an integrated modelling framework that converted the residential density forecasts of a regional model into a representation of the building dimensions and land of the future housing stock. This included a method of estimating the variability of the dwellings and residential land. We present the findings of a case study of the wider south east regions of England that forecasted the impacts of energy efficiency and decentralised supply scenarios to year 2031. Our novel and innovative method substantially improves the spatial estimates of energy consumption compared to building energy models that only use standard dwelling typologies. We tested the impact of an alternative spatial planning policy on the future

Cost-Effectiveness of the 'One4All' HIV Linkage Intervention in Guangxi Zhuang Autonomous Region, China.

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Xiao Zang

Full Text Available In Guangxi Zhuang Autonomous Region, China, an estimated 80% of newly-identified antiretroviral therapy (ART-eligible patients are not engaged in ART. Delayed ART uptake ultimately translates into high rates of HIV morbidity, mortality, and transmission. To enhance HIV testing receipt and subsequent treatment uptake in Guangxi, the Chinese Center for Disease Control and Prevention (CDC executed a cluster-randomized trial to assess the effectiveness and cost-effectiveness of a streamlined HIV testing algorithm (the One4All intervention in 12 county-level hospitals.To determine the incremental cost-effectiveness of the One4All intervention delivered at county hospitals in Guangxi, China, compared to the current standard of care (SOC.Health System.1-, 5-and 25-years.We adapted a dynamic, compartmental HIV transmission model to simulate HIV transmission and progression in Guangxi, China and identify the economic impact and health benefits of implementing the One4All intervention in all Guangxi hospitals. The One4All intervention algorithm entails rapid point-of-care HIV screening, CD4 and viral load testing of individuals presenting for HIV screening, with same-day results and linkage to counselling. We populated the model with data from the One4All trial (CTN-0056, China CDC HIV registry and published reports. Model outcomes were HIV incidence, mortality, costs, quality-adjusted life years (QALYs, and the incremental cost-effectiveness ratio (ICER of the One4All intervention compared to SOC.The One4All testing intervention was more costly than SOC (CNY 2,182 vs. CNY 846, but facilitated earlier ART access, resulting in delayed disease progression and mortality. Over a 25-year time horizon, we estimated that introducing One4All in Guangxi would result in 802 averted HIV cases and 1629 averted deaths at an ICER of CNY 11,678 per QALY gained. Sensitivity analysis revealed that One4All remained cost-effective at even minimal levels of effectiveness

Cost Effective Regional Ballistic Missile Defense

Science.gov (United States)

2016-02-16

deploying advanced air defense systems18, such as the Russian S-300 and S-500, and concealing them in hardened, camouflaged sites, such as extensive... Russian objections to the European Phased Adaptive Approach (EPAA) and fund homeland defense priorities.39 Furthermore, the PTSS system was also... Theatre Ballistic Missile Defence Capability Becomes Operational,” Jane’s Missiles & Rockets, 1 February 2011. 55 Joseph W. Kirschbaum, REGIONAL MISSILE

Radially and azimuthally dependent resonance self-shielding treatment for general multi-region geometry based on a unified theory

International Nuclear Information System (INIS)

Koike, Hiroki; Kirimura, Kazuki; Yamaji, Kazuya; Kosaka, Shinya; Yamamoto, Akio

2018-01-01

A unified resonance self-shielding method, which can treat general sub-divided fuel regions, is developed for lattice physics calculations in reactor physics field. In a past study, a hybrid resonance treatment has been developed by theoretically integrating equivalence theory and ultra-fine-group slowing-down calculation. It can be applied to a wide range of neutron spectrum conditions including low moderator density ranges in severe accident states, as long as each fuel region is not sub-divided. In order to extend the method for radially and azimuthally sub-divided multi-region geometry, a new resonance treatment is established by incorporating the essence of sub-group method. The present method is composed of two-step flux calculation, i.e. 'coarse geometry + fine energy' (first step) and 'fine geometry + coarse energy' (second step) calculations. The first step corresponds to a hybrid model of the equivalence theory and the ultra-fine-group calculation, and the second step corresponds to the sub-group method. From the verification results, effective cross-sections by the new method show good agreement with the continuous energy Monte-Carlo results for various multi-region geometries including non-uniform fuel compositions and temperature distributions. The present method can accurately generate effective cross-sections with short computation time in general lattice physics calculations. (author)

45 CFR 1180.56 - Allowable costs.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Allowable costs. 1180.56 Section 1180.56 Public... by a Grantee General Administrative Responsibilities § 1180.56 Allowable costs. (a) Determination of costs allowable under a grant is made in accordance with government-wide cost principles in applicable...

Integrated analysis considered mitigation cost, damage cost and adaptation cost in Northeast Asia

Science.gov (United States)

Park, J. H.; Lee, D. K.; Kim, H. G.; Sung, S.; Jung, T. Y.

2015-12-01

Various studies show that raising the temperature as well as storms, cold snap, raining and drought caused by climate change. And variety disasters have had a damage to mankind. The world risk report(2012, The Nature Conservancy) and UNU-EHS (the United Nations University Institute for Environment and Human Security) reported that more and more people are exposed to abnormal weather such as floods, drought, earthquakes, typhoons and hurricanes over the world. In particular, the case of Korea, we influenced by various pollutants which are occurred in Northeast Asian countries, China and Japan, due to geographical meteorological characteristics. These contaminants have had a significant impact on air quality with the pollutants generated in Korea. Recently, around the world continued their effort to reduce greenhouse gas and to improve air quality in conjunction with the national or regional development goals priority. China is also working on various efforts in accordance with the international flows to cope with climate change and air pollution. In the future, effect of climate change and air quality in Korea and Northeast Asia will be change greatly according to China's growth and mitigation policies. The purpose of this study is to minimize the damage caused by climate change on the Korean peninsula through an integrated approach taking into account the mitigation and adaptation plan. This study will suggest a climate change strategy at the national level by means of a comprehensive economic analysis of the impacts and mitigation of climate change. In order to quantify the impact and damage cost caused by climate change scenarios in a regional scale, it should be priority variables selected in accordance with impact assessment of climate change. The sectoral impact assessment was carried out on the basis of selected variables and through this, to derive the methodology how to estimate damage cost and adaptation cost. And then, the methodology was applied in Korea

ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

Directory of Open Access Journals (Sweden)

M. A. Demidova

2012-01-01

Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

Access to diagnostic tests and essential medicines for cardiovascular diseases and diabetes care: cost, availability and affordability in the West Region of Cameroon.

Directory of Open Access Journals (Sweden)

Ahmadou M Jingi

Full Text Available To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD and diabetes in the West region of Cameroon, a low-income setting.A survey was conducted on the availability and cost of twelve routine tests and twenty medicines for CVD and diabetes in eight health districts (four urban and four rural covering over 60% of the population of the region (1.8 million. We analyzed the percentage of tests and medicines available, the median price against the international reference price (median price ratio for the medicines, and affordability in terms of the number of days' wages it would cost the lowest-paid unskilled government worker for initial investigation tests and procurement for one month of treatment.The availability of tests varied between 10% for the ECG to 100% for the fasting blood sugar. The average cost for the initial investigation using the minimum tests cost 29.76 days' wages. The availability of medicines varied from 36.4% to 59.1% in urban and from 9.1% to 50% in rural settings. Only metformin and benzathine-benzylpenicilline had a median price ratio of ≤ 1.5, with statins being largely unaffordable (at least 30.51 days' wages. One month of combination treatment for coronary heart disease costs at least 40.87 days' wages.The investigation and management of patients with medium-to-high cardiovascular risk remains largely unavailable and unaffordable in this setting. An effective non-communicable disease program should lay emphasis on primary prevention, and improve affordable access to essential medicines in public outlets.

Cost Accounting: Production and Equipment Services.

Science.gov (United States)

Schmid, William T.

Cost accounting for audiovisual productions should include direct costs, and, in some cases, the media administrator may have to calculate a per-hour surcharge for general operating overhead as well. Such procedures enable the administrator to determine cost effectiveness, to control cost overruns, and to generate more staff efficiency. Cost…

Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

Directory of Open Access Journals (Sweden)

Yuxuan Gao

2017-01-01

Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

Costs and benefits of embedded generation

International Nuclear Information System (INIS)

1996-01-01

Ilex Associates has been appointed by ETSU to examine the underlying costs and benefits of embedded generation (i.e. generation which is directly connected into a REF's distribution network instead of the national transmission network). The main impetus for this work stems from the need to understand the true value of embedded generation in time to review the development of further NFFO contracts following the expiry of the, so called, ''nuclear levy''. This is particularly important at this time because of the view expressed by the Director General of Electricity Supply (DGES) that to continue to receive support renewables technologies should be able to demonstrate good progress in converging towards a market price. The prime objectives of this study are to determine the costs and benefits of connecting and operating a generator that is embedded in a local Regional Electricity Company's (REC's) distribution network compared to the alternative option of providing electricity from a large generating station which is connected directly to the transmission system (and colloquially known as directly connected generation). (UK)

Review of the cost of venous thromboembolism

Science.gov (United States)

Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

2015-01-01

Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new

48 CFR 30.102 - Cost Accounting Standards Board publication.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.102 Cost Accounting Standards Board publication. Copies of the CASB Standards and Regulations are printed in title 48...

A low cost automatic detection and ranging system for space surveillance in the medium Earth orbit region and beyond.

Science.gov (United States)

Danescu, Radu; Ciurte, Anca; Turcu, Vlad

2014-02-11

The space around the Earth is filled with man-made objects, which orbit the planet at altitudes ranging from hundreds to tens of thousands of kilometers. Keeping an eye on all objects in Earth's orbit, useful and not useful, operational or not, is known as Space Surveillance. Due to cost considerations, the space surveillance solutions beyond the Low Earth Orbit region are mainly based on optical instruments. This paper presents a solution for real-time automatic detection and ranging of space objects of altitudes ranging from below the Medium Earth Orbit up to 40,000 km, based on two low cost observation systems built using commercial cameras and marginally professional telescopes, placed 37 km apart, operating as a large baseline stereovision system. The telescopes are pointed towards any visible region of the sky, and the system is able to automatically calibrate the orientation parameters using automatic matching of reference stars from an online catalog, with a very high tolerance for the initial guess of the sky region and camera orientation. The difference between the left and right image of a synchronized stereo pair is used for automatic detection of the satellite pixels, using an original difference computation algorithm that is capable of high sensitivity and a low false positive rate. The use of stereovision provides a strong means of removing false positives, and avoids the need for prior knowledge of the orbits observed, the system being able to detect at the same time all types of objects that fall within the measurement range and are visible on the image.

42 CFR 417.802 - Allowable costs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Allowable costs. 417.802 Section 417.802 Public... PLANS Health Care Prepayment Plans § 417.802 Allowable costs. (a) General rule. The costs that are considered allowable for HCPP reimbursement are the same as those for reasonable cost HMOs and CMPs specified...

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

Science.gov (United States)

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

2016-08-01

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

Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach

Directory of Open Access Journals (Sweden)

Augestad KM

2014-09-01

Full Text Available Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 4Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs' EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £ to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670 and 37 (range 29–49 referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to

Socio-economic costs of osteoarthritis: a systematic review of cost-of-illness studies.

Science.gov (United States)

Puig-Junoy, Jaume; Ruiz Zamora, Alba

2015-04-01

The burden of illness that can be attributed to osteoarthritis is considerable and ever increasing. The aim of this systematic review is to analyze currently available data derived from cost-of-illness studies on the healthcare and non-healthcare costs of osteoarthritis. PubMed, Index Medicus Español (IME), and the Spanish Database of Health Sciences [Índice Bibliográfico Español en Ciencias de la Salud (IBECS)] were searched up to the end of April 2013. This study adhered to the PRISMA guidelines. Articles were reviewed and the study quality assessed by two independent investigators with consensus resolution of discrepancies. We identified 39 studies that investigated the socio-economic cost of osteoarthritis. Only nine studies took a social perspective. Rather than estimating the incremental cost of osteoarthritis, nine studies estimated the total cost of treating patients with osteoarthritis without a control for comorbidity. The other 30 studies determined the incremental cost with or without a control group. Only nine studies assessed a comprehensive list of healthcare resources. The annual incremental healthcare costs of generalized osteoarthritis ranged from €705 to €19,715. The annual incremental non-healthcare-related costs of generalized osteoarthritis ranged from €432 to €11,956. The study concludes that the social cost of osteoarthritis could be between 0.25% and 0.50% of a country׳s GDP. This should be considered in order to foster studies that take into account both healthcare and non-healthcare costs. Copyright © 2014 Elsevier Inc. All rights reserved.

Networks and RegionalCompetitiveness: Towards a Transaction Cost Approach of Small-Scale Cooperation

Directory of Open Access Journals (Sweden)

Daniel Friel

2005-06-01

Full Text Available A preoccupation with competition often dominates the study of governance. A focus on competition often unnecessarily precludes the possibility that regional institutions can suspend competition in certain areas and facilitate cooperation among potential rivals, thereby potentially contributing to their mutual success. In many ways companies cooperating through these types of networks have a greater degree of flexibility than firms which are forced to rely solely on hierarchies or markets for solutions to their problems. In order to fully understand how such networks work, this article first parses out differences in definitions of networks in order to understand how the type of network mentioned above actually differs from other uses of this term. Then it develops a theory of governance that goes beyond hierarchies and markets by demonstrating how this type of network can lead to reductions in transaction costs. This claim is illustrated on hand from examples of alternative forms of organization in Germany and Italy.

Pricing landfill externalities: Emissions and disamenity costs in Cape Town, South Africa

International Nuclear Information System (INIS)

Nahman, Anton

2011-01-01

Highlights: → The paper estimates landfill externalities associated with emissions, disamenities and transport. → Transport externalities vary from 24.22 to 31.42 Rands per tonne. → Costs of emissions (estimated using benefits transfer) vary from 0.07 to 28.91 Rands per tonne. → Disamenities (estimated using hedonic pricing) vary from 0.00 to 57.46 Rands per tonne. → Overall, external costs for urban landfills exceed those of a regional landfill. - Abstract: The external (environmental and social) costs of landfilling (e.g. emissions to air, soil and water; and 'disamenities' such as odours and pests) are difficult to quantify in monetary terms, and are therefore not generally reflected in waste disposal charges or taken into account in decision making regarding waste management options. This results in a bias against alternatives such as recycling, which may be more expensive than landfilling from a purely financial perspective, but preferable from an environmental and social perspective. There is therefore a need to quantify external costs in monetary terms, so that different disposal options can be compared on the basis of their overall costs to society (financial plus external costs). This study attempts to estimate the external costs of landfilling in the City of Cape Town for different scenarios, using the benefits transfer method (for emissions) and the hedonic pricing method (for disamenities). Both methods (in particular the process of transferring and adjusting estimates from one study site to another) are described in detail, allowing the procedures to be replicated elsewhere. The results show that external costs are currently R111 (in South African Rands, or approximately US$16) per tonne of waste, although these could decline under a scenario in which energy is recovered, or in which the existing urban landfills are replaced with a new regional landfill.

[Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

Science.gov (United States)

Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

2011-08-01

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

Making choices in health: WHO guide to cost effectiveness analysis

National Research Council Canada - National Science Library

Tan Torres Edejer, Tessa

2003-01-01

... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

International Nuclear Information System (INIS)

Jacobsen, R.; Buysse, J.; Gellynck, X.

2013-01-01

Highlights: ► The goal is to compare collection costs for residual household waste. ► We have clustered all municipalities in order to find mutual comparable pairs. ► Each pair consists of one private and one public operating waste collection program. ► All cases show that private service has lower costs than public service. ► Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticed in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.

Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

Energy Technology Data Exchange (ETDEWEB)

Jacobsen, R., E-mail: ray.jacobsen@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium); Buysse, J., E-mail: j.buysse@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium); Gellynck, X., E-mail: xavier.gellynck@ugent.be [Department of Agricultural Economics, Ghent University, Coupure Links 653, B-9000 Ghent (Belgium)

2013-01-15

Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticed in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.

48 CFR 49.113 - Cost principles.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost principles. 49.113 Section 49.113 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.113 Cost principles. The cost principles and procedures in the...

The cost of tuberculosis in Denmark

DEFF Research Database (Denmark)

Fløe, Andreas; Hilberg, Ole; Wejse, Christian

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

12 CFR 360.1 - Least-cost resolution.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Least-cost resolution. 360.1 Section 360.1 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY RESOLUTION AND RECEIVERSHIP RULES § 360.1 Least-cost resolution. (a) General rule. Except as provided in...

Regional estimation of rainfall intensity-duration-frequency curves using generalized least squares regression of partial duration series statistics

DEFF Research Database (Denmark)

Madsen, H.; Mikkelsen, Peter Steen; Rosbjerg, Dan

2002-01-01

A general framework for regional analysis and modeling of extreme rainfall characteristics is presented. The model is based on the partial duration series (PDS) method that includes in the analysis all events above a threshold level. In the PDS model the average annual number of exceedances...

Regional boundaries study

International Nuclear Information System (INIS)

Zavatsky, S.; Phaneuf, P.; Topaz, D.; Ward, D.

1978-02-01

The NRC Office of Inspection and Enforcement (IE) has elected to evaluate the effectiveness and efficiency of its existing regional boundary alignment because of the anticipated future growth of nuclear power generating facilities and corresponding inspection requirements. This report documents a management study designed to identify, analyze, and evaluate alternative regional boundary configurations for the NRC/IE regions. Eight boundary configurations were chosen for evaluation. These configurations offered alternatives ranging from two to ten regions, and some included the concepts of subregional or satellite offices. Each alternative configuration was evaluated according to three major criteria: project workload, cost, and office location. Each major criterion included elements such as management control, program uniformity, disruption, costs, and coordination with other agencies. The conclusion reached was that regional configurations with regions of equal and relatively large workloads, combined with the concepts of subregional or satellite offices, may offer a significant benefit to the Office of Inspection and Enforcement and the Commission and are worthy of further study. A phased implementation plan, which is suitable to some configurations, may help mitigate the disruption created by realignment

Review of the cost of venous thromboembolism

Directory of Open Access Journals (Sweden)

Fernandez MM

2015-08-01

Full Text Available Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods: Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results: Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion: Costs for VTE treatment are

48 CFR 30.101 - Cost Accounting Standards.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.101 Cost Accounting Standards. (a... Accounting Standards (CAS) and to disclose in writing and follow consistently their cost accounting practices...

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

Science.gov (United States)

Alexandrescu, Doru Traian

2009-11-15

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

Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study.

Science.gov (United States)

Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

2016-04-26

Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken. Five key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff. The move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health

Regional analysis of the nuclear-electricity

International Nuclear Information System (INIS)

Parera, M. D.

2011-11-01

In this study was realized a regional analysis of the Argentinean electric market contemplating the effects of regional cooperation, the internal and international interconnections; and the possibilities of insert of new nuclear power stations were evaluated in different regions of the country, indicating the most appropriate areas to carry out these facilities to increase the penetration of the nuclear energy in the national energy matrix. Also was studied the interconnection of the electricity and natural gas markets, due to the existent linking among both energy forms. With this purpose the program Message (Model for energy supply strategy alternatives and their general environmental impacts) was used, promoted by the International Atomic Energy Agency. This model carries out an economic optimization level country, obtaining the minimum cost as a result for the modeling system. The division for regions realized by the Compania Administradora del Mercado Mayorista Electrico (CAMMESA) was used, which divides to the country in eight regions. They were considered the characteristics and necessities of each one of them, their respective demands and offers of electric power and natural gas, as well as their existent and projected interconnections, composed by the electric lines and gas pipes. According to the results obtained through the model, the nuclear-electricity is a competitive option. (Author)

An integrated tool to study MHC region: accurate SNV detection and HLA genes typing in human MHC region using targeted high-throughput sequencing.

Directory of Open Access Journals (Sweden)

Hongzhi Cao

Full Text Available The major histocompatibility complex (MHC is one of the most variable and gene-dense regions of the human genome. Most studies of the MHC, and associated regions, focus on minor variants and HLA typing, many of which have been demonstrated to be associated with human disease susceptibility and metabolic pathways. However, the detection of variants in the MHC region, and diagnostic HLA typing, still lacks a coherent, standardized, cost effective and high coverage protocol of clinical quality and reliability. In this paper, we presented such a method for the accurate detection of minor variants and HLA types in the human MHC region, using high-throughput, high-coverage sequencing of target regions. A probe set was designed to template upon the 8 annotated human MHC haplotypes, and to encompass the 5 megabases (Mb of the extended MHC region. We deployed our probes upon three, genetically diverse human samples for probe set evaluation, and sequencing data show that ∼97% of the MHC region, and over 99% of the genes in MHC region, are covered with sufficient depth and good evenness. 98% of genotypes called by this capture sequencing prove consistent with established HapMap genotypes. We have concurrently developed a one-step pipeline for calling any HLA type referenced in the IMGT/HLA database from this target capture sequencing data, which shows over 96% typing accuracy when deployed at 4 digital resolution. This cost-effective and highly accurate approach for variant detection and HLA typing in the MHC region may lend further insight into immune-mediated diseases studies, and may find clinical utility in transplantation medicine research. This one-step pipeline is released for general evaluation and use by the scientific community.

Pollution control costs of a transboundary river basin: Empirical tests of the fairness and stability of cost allocation mechanisms using game theory.

Science.gov (United States)

Shi, Guang-Ming; Wang, Jin-Nan; Zhang, Bing; Zhang, Zhe; Zhang, Yong-Liang

2016-07-15

With rapid economic growth, transboundary river basin pollution in China has become a very serious problem. Based on practical experience in other countries, cooperation among regions is an economic way to control the emission of pollutants. This study develops a game theoretic simulation model to analyze the cost effectiveness of reducing water pollutant emissions in four regions of the Jialu River basin while considering the stability and fairness of four cost allocation schemes. Different schemes (the nucleolus, the weak nucleolus, the Shapley value and the Separable Cost Remaining Benefit (SCRB) principle) are used to allocate regionally agreed-upon water pollutant abatement costs. The main results show that the fully cooperative coalition yielded the highest incremental gain for regions willing to cooperate if each region agreed to negotiate by transferring part of the incremental gain obtained from the cooperation to cover the losses of other regions. In addition, these allocation schemes produce different outcomes in terms of their fairness to the players and in terms of their derived stability, as measured by the Shapley-Shubik Power Index and the Propensity to Disrupt. Although the Shapley value and the SCRB principle exhibit superior fairness and stabilization to the other methods, only the SCRB principle may maintains full cooperation among regions over the long term. The results provide clear empirical evidence that regional gain allocation may affect the sustainability of cooperation. Therefore, it is implied that not only the cost-effectiveness but also the long-term sustainability should be considered while formulating and implementing environmental policies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Regional applicability and potential of salt-gradient solar ponds in the United States. Volume 2: Detailed report

Science.gov (United States)

Lin, E. I. H.

1982-03-01

A comprehensive assessment of the regional applicability and potential of salt-gradient solar ponds in the United States is provided. The assessment is focused on the general characteristics of twelve defined geographic regions. Natural resources essential to solar ponds are surveyed. Meteorological and hydrogeological conditions affecting pond performance are examined. Potentially favorable pond sites are identified. Regional thermal and electrical energy output from solar ponds is calculated. Selected pond design cases are studied. Five major potential market sectors are evaluated in terms of technical and energy-consumption characteristics, and solar-pond applicability and potential. Relevant pond system data and financial factors are analyzed. Solar-pond energy costs are compared with conventional energy costs. The assessment concludes that, excepting Alaska, ponds are applicable in all regions for at least two market sectors. Total solar pond energy supply potential in the five market sectors examined is estimated to be 8.94 quads/yr by the year 2000, approximately 7.2% of the projected total national energy demand.

Hydropower Impacts on Electrical System Production Costs in the Southwest United States

Directory of Open Access Journals (Sweden)

Dominique M. Bain

2018-02-01

Full Text Available The Colorado River is an important natural resource for the Southwestern United States. Predicted climate change impacts include increased temperature, decreased rainfall and increased probability of drought in this region. Given the large amount of hydropower on the Colorado River and its importance to the bulk electricity system, this purpose of this study was to quantify the value hydropower in operating the electrical system, and examined changes in hydropower value and electricity costs under different possible future drought conditions and regional generation scenarios. The goal was to better understand how these scenarios affect operating costs of the bulk electrical system, as well as the value of the hydropower produced, and proposed a method for doing so. The calculated value of the hydroelectric power was nearly double the mean locational marginal price in the study area, about $73 to $75 for most scenarios, demonstrating a high value of the hydropower. In general, it was found that reduced water availability increased operating costs, and increased the value of the hydropower. A calculated value factor showed that when less hydroelectric power is available, the hydropower is more valuable. Furthermore, the value factor showed that the value of hydro increases with the addition of solar or the retirement of thermal generating resources.

The spread amongst ENSEMBLES regional scenarios: regional climate models, driving general circulation models and interannual variability

Energy Technology Data Exchange (ETDEWEB)

Deque, M.; Somot, S. [Meteo-France, Centre National de Recherches Meteorologiques, CNRS/GAME, Toulouse Cedex 01 (France); Sanchez-Gomez, E. [Cerfacs/CNRS, SUC URA1875, Toulouse Cedex 01 (France); Goodess, C.M. [University of East Anglia, Climatic Research Unit, Norwich (United Kingdom); Jacob, D. [Max Planck Institute for Meteorology, Hamburg (Germany); Lenderink, G. [KNMI, Postbus 201, De Bilt (Netherlands); Christensen, O.B. [Danish Meteorological Institute, Copenhagen Oe (Denmark)

2012-03-15

Various combinations of thirteen regional climate models (RCM) and six general circulation models (GCM) were used in FP6-ENSEMBLES. The response to the SRES-A1B greenhouse gas concentration scenario over Europe, calculated as the difference between the 2021-2050 and the 1961-1990 means can be viewed as an expected value about which various uncertainties exist. Uncertainties are measured here by variance explained for temperature and precipitation changes over eight European sub-areas. Three sources of uncertainty can be evaluated from the ENSEMBLES database. Sampling uncertainty is due to the fact that the model climate is estimated as an average over a finite number of years (30) despite a non-negligible interannual variability. Regional model uncertainty is due to the fact that the RCMs use different techniques to discretize the equations and to represent sub-grid effects. Global model uncertainty is due to the fact that the RCMs have been driven by different GCMs. Two methods are presented to fill the many empty cells of the ENSEMBLES RCM x GCM matrix. The first one is based on the same approach as in FP5-PRUDENCE. The second one uses the concept of weather regimes to attempt to separate the contribution of the GCM and the RCM. The variance of the climate response is analyzed with respect to the contribution of the GCM and the RCM. The two filling methods agree that the main contributor to the spread is the choice of the GCM, except for summer precipitation where the choice of the RCM dominates the uncertainty. Of course the implication of the GCM to the spread varies with the region, being maximum in the South-western part of Europe, whereas the continental parts are more sensitive to the choice of the RCM. The third cause of spread is systematically the interannual variability. The total uncertainty about temperature is not large enough to mask the 2021-2050 response which shows a similar pattern to the one obtained for 2071-2100 in PRUDENCE. The uncertainty

Wildfire Suppression Costs for Canada under a Changing Climate.

Directory of Open Access Journals (Sweden)

Emily S Hope

Full Text Available Climate-influenced changes in fire regimes in northern temperate and boreal regions will have both ecological and economic ramifications. We examine possible future wildfire area burned and suppression costs using a recently compiled historical (i.e., 1980-2009 fire management cost database for Canada and several Intergovernmental Panel on Climate Change (IPCC climate projections. Area burned was modelled as a function of a climate moisture index (CMI, and fire suppression costs then estimated as a function of area burned. Future estimates of area burned were generated from projections of the CMI under two emissions pathways for four General Circulation Models (GCMs; these estimates were constrained to ecologically reasonable values by incorporating a minimum fire return interval of 20 years. Total average annual national fire management costs are projected to increase to just under $1 billion (a 60% real increase from the 1980-2009 period under the low greenhouse gas emissions pathway and $1.4 billion (119% real increase from the base period under the high emissions pathway by the end of the century. For many provinces, annual costs that are currently considered extreme (i.e., occur once every ten years are projected to become commonplace (i.e., occur once every two years or more often as the century progresses. It is highly likely that evaluations of current wildland fire management paradigms will be necessary to avoid drastic and untenable cost increases as the century progresses.

A regional assessment of the cost and effectiveness of mitigation measures for reducing nutrient losses to water and greenhouse gas emissions to air from pastoral farms.

Science.gov (United States)

Vibart, Ronaldo; Vogeler, Iris; Dennis, Samuel; Kaye-Blake, William; Monaghan, Ross; Burggraaf, Vicki; Beautrais, Josef; Mackay, Alec

2015-06-01

Using a novel approach that links geospatial land resource information with individual farm-scale simulation, we conducted a regional assessment of nitrogen (N) and phosphorous (P) losses to water and greenhouse gas (GHG) emissions to air from the predominant mix of pastoral industries in Southland, New Zealand. An evaluation of the cost-effectiveness of several nutrient loss mitigation strategies applied at the farm-scale, set primarily for reducing N and P losses and grouped by capital cost and potential ease of adoption, followed an initial baseline assessment. Grouped nutrient loss mitigation strategies were applied on an additive basis on the assumption of full adoption, and were broadly identified as 'improved nutrient management' (M1), 'improved animal productivity' (M2), and 'restricted grazing' (M3). Estimated annual nitrate-N leaching losses occurring under representative baseline sheep and beef (cattle) farms, and representative baseline dairy farms for the region were 10 ± 2 and 32 ± 6 kg N/ha (mean ± standard deviation), respectively. Both sheep and beef and dairy farms were responsive to N leaching loss mitigation strategies in M1, at a low cost per kg N-loss mitigated. Only dairy farms were responsive to N leaching loss abatement from adopting M2, at no additional cost per kg N-loss mitigated. Dairy farms were also responsive to N leaching loss abatement from adopting M3, but this reduction came at a greater cost per kg N-loss mitigated. Only dairy farms were responsive to P-loss mitigation strategies, in particular by adopting M1. Only dairy farms were responsive to GHG abatement; greater abatement was achieved by the most intensified dairy farm system simulated. Overall, M1 provided for high levels of regional scale N- and P-loss abatement at a low cost per farm without affecting overall farm production, M2 provided additional N-loss abatement but only marginal P-loss abatement, whereas M3 provided the greatest N-loss abatement, but

Ventilation cost and air cleaning

Science.gov (United States)

Goodfellow, H. D.

The components associated with the costs of the purchase of pollution control equipment are discussed. These include the capital cost to purchase the equipment and installation, and the costs incurred to operate the control device on an annual basis. Although the capital costs can represent a significant outlay of money, typically these costs are spread out over the life of the equipment. In general, this amortized cost is combined with the operating cost and is referred to as an 'annualized cost'. The annualized cost is a commonly used indicator to demonstrate the actual year to year cost that the equipment and operation will represent. Values and methods used to estimate costs, typical cost indicators, and sources of computerized costing models are presented. A comparison of the capital cost expenditure required for a model case (a cement kiln operation), using three control device alternatives is made.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-14

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

48 CFR 31.205-46 - Travel costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Travel costs. 31.205-46....205-46 Travel costs. (a) Costs for transportation, lodging, meals, and incidental expenses. (1) Costs... at the time of travel as set forth in the— (i) Federal Travel Regulation, prescribed by the General...

25 CFR 700.81 - Monthly housing cost.

Science.gov (United States)

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for a...

Anti-Crisis Solutions for Regional Energy Sector

Directory of Open Access Journals (Sweden)

Leonid Davidovich Gitelman

2015-09-01

Full Text Available The paper considers anti-crisis solutions for the electricity sector that fall into the category of strategic ones. Their primary purpose is to ensure the flexibility and adaptability of the system and prevent emergencies in the future. The authors explain the need for a holistic approach to taking anti-crisis decisions in power engineering and propose ways to improve the economic mechanism of cost reduction based upon international practice and placed in the Russian context. The benefits of demand-side management in ensuring the reliability of power supplies amid crisis are shown. The paper looks at various implementation modalities for demandside management programmes and explores development prospects for distributed generation in Russia and stand-alone power supply options for manufacturing companies. Factors are assessed that affect the cost effectiveness of going off the grid. A general scheme of cost management aimed at reaching the strategic goals of the regional electricity sector is presented. The authors reveal possible applications and advantages of using predictive analytics for effective cost management. Ways of improving asset management are considered as well as the possibility of their employment in the Russian context. The key barriers to their implementations and ways of overcoming them are identified

What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.

Science.gov (United States)

Philips, Hilde; Remmen, Roy; Van Royen, Paul; Teblick, Marc; Geudens, Leo; Bronckaers, Marc; Meeuwis, Herman

2010-07-30

Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice. We used a prospective before/after interventional study design. The intervention was the implementation of a GPC. One year after the implementation of a GPC, the number of patient contacts in the intervention region significantly increased at the GPC (OR: 1.645; 95% CI: 1.439-1.880), while there were no significant changes in patient contacts at the Emergency Department (ED) or in other regions where a simultaneous registration was performed. Although home visits decreased in all general practitioner registrations, the difference was more pronounced in the intervention region (intervention region: OR: 0.515; 95% CI: 0.411-0.646, other regions: OR: 0.743; 95% CI: 0.608-0.908). At the ED we observed a decrease in the number of trauma cases (OR: 0.789; 95% CI: 0.648-0.960) and of patients who came to hospital by ambulance (OR: 0.687; 95% CI: 0.565-0.836). One year after its implementation more people seek help at the GPC, while the number of contacts at the ED remains the same. The most prominent changes in caseload are found in the trauma cases. Establishing a GPC in an open health care system, might redirect some patients with particular medical problems to primary care. This could lead to a lowering of costs or a more cost-effective out of hours care, but further research should focus on effective usage to divert patient flows and on quality and outcome of care.

Education, cost of living and regional wage inequality in Brazil

OpenAIRE

Luciana M.S. Servo; Carlos R. Azzoni

2002-01-01

The objective of this article is to analyze wage inequality among the 10 largest metropolitan regions in Brazil in the 1990s. We assess the extent to which worker characteristics (education, age, gender, race, position in the family) and job characteristics (occupational position, sector, experience) can explain wage inequality. The analysis is made both with regional-nominal and with regional-real wage data. In the second case regional price indexes are used to control for differences in cos...

Costs associated with wheeling

International Nuclear Information System (INIS)

Anon.

1991-01-01

Wheeling costs are incurred by all companies that experience a change in power flows over their transmission lines during a specific transaction, whether or not the lines of that company are part of the contract path. The costs of providing wheeling service differ from one system to another and from one kind of wheeling transaction to another. While most transactions may be completed using existing capacity, others may require an increase in line. Depending on the situation, some cost components may be high, low, negative, or not incurred at all. This article discusses two general categories of costs; transactional and capital. The former are all operation, maintenance and opportunity costs incurred in completing a specific transaction assuming the existence of adequate capacity. Capital costs are the costs of major new equipment purchases and lines necessary to provide any increased level of transmission services

Health care costs, wages, and aging

OpenAIRE

Louise Sheiner

1999-01-01

While economists generally agree that workers pay for their health insurance costs through reduced wages, there has been little thought devoted to the level at which these costs are passed on: Is each employee's wage reduced by the amount of his or her own health costs, by the average health costs of employees in the firm, or by some amount in between? This paper analyzes one dimension of the question of how firms pass health costs to workers. Using cross-city variation in health costs, I tes...

Effects of category-specific costs on neural systems for perceptual decision-making.

Science.gov (United States)

Fleming, Stephen M; Whiteley, Louise; Hulme, Oliver J; Sahani, Maneesh; Dolan, Raymond J

2010-06-01

Perceptual judgments are often biased by prospective losses, leading to changes in decision criteria. Little is known about how and where sensory evidence and cost information interact in the brain to influence perceptual categorization. Here we show that prospective losses systematically bias the perception of noisy face-house images. Asymmetries in category-specific cost were associated with enhanced blood-oxygen-level-dependent signal in a frontoparietal network. We observed selective activation of parahippocampal gyrus for changes in category-specific cost in keeping with the hypothesis that loss functions enact a particular task set that is communicated to visual regions. Across subjects, greater shifts in decision criteria were associated with greater activation of the anterior cingulate cortex (ACC). Our results support a hypothesis that costs bias an intermediate representation between perception and action, expressed via general effects on frontal cortex, and selective effects on extrastriate cortex. These findings indicate that asymmetric costs may affect a neural implementation of perceptual decision making in a similar manner to changes in category expectation, constituting a step toward accounting for how prospective losses are flexibly integrated with sensory evidence in the brain.

23 CFR 140.906 - Labor costs.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Labor costs. 140.906 Section 140.906 Highways FEDERAL... Railroad Work § 140.906 Labor costs. (a) General. (1) Salaries and wages, at actual or average rates, and... reimbursable when supported by adequate records. This shall include labor costs associated with preliminary...

Regional energy resource development and energy security under CO2 emission constraint in the greater Mekong sub-region countries (GMS)

International Nuclear Information System (INIS)

Watcharejyothin, Mayurachat; Shrestha, Ram M.

2009-01-01

The paper evaluates effects of energy resource development within the Greater Mekong Sub-region (GMS) on energy supply mix, energy system cost, energy security and environment during 2000-2035. A MARKAL-based integrated energy system model of the five GMS countries was developed to examine benefits of regional energy resource development for meeting the energy demand of these countries. The study found that an unrestricted energy resource development and trade within the region would reduce the total-regional energy systems cost by 18% and would abate the total CO 2 emission by 5% as compared to the base case. All the five countries except Myanmar would benefit from the expansion of regional energy resource integration in terms of lower energy systems costs and better environmental qualities. An imposition of CO 2 emission reduction constraint by 5% on each of the study countries from that of the corresponding emissions under the unrestricted energy resource development in the GMS is found to improve energy security, reduce energy import and fossil fuels dependences and increase volume of power trade within the region. The total energy system cost under the joint CO 2 emission reduction strategy would be less costly than that under the individual emission targets set for each country.

24 CFR 1000.22 - Are the costs of the environmental review an eligible cost?

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Are the costs of the environmental review an eligible cost? 1000.22 Section 1000.22 Housing and Urban Development Regulations Relating to..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES General § 1000.22 Are the...

A Socio-Ecological Approach to GIS Least-Cost Modelling for Regional Mining Infrastructure Planning: A Case Study from South-East Sulawesi, Indonesia

Directory of Open Access Journals (Sweden)

Alex M. Lechner

2017-01-01

Full Text Available Regional planning approaches to mining infrastructure aim to reduce the conflict associated with mining operations and existing land uses, such as urban areas and biodiversity conservation, as well as the cumulative impacts that occur offsite. In this paper, we describe a method for conducting Geographical Information System (GIS least-cost path and least-cost corridor analysis for linear mining infrastructure, such as roads. Least-cost path analysis identifies the optimal pathways between two locations as a function of the cost of traveling through different land use/cover types. In a case study from South-East Sulawesi, Indonesia, we identify potential linear networks for road infrastructure connecting mines, smelters, and ports. The method used interview data from government officials to characterise their orientation (perceived importance and positive/negative attitude toward the social and environmental factors associated with mining infrastructure. A cost-surface was constructed by integrating spatial layers representing the social and environmental factors to identify areas that should be avoided and areas that were compatible with linear infrastructure using the least-cost path analysis. We compared infrastructure scenario outputs from local and national government officials by the degree of spatial overlap and found broad spatial agreement for infrastructure corridors. We conclude by discussing this approach in relation to the wider social-ecological and mine planning literature and how quantitative approaches can reduce the conflict associated with infrastructure planning.

Cost of tobacco-related diseases, including passive smoking, in Hong Kong.

Science.gov (United States)

McGhee, S M; Ho, L M; Lapsley, H M; Chau, J; Cheung, W L; Ho, S Y; Pow, M; Lam, T H; Hedley, A J

2006-04-01

Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking. To estimate the health-related costs of tobacco from both active and passive smoking. Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of USD 1.3 million for a life lost. In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was USD 532 million for active smoking and USD 156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to USD 9.4 billion. The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere.

A generalized global alignment algorithm.

Science.gov (United States)

Huang, Xiaoqiu; Chao, Kun-Mao

2003-01-22

Homologous sequences are sometimes similar over some regions but different over other regions. Homologous sequences have a much lower global similarity if the different regions are much longer than the similar regions. We present a generalized global alignment algorithm for comparing sequences with intermittent similarities, an ordered list of similar regions separated by different regions. A generalized global alignment model is defined to handle sequences with intermittent similarities. A dynamic programming algorithm is designed to compute an optimal general alignment in time proportional to the product of sequence lengths and in space proportional to the sum of sequence lengths. The algorithm is implemented as a computer program named GAP3 (Global Alignment Program Version 3). The generalized global alignment model is validated by experimental results produced with GAP3 on both DNA and protein sequences. The GAP3 program extends the ability of standard global alignment programs to recognize homologous sequences of lower similarity. The GAP3 program is freely available for academic use at http://bioinformatics.iastate.edu/aat/align/align.html.

Cost and Demand Characteristics of Telecom Networks

DEFF Research Database (Denmark)

Falch, Morten

1997-01-01

The Chapter presents the general characteristics of the cost and demand profiles for telecommunication services and identifies the barriers towards a free competitive market for telecommunication services related to these characteristics.......The Chapter presents the general characteristics of the cost and demand profiles for telecommunication services and identifies the barriers towards a free competitive market for telecommunication services related to these characteristics....

A genetic-algorithm-aided stochastic optimization model for regional air quality management under uncertainty.

Science.gov (United States)

Qin, Xiaosheng; Huang, Guohe; Liu, Lei

2010-01-01

A genetic-algorithm-aided stochastic optimization (GASO) model was developed in this study for supporting regional air quality management under uncertainty. The model incorporated genetic algorithm (GA) and Monte Carlo simulation techniques into a general stochastic chance-constrained programming (CCP) framework and allowed uncertainties in simulation and optimization model parameters to be considered explicitly in the design of least-cost strategies. GA was used to seek the optimal solution of the management model by progressively evaluating the performances of individual solutions. Monte Carlo simulation was used to check the feasibility of each solution. A management problem in terms of regional air pollution control was studied to demonstrate the applicability of the proposed method. Results of the case study indicated the proposed model could effectively communicate uncertainties into the optimization process and generate solutions that contained a spectrum of potential air pollutant treatment options with risk and cost information. Decision alternatives could be obtained by analyzing tradeoffs between the overall pollutant treatment cost and the system-failure risk due to inherent uncertainties.

Mandatory cost and other cost coming from the adoption of quality certifications in the hospitality business

OpenAIRE

Sanchez Rebull, M. Victoria; Hernandez, Ana Betriz; Banchieri, Lucia; Campa Planas, Fernando; Ginieis, Matias

2011-01-01

The adaptation to the regulation of hospitality business implies a relevant cost in the profit and loss account. Additionally, some companies in this business decide to add some voluntary quality and environmental certification systems, which also yields to increased costs. The purpose of this paper is to quantify these costs and to analyse if the hotel size influences them. A total of 67 different costs were considered in hotels of all sizes, in the region of Catalonia as one of the most rel...

Cost Analysis for Large Civil Transport Rotorcraft

Science.gov (United States)

Coy, John J.

2006-01-01

This paper presents cost analysis of purchase price and DOC+I (direct operating cost plus interest) that supports NASA s study of three advanced rotorcraft concepts that could enter commercial transport service within 10 to 15 years. The components of DOC+I are maintenance, flight crew, fuel, depreciation, insurance, and finance. The cost analysis aims at VTOL (vertical takeoff and landing) and CTOL (conventional takeoff and landing) aircraft suitable for regional transport service. The resulting spreadsheet-implemented cost models are semi-empirical and based on Department of Transportation and Army data from actual operations of such aircraft. This paper describes a rationale for selecting cost tech factors without which VTOL is more costly than CTOL by a factor of 10 for maintenance cost and a factor of two for purchase price. The three VTOL designs selected for cost comparisons meet the mission requirement to fly 1,200 nautical miles at 350 knots and 30,000 ft carrying 120 passengers. The lowest cost VTOL design is a large civil tilt rotor (LCTR) aircraft. With cost tech factors applied, the LCTR is reasonably competitive with the Boeing 737-700 when operated in economy regional service following the business model of the selected baseline operation, that of Southwest Airlines.

Initiatives for regional dialogue consideration of regional disarmament guidelines

International Nuclear Information System (INIS)

Marschik, R.

1994-01-01

The General Assembly of the United Nations adopted guidelines and recommendations for regional approaches to disarmament within the context of global security. The guidelines contain 52 principles on: relationship between regional disarmament, arm limitation and global security; general guidelines and recommendations for regional disarmament efforts; possible ways and means to assist and implement these efforts; possible role of the United Nations in aiding these efforts. Experiences gained in Europe and Near East are analysed in the framework of the situation in Northeast, South and Southeast Asia

Assessing the Costs and Benefits of Resilience Investments: Tennessee Valley Authority Case Study

Energy Technology Data Exchange (ETDEWEB)

Allen, Melissa R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilbanks, Thomas J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Preston, Benjamin L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kao, Shih-Chieh [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Bradbury, James [U.S. Department of Energy (DOE), Office of Energy Policy and Systems Analysis (EPSA), Washington, DC (United States)

2017-01-01

This report describes a general approach for assessing climate change vulnerabilities of an electricity system and evaluating the costs and benefits of certain investments that would increase system resilience. It uses Tennessee Valley Authority (TVA) as a case study, concentrating on the Cumberland River basin area on the northern side of the TVA region. The study focuses in particular on evaluating risks associated with extreme heat wave and drought conditions that could be expected to affect the region by mid-century. Extreme climate event scenarios were developed using a combination of dynamically downscaled output from the Community Earth System Model and historical heat wave and drought conditions in 1993 and 2007, respectively.

A decision analytical cost analysis of offering ECV in a UK district general hospital

Directory of Open Access Journals (Sweden)

Burr Robin

2001-07-01

Full Text Available Abstract Objective To determine the care pathways and implications of offering mothers the choice of external cephalic version (ECV at term for singleton babies who present with an uncomplicated breech pregnancy versus assisted breech delivery or elective caesarean. Design A prospective observational audit to construct a decision analysis of uncomplicated full term breech presentations. Setting The North Staffordshire NHS Trust. Subjects All women (n = 176 who presented at full term with a breech baby without complications during July 1995 and June 1997. Main outcome measures The study determined to compare the outcome in terms of the costs and cost consequences for the care pathways that resulted from whether a women chose to accept the offer of ECV or not. All the associated events were then mapped for the two possible pathways. The costs were considered only within the hospital setting, from the perspective of the health care provider up to the point of delivery. Results The additional costs for ECV, assisted breech delivery and elective caesarean over and above a normal birth were £186.70, £425.36 and £1,955.22 respectively. The total expected cost of the respective care pathways for "ECV accepted" and "ECV not accepted" (including the probability of adverse events were £1,452 and £1,828 respectively, that is the cost of delivery through the ECV care pathways is less costly than the non ECV delivery care pathway. Conclusions Implementing an ECV service may yield cost savings in secondary care over and above the traditional delivery methods for breech birth of assisted delivery or caesarean section. The scale of these expected cost savings are in the range of £248 to £376 per patient. This converts to a total expected cost saving of between £43,616 and £44,544 for the patient cohort considered in this study.

Nuclear power regional analysis; Análisis regional de la nucleoelectricidad

Energy Technology Data Exchange (ETDEWEB)

Parera, María Delia, E-mail: dparera@cnea.gov.ar [Comisión Nacional de Energía Atómica, San Martin (Argentina). Gerencia de Planificación Coordinación y Control, Subgerencia de Planificación Estratégica

2011-07-01

In this study, a regional analysis of the Argentine electricity market was carried out considering the effects of regional cooperation, national and international interconnections; additionally, the possibilities of insertion of new nuclear power plants in different regions were evaluated, indicating the most suitable areas for these facilities to increase the penetration of nuclear energy in national energy matrix. The interconnection of electricity markets and natural gas due to the linkage between both energy forms was also studied. With this purpose, MESSAGE program was used (Model for Energy Supply Strategy Alternatives and their General Environmental Impacts), promoted by the International Atomic Energy Agency (IAEA). This model performs a country-level economic optimization, resulting in the minimum cost for the modelling system. Regionalization executed by the Wholesale Electricity Market Management Company (CAMMESA, by its Spanish acronym) that divides the country into eight regions. The characteristics and the needs of each region, their respective demands and supplies of electricity and natural gas, as well as existing and planned interconnections, consisting of power lines and pipelines were taken into account. According to the results obtained through the model, nuclear is a competitive option. (author) [Spanish] En el presente estudio se realizó un análisis regional del mercado eléctrico argentino contemplando los efectos de cooperación regional, las interconexiones internas e internacionales; y se evaluó las posibilidades de inserción de nuevas centrales nucleares en diferentes regiones del país, indicando las zonas más adecuadas para realizar estas instalaciones para aumentar la penetración de la energía nuclear en la matriz energética nacional. Asimismo se estudió la interconexión de los mercados de electricidad y gas natural, debido a la vinculación existente entre ambas formas de energía. Con este fin se utilizó el programa

The Cost-Effectiveness of Spinal Cord Stimulation for Complex Regional Pain Syndrome

NARCIS (Netherlands)

Kemler, Marius A.; Raphael, Jon H.; Bentley, Anthony; Taylor, Rod S.

2010-01-01

Objectives: Health-care policymakers and payers require cost-effectiveness evidence to inform their treatment funding decisions. The aims of this study were to assess the cost-effectiveness of the addition of spinal cord stimulation (SCS) compared with conventional management alone (CMM) in patients

Trends and costs of overtime among nurses in Canada.

Science.gov (United States)

Drebit, Sharla; Ngan, Karen; Hay, Mande; Alamgir, Hasanat

2010-06-01

To examine the regular and overtime working hours of Registered Nurses in acute care and their associated costs by employment status (full time, part time, casual) and department over a 4-year period. Data were extracted for 2005-2008 from one health region's payroll database for Registered Nurses in acute care in British Columbia, Canada. Regular and overtime hours by employment status and department were plotted over time and tested using simple linear regression. Regular and overtime wage costs were calculated at the individual level using the employee's wage rate and stratified by year, gender, age, employment status and department. Full time Registered Nurses are working an increasing amount of overtime hours each year. Full time nurses in Emergency, Intensive Care and General Medical departments are working the highest proportion of overtime hours per total hours and consequently, contributing the highest proportion of overtime costs. Efforts to lighten the burden of overtime should be focused at the department level. Creating more full time positions out of overtime hours may be one solution to alleviate this burden of overtime and to assuage the nursing shortage in Canada. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

The influence of patients' complexity and general practitioners' characteristics on referrals to outpatient health services in an Italian region

Directory of Open Access Journals (Sweden)

Francesca Valent

2015-09-01

Full Text Available BACKGROUND. Patient referrals to outpatient health services may affect both health outcomes and health expenditures. General practitioners (GP have a crucial role in driving the use of outpatient services and recognizing factors which affect referrals is important for health managers and planners. OBJECTIVES. We investigated patient- and physician-related determinants of patient referrals in an Italian region. METHODS. This was cross-sectional study based on the individual linkage of administrative databases from the health information system of the Friuli Venezia Giulia region. For each GP of the region, the association of the number of patient referrals to different types of outpatient services with the proportion of patients with chronic conditions, with the number of hospital admissions and drug prescriptions in 2012, and with GP's characteristics was investigated through multilevel multivariable Poisson regression models. RESULTS. Some chronic conditions (e.g., cancer, autoimmune diseases, endocrine diseases, digestive system diseases were positively associated with the number of referrals, as were hospital admissions and drug prescriptions. Time since GP's graduation was inversely related with referrals. CONCLUSION. Patient complexity and GP's experience affect referral rates. These factors should be considered in case of a reorganization of the general practice structure in Friuli Venezia Giulia.

48 CFR 31.205-10 - Cost of money.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost of money. 31.205-10....205-10 Cost of money. (a) General. Cost of money— (1) Is an imputed cost that is not a form of...) Refers to— (i) Facilities capital cost of money (48 CFR 9904.414); and (ii) Cost of money as an element...

Excess costs of social anxiety disorder in Germany.

Science.gov (United States)

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

2017-04-15

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

Environmental mitigation at hydroelectric projects. Volume 2, Benefits and costs of fish passage and protection

Energy Technology Data Exchange (ETDEWEB)

Francfort, J.E.; Rinehart, B.N.; Sommers, G.L. [EG and G Idaho, Inc., Idaho Falls, ID (United States); Cada, G.F.; Jones, D.W. [Oak Ridge National Lab., TN (United States); Dauble, D.D. [Pacific Northwest Lab., Richland, WA (United States); Hunt, R.T. [Hunt (Richard) Associates, Inc., Concord, NH (United States); Costello, R.J. [Northwest Water Resources Advisory Services (United States)

1994-01-01

This study examines envirorunental mitigation practices that provide upstream and downstream fish passage and protection at hydroelectric projects. The study includes a survey of fish passage and protection mitigation practices at 1,825 hydroelectric plants regulated by the Federal Energy Regulatory Commission (FERC) to determine frequencies of occurrence, temporal trends, and regional practices based on FERC regions. The study also describes, in general terms, the fish passage/protection mitigation costs at 50 non-Federal hydroelectric projects. Sixteen case studies are used to examine in detail the benefits and costs of fish passage and protection. The 16 case studies include 15 FERC licensed or exempted hydroelectric projects and one Federally-owned and-operated hydroelectric project. The 16 hydroelectric projects are located in 12 states and range in capacity from 400 kilowatts to 840 megawatts. The fish passage and protection mitigation methods at the case studies include fish ladders and lifts, an Eicher screen, spill flows, airburst-cleaned inclined and cylindrical wedgewire screens, vertical barrier screens, and submerged traveling screens. The costs, benefits, monitoring methods, and operating characteristics of these and other mitigation methods used at the 16 case studies are examined.

The social costs of production and the structure of technology in the Brazilian ethanol industry: A cost-benefit analysis and an infant industry evaluation, 1978-1987

International Nuclear Information System (INIS)

Rask, K.N.

1991-01-01

Only one country, Brazil, has developed an economy-wide liquid fuel industry which directly substitutes for gasoline. The experience of sugar-cane-based ethanol production in Brazil provides an important case study in the economic efficiency of this petroleum substitute. Partial equilibrium cost-benefit analysis is used to evaluate the net social benefits of ethanol production over the decade beginning in 1978. Ethanol production from the southern region of Brazil is found to be an economically efficient substitute for petroleum when world oil prices are over $20 per barrel. Ethanol production in the northern Brazil has never been economic and will not be until oil prices rise above $40 per barrel. The second half of this thesis uses applied production analysis to determine the source of the ethanol unit cost reductions. For sugar-cane production, a modified symmetric generalized McFadden cost function which includes fixed factors of production is estimated. There is little evidence of technical progress and no evidence of increasing returns to scale in sugar-cane production

48 CFR 32.601 - General.

Science.gov (United States)

2010-10-01

... costs related to defaults in performance. (10) Breach of contract obligations concerning progress....601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Contract Debts 32.601 General. (a) Contract debts are amounts that— (1) Have...

Regional energy resource development and energy security under CO{sub 2} emission constraint in the greater Mekong sub-region countries (GMS)

Energy Technology Data Exchange (ETDEWEB)

Watcharejyothin, Mayurachat; Shrestha, Ram M. [School of Environment, Resources and Development, Asian Institute of Technology (Thailand)

2009-11-15

The paper evaluates effects of energy resource development within the Greater Mekong Sub-region (GMS) on energy supply mix, energy system cost, energy security and environment during 2000-2035. A MARKAL-based integrated energy system model of the five GMS countries was developed to examine benefits of regional energy resource development for meeting the energy demand of these countries. The study found that an unrestricted energy resource development and trade within the region would reduce the total-regional energy systems cost by 18% and would abate the total CO{sub 2} emission by 5% as compared to the base case. All the five countries except Myanmar would benefit from the expansion of regional energy resource integration in terms of lower energy systems costs and better environmental qualities. An imposition of CO{sub 2} emission reduction constraint by 5% on each of the study countries from that of the corresponding emissions under the unrestricted energy resource development in the GMS is found to improve energy security, reduce energy import and fossil fuels dependences and increase volume of power trade within the region. The total energy system cost under the joint CO{sub 2} emission reduction strategy would be less costly than that under the individual emission targets set for each country. (author)

Costs of biodiesel supply chain in Latvia

International Nuclear Information System (INIS)

Birzietis, G.; Kunkule, D.

2003-01-01

Biodiesels has already become reality in Latvia, but still not are extensively used due to number of reasons. Cost reduction would be one of the most efficient tools that could encourage wider use of biodiesel. Identifying costs in biodiesel supply chain and evaluating their weight in total cost of final product is the first step to finding most costly elements and potential for cost reduction. General cost breakdown in final price is calculated and analysed in this study (authors)

MONITORED GEOLOGIC REPOSITORY LIFE CYCLE COST ESTIMATE ASSUMPTIONS DOCUMENT

International Nuclear Information System (INIS)

R.E. Sweeney

2001-01-01

The purpose of this assumptions document is to provide general scope, strategy, technical basis, schedule and cost assumptions for the Monitored Geologic Repository (MGR) life cycle cost (LCC) estimate and schedule update incorporating information from the Viability Assessment (VA) , License Application Design Selection (LADS), 1999 Update to the Total System Life Cycle Cost (TSLCC) estimate and from other related and updated information. This document is intended to generally follow the assumptions outlined in the previous MGR cost estimates and as further prescribed by DOE guidance

Monitored Geologic Repository Life Cycle Cost Estimate Assumptions Document

International Nuclear Information System (INIS)

Sweeney, R.

2000-01-01

The purpose of this assumptions document is to provide general scope, strategy, technical basis, schedule and cost assumptions for the Monitored Geologic Repository (MGR) life cycle cost estimate and schedule update incorporating information from the Viability Assessment (VA), License Application Design Selection (LADS), 1999 Update to the Total System Life Cycle Cost (TSLCC) estimate and from other related and updated information. This document is intended to generally follow the assumptions outlined in the previous MGR cost estimates and as further prescribed by DOE guidance

An analysis of geothermal heating and engineering cost in Tianjin, China

International Nuclear Information System (INIS)

Wang, W.

1990-01-01

Tianjin is a region with fairly rich low-temperature geothermal resources. Its climate and soaring price of raw coals have made geo heating in Tianjin develop rapidly over the past 5 years. The types of heating systems fall into 3 categories and the primary factors for using temperature drop are 5. According to economical analysis, the optimal discharge temperature in the space heating is about 43 degrees C and the minimum discharge temperature 35 degrees C approximately. This paper reports that an analysis of a typical engineering costs involved shows that the advantages of geo space heating are not notable when compared with burning coals. However, to reduce air pollution, the state and general public are ready to support the development of such geothermal wells as deep as 3,000 m for space heating irrespective of their sole engineering costs

48 CFR 9903.101 - Cost Accounting Standards.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost Accounting Standards. 9903.101 Section 9903.101 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE General 9903.101 Cost Accounting Standards. Public Law 100-679 (41 U.S...

Brain network analysis: separating cost from topology using cost-integration.

Directory of Open Access Journals (Sweden)

Cedric E Ginestet

Full Text Available A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i differences in weighted costs and (ii differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

Brain Network Analysis: Separating Cost from Topology Using Cost-Integration

Science.gov (United States)

Ginestet, Cedric E.; Nichols, Thomas E.; Bullmore, Ed T.; Simmons, Andrew

2011-01-01

A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i) differences in weighted costs and (ii) differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration. PMID:21829437

Cost-effective and robust mitigation of space debris in low earth orbit

Science.gov (United States)

Walker, R.; Martin, C.

It is predicted that the space debris population in low Earth orbit (LEO) will continue to grow and in an exponential manner in the long-term due to an increasing rate of collisions between large objects, unless internationally-accepted space debris mitigation measures are adopted soon. Such measures are aimed at avoiding the future generation of space debris objects and primarily need to be effective in preventing significant long-term growth in the debris population, even in the potential scenario of an increase in future space activity. It is also important that mitigation measures can limit future debris population levels, and therefore the underlying collision risk to space missions, to the lowest extent possible. However, for their wide acceptance, the cost of implementation associated with mitigation measures needs to be minimised as far as possible. Generally, a lower collision risk will cost more to achieve and vice versa, so it is necessary to strike a balance between cost and risk in order to find a cost-effective set of mitigation measures. In this paper, clear criteria are established in order to assess the cost-effectiveness of space debris mitigation measures. A full cost-risk-benefit trade-off analysis of numerous mitigation scenarios is presented. These scenarios consider explosion prevention and post-mission disposal of space systems, including de-orbiting to limited lifetime orbits and re-orbiting above the LEO region. The ESA DELTA model is used to provide long-term debris environment projections for these scenarios as input to the benefit and risk parts of the trade-off analysis. Manoeuvre requirements for the different post-mission disposal scenarios were also calculated in order to define the cost-related element. A 25-year post-mission lifetime de-orbit policy, combined with explosion prevention and mission-related object limitation, was found to be the most cost-effective solution to the space debris problem in LEO. This package would also

On financial equilibrium with intermediation costs

DEFF Research Database (Denmark)

Markeprand, Tobias Ejnar

2008-01-01

This paper studies the set of competitive equilibria in financial economies with intermediation costs. We consider an arbitrary dividend structure, which includes options and equity with limited liabilities.We show a general existence result and upper-hemi continuity of the equilibrium correspond......This paper studies the set of competitive equilibria in financial economies with intermediation costs. We consider an arbitrary dividend structure, which includes options and equity with limited liabilities.We show a general existence result and upper-hemi continuity of the equilibrium...

Preliminaries to a feasibility analysis of the Maglev proposal of the Southern California Association of Governments for the region : a seed grant study report

Science.gov (United States)

2009-08-30

This is a seed grant study to perform a preliminary investigation of the system components and : generalized costs of the magnetic levitation type of high speed rail system that is proposed for the : Southern California Region, TGVbased high speed...

Some Observations on Cost-Effectiveness Analysis in Education.

Science.gov (United States)

Geske, Terry G.

1979-01-01

The general nature of cost-effectiveness analysis is discussed, analytical frameworks for conducting cost-effectiveness studies are described, and some of the problems inherent in measuring educational costs and in assessing program effectiveness are addressed. (Author/IRT)

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

Science.gov (United States)

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

2009-04-01

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

The nitrogen abatement cost in wetlands

International Nuclear Information System (INIS)

Bystroem, Olof

1998-01-01

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

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

Directory of Open Access Journals (Sweden)

Daniel G Datiko

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

Health care costs before and after diagnosis of depression in patients with unexplained pain: a retrospective cohort study using the United Kingdom General Practice Research Database

Directory of Open Access Journals (Sweden)

Reed C

2013-01-01

Full Text Available Catherine Reed,1 Jihyung Hong,2 Diego Novick,1 Alan Lenox-Smith,3 Michael Happich41Global Health Outcomes, Eli Lilly and Company, Windlesham, Surrey, UK; 2Personal Social Services Research Unit, London School of Economics and Political Science, London, UK; 3Eli Lilly UK, Basingstoke, UK; 4Eli Lilly and Company, Bad Homburg, GermanyPurpose: To assess the impact of pain severity and time to diagnosis of depression on health care costs for primary care patients with pre-existing unexplained pain symptoms who subsequently received a diagnosis of depression.Patients and methods: This retrospective cohort study analyzed 4000 adults with unexplained pain (defined as painful physical symptoms [PPS] without any probable organic cause and a subsequent diagnosis of depression, identified from the UK General Practice Research Database using diagnostic codes. Patients were categorized into four groups based on pain severity (milder or more severe; based on number of pain-relief medications and use of opioids and time to diagnosis of depression (≤1 year or >1 year from PPS index date. Annual health care costs were calculated (2009 values and included general practitioner (GP consultations, secondary care referrals, and prescriptions for pain-relief medications for the 12 months before depression diagnosis and in the subsequent 2 years. Multivariate models of cost included time period as a main independent variable, and adjusted for age, gender, and comorbidities.Results: Total annual health care costs before and after depression diagnosis for the four patient groups were higher for the groups with more severe pain (£819–£988 versus £565–£628; P < 0.001 for all pairwise comparisons and highest for the group with more severe pain and longer time to depression diagnosis in the subsequent 2 years (P < 0.05. Total GP costs were highest in the group with more severe pain and longer time to depression diagnosis both before and after depression diagnosis (P

The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study

NARCIS (Netherlands)

Biezen, M.G. van der; Adang, E.M.; Burgt, R. Van Der; Wensing, M.; Laurant, M.G.

2016-01-01

BACKGROUND: The pressure in out-of-hours primary care is high due to an increasing demand for care and rising health-care costs. During the daytime, substituting general practitioners (GPs) with nurse practitioners (NPs) shows positive results to contribute to these challenges. However, there is a

Securitization: A state attorney general`s perspective

Energy Technology Data Exchange (ETDEWEB)

Kelley, F.J.

1997-10-01

Securitization will put hundreds of millions of dollars in the hands of utilities and line the pockets of Wall Street bankers, but it`s a highly dubious proposition for consumers and advocates of competition. Investor-owned utilities are not just salivating over large stranded cost recovery for past uneconomic decisions, but are dreaming of billions of dollars of up-front cash that securitization will provide. Whether the utilities sense any {open_quotes}ill a brewing,{close_quotes} the author does not know, but he believes that once the particulars of securitization are brought to the light of day, public pressures will mount and will indeed bring {open_quotes}some ill a-brewing{close_quotes} to the morass known as securitization. Securitization has arisen as a means by which utilities can recover their stranded costs. Under the pending concept of securitization, utilities calculate their estimated future losses and then offer bonds on the open market equal to the amount of stranded costs they wish to recover. This article addresses the myriad shortcomings of the securitization process from the perspective of the general public. It does not address whether any level of stranded cost recovery, in and of itself, is appropriate, but assumes, for the sake of argument, that utilities will be permitted some level of stranded cost recovery and addresses only the question of whether securitization is the proper vehicle for recovery of those costs.

Nuclear costs: indicators and uncertainties

International Nuclear Information System (INIS)

Leveque, Francois

2013-01-01

In order to identify whether it is better to build a gas plant, a nuclear plant or a wind farm, to identify the technology leading to the lowest KWh cost, to identify under which conditions nuclear production is profitable for a private investor, and to identify whether taking the dismantling cost and the waste storage cost into account modifies the nuclear competitiveness with respect to general interest, the author first discusses the different costs of the nuclear sector, their sensitivity to different factors. In a second part, he proposes a retrospective discussion of cost dynamics. Then, as nuclear technology seems characterized by always increasing costs, and as this trend may last, notably because of safety concerns, the author proposes an analysis of the poor competitiveness of nuclear with respect to its cost

A cost-minimization analysis of root canal treatment before and after education in nickel-titanium rotary technique in general practice.

Science.gov (United States)

Koch, M; Tegelberg, A; Eckerlund, I; Axelsson, S

2012-07-01

To compare root canal treatments performed before and after education in a nickel-titanium rotary technique (NiTiR) with respect to costs for instrumentation and number of instrumentation sessions in a County Public Dental Service in Sweden.   Following education, 77% of the general dental practitioners adopted completely the NiTiR. The randomly selected sample comprised 850 root canal treatments: 425 performed after the education, mainly using the NiTiR-technique (group A) and 425 performed before, using mainly stainless steel hand instrumentation (SSI) (group B). The number of instrumentation sessions in root canal treatments in group A and B was calculated. A CMA was undertaken on the assumption that treatment outcome was identical in group A and B. Direct costs associated with SSI and NiTiR were estimated and compared. Investment costs required for implementation of NiTiR were calculated, but not included in the CMA. Instrumentation sessions were counted in 418 (98%) root canal treatments performed in group A and 419 (99%) in group B. The number of instrumentation sessions in group A was significantly lower; 2.38, compared with 2.82 in group B (P session was saved. Root canal treatments in teeth with one canal, and three or more canals, were completed in significantly fewer instrumentation sessions after the education (P sessions were SEK 2587 (USD 411) for group A and SEK 2851 (USD 453) for group B, for teeth with one canal, and SEK 2946 (USD 468) for group A and SEK 3510 (USD 558) for group B, for teeth with three or more canals (year 2011). Root canal treatments of teeth with two canals showed no significant difference with respect to number of instrumentation sessions and costs. Significantly fewer instrumentation sessions were required in group A, and root canal instrumentation therefore costs less than in group B. On the assumption that treatment outcome is identical in group A and B, root canal instrumentation performed after the education was more

Estimation of Damage Costs Associated with Flood Events

Science.gov (United States)

Andrews, T. A.; Wauthier, C.; Zipp, K.

2017-12-01

This study investigates the possibility of creating a mathematical function that enables the estimation of flood-damage costs. We begin by examining the costs associated with past flood events in the United States. The data on these tropical storms and hurricanes are provided by the National Oceanic and Atmospheric Administration. With the location, extent of flooding, and damage reparation costs identified, we analyze variables such as: number of inches rained, land elevation, type of landscape, region development in regards to building density and infrastructure, and population concentration. We seek to identify the leading drivers of high flood-damage costs and understand which variables play a large role in the costliness of these weather events. Upon completion of our mathematical analysis, we turn out attention to the 2017 natural disaster of Texas. We divide the region, as we did above, by land elevation, type of landscape, region development in regards to building density and infrastructure, and population concentration. Then, we overlay the number of inches rained in those regions onto the divided landscape and apply our function. We hope to use these findings to estimate the potential flood-damage costs of Hurricane Harvey. This information is then transformed into a hazard map that could provide citizens and businesses of flood-stricken zones additional resources for their insurance selection process.

48 CFR 30.606 - Resolving cost impacts.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Resolving cost impacts. 30... impacts. (a) General. (1) The CFAO shall coordinate with the affected contracting officers before negotiating and resolving the cost impact when the estimated cost impact on any of their contracts is at least...

What is the cost of supply

International Nuclear Information System (INIS)

Commichau, A.

1994-01-01

The conference paper discusses the cost of natural gas supply in Europe. The gas consumption has tripled over the last 20 years, and another 50-80% growth is expected for the following two decades despite a more or less stagnant total energy consumption and the introduction of a CO 2 tax to curb the greenhouse effect. Topics are as follow: European natural gas supply; European supply regions; cost of new pipeline gas to Europe; cost of new LNG to Europe; European gas imports - cost of incremental supplies

Cost effectiveness of radon mitigation in Canada

International Nuclear Information System (INIS)

Letourneau, E.G.; Krewski, D.; Zielinski, J.M.; McGregor, R.G.

1992-01-01

This paper examines the cost effectiveness of comprehensive strategies for reducing exposure to radon gas in indoor air in Canadian homes. The analysis is conducted within the context of a general framework for risk management programme evaluation which includes well-known evaluation techniques such as cost effectiveness and cost-benefit analyses as special cases. Based on this analysis, it is clear that any comprehensive programme to reduce exposure to environmental radon will be extremely expensive, and may not be justifiable in terms of health impact, particularly when considered in relation to other public health programmes. Testing of homes at the point of sale and installing sub-slab suction equipment to reduce exposure to indoor radon where necessary appears to be a relatively cost-effective radon mitigation strategy. In general, radon mitigation was found to be most cost effective in cities with relatively high levels of radon. (author)

Regionalization of surgical services in central Florida: the next step in acute care surgery.

Science.gov (United States)

Block, Ernest F J; Rudloff, Beth; Noon, Charles; Behn, Bruce

2010-09-01

There is a national loss of access to surgeons for emergencies. Contributing factors include reduced numbers of practicing general surgeons, superspecialization, reimbursement issues, emphasis on work and life balance, and medical liability. Regionalizing acute care surgery (ACS), as exists for trauma care, represents a potential solution. The purpose of this study is to assess the financial and resources impact of transferring all nontrauma ACS cases from a community hospital (CH) to a trauma center (TC). We performed a case mix and financial analysis of patient records with ACS for a rural CH located near an urban Level I TC. ACS patients were analyzed for diagnosis, insurance status, procedures, and length of stay. We estimated physician reimbursement based on evaluation and management codes and procedural CPT codes. Hospital revenues were based on regional diagnosis-related group rates. All third-party remuneration was set at published Medicare rates; self-pay was set at nil. Nine hundred ninety patients were treated in the CH emergency department with 188 potential surgical diseases. ACS was necessary in 62 cases; 25.4% were uninsured. Extrapolated to 12 months, 248 patients would generate new TC physician revenue of >$155,000 and hospital profits of >$1.5 million. CH savings for call pay and other variable costs are >$100,000. TC operating room volume would only increase by 1%. Regionalization of ACS to TCs is a viable option from a business perspective. Access to care is preserved during an approaching crisis in emergency general surgical coverage. The referring hospital is relieved of an unfavorable payer mix and surgeon call problems. The TC receives a new revenue stream with limited impact on resources by absorbing these patients under its fixed costs, saving the CH variable costs.

48 CFR 1631.203 - Indirect costs.

Science.gov (United States)

2010-10-01

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

Cost/benefit analysis of biomass energy supply options for rural smallholders in the semi-arid eastern part of Shinyanga Region in Tanzania

Energy Technology Data Exchange (ETDEWEB)

Wiskerke, W.T.; Dornburg, V.; Faaij, A.P.C. [Department of Science, Technology and Society, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht (Netherlands); Rubanza, C.D.K. [Tanzania Forestry Research Institute (TAFORI)/National Forest Resource Management and Agroforestry Centre (NACRAF), P.O. Box 1257, Shinyanga (Tanzania); Malimbwi, R.E. [Faculty of Forestry and Natural Resources, Sokoine University, P.O. Box 3010, Morogoro (Tanzania)

2010-01-15

This study analyzes the economic feasibility of sustainable smallholder bio-energy production under semi-arid conditions. The eastern part of Shinyanga region in Tanzania was chosen as a case study area. Three different sustainable biomass energy supply systems were compared by means of cost/benefit analysis: a small-scale forestation project for carbon sequestration, a short rotation woodlot and a Jatropha plantation, thereby using the produced Jatropha oil as a substitute for fuelwood or diesel. Rotational woodlots are most profitable with a Net Present Value of up to US${sub 2007} 1165/ha, a return on labour of up to US${sub 2007} 6.69/man-day and a fuelwood production cost of US${sub 2007} 0.53/GJ, compared to a local market price of US${sub 2007} 1.95/GJ. With a production cost of US${sub 2007} 19.60/GJ, Jatropha oil is too expensive to be used as an alternative for fuelwood. Instead it can be utilized economically as a diesel substitute, at an observed diesel cost of US${sub 2007} 1.49/l. The mean annual biomass increment (MAI) in semi-arid East Shinyanga is too low to collect sufficient benefits from trading forestation carbon credits under the Clean Development Mechanism (CDM) to cover the costs of forestation and forest management. (author)

Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy.

Science.gov (United States)

Jones, Lisa J; Craven, Paul D; Lakkundi, Anil; Foster, Jann P; Badawi, Nadia

2015-06-09

With improvements in neonatal intensive care, more preterm infants are surviving the neonatal period and presenting for surgery in early infancy. Inguinal hernia is the most common condition requiring early surgery, appearing in 38% of infants whose birth weight is between 751 grams and 1000 grams. Approximately 20% to 30% of otherwise healthy preterm infants having general anaesthesia for inguinal hernia surgery at a postmature age have at least one apnoeic episode within the postoperative period. Research studies have failed to adequately distinguish the effects of apnoeic episodes from other complications of extreme preterm gestation on the risk of brain injury, or to investigate the potential impact of postoperative apnoea upon longer term neurodevelopment. In addition to episodes of apnoea, there are concerns that anaesthetic and sedative agents may have a direct toxic effect on the developing brain of preterm infants even after reaching postmature age. It is proposed that regional anaesthesia may reduce the risk of postoperative apnoea, avoid the risk of anaesthetic-related neurotoxicity and improve neurodevelopmental outcomes in preterm infants requiring surgery for inguinal hernia at a postmature age. To determine if regional anaesthesia reduces postoperative apnoea, bradycardia, the use of assisted ventilation, and neurological impairment, in comparison to general anaesthesia, in preterm infants undergoing inguinal herniorrhaphy at a postmature age. The following databases and resources were searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2015, Issue 2), MEDLINE (December 2002 to 25 February 2015), EMBASE (December 2002 to 25 February 2015), controlled-trials.com and clinicaltrials.gov, reference lists of published trials and abstracts published in Pediatric Research and Pediatric Anesthesia. Randomised and quasi-randomised controlled trials of regional (spinal, epidural, caudal) versus general anaesthesia, or

Predictors for total medical costs for acute hemorrhagic stroke patients transferred to the rehabilitation ward at a regional hospital in Taiwan.

Science.gov (United States)

Chen, Chien-Min; Ke, Yen-Liang

2016-02-01

One-third of the acute stroke patients in Taiwan receive rehabilitation. It is imperative for clinicians who care for acute stroke patients undergoing inpatient rehabilitation to identify which medical factors could be the predictors of the total medical costs. The aim of this study was to identify the most important predictors of the total medical costs for first-time hemorrhagic stroke patients transferred to inpatient rehabilitation using a retrospective design. All data were retrospectively collected from July 2002 to June 2012 from a regional hospital in Taiwan. A stepwise multivariate linear regression analysis was used to identify the most important predictors for the total medical costs. The medical records of 237 patients (137 males and 100 females) were reviewed. The mean total medical cost per patient was United States dollar (USD) 5939.5 ± 3578.5.The following were the significant predictors for the total medical costs: impaired consciousness [coefficient (B), 1075.7; 95% confidence interval (CI) = 138.5-2012.9], dysphagia [coefficient (B), 1025.8; 95% CI = 193.9-1857.8], number of surgeries [coefficient (B), 796.4; 95% CI = 316.0-1276.7], pneumonia in the neurosurgery ward [coefficient (B), 2330.1; 95% CI = 1339.5-3320.7], symptomatic urinary tract infection (UTI) in the rehabilitation ward [coefficient (B), 1138.7; 95% CI = 221.6-2055.7], and rehabilitation ward stay [coefficient (B), 64.9; 95% CI = 31.2-98.7] (R(2) = 0.387). Our findings could help clinicians to understand that cost reduction may be achieved by minimizing complications (pneumonia and UTI) in these patients.

23 CFR 1200.20 - General.

Science.gov (United States)

2010-04-01

... cost principles govern the implementation and management of State highway safety programs carried out under 23 U.S.C. 402. Cost principles include those referenced in 49 CFR 18.22 and those set forth in... Implementation and Management of the Highway Safety Program § 1200.20 General. Except as otherwise provided in...

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.

Cost and time models for the evaluation of intermodal chains by using short sea shipping in the North Sea Region: the Rosyth-Zeebrugge route

DEFF Research Database (Denmark)

Lopez, Alba Martínez; Kronbak, Jacob; Jiang, Liping

2015-01-01

This paper is framed in the context of the EU Interreg IVB North Sea Region project Food Port. In line with this project, this paper aims to define mathematically cost and time models able to provide realistic information about the performances of road haulage and of intermodal chains using short...

48 CFR 31.205-30 - Patent costs.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Patent costs. 31.205-30....205-30 Patent costs. (a) The following patent costs are allowable to the extent that they are incurred... patent application where title or royalty-free license is to be conveyed to the Government. (b) General...

The cost of children

DEFF Research Database (Denmark)

Nordström, Leif Jonas

, the opportunity cost of two children is estimated to 28-29 per cent of full income, which in monetary units is close to estimated income difference between women employed in the public and private sector. The opportunity cost of fatherhood is generally positive, but only significantly positive for men born......In this paper we estimate the opportunity cost of children. The underlying theoretical model is represented by a household production model. In the empirical analysis, we consider three different cohorts for men and women born between 1955 and 1970. For the women in the two oldest cohorts...

The cost of chronic pain: an analysis of a regional pain management service in Ireland.

Science.gov (United States)

Gannon, Brenda; Finn, David P; O'Gorman, David; Ruane, Nancy; McGuire, Brian E

2013-10-01

The objective of the study was to collect data on the direct and indirect economic cost of chronic pain among patients attending a pain management clinic in Ireland. A tertiary pain management clinic serving a mixed urban and rural area in the West of Ireland. Data were collected from 100 patients using the Client Services Receipt Inventory and focused on direct and indirect costs of chronic pain. Patients were questioned about health service utilization, payment methods, and relevant sociodemographics. Unit costs were multiplied by resource use data to obtain full costs. Cost drivers were then estimated. Our study showed a cost per patient of US$24,043 over a 12-month period. Over half of this was attributable to wage replacement costs and lost productivity in those unable to work because of pain. Hospital stays and outpatient hospital services were the main drivers for health care utilization costs, together accounting for 63% of the direct medical costs per study participant attending the pain clinic. The cost of chronic pain among intensive service users is significant, and when extrapolated to a population level, these costs represent a very substantial economic burden. Wiley Periodicals, Inc.