41 CFR 301-70.903 - What are our responsibilities for ensuring that Government aircraft are the most cost-effective...

Science.gov (United States)

2010-07-01

... responsibilities for ensuring that Government aircraft are the most cost-effective alternative for travel? 301-70... our responsibilities for ensuring that Government aircraft are the most cost-effective alternative for travel? To help ensure that Government aircraft are the most cost-effective alternative for travel, your...

Evaluation and comparison of safety, convenience and cost of administering intravenous pamidronate infusions to children in the home and ambulatory care settings.

Science.gov (United States)

Rush, Eric T; DeHaai, Kristi; Kreikemeier, Rose M; Lutz, Richard E

2012-01-01

The use of bisphosphonates in children to treat low bone mineral density has increased. Safety and efficacy of pamidronate has been previously demonstrated. However, little research has been done on pamidronate infusion in the home health setting for patients with metabolic bone disease. Data were collected via a survey to assess satisfaction and convenience of infusions. Adverse events were measured by collecting calcium levels before and after infusions. Infusion costs were estimated from the standard orders from one home health agency and our infusion center. We found no difference in the rates of hypocalcemia between the two groups. The survey results showed high satisfaction for both groups, with higher scores in the home health group for convenience and stress. Home health infusions showed lower cost and less absenteeism from school and work. Home health-based pamidronate infusion appears to be safe, less expensive, and is associated with high patient satisfaction.

Increasing fresh fruit and vegetable availability in a low-income neighborhood convenience store: a pilot study.

Science.gov (United States)

Jetter, Karen M; Cassady, Diana L

2010-09-01

Changing the food environment in low-income communities may be an effective way to increase the consumption of fruits and vegetables by low-income consumers. This study examines the impacts of a pilot study that increases the availability of fresh produce in a convenience store in a low-income neighborhood not served by a supermarket. Two hypotheses based on theories of technology adoption are tested regarding the lack of fresh produce in low-income neighborhood stores: the first is that high fixed costs present a barrier for store owners in developing produce sections; the second is that there is insufficient consumer demand to cover the variable costs of a fresh produce section. The impacts of changing the food environment on store owners and the consumer response to environmental change are measured through weekly inventories of fresh produce. The results show that fixed costs are one barrier for store owners and that although the consumer response is sufficient to cover the direct costs of operating the produce case, it is not enough to cover variable management costs. Consequently, alternative management paradigms or venues may offer a better method to meet the demand for fresh produce by low-income consumers to promote better health through healthier diets in low-income communities.

Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007-2010.

Science.gov (United States)

Aggarwal, Anju; Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

2016-09-01

Concerns with taste, nutrition, cost, and convenience are said to be key influences on food choices. This study examined the importance of food-related attitudes in relation to diet quality using US national level data. Interactions by socioeconomic status (SES), gender and race/ethnicity were tested. Analyses of 8957 adults from National Health and Nutrition Examination Survey (NHANES 2007-2010) were conducted in 2014-15. Perceived importance of taste, nutrition, cost, and convenience in dietary choices were assessed using 4-point Likert scales. Education and family income-to-poverty ratio (FIPR) were SES indicators. Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was the diet quality measure. Survey-weighted regressions examined associations between attitudes and HEI, and tested for interactions. Taste was rated as "very important" by 77.0% of the US adults, followed by nutrition (59.9%), cost (39.9%), and convenience (29.8%). However, it was the perceived importance of nutrition that most strongly predicted HEI (β: +8.0 HEI scores among "very important" vs. "not at all important"). By contrast, greater importance for taste and convenience had a weak inverse relation with HEI (β: -5.1 and -1.5 respectively), adjusting for SES. Significant interactions were observed by race/ethnicity, but not SES and gender. Those who prioritized nutrition during food shopping had higher-quality diets regardless of gender, education and income in the US. Certain racial/ethnic groups managed to eat healthy despite attaching importance to cost and convenience. This is the first evidence of nutrition resilience among US adults using national data, which has huge implications for nutrition interventions. Published by Elsevier Inc.

The effects of response cost and species-typical behaviors on a daily time-place learning task.

Science.gov (United States)

Deibel, Scott H; Thorpe, Christina M

2013-03-01

Two theories that have been hypothesized to mediate acquisition in daily time-place learning (TPL) tasks were investigated in a free operant daily TPL task: the response cost hypothesis and the species-typical behavior hypothesis. One lever at the end of one of the choice arms of a T-maze provided food in the morning, and 6 h later, a lever in the other choice arm provided food. Four groups were used to assess the effect of two possible sources of response cost: physical effort of the task and costs associated with foraging ecology. One group was used to assess the effect of explicitly allowing for species-typical behaviors. If only first arm choice data were considered, there was little evidence of learning. However, both first press and percentage of presses on the correct lever prior to the first reinforcement revealed evidence of TPL in most rats tested. Unexpectedly, the high response cost groups for both of the proposed sources did not perform better than the low response cost groups. The groups that allowed animals to display species-typical behaviors performed the worst. Skip session probe trials confirmed that the majority of the rats that acquired the task were using a circadian timing strategy. The results from the present study suggest that learning in free operant daily TPL tasks might not be dependent on response cost.

Effects of Consumer-Perceived Convenience on Shopping Intention in Mobile Commerce: An Empirical study

OpenAIRE

Wen-Jang ("Kenny") Jih

2007-01-01

Wireless communication and Internet services are converging to provide an unprecedented level of convenience for online shopping. Although the concept of consumer-perceived convenience has been extensively discussed in marketing and consumer behavior literature, there still is a lack of empirical validation in the context of mobile commerce. This study was conducted to examine the effect of convenience on customers’ intention of shopping via their mobile communication devices. The primary d...

Disparities of food availability and affordability within convenience stores in Bexar County, Texas.

Science.gov (United States)

Smith, Matthew Lee; Sunil, T S; Salazar, Camerino I; Rafique, Sadaf; Ory, Marcia G

2013-01-01

The American Diabetes Association (ADA) recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our "grab and go" society. The purposes of this study were to (1) identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2) compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ (2) = 4.17, P = 0.003), whole grain bread (χ (2) = 8.33, P = 0.004), and baked potato chips (χ (2) = 13.68, P convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community's food environment by stocking healthier foods at affordable prices.

Compliance to two city convenience store ordinance requirements

Science.gov (United States)

Menéndez, Cammie K Chaumont; Amandus, Harlan E; Wu, Nan; Hendricks, Scott A

2015-01-01

Background Robbery-related homicides and assaults are the leading cause of death in retail businesses. Robbery reduction approaches focus on compliance to Crime Prevention Through Environmental Design (CPTED) guidelines. Purpose We evaluated the level of compliance to CPTED guidelines specified by convenience store safety ordinances effective in 2010 in Dallas and Houston, Texas, USA. Methods Convenience stores were defined as businesses less than 10 000 square feet that sell grocery items. Store managers were interviewed for store ordinance requirements from August to November 2011, in a random sample of 594 (289 in Dallas, 305 in Houston) convenience stores that were open before and after the effective dates of their city’s ordinance. Data were collected in 2011 and analysed in 2012–2014. Results Overall, 9% of stores were in full compliance, although 79% reported being registered with the police departments as compliant. Compliance was consistently significantly higher in Dallas than in Houston for many requirements and by store type. Compliance was lower among single owner-operator stores compared with corporate/franchise stores. Compliance to individual requirements was lowest for signage and visibility. Conclusions Full compliance to the required safety measures is consistent with industry ‘best practices’ and evidence-based workplace violence prevention research findings. In Houston and Dallas compliance was higher for some CPTED requirements but not the less costly approaches that are also the more straightforward to adopt. PMID:26337569

Determining a cost effective intervention response to HIV/AIDS in Peru

Science.gov (United States)

Aldridge, Robert W; Iglesias, David; Cáceres, Carlos F; Miranda, J Jaime

2009-01-01

Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its

Determining a cost effective intervention response to HIV/AIDS in Peru

Directory of Open Access Journals (Sweden)

Cáceres Carlos F

2009-09-01

Full Text Available Abstract Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country

The Effect of Social perception of environmental problems and goods on the practice of cost-benefit analysis

Energy Technology Data Exchange (ETDEWEB)

Bunuel, M.; Delgado, M. L.

2002-07-01

When revealed, willingness to pay (WTP) is considerably lesser than willingness to accept (WTA), as economists explain. Sociological studies in Spain reveal that citizens assign a high value to the environment (high WTA), but are not ready to pay to preserve it (low WTP)because they think that it is industrial sector and the government's responsibility. This is a new factor, not studied before, that may result in underestimating environmental goods when WTP is used. The gap between WTP and WTA makes cost-benefits analysis difficult, creating the risk of environmental political judgments being replaced by pseudo scientific noise instead of by objective economic analysis.hence, it is sometimes convenient to use alternative methods to cost-benefit analysis: cost-effectiveness analysis trade-off analysis, economic-impact valuation, and risk-benefit analysis. (Author)

48 CFR 49.503 - Termination for convenience of the Government and default.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Termination for convenience of the Government and default. 49.503 Section 49.503 Federal Acquisition Regulations System... 49.503 Termination for convenience of the Government and default. (a) Cost-reimbursement contracts—(1...

30 CFR 886.26 - When and how can my grant be terminated for convenience?

Science.gov (United States)

2010-07-01

... convenience? 886.26 Section 886.26 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... INDIAN TRIBES § 886.26 When and how can my grant be terminated for convenience? Either you or we may... worth the additional costs. We will handle a termination for convenience as an amendment to the grant to...

Compliance to two city convenience store ordinance requirements.

Science.gov (United States)

Chaumont Menéndez, Cammie K; Amandus, Harlan E; Wu, Nan; Hendricks, Scott A

2016-04-01

Robbery-related homicides and assaults are the leading cause of death in retail businesses. Robbery reduction approaches focus on compliance to Crime Prevention Through Environmental Design (CPTED) guidelines. We evaluated the level of compliance to CPTED guidelines specified by convenience store safety ordinances effective in 2010 in Dallas and Houston, Texas, USA. Convenience stores were defined as businesses less than 10 000 square feet that sell grocery items. Store managers were interviewed for store ordinance requirements from August to November 2011, in a random sample of 594 (289 in Dallas, 305 in Houston) convenience stores that were open before and after the effective dates of their city's ordinance. Data were collected in 2011 and analysed in 2012-2014. Overall, 9% of stores were in full compliance, although 79% reported being registered with the police departments as compliant. Compliance was consistently significantly higher in Dallas than in Houston for many requirements and by store type. Compliance was lower among single owner-operator stores compared with corporate/franchise stores. Compliance to individual requirements was lowest for signage and visibility. Full compliance to the required safety measures is consistent with industry 'best practices' and evidence-based workplace violence prevention research findings. In Houston and Dallas compliance was higher for some CPTED requirements but not the less costly approaches that are also the more straightforward to adopt. 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/

Reframing convenience food.

Science.gov (United States)

Jackson, Peter; Viehoff, Valerie

2016-03-01

This paper provides a critical review of recent research on the consumption of 'convenience' food, highlighting the contested nature of the term and exploring its implications for public health and environmental sustainability. It distinguishes between convenience food in general and particular types of convenience food, such as ready-meals, tracing the structure and growth of the market for such foods with a particular emphasis on the UK which currently has the highest rate of ready-meal consumption in Europe. Having established the definitional complexities of the term, the paper presents the evidence from a systematic review of the literature, highlighting the significance of convenience food in time-saving and time-shifting, the importance of recent changes in domestic labour and family life, and the way the consumption of convenience food is frequently moralized. The paper shows how current debates about convenience food are part of a longer discursive history about food, health and nutrition. It discusses current levels of public understanding about the links between convenience food, environmental sustainability and food waste. The paper concludes by making a case for understanding the consumption of convenience food in terms of everyday social practices, emphasising its habitual and routine character. Copyright © 2015 Elsevier Ltd. All rights reserved.

Disparities of Food Availability and Affordability within Convenience Stores in Bexar County, Texas

Directory of Open Access Journals (Sweden)

Matthew Lee Smith

2013-01-01

Full Text Available The American Diabetes Association (ADA recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our “grab and go” society. The purposes of this study were to (1 identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2 compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ2=4.17, P=0.003, whole grain bread (χ2=8.33, P=0.004, and baked potato chips (χ2=13.68, P<0.001. On average, the price of diet cola (t=−2.12, P=0.044 and certain produce items (e.g., bananas, oranges, tomatoes, broccoli, and cucumber was significantly higher within convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community’s food environment by stocking healthier foods at affordable prices.

Controlling health costs: physician responses to patient expectations for medical care.

Science.gov (United States)

Sabbatini, Amber K; Tilburt, Jon C; Campbell, Eric G; Sheeler, Robert D; Egginton, Jason S; Goold, Susan D

2014-09-01

Physicians have dual responsibilities to make medical decisions that serve their patients' best interests but also utilize health care resources wisely. Their ability to practice cost-consciously is particularly challenged when faced with patient expectations or requests for medical services that may be unnecessary. To understand how physicians consider health care resources and the strategies they use to exercise cost-consciousness in response to patient expectations and requests for medical care. Exploratory, qualitative focus groups of practicing physicians were conducted. Participants were encouraged to discuss their perceptions of resource constraints, and experiences with redundant, unnecessary and marginally beneficial services, and were asked about patient requests or expectations for particular services. Sixty-two physicians representing a variety of specialties and practice types participated in nine focus groups in Michigan, Ohio, and Minnesota in 2012 MEASUREMENTS: Iterative thematic content analysis of focus group transcripts Physicians reported making trade-offs between a variety of financial and nonfinancial resources, considering not only the relative cost of medical decisions and alternative services, but the time and convenience of patients, their own time constraints, as well as the logistics of maintaining a successful practice. They described strategies and techniques to educate patients, build trust, or substitute less costly alternatives when appropriate, often adapting their management to the individual patient and clinical environment. Physicians often make nuanced trade-offs in clinical practice aimed at efficient resource use within a complex flow of clinical work and patient expectations. Understanding the challenges faced by physicians and the strategies they use to exercise cost-consciousness provides insight into policy measures that will address physician's roles in health care resource use.

Compact fluorescent lights and the impact of convenience and knowledge on household recycling rates.

Science.gov (United States)

Wagner, Travis P

2011-06-01

Increased energy costs, social marketing campaigns, public subsidies, and reduced retail prices have dramatically increased the number of compact fluorescent lights (CFLs) installed worldwide. CFLs provide many benefits, but they contain a very small amount of mercury. Given the billions of CFLs in use worldwide, they represent a significant source of mercury unless CFLs are recycled and the mercury recovered in an environmentally sound manner. In the state of Maine (northeast United States), despite mandated recycling of CFLs and availability of free CFL recycling, the household CFL recycling rate is very low. A study was undertaken to identify the primary factors responsible for low recycling. The first step was to survey householders who use CFLs. The 520 survey responses indicated that insufficient knowledge regarding recycling and inconvenience of the collection system are the two primary factors for the low recycling rate. To validate these findings, the second step was an examination of the current collection system to assess (a) the knowledge requirements necessary for recycling and (b) the convenience of the collection system. The results of this examination validated that knowledge requirements were excessively difficult to fulfill and the collection system is not sufficiently convenient. Based on these results, waste managers should focus on increasing convenience and simplifying access to information when designing or improving household collection and recycling of CFLs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Raised crosswalks on entrance to the roundabout-a case study on effectiveness of treatment on pedestrian safety and convenience.

Science.gov (United States)

Candappa, Nimmi; Stephan, Karen; Fotheringham, Nicola; Lenné, Michael G; Corben, Bruce

2014-01-01

A common concern in the use of a roundabout is providing adequately for the pedestrian. This unique roundabout layout, which introduces raised crosswalks directly at the roundabout entrance, as opposed to at a car length back, aims at improving safety and convenience for pedestrians at roundabouts. A preliminary evaluation of the layout was undertaken to establish its effectiveness in meeting study objectives. A quasi-experimental before-and-after study design was used to compare speeds on approach and immediately prior to the crossing to ascertain potential impact speed and implications for pedestrian safety. Compliance to crossing and crossing time were also compared in relation to safety and convenience outcomes. A questionnaire assessed pedestrian perception of the safety and convenience at the roundabout before and after treatment. Results from this case study indicate that mean approach speeds (free speeds 30 m from crossing) reduced from 32.7 to 30.7 km/h and immediately prior to crossing, mean speeds reduced from 19.1 to 16.3 km/h. There was also a marked reduction in proportions of vehicles traveling at speeds that could elevate risk to pedestrians. Total crossing time after treatment reduced by around 4 s, and crossing compliance increased from approximately half to approximately 90 percent. Survey of pedestrians indicated positive response to the perceived safety and convenience posttreatment. Preliminary results of the case study suggest positive safety and convenience outcomes. Implications for pedestrian safety include less exposure to traffic and lower risk of serious injury, particularly for elderly pedestrians; convenience outcomes include shorter waiting times to cross and greater compliance to the crossing. A larger study is required to substantiate the findings.

Meal box schemes as a convenient way to avoid convenience food?

DEFF Research Database (Denmark)

Hertz, Frej; Halkier, Bente

2017-01-01

to categorize meal box schemes as a new form of convenience food called convenient food. In addition, results suggest that meal box schemes reduce leftovers from dinner. Meal boxes also influence dinner related activities such as planning ahead in time and grocery shopping, which require less physical......The term convenience food is subject to diversification, lack of clarity and moral ambiguity. In this paper we address these issues and critically discuss convenience food by using empirical findings from a Danish study that deals with practitioners' uses of meal box schemes. The methodological...

Exploratory Cost-Effectiveness Analysis of Response-Guided Neoadjuvant Chemotherapy for Hormone Positive Breast Cancer Patients.

Directory of Open Access Journals (Sweden)

Anna Miquel-Cases

Full Text Available Guiding response to neoadjuvant chemotherapy (guided-NACT allows for an adaptative treatment approach likely to improve breast cancer survival. In this study, our primary aim is to explore the expected cost-effectiveness of guided-NACT using as a case study the first randomized controlled trial that demonstrated effectiveness (GeparTrio trial.As effectiveness was shown in hormone-receptor positive (HR+ early breast cancers (EBC, our decision model compared the health-economic outcomes of treating a cohort of such women with guided-NACT to conventional-NACT using clinical input data from the GeparTrio trial. The expected cost-effectiveness and the uncertainty around this estimate were estimated via probabilistic cost-effectiveness analysis (CEA, from a Dutch societal perspective over a 5-year time-horizon.Our exploratory CEA predicted that guided-NACT as proposed by the GeparTrio, costs additional €110, but results in 0.014 QALYs gained per patient. This scenario of guided-NACT was considered cost-effective at any willingness to pay per additional QALY. At the prevailing Dutch willingness to pay threshold (€80.000/QALY cost-effectiveness was expected with 78% certainty.This exploratory CEA indicated that guided-NACT (as proposed by the GeparTrio trial is likely cost-effective in treating HR+ EBC women. While prospective validation of the GeparTrio findings is advisable from a clinical perspective, early CEAs can be used to prioritize further research from a broader health economic perspective, by identifying which parameters contribute most to current decision uncertainty. Furthermore, their use can be extended to explore the expected cost-effectiveness of alternative guided-NACT scenarios that combine the use of promising imaging techniques together with personalized treatments.

Normalising convenience food?

DEFF Research Database (Denmark)

Halkier, Bente

2017-01-01

The construction of convenience food as a social and cultural category for food provisioning, cooking and eating seems to slide between or across understandings of what is considered “proper food” in the existing discourses in everyday life and media. This article sheds light upon some...... of the social and cultural normativities around convenience food by describing the ways in which convenience food forms part of the daily life of young Danes. Theoretically, the article is based on a practice theoretical perspective. Empirically, the article builds upon a qualitative research project on food...... habits among Danes aged 20–25. The article presents two types of empirical patterns. The first types of patterns are the degree to which and the different ways in which convenience food is normalised to use among the young Danes. The second types of patterns are the normative places of convenient food...

Service Convenience pada PT. Bank Kesejahteraan Ekonomi (Survei pada Koperasi Pegawai Negeri di Pontianak)

OpenAIRE

B11108008, Hermawan Maulana

2012-01-01

This study aims to determine cooperative customer response on Decision Convenience, Convenience Access, Transaction Convenience, Benefit Convenience and Postbenefit Convenience in PT. Kesejahteraan Ekonomi Bank. The research method used is quantitative research methods, the research is a survey form. In this sample, the researcher used purposive sampling technique. The sample in this study are grouped into 2, that is cooperative organizer (12 cooperatives) and members of cooperatives (60 peop...

Low-cost humic acid-bonded silica as an effective solid-phase extraction sorbent for convenient determination of aflatoxins in edible oils

Energy Technology Data Exchange (ETDEWEB)

Zhou, Neng-Zhi [Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi 530028 (China); Liu, Ping [School of Pharmaceutical Science, Guangxi Medical University, Nanning, Guangxi 530021 (China); Su, Xiao-Chuan; Liao, Yan-Hua; Lei, Ning-Sheng [Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi 530028 (China); Liang, Yong-Hong [School of Pharmaceutical Science, Guangxi Medical University, Nanning, Guangxi 530021 (China); Zhou, Shao-Huan; Lin, Wen-Si; Chen, Jie [Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi 530028 (China); Feng, Yu-Qi [Key Laboratory of Analytical Chemistry for Biology and Medicine, Ministry of Education, Department of Chemistry, Wuhan University, Wuhan 430072 (China); Tang, Yang, E-mail: tycarson2@163.com [Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi 530028 (China)

2017-06-01

Aflatoxins (AFs) are highly toxic, mutagenic, carcinogenic, and teratogenic secondary metabolites produced by the toxigenic fungi Aspergillus flavus and Aspergillus parasiticus. AFs tend to contaminate a wide range of foods which is a serious and recurring food safety problem worldwide. Currently, immunoaffinity chromatography (IAC) has become the most conventional sample clean-up method for determining AFs in foodstuffs. However, IAC method is limited in the large-scale food analysis because it requires the use of expensive disposable cartridges and the IA procedure is time-consuming. Herein, to achieve the cost-effective determination of AFs in edible oils, we developed a promising solid-phase extraction (SPE) method based on commercially available humic acid-bonded silica (HAS) sorbent, followed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) analysis. In HAS-SPE, AFs can be captured by the HAS sorbent with both hydrophobic and hydrophilic interactions, whereas the oil matrix was captured only with the hydrophobic interactions. The oil matrix can be sufficiently washed off with isopropanol, while the AFs were still retained on the SPE packing, thus achieving selective extraction of AFs and clean-up of oil matrices. Under the optimal conditions of HAS-SPE, satisfactory recoveries ranging from 82% to 106% for four AFs (B{sub 1}, B{sub 2}, G{sub 1}, and G{sub 2}) were achieved in various oil matrices, containing blended oil, tea oil, rapeseed oil, peanut oil, sunflower seed oil, corn oil, blended olive oil, rice oil, soybean oil, and sesame oil. Only minor matrix effects ranging from 99% to 105% for four AFs were observed. Moreover, the LODs of AFs between 0.012 and 0.035 μg/kg completely meet the regulatory levels fixed by the EU, China or other countries. The methodology was further validated for assaying the naturally contaminated peanut oils, and consistent results between the HAS-SPE and the referenced IAC were

Assessing cost-effectiveness of bioretention on stormwater in response to climate change and urbanization for future scenarios

Science.gov (United States)

Wang, Mo; Zhang, Dongqing; Adhityan, Appan; Ng, Wun Jern; Dong, Jianwen; Tan, Soon Keat

2016-12-01

Bioretention, as a popular low impact development practice, has become more important to mitigate adverse impacts on urban stormwater. However, there is very limited information regarding ensuring the effectiveness of bioretention response to uncertain future challenges, especially when taking into consideration climate change and urbanization. The main objective of this paper is to identify the cost-effectiveness of bioretention by assessing the hydrology performance under future scenarios modeling. First, the hydrology model was used to obtain peak runoff and TSS loads of bioretention with variable scales under different scenarios, i.e., different Representative Concentration Pathways (RCPs) and Shared Socio-economic reference Pathways (SSPs) for 2-year and 10-year design storms in Singapore. Then, life cycle costing (LCC) and life cycle assessment (LCA) were estimated for bioretention, and the cost-effectiveness was identified under different scenarios. Our finding showed that there were different degree of responses to 2-year and 10-year design storms but the general patterns and insights deduced were similar. The performance of bioretenion was more sensitive to urbanization than that for climate change in the urban catchment. In addition, it was noted that the methodology used in this study was generic and the findings could be useful as reference for other LID practices in response to climate change and urbanization.

The Interpersonal Sunk-Cost Effect.

Science.gov (United States)

Olivola, Christopher Y

2018-05-01

The sunk-cost fallacy-pursuing an inferior alternative merely because we have previously invested significant, but nonrecoverable, resources in it-represents a striking violation of rational decision making. Whereas theoretical accounts and empirical examinations of the sunk-cost effect have generally been based on the assumption that it is a purely intrapersonal phenomenon (i.e., solely driven by one's own past investments), the present research demonstrates that it is also an interpersonal effect (i.e., people will alter their choices in response to other people's past investments). Across eight experiments ( N = 6,076) covering diverse scenarios, I documented sunk-cost effects when the costs are borne by someone other than the decision maker. Moreover, the interpersonal sunk-cost effect is not moderated by social closeness or whether other people observe their sunk costs being "honored." These findings uncover a previously undocumented bias, reveal that the sunk-cost effect is a much broader phenomenon than previously thought, and pose interesting challenges for existing accounts of this fascinating human tendency.

Design of a cost-effective laser spot tracker

Science.gov (United States)

Artan, Göktuǧ Gencehan; Sari, Hüseyin

2017-05-01

One of the most important aspects of guided systems is detection. The most convenient detection in the sense of precision can be achieved with a laser spot tracker. This study deals with a military grade, high performance and cost-effective laser spot tracker for a guided system. The aim is to develop a high field of view system that will detect a laser spot from a distance of 3 kilometers in which the target is designated from 3 kilometers with a laser. The study basically consists of the system design, modeling, producing and the conducting performance tests of the whole system.

Is a 'convenience' sample useful for estimating immunization coverage in a small population?

Science.gov (United States)

Weir, Jean E; Jones, Carrie

2008-01-01

Rapid survey methodologies are widely used for assessing immunization coverage in developing countries, approximating true stratified random sampling. Non-random ('convenience') sampling is not considered appropriate for estimating immunization coverage rates but has the advantages of low cost and expediency. We assessed the validity of a convenience sample of children presenting to a travelling clinic by comparing the coverage rate in the convenience sample to the true coverage established by surveying each child in three villages in rural Papua New Guinea. The rate of DTF immunization coverage as estimated by the convenience sample was within 10% of the true coverage when the proportion of children in the sample was two-thirds or when only children over the age of one year were counted, but differed by 11% when the sample included only 53% of the children and when all eligible children were included. The convenience sample may be sufficiently accurate for reporting purposes and is useful for identifying areas of low coverage.

And another thing - flags of convenience

International Nuclear Information System (INIS)

Flatern, R. von

2002-01-01

Crude oil being shipped around the world, when spilled, is a threat to the environment unlike any other commodity, save perhaps for radioactive materials. Therefore, if the oil industry expects to be taken seriously in its role of protecting the environment, it must assume responsibility for its product from wellhead to consumer. Whilst there are many operators paying considerable attention to transportation issues - the largest of them using their own double-hulled tanker fleets - there still too many using ships unsuitable for the purpose, either because of age or the fact that they are single hulled vessels. These derelicts are kept in business by owners who have registered them in country's where inspections are a local joke, registration requires only a fraction of the fee charged by more conscientious nations, and taxes are low. Ships flying flags of convenience have no ties to any country, including the ones in which they are registered. The author says that it is up to the oil industry to clean up their act, for instance they could refuse to use ships that sail under a flag of convenience or single hulled vessels to move their product. The major and large independent companies learned some time ago that taking care of the environment is very much in their interest, and further that only they can do it effectively

Just how convenient is convenience? An empirical study of the associations between perceived convenience, meal preparation activities and ready meals' characteristics

DEFF Research Database (Denmark)

Costa, Ana I.A.; Ruijschop, R. M. A. J.

2006-01-01

Parallel to considerations about settings, selection of the appropriate level of time, effort and care to be put into meal preparation is an important determinant of food choice. Nevertheless, significant relations between the time/energy consumers are willing to devote to food preparation...... and the types of meals they eat are surprisingly hard to find. One explanation for this could be that perceived convenience finds little support on the technological attributes of products like ready meals. This study's aim was to uncover significant relations between perceived convenience, meal preparation...... activities and technological attributes of frozen pizzas. Ninety-eight Dutch meal preparers, 18-29 years old, were asked to rate expected convenience attributes of frozen pizzas; (2) prepare and consume these pizzas in a home-like setting; (3) rate experienced convenience after consumption. Pizzas were also...

Pengaruh Pengungkapan Corporate Social Responsibility terhadap Cost Of Equity Perusahaan

Directory of Open Access Journals (Sweden)

Mitta Ariyani

2016-06-01

The purpose of this study is to investigate the effect of Corporate Social Responsibility (CSR Disclosure on Cost of Equity Capital. CSR disclosure index is measured based on Global Reporting Initiative standards, while Cost of Equity Capital is measured by Capital Asset Pricing Model (CAPM. This study uses manufacturing companies which is listed on Indonesia Stock Exchange (IDX in 2010. By purposive sampling, this research obtained 72 companies as a samples. The control variables used are financial leverage and firm size. Multiple regression analysis by SPSS 16 was run for testing the hypothesis. The result show that CSR disclosure and financial leverage have no effect to Cost of Equity. Then, firm size have positive effect to Cost of Equity.

Effectiveness and cost-effectiveness of potential responses to future high levels of transmitted HIV drug resistance in antiretroviral drug-naive populations beginning treatment

DEFF Research Database (Denmark)

Phillips, Andrew N; Cambiano, Valentina; Miners, Alec

2014-01-01

BACKGROUND: With continued roll-out of antiretroviral therapy (ART) in resource-limited settings, evidence is emerging of increasing levels of transmitted drug-resistant HIV. We aimed to compare the effectiveness and cost-effectiveness of different potential public health responses to substantial...

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction.

Science.gov (United States)

Fast, Shannon M; González, Marta C; Markuzon, Natasha

2015-01-01

Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction.

Directory of Open Access Journals (Sweden)

Shannon M Fast

Full Text Available Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence.The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response.The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.

Human Responding on Random-Interval Schedules of Response-Cost Punishment: The Role of Reduced Reinforcement Density

Science.gov (United States)

Pietras, Cynthia J.; Brandt, Andrew E.; Searcy, Gabriel D.

2010-01-01

An experiment with adult humans investigated the effects of response-contingent money loss (response-cost punishment) on monetary-reinforced responding. A yoked-control procedure was used to separate the effects on responding of the response-cost contingency from the effects of reduced reinforcement density. Eight adults pressed buttons for money…

Pricing a Convenience Food.

Science.gov (United States)

Gabor, Andre

1980-01-01

Discusses a study undertaken by the Nottingham University Consumer Study Group to determine market operation for popular convenience foods in England. Information is presented on distribution of purchases, brand loyalties of respondents to a questionnaire regarding convenience foods, and market fluctuation due to inflation. (Author/DB)

Consumers, food and convenience: The long way from resource constraints to actual consumption patterns

DEFF Research Database (Denmark)

Scholderer, Joachim; Grunert, Klaus G.

2005-01-01

that the influence of resource constraints on actual convenience behaviours is doubly mediated, first by perceptions of resource constraints, and then by convenience orientations. In Study 1, the model is calibrated based on a sample of 1000 French respondents with main responsibility for food shopping and meal...

Low-cost humic acid-bonded silica as an effective solid-phase extraction sorbent for convenient determination of aflatoxins in edible oils.

Science.gov (United States)

Zhou, Neng-Zhi; Liu, Ping; Su, Xiao-Chuan; Liao, Yan-Hua; Lei, Ning-Sheng; Liang, Yong-Hong; Zhou, Shao-Huan; Lin, Wen-Si; Chen, Jie; Feng, Yu-Qi; Tang, Yang

2017-06-01

Aflatoxins (AFs) are highly toxic, mutagenic, carcinogenic, and teratogenic secondary metabolites produced by the toxigenic fungi Aspergillus flavus and Aspergillus parasiticus. AFs tend to contaminate a wide range of foods which is a serious and recurring food safety problem worldwide. Currently, immunoaffinity chromatography (IAC) has become the most conventional sample clean-up method for determining AFs in foodstuffs. However, IAC method is limited in the large-scale food analysis because it requires the use of expensive disposable cartridges and the IA procedure is time-consuming. Herein, to achieve the cost-effective determination of AFs in edible oils, we developed a promising solid-phase extraction (SPE) method based on commercially available humic acid-bonded silica (HAS) sorbent, followed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) analysis. In HAS-SPE, AFs can be captured by the HAS sorbent with both hydrophobic and hydrophilic interactions, whereas the oil matrix was captured only with the hydrophobic interactions. The oil matrix can be sufficiently washed off with isopropanol, while the AFs were still retained on the SPE packing, thus achieving selective extraction of AFs and clean-up of oil matrices. Under the optimal conditions of HAS-SPE, satisfactory recoveries ranging from 82% to 106% for four AFs (B 1 , B 2 , G 1 , and G 2 ) were achieved in various oil matrices, containing blended oil, tea oil, rapeseed oil, peanut oil, sunflower seed oil, corn oil, blended olive oil, rice oil, soybean oil, and sesame oil. Only minor matrix effects ranging from 99% to 105% for four AFs were observed. Moreover, the LODs of AFs between 0.012 and 0.035 μg/kg completely meet the regulatory levels fixed by the EU, China or other countries. The methodology was further validated for assaying the naturally contaminated peanut oils, and consistent results between the HAS-SPE and the referenced IAC were obtained. In

"Convenience Food."

Science.gov (United States)

Lemieux, Colette

1980-01-01

Defines the meaning of the American expression "convenience food," quoting definitions given by dictionaries and specialized publications. Discusses the problem of finding the exact equivalent of this expression in French, and recommends some acceptable translations. (MES)

Utility and Cost-Effectiveness of Motivational Messaging to Increase Survey Response in Physicians: A Randomized Controlled Trial

Science.gov (United States)

Chan, Randolph C. H.; Mak, Winnie W. S.; Pang, Ingrid H. Y.; Wong, Samuel Y. S.; Tang, Wai Kwong; Lau, Joseph T. F.; Woo, Jean; Lee, Diana T. F.; Cheung, Fanny M.

2018-01-01

The present study examined whether, when, and how motivational messaging can boost the response rate of postal surveys for physicians based on Higgin's regulatory focus theory, accounting for its cost-effectiveness. A three-arm, blinded, randomized controlled design was used. A total of 3,270 doctors were randomly selected from the registration…

Effect of Entry into Socially Responsible Investment Index on Cost of Equity and Firm Value

Directory of Open Access Journals (Sweden)

Kijung Eom

2017-04-01

Full Text Available The purpose of this study was to identify the effect of a company’s incorporation into the Socially Responsible Investment (SRI index on its cost of equity (COE and corporate value. The study collected and analyzed data about the four-year long changes of the component stocks of the Korea Exchange (KRX SRI index from September 2010 to September 2013 to verify the correlation between the incorporation of the SRI index and the cost of equity or corporate value by using the Price-Earnings Growth (PEG, Modified PEG (MPEG and Gode and Mohanram (GM models for estimation of the implied costs of equity capital, as well as Tobin’s Q ratio. The analysis results failed to show any significant relation between the incorporation of the SRI index and the cost of equity capital. Also, no statistically significant correlation between the incorporation of the SRI index and corporate value was observed. However, at an early phase of introduction of the SRI index, the included companies revealed a negative correlation with the cost of equity. However, after changing the listed stocks, they showed a positive correlation with the cost of equity capital. All in all, this can be ascribed to a mixed presence of optimistic and pessimistic investors about CSR activities, or there is a possibility that the KRX SRI index might not correctly reflect the CSR activities of companies.

40 CFR 35.6285 - Recipient payment of response costs.

Science.gov (United States)

2010-07-01

... payment of response costs. The recipient may pay for its share of response costs using cash, services... costs in the form of cash. (b) Services. The recipient may provide equipment and services to satisfy its... CFR part 300). (d) Excess cash cost share contributions/overmatch. The recipient may direct EPA to...

Convenience foods. What, why, and when.

Science.gov (United States)

Scholliers, Peter

2015-11-01

An attempt is made to assess the academic interest in convenience foods in the past decades in order to introduce this special section on historical dimensions of convenience foods, prepared by FOST, a unit that investigates the history and culture of food (up to today). First, the rise of academic interest is trailed since the appearance of the concept in the 1920s and, next, themes in connection to this interest are considered (e.g., time, health, or gender). Then, definitions of convenience foods are tracked since the 1950s, which leads to suggesting a clear focus (linking convenience foods to home cooking of meals and industrially produced foods). The conclusion stresses the changing definition of the concept, as well as the need to gain historical insight in present-day issues related to convenience foods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Costs and cost-effectiveness of periviable care.

Science.gov (United States)

Caughey, Aaron B; Burchfield, David J

2014-02-01

With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

Individualised therapy is more cost-effective than dose intensification in patients with Crohn's disease who lose response to anti-TNF treatment

DEFF Research Database (Denmark)

Steenholdt, Casper; Brynskov, Jørn; Thomsen, Ole Østergaard

2014-01-01

OBJECTIVE: Although the reasons for secondary loss of response to infliximab (IFX) maintenance therapy in Crohn's disease vary, dose intensification is usually recommended. This study investigated the cost-effectiveness of interventions defined by an algorithm designed to identify specific reasons...... by response rates, was similar: 58% and 53%, respectively, p=0.81; difference 5% (-19% to 28%). For per-protocol patients, treatment costs were even lower (56%) in the algorithm-treated group (€ 4062 vs € 9178, presponse rates (47% vs 53%, p=0.78; difference -5% (-33% to 22...

A Response Surface-Based Cost Model for Wind Farm Design

International Nuclear Information System (INIS)

Zhang Jie; Chowdhury, Souma; Messac, Achille; Castillo, Luciano

2012-01-01

A Response Surface-Based Wind Farm Cost (RS-WFC) model is developed for the engineering planning of wind farms. The RS-WFC model is developed using Extended Radial Basis Functions (E-RBF) for onshore wind farms in the U.S. This model is then used to explore the influences of different design and economic parameters, including number of turbines, rotor diameter and labor cost, on the cost of a wind farm. The RS-WFC model is composed of three components that estimate the effects of engineering and economic factors on (i) the installation cost, (ii) the annual Operation and Maintenance (O and M) cost, and (iii) the total annual cost of a wind farm. The accuracy of the cost model is favorably established through comparison with pertinent commercial data. The final RS-WFC model provided interesting insights into cost variation with respect to critical engineering and economic parameters. In addition, a newly developed analytical wind farm engineering model is used to determine the power generated by the farm, and the subsequent Cost of Energy (COE). This COE is optimized for a unidirectional uniform “incoming wind speed” scenario using Particle Swarm Optimization (PSO). We found that the COE could be appreciably minimized through layout optimization, thereby yielding significant cost savings. - Highlights: ► We present a Response Surface-Based Wind Farm Cost (RS-WFC) model for wind farm design. ► The model could estimate installation cost, Operation and Maintenance cost, and total annual cost of a wind farm. ► The Cost of Energy is optimized using Particle Swarm Optimization. ► Layout optimization could yield significant cost savings.

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

Science.gov (United States)

Shannon, David M.; Bradshaw, Carol C.

2002-01-01

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

Effect of radiation on preservation of convenient dish 'bowl-shape packed pig elbow'

International Nuclear Information System (INIS)

Wang Keqin; Chen Jingping; Li Wenge; Peng Weizheng

2005-01-01

The suitable parameters for radiation processing were investiqated by analyzing the microload of material and product, and radiation effect on the preservation of convenient dish 'bowl-shape packed pig elbow'. The results showed the store period of the product could be extended 2-6 month by 4.0-6.0 kGy radiation at different storage temperature. The sensory, physical and chemical index of the products met the requirement of relevant national standard of food hygiene. (authors)

Can a Costly Intervention Be Cost-effective?

Science.gov (United States)

Foster, E. Michael; Jones, Damon

2009-01-01

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

An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel) versus conventional paclitaxel for metastatic breast cancer patients: the COSTANza study

Science.gov (United States)

Lazzaro, Carlo; Bordonaro, Roberto; Cognetti, Francesco; Fabi, Alessandra; De Placido, Sabino; Arpino, Grazia; Marchetti, Paolo; Botticelli, Andrea; Pronzato, Paolo; Martelli, Elisa

2013-01-01

Purpose Paclitaxel albumin (nab-paclitaxel) is a nanoparticle albumin-bound paclitaxel formulation aimed at increasing therapeutic index in metastatic breast cancer. When compared to conventional paclitaxel, nab-paclitaxel has a reported longer time to progression, higher response, lower incidence of neutropenia, no need for premedication, shorter time of administration, and in pretreated metastatic breast cancer patients, extended overall survival. This study investigates the cost-effectiveness of nab-paclitaxel versus conventional paclitaxel for pretreated metastatic breast cancer patients in Italy. Materials and methods A Markov model with progression-free, progressed, and dead states was developed to estimate costs, outcomes, and quality adjusted life years over 5 years from the Italian National Health Service viewpoint. Patients were assumed to receive nab-paclitaxel 260 mg/m2 three times weekly or conventional paclitaxel 175 mg/m2 three times weekly. Data on health care resource consumption was collected from a convenience sample of five Italian centers. Resources were valued at Euro (€) 2011. Published utility weights were applied to health states to estimate the impact of response, disease progression, and adverse events on quality adjusted life years. Three sensitivity analyses tested the robustness of the base case incremental cost-effectiveness ratio (ICER). Results and conclusion Compared to conventional paclitaxel, nab-paclitaxel gains an extra 0.165 quality adjusted life years (0.265 life years saved) and incurs additional costs of €2506 per patient treated. This translates to an ICER of €15,189 (95% confidence interval: €11,891–€28,415). One-way sensitivity analysis underscores that ICER for nab-paclitaxel remains stable despite varying taxanes cost. Threshold analysis shows that ICER for nab-paclitaxel exceeds €40,000 only if cost per mg of conventional paclitaxel is set to zero. Probabilistic sensitivity analysis highlights that nab

The Effect of Corporate Social Responsibility Disclosure on the Cost of Equity of Firms and the Moderating Role of Ownership

NARCIS (Netherlands)

Kabir, Rezaul; Thái Minh, H¿nh

2017-01-01

The empirical relationship between corporate social responsibility (CSR) disclosure and the cost of equity is conflicting. Various corporate governance mechanisms may moderate this relationship. However, the moderating effect of foreign ownership - a key corporate governance mechanism in many

An experimental strategy validated to design cost-effective culture media based on response surface methodology.

Science.gov (United States)

Navarrete-Bolaños, J L; Téllez-Martínez, M G; Miranda-López, R; Jiménez-Islas, H

2017-07-03

For any fermentation process, the production cost depends on several factors, such as the genetics of the microorganism, the process condition, and the culture medium composition. In this work, a guideline for the design of cost-efficient culture media using a sequential approach based on response surface methodology is described. The procedure was applied to analyze and optimize a culture medium of registered trademark and a base culture medium obtained as a result of the screening analysis from different culture media used to grow the same strain according to the literature. During the experiments, the procedure quantitatively identified an appropriate array of micronutrients to obtain a significant yield and find a minimum number of culture medium ingredients without limiting the process efficiency. The resultant culture medium showed an efficiency that compares favorably with the registered trademark medium at a 95% lower cost as well as reduced the number of ingredients in the base culture medium by 60% without limiting the process efficiency. These results demonstrated that, aside from satisfying the qualitative requirements, an optimum quantity of each constituent is needed to obtain a cost-effective culture medium. Study process variables for optimized culture medium and scaling-up production for the optimal values are desirable.

Link Design Rules for Cost-Effective Short-Range Radio Over Multimode Fiber Systems

DEFF Research Database (Denmark)

Visani, Davide; Tartarini, Giovanni; Petersen, Martin Nordal

2010-01-01

Referring to short-range radio over multimode fiber links, we find out important guidelines for the realization of cost-effective intensity modulated directly detected systems. Since the quality of today's connectors is considerably higher than in the past, we demonstrate that two important...... parameters of the system are the finite detecting area of the photodiode and the laser frequency chirp. Furthemore, we show that the use of the central launch technique inherently determines a lower impact of modal noise fluctuations with respect to the offset launch one. This makes CL more convenient...

Prepaid convenience.

Science.gov (United States)

Kaiser, F

1998-01-01

Consider prepaid calling cards as a new tool in your marketing arsenal. Your hospitality facility may be considering the sale and distribution of prepaid phone cards to provide more convenience to patients or as a replacement to traditional calling cards for mobile employees. Prepaid phone cards represent a new twist and many advantages for long distance calling.

Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs

Energy Technology Data Exchange (ETDEWEB)

Potter, Jennifer; Cappers, Peter

2017-08-28

The Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs research describe a variety of DR opportunities and the various bulk power system services they can provide. The bulk power system services are mapped to a generalized taxonomy of DR “service types”, which allows us to discuss DR opportunities and bulk power system services in fewer yet broader categories that share similar technological requirements which mainly drive DR enablement costs. The research presents a framework for the costs to automate DR and provides descriptions of the various elements that drive enablement costs. The report introduces the various DR enabling technologies and end-uses, identifies the various services that each can provide to the grid and provides the cost assessment for each enabling technology. In addition to a report, this research includes a Demand Response Advanced Controls Database and User Manual. They are intended to provide users with the data that underlies this research and instructions for how to use that database more effectively and efficiently.

The network-based energy management system for convenience stores

Energy Technology Data Exchange (ETDEWEB)

Wang, An-Ping; Hsu, Pau-Lo [Department of Electrical and Control Engineering, National Chiao-Tung University, 1001 Ta-Hsiue Road, Hsinchu City 310 (China)

2008-07-01

Convenience stores generally consume energy higher than other retailing merchants. As the problem of energy shortage becomes more serious during summer, almost all convenience stores sign a contract with power plants, which provides for fines if demand limiting occurs in Taiwan and many other countries. Therefore, a reliable and effective method to reduce their utility consumption is required for modern business and industry. This research integrates the remote sensors, the control network, and the embedded system technologies to construct a distributed energy management control system for dedicated convenience stores. Energy consumption can thus be reasonably managed with demand limits by measuring and analyzing the power consumption sources in four major subsystems of convenience stores, namely, (1) air-conditioning, (2) lighting, (3) heating, and (4) refrigeration. By applying the proposed demand prediction and control method, the demand limiting condition can be properly predicted, and the possible peak load can thus be eliminated via the network control mechanism. Moreover, by integrating the LonWork fieldbus and the WinCE operating system (OS), the proposed system has been successfully applied to a convenience store. The experimental results indicate that the proposed distributed energy management system suitably predicts the peak loading condition and successfully prevents its occurrence by switching the air-conditioning system without affecting the indoor temperature regulation. (author)

Impacts of optimum cost effective energy efficiency standards

International Nuclear Information System (INIS)

Brancic, A.B.; Peters, J.S.; Arch, M.

1991-01-01

Building Codes are increasingly required to be responsive to social and economic policy concerns. In 1990 the State of Connecticut passes An Act Concerning Global Warming, Public Act 90-219, which mandates the revision of the state building code to require that buildings and building elements be designed to provide optimum cost-effective energy efficiency over the useful life of the building. Further, such revision must meet the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standard 90.1 - 1989. As the largest electric energy supplier in Connecticut, Northeast Utilities (NU) sponsored a pilot study of the cost effectiveness of alternative building code standards for commercial construction. This paper reports on this study which analyzed design and construction means, building elements, incremental construction costs, and energy savings to determine the optimum cost-effective building code standard. Findings are that ASHRAE 90.1 results in 21% energy savings and alternative standards above it result in significant additional savings. Benefit/cost analysis showed that both are cost effective

The Potential Cost-Effectiveness of Amblyopia Screening Programs

Science.gov (United States)

Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

2013-01-01

Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

Generalizability of causal inference in observational studies under retrospective convenience sampling.

Science.gov (United States)

Hu, Zonghui; Qin, Jing

2018-05-20

Many observational studies adopt what we call retrospective convenience sampling (RCS). With the sample size in each arm prespecified, RCS randomly selects subjects from the treatment-inclined subpopulation into the treatment arm and those from the control-inclined into the control arm. Samples in each arm are representative of the respective subpopulation, but the proportion of the 2 subpopulations is usually not preserved in the sample data. We show in this work that, under RCS, existing causal effect estimators actually estimate the treatment effect over the sample population instead of the underlying study population. We investigate how to correct existing methods for consistent estimation of the treatment effect over the underlying population. Although RCS is adopted in medical studies for ethical and cost-effective purposes, it also has a big advantage for statistical inference: When the tendency to receive treatment is low in a study population, treatment effect estimators under RCS, with proper correction, are more efficient than their parallels under random sampling. These properties are investigated both theoretically and through numerical demonstration. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

An Overview Of Tool For Response Action Cost Estimating (TRACE)

International Nuclear Information System (INIS)

Ferries, S.R.; Klink, K.L.; Ostapkowicz, B.

2012-01-01

Tools and techniques that provide improved performance and reduced costs are important to government programs, particularly in current times. An opportunity for improvement was identified for preparation of cost estimates used to support the evaluation of response action alternatives. As a result, CH2M HILL Plateau Remediation Company has developed Tool for Response Action Cost Estimating (TRACE). TRACE is a multi-page Microsoft Excel(reg s ign) workbook developed to introduce efficiencies into the timely and consistent production of cost estimates for response action alternatives. This tool combines costs derived from extensive site-specific runs of commercially available remediation cost models with site-specific and estimator-researched and derived costs, providing the best estimating sources available. TRACE also provides for common quantity and key parameter links across multiple alternatives, maximizing ease of updating estimates and performing sensitivity analyses, and ensuring consistency.

Pengaruh Lebar Fasad, Warna Interior, dan Lokasi Meja Kasir terhadap Persepsi Aman dan Sikap Konsumen pada Convenience Store

Directory of Open Access Journals (Sweden)

Imtihan Hanum

2016-12-01

experiment for this study 43 respondents were used to evaluate a stimulus set consisting of simulated images of a convenience store interior. The response data were analyzed using ANOVA. The experiment results showed that a cashier location far from the exit with a cool color combination is deemed secure by the respondents, while the location of a counter away from the exit has a positive effect on client behavior. However, the façade variable did not contribute significantly to improving security perception and client behavior. The experimental results can be used in convenience store design guidelines and for developing design knowledge. In the future, other types of shops or public spaces with similar problems can be studied.Keywords: convenience store; crime prevention; consumer behavior; security perception.

The proportion of unhealthy foodstuffs children are exposed to at the checkout of convenience supermarkets.

Science.gov (United States)

Horsley, Jason A; Absalom, Katie Ar; Akiens, Evie M; Dunk, Robert J; Ferguson, Alice M

2014-11-01

To investigate the proportion of foods that are unhealthy to which children are exposed at the checkout of convenience supermarkets. We performed a cross-sectional survey of foodstuffs displayed at the checkout. Products displayed at or below children's eye-level were designated as healthy, unhealthy or unclassifiable using the Food Standards Agency's scoring criteria. Thirteen convenience supermarkets from the three leading UK supermarket chains were selected on the basis of proximity to the town hall in Sheffield, England. Convenience supermarkets were defined as branches of supermarket chains that were identified as being other than superstores on their company's store locator website. In almost all of the convenience supermarkets surveyed, the main healthy product on display was sugar-free chewing gum. On average, when chewing gum was not included as a foodstuff, 89% of the products on display at the checkouts of convenience supermarkets were unhealthy using the Food Standards Agency's criteria. One store was a notable outlier, providing only fruit and nuts at its checkout. The overwhelming majority of products to which children are exposed at the convenience supermarket checkout are unhealthy. This is despite all the supermarket chains surveyed having signed up to the UK Government's 'responsibility deal'.

Are new supraglottic airway devices, tracheal tubes and airway viewing devices cost-effective?

Science.gov (United States)

Slinn, Simon J; Froom, Stephen R; Stacey, Mark R W; Gildersleve, Christopher D

2015-01-01

Over the past two decades, a plethora of new airway devices has become available to the pediatric anesthetist. While all have the laudable intention of improving patient care and some have proven clinical benefits, these devices are often costly and at times claims of an advantage over current equipment and techniques are marginal. Supraglottic airway devices are used in the majority of pediatric anesthetics delivered in the U.K., and airway-viewing devices provide an alternative for routine intubation as well as an option in the management of the difficult airway. Yet hidden beneath the convenience of the former and the technology of the latter, the impact on basic airway skills with a facemask and the lack of opportunities to fine-tune the core skill of intubation represent an unrecognised and unquantifiable cost. A judgement on this value must be factored into the absolute purchase cost and any potential benefits to the quality of patient care, thus blurring any judgement on cost-effectiveness that we might have. An overall value on cost-effectiveness though not in strict monetary terms can then be ascribed. In this review, we evaluate the role of these devices in the care of the pediatric patient and attempt to balance the advantages they offer against the cost they incur, both financial and environmental, and in any quality improvement they might offer in clinical care. © 2014 John Wiley & Sons Ltd.

A smartphone-optimized web site for conveniently viewing otolaryngology journal abstracts.

Science.gov (United States)

Golub, Justin S; Sharma, Arun; Samy, Ravi N

2014-12-01

Access to the medical literature has not kept pace with the mobile revolution. We aimed to (1) gauge interest in a smartphone-optimized Web site for conveniently accessing otolaryngology literature and (2) create an easy-to-access and convenient Web site that displays otolaryngology journal abstracts in a format optimized for smartphones. A survey was sent to physicians of a major US academic otolaryngology-head and neck surgery department. Demographics, literature-browsing habits, and barriers to staying updated were assessed. The response rate was 87%. Ninety-one percent of respondents used a smartphone, and 85% wished they could stay more up to date with the otolaryngology literature. Most respondents believed a convenient smartphone-optimized Web site could help them achieve this goal. A Web site was then developed in collaboration with a university creative department as a proof of concept. The site uses a simple RSS aggregator to display journal abstracts formatted for smartphone-sized screens (www.otosurg.com). © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

How convenient!? Adolescents’ vistas on food competences in a convenience context

NARCIS (Netherlands)

Wahlen, S.; Horst, van der Hilje; Pothoff, Roosje

2016-01-01

Purpose – Adolescents are at a stage in their life course in which they increasingly become choosers, buyers and preparers of food. Hence, they develop and employ required competences. Current food-related competences of adolescents are shaped in an environment with an abundance of convenience

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

Science.gov (United States)

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

2015-06-01

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

Performance Determinants for Convenience Store Suppliers

OpenAIRE

Zainah Abdullah; Aznur Hajar Abdullah

2012-01-01

This paper examines the impact of information and communication technology (ICT) usage, internal relationship, supplier-retailer relationship, logistics services and inventory management on convenience store suppliers- performance. Data was collected from 275 convenience store managers in Malaysia using a set of questionnaire. The multiple linear regression results indicate that inventory management, supplier-retailer relationship, logistics services and internal relation...

Meal box schemes a convenient way to avoid convenience food? Uses and understandings of meal box schemes among Danish consumers.

Science.gov (United States)

Hertz, Frej Daniel; Halkier, Bente

2017-07-01

The term convenience food is subject to diversification, lack of clarity and moral ambiguity. In this paper we address these issues and critically discuss convenience food by using empirical findings from a Danish study that deals with practitioners' uses of meal box schemes. The methodological design consists of thirteen individual interviews, four focus groups and some observations of cooking practices. We combine the empirical findings with a particular definition of convenience food by Brunner et al. (2010) and selected practice theoretical concepts. This particular combination enables us to categorize meal box schemes as a new form of convenience food called convenient food. In addition, results suggest that meal box schemes reduce leftovers from dinner. Meal boxes also influence dinner related activities such as planning ahead in time and grocery shopping, which require less physical and mental effort. Copyright © 2017 Elsevier Ltd. All rights reserved.

The stochastic seasonal behavior of energy commodity convenience yields

International Nuclear Information System (INIS)

Mirantes, Andrés García; Población, Javier; Serna, Gregorio

2013-01-01

This paper contributes to the commodity pricing literature by consistently modeling the convenience yield with its empirically observed properties. Specifically, in this paper, we show how a four-factor model for the stochastic behavior of commodity prices, with two long- and short-term factors and two additional seasonal factors, may accommodate some of the most important empirically observed characteristics of commodity convenience yields, such as the mean reversion and stochastic seasonality. Based on this evidence, a theoretical model is presented and estimated to characterize the commodity convenience yield dynamics that are consistent with previous findings. We also show that commodity price seasonality is better estimated through convenience yields than through futures prices. - Highlights: • Energy commodity convenience yields exhibit mean reversion and stochastic seasonality. • We present a model for convenience yields accounting for their observed characteristics. • Commodity price seasonality is better estimated through convenience yields

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada.

Science.gov (United States)

Jozaghi, Ehsan; Reid, Andrew A; Andresen, Martin A; Juneau, Alexandre

2014-08-04

Supervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada's capital city, Ottawa. The current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed. The sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases--when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent. Funded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain.

Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

NARCIS (Netherlands)

Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.

2007-01-01

OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian

Revealing the values behind convenience food consumption.

Science.gov (United States)

Botonaki, Anna; Mattas, Konstadinos

2010-12-01

The increasing importance of convenience in consumer food choices has attracted researchers' interest. In the effort to understand how convenience affects consumers' food preferences, values are believed to play an important role. The present study attempts to examine the way personal values suggested by Schwartz (1992) are associated with behaviour and attitudes regarding convenience food. A number of constructs describing food related attitudes and behaviours were developed and their relationship with personal values was analyzed following the methodology proposed by Brunsø, Scholderer, and Grunert (2004). Data were collected through a questionnaire survey from a random sample of consumers in Thessaloniki city, Greece. The results reveal that convenience food consumption and convenience orientation in the food domain are mainly connected with values that motivate people to seek new experiences, act independently and enhance their own personal interests, while are in conflict with values of conservation and self-transcendence. The opposite holds for other food related attitudes and behaviours like involvement with cooking and variety in diet. The findings seem to be of particular interest not only for marketers of food products, but also for food policy makers. Copyright © 2010 Elsevier Ltd. All rights reserved.

Cost-effectiveness of using small vertebrates as indicators of disturbance.

Science.gov (United States)

Peck, Mika Robert; Maddock, Simon T; Morales, Jorge Noe; Oñate, Hugolino; Mafla-Endara, Paola; Peñafiel, Vanessa Aguirre; Torres-Carvajal, Omar; Pozo-Rivera, Wilmer E; Cueva-Arroyo, Xavier A; Tolhurst, Bryony A

2014-10-01

In species-rich tropical forests, effective biodiversity management demands measures of progress, yet budgetary limitations typically constrain capacity of decision makers to assess response of biological communities to habitat change. One approach is to identify ecological-disturbance indicator species (EDIS) whose monitoring is also monetarily cost-effective. These species can be identified by determining individual species' responses to disturbance across a gradient; however, such responses may be confounded by factors other than disturbance. For example, in mountain environments the effects of anthropogenic habitat alteration are commonly confounded by elevation. EDIS have been identified with the indicator value (IndVal) metric, but there are weaknesses in the application of this approach in complex montane systems. We surveyed birds, small mammals, bats, and leaf-litter lizards in differentially disturbed cloud forest of the Ecuadorian Andes. We then incorporated elevation in generalized linear (mixed) models (GL(M)M) to screen for EDIS in the data set. Finally, we used rarefaction of species accumulation data to compare relative monetary costs of identifying and monitoring EDIS at equal sampling effort, based on species richness. Our GL(M)M generated greater numbers of EDIS but fewer characteristic species relative to IndVal. In absolute terms birds were the most cost-effective of the 4 taxa surveyed. We found one low-cost bird EDIS. In terms of the number of indicators generated as a proportion of species richness, EDIS of small mammals were the most cost-effective. Our approach has the potential to be a useful tool for facilitating more sustainable management of Andean forest systems. © 2014 Society for Conservation Biology.

Dopamine Manipulation Affects Response Vigor Independently of Opportunity Cost.

Science.gov (United States)

Zénon, Alexandre; Devesse, Sophie; Olivier, Etienne

2016-09-14

Dopamine is known to be involved in regulating effort investment in relation to reward, and the disruption of this mechanism is thought to be central in some pathological situations such as Parkinson's disease, addiction, and depression. According to an influential model, dopamine plays this role by encoding the opportunity cost, i.e., the average value of forfeited actions, which is an important parameter to take into account when making decisions about which action to undertake and how fast to execute it. We tested this hypothesis by asking healthy human participants to perform two effort-based decision-making tasks, following either placebo or levodopa intake in a double blind within-subject protocol. In the effort-constrained task, there was a trade-off between the amount of force exerted and the time spent in executing the task, such that investing more effort decreased the opportunity cost. In the time-constrained task, the effort duration was constant, but exerting more force allowed the subject to earn more substantial reward instead of saving time. Contrary to the model predictions, we found that levodopa caused an increase in the force exerted only in the time-constrained task, in which there was no trade-off between effort and opportunity cost. In addition, a computational model showed that dopamine manipulation left the opportunity cost factor unaffected but altered the ratio between the effort cost and reinforcement value. These findings suggest that dopamine does not represent the opportunity cost but rather modulates how much effort a given reward is worth. Dopamine has been proposed in a prevalent theory to signal the average reward rate, used to estimate the cost of investing time in an action, also referred to as opportunity cost. We contrasted the effect of dopamine manipulation in healthy participants in two tasks, in which increasing response vigor (i.e., the amount of effort invested in an action) allowed either to save time or to earn more

Linking service convenience to satisfaction: Dimensions and key moderators

OpenAIRE

Benoit, Sabine; Klose, S; Ettinger, A

2017-01-01

Purpose: Demand for service convenience, defined as a consumer’s perception of minimized time and effort spent to obtain a service, has increased in conjunction with certain sociocultural and demographic changes. Prior research notes the significance of service convenience, but the importance of different dimensions of service convenience as well as the role of key moderators affecting the link between convenience and satisfaction (like customer psychographic and sociodemograph...

28 CFR 66.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Termination for convenience. 66.44 Section 66.44 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) UNIFORM ADMINISTRATIVE... Reports, Records, Retention, and Enforcement § 66.44 Termination for convenience. Except as provided in...

48 CFR 8.406-5 - Termination for the Government's convenience.

Science.gov (United States)

2010-10-01

... Government's convenience. 8.406-5 Section 8.406-5 Federal Acquisition Regulations System FEDERAL ACQUISITION... Termination for the Government's convenience. (a) An ordering activity contracting officer may terminate individual orders for the Government's convenience. Terminations for the Government's convenience shall...

Exploring Convenience Food Consumption through a Structural Equation Model

OpenAIRE

Botonaki, Anna; Natos, Dimitrios; Mattas, Konstadinos

2007-01-01

In this study the model of convenience orientation suggested by Scholderer and Grunert (2005) is applied in order to examine consumer behavior in the context of convenience food usage. The empirical results indicate that socio-demographic characteristics affect behavior both directly and indirectly through perceived time resources and convenience orientation towards meal preparation and clearing up. Findings seem to be important for all the bodies involved in the marketing of convenience food...

14 CFR 152.507 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Termination for convenience. 152.507 Section 152.507 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... convenience. (a) When the continuation of the project would not produce beneficial results commensurate with...

45 CFR 2541.440 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Termination for convenience. 2541.440 Section 2541.440 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND... LOCAL GOVERNMENTS Reports, Records, Retention and Enforcement § 2541.440 Termination for convenience...

45 CFR 92.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Termination for convenience. 92.44 Section 92.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION UNIFORM ADMINISTRATIVE... Requirements Reports, Records Retention, and Enforcement § 92.44 Termination for convenience. Except as...

14 CFR 1273.44 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Termination for convenience. 1273.44 Section 1273.44 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION UNIFORM ADMINISTRATIVE... Reports, Records, Retention, and Enforcement § 1273.44 Termination for convenience. Except as provided in...

13 CFR 143.44 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Termination for convenience. 143.44 Section 143.44 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION UNIFORM ADMINISTRATIVE... Reports, Records, Retention, and Enforcement § 143.44 Termination for convenience. Except as provided in...

Cost-effective strategy to mitigate transportation disruptions in supply chain

Science.gov (United States)

Albertzeth, G.; Pujawan, I. N.

2018-04-01

Supply chain disruptions have gained significant attention by scholars. But, even though transportation plays a central role in supply chain, only few studies address transportation disruptions. This research demonstrates a real case of an order delivery process from a focal company (FC) to a single distributor, where transportation disruptions stochastically occurs. Considering the possibility of sales loss during the disruption duration, we proposed a redundant stock, flexible route, and combined flexibility-redundancy (ReFlex) as mitigation strategies and a base case as a risk acceptance strategy. The objective is to find out the best strategy that promotes cost-effectiveness against transportation disruptions. To fulfill this objective, we use simulation modeling and cost-effectiveness analysis (CEA) as our research method. We simulate the delivery process of 5 brands using each strategy to produce two different responses: loss of sales percentage and the incurred costs. Next, using these responses, we evaluate and compare the cost-effectiveness ratio of each strategy using CEA. We found that redundant stock gave the best effectiveness on all brands, ReFlex as the second best, while flexible route gave the least effectiveness. Finally, we recommend which strategy should be applied based on the decision maker willingness to pay.

40 CFR 35.6760 - Enforcement and termination for convenience.

Science.gov (United States)

2010-07-01

... convenience. 35.6760 Section 35.6760 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND... Enforcement and termination for convenience. The recipient must comply with all terms and conditions in the... termination for convenience described in 40 CFR 31.43 and 31.44. ...

20 CFR 437.44 - Termination for convenience.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Termination for convenience. 437.44 Section 437.44 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR..., Retention, and Enforcement § 437.44 Termination for convenience. Except as provided in § 437.43, awards may...

29 CFR 1470.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Termination for convenience. 1470.44 Section 1470.44 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE UNIFORM ADMINISTRATIVE... Reports, Records Retention, and Enforcement § 1470.44 Termination for convenience. Except as provided in...

Attitudes and behaviour towards convenience food and food waste in the United Kingdom.

Science.gov (United States)

Mallinson, Lucy J; Russell, Jean M; Barker, Margo E

2016-08-01

Households in the UK discard much food. A reduction in such waste to mitigate environmental impact is part of UK government policy. This study investigated whether household food waste is linked to a lifestyle reliant on convenience food in younger consumers. A survey of 928 UK residents aged 18-40 years and responsible for the household food shopping (male n = 278; female n = 650) completed an online questionnaire designed to measure attitudes to convenience food and to quantify household food waste. Cluster analysis of 24 food-related lifestyle factors identified 5 consumer groups. General linear modelling techniques were used to test relationships between the purchase frequency of convenience food and household food waste. From the cluster analysis, five distinct convenience profiles emerged comprising: 'epicures' (n = 135), 'traditional consumers' (n = 255), 'casual consumers' (n = 246), 'food detached consumers' (n = 151) and 'kitchen evaders' (n = 141). Casual consumers and kitchen evaders were the most reliant on convenience food and notably were the most wasteful. The demographic profile of kitchen evaders matched the population groups currently targeted by UK food waste policy. Casual consumers represent a new and distinct group characterised by "buy a lot and waste a lot" behaviour. Household size, packaging format, price-awareness and marketing all appear to influence levels of food waste. However, it seems that subtle behavioural and sociocultural factors also have impact. Further research is needed to elucidate the factors that mediate the positive association between the purchase of convenience food and reported food waste in order to inform food waste policy and initiatives. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

1988-05-01

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

22 CFR 135.44 - Termination for convenience.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Termination for convenience. 135.44 Section 135.44 Foreign Relations DEPARTMENT OF STATE MISCELLANEOUS UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS..., Retention, and Enforcement § 135.44 Termination for convenience. Except as provided in § 135.43 awards may...

15 CFR 24.44 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Termination for convenience. 24.44 Section 24.44 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM ADMINISTRATIVE... Reports, Records, Retention, and Enforcement § 24.44 Termination for convenience. Except as provided in...

10 CFR 600.244 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Termination for convenience. 600.244 Section 600.244 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform... Requirements § 600.244 Termination for convenience. Except as provided in § 600.443 awards may be terminated in...

44 CFR 13.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Termination for convenience. 13.44 Section 13.44 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... § 13.44 Termination for convenience. Except as provided in § 13.43 awards may be terminated in whole or...

Consumers' convenience orientation towards meal preparation: conceptualization and measurement.

Science.gov (United States)

Candel, M

2001-02-01

Consumer researchers consider convenience orientation towards meal preparation to be a relevant construct for understanding consumer behavior towards foods. This study set out to conceptualize this construct and to develop a scale that measures it. As examined in two different samples of meal preparers, the resulting scale is reliable, satisfies a unifactorial structure and has satisfactory convergent validity. The scale's nomological validity is supported in that it conforms to expectations regarding various psychographic constructs and various food-related behaviors. Convenience orientation was found to be negatively related to cooking enjoyment, involvement with food products and variety seeking, and to be positively related to role overload. The analyses also suggest that the lack of relation between the meal preparer's working status and convenience food consumption, as found in many studies, is due to convenience food not offering enough preparation convenience. Consuming take-away meals and eating in restaurants appear to satisfy the consumer's need for convenience more adequately. Copyright 2001 Academic Press.

49 CFR 18.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Termination for convenience. 18.44 Section 18.44 Transportation Office of the Secretary of Transportation UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND... Enforcement § 18.44 Termination for convenience. Except as provided in § 18.43 awards may be terminated in...

36 CFR 1207.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Termination for convenience. 1207.44 Section 1207.44 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS... Termination for convenience. Except as provided in § 1207.43 awards may be terminated in whole or in part only...

34 CFR 80.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Termination for convenience. 80.44 Section 80.44 Education Office of the Secretary, Department of Education UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS... Retention, and Enforcement § 80.44 Termination for convenience. Except as provided in § 80.43 awards may be...

40 CFR 31.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Termination for convenience. 31.44 Section 31.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... convenience. Except as provided in § 31.43 awards may be terminated in whole or in part only as follows: (a...

45 CFR 1157.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Termination for convenience. 1157.44 Section 1157.44 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS... Enforcement § 1157.44 Termination for convenience. Except as provided in § 1157.43 awards may be terminated in...

45 CFR 1183.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Termination for convenience. 1183.44 Section 1183.44 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS..., Retention, and Enforcement § 1183.44 Termination for convenience. Except as provided in § 1183.43 awards may...

21 CFR 1403.44 - Termination for convenience.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Termination for convenience. 1403.44 Section 1403.44 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY UNIFORM ADMINISTRATIVE REQUIREMENTS FOR..., Retention, and Enforcement § 1403.44 Termination for convenience. Except as provided in § 1403.43 awards may...

45 CFR 1174.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Termination for convenience. 1174.44 Section 1174.44 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS..., Retention, and Enforcement § 1174.44 Termination for convenience. Except as provided in § 1174.43 awards may...

45 CFR 602.44 - Termination for convenience.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Termination for convenience. 602.44 Section 602.44 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION UNIFORM... Requirements § 602.44 Termination for convenience. Except as provided in § 602.43 awards may be terminated in...

You can't take it with you? Effects of handheld portable media consoles on physiological and psychological responses to video game and movie content.

Science.gov (United States)

Ivory, James D; Magee, Robert G

2009-06-01

Portable media consoles are becoming extremely popular devices for viewing a number of different types of media content, both for entertainment and for educational purposes. Given the increasingly heavy use of portable consoles as an alternative to traditional television-style monitors, it is important to investigate how physiological and psychological effects of portable consoles may differ from those of television-based consoles, because such differences in physiological and psychological responses may precipitate differences in the delivered content's effectiveness. Because portable consoles are popular as a delivery system for multiple types of media content, such as movies and video games, it is also important to investigate whether differences between the effects of portable and television-based consoles are consistent across multiple types of media. This article reports a 2 x 2 (console: portable or television-based x medium: video game or movie) mixed factorial design experiment with physiological arousal and self-reported flow experience as dependent variables, designed to explore whether console type affects media experiences and whether these effects are consistent across different media. Results indicate that portable media consoles evoke lower levels of physiological arousal and flow experience and that this effect is consistent for both video games and movies. These findings suggest that even though portable media consoles are often convenient compared to television-based consoles, the convenience may come at a cost in terms of the user experience.

Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia.

Science.gov (United States)

Aponte-González, Johanna; Fajardo-Bernal, Luisa; Diaz, Jorge; Eslava-Schmalbach, Javier; Gamboa, Oscar; Hay, Joel W

2013-01-01

To compare costs and effectiveness of three strategies used against cervical cancer (CC) and genital warts: (i) Screening for CC; (ii) Bivalent Human Papillomavirus (HPV) 16/18 vaccine added to screening; (iii) Quadrivalent HPV 6/11/16/18 vaccine added to screening. A Markov model was designed in order to simulate the natural history of the disease from 12 years of age (vaccination) until death. Transition probabilities were selected or adjusted to match the HPV infection profile in Colombia. A systematic review was undertaken in order to derive efficacy values for the two vaccines as well as for the operational characteristics of the cytology test. The societal perspective was used. Effectiveness was measured in number of averted Disability Adjusted Life Years (DALYS). At commercial prices reported for 2010 the two vaccines were shown to be non-cost-effective alternatives when compared with the existing screening strategy. Sensitivity analyses showed that results are affected by the cost of vaccines and their efficacy values, making it difficult to determine with certainty which of the two vaccines has the best cost-effectiveness profile. To be 'cost-effective' vaccines should cost between 141 and 147 USD (Unite States Dollars) per vaccinated girl at the most. But at lower prices such as those recommended by WHO or the price of other vaccines in Colombia, HPV vaccination could be considered very cost-effective. HPV vaccination could be a convenient alternative for the prevention of CC in Colombia. However, the price of the vaccine should be lower for this vaccination strategy to be cost-effective. It is also important to take into consideration the willingness to pay, budgetary impact, and program implications, in order to determine the relevance of a vaccination program in this country, as well as which vaccine should be selected for use in the program.

Costs and Cost-Effectiveness of Plasmodium vivax Control.

Science.gov (United States)

White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

2016-12-28

The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

Reliability-oriented Design of a Cost-effective Active Capacitor

DEFF Research Database (Denmark)

Wang, Haoran; Wang, Huai

2017-01-01

This paper presents the reliability-oriented design of a two-terminal active capacitor proposed recently. The two-terminal active capacitor has the same level of convenience as a passive capacitor with reduced requirement of overall energy storage. In order to fully explore the potential...... of the proposed concept, a comprehensive design procedure is necessary to optimally sizing the key components of the active capacitor in terms of cost and reliability. Moreover, the inherent condition monitoring capability of the active capacitor is discussed by utilizing the existing feedback signals. A 500 W...

29 CFR 97.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Termination for convenience. 97.44 Section 97.44 Labor Office of the Secretary of Labor UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE... § 97.44 Termination for convenience. Except as provided in § 97.43 awards may be terminated in whole or...

38 CFR 43.44 - Termination for convenience.

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2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Termination for convenience. 43.44 Section 43.44 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... convenience. Except as provided in § 43.43 awards may be terminated in whole or in part only as follows: (a...

43 CFR 12.84 - Termination for convenience.

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2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Termination for convenience. 12.84 Section 12.84 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT... Termination for convenience. Except as provided in § 12.83 awards may be terminated in whole or in part only...

7 CFR 3016.44 - Termination for convenience.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Termination for convenience. 3016.44 Section 3016.44 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER... Termination for convenience. Except as provided in § 3016.43 awards may be terminated in whole or in part only...

Is individualized medicine more cost-effective? A systematic review.

Science.gov (United States)

Hatz, Maximilian H M; Schremser, Katharina; Rogowski, Wolf H

2014-05-01

Individualized medicine (IM) is a rapidly evolving field that is associated with both visions of more effective care at lower costs and fears of highly priced, low-value interventions. It is unclear which view is supported by the current evidence. Our objective was to systematically review the health economic evidence related to IM and to derive general statements on its cost-effectiveness. A literature search of MEDLINE database for English- and German-language studies was conducted. Cost-effectiveness and cost-utility studies for technologies meeting the MEDLINE medical subject headings (MeSH) definition of IM (genetically targeted interventions) were reviewed. This was followed by a standardized extraction of general study characteristics and cost-effectiveness results. Most of the 84 studies included in the synthesis were from the USA (n = 43, 51 %), cost-utility studies (n = 66, 79 %), and published since 2005 (n = 60, 71 %). The results ranged from dominant to dominated. The median value (cost-utility studies) was calculated to be rounded $US22,000 per quality-adjusted life year (QALY) gained (adjusted to $US, year 2008 values), which is equal to the rounded median cost-effectiveness in the peer-reviewed English-language literature according to a recent review. Many studies reported more than one strategy of IM with highly varying cost-effectiveness ratios. Generally, results differed according to test type, and tests for disease prognosis or screening appeared to be more favorable than tests to stratify patients by response or by risk of adverse effects. However, these results were not significant. Different definitions of IM could have been used. Quality assessment of the studies was restricted to analyzing transparency. IM neither seems to display superior cost-effectiveness than other types of medical interventions nor to be economically inferior. Instead, rather than 'whether' healthcare was individualized, the question of 'how' it was individualized was

A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors

Directory of Open Access Journals (Sweden)

Witt Julia

2011-09-01

Full Text Available Abstract Background Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. Methods A stratified random sample of 4.9% (2,702/54,160 of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902; simultaneous mixed mode (a paper questionnaire and login details sent together (900; or, sequential mixed mode (online followed by a paper questionnaire with the reminder (900. Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. Results The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared

A time-cost augmented economic evaluation of oral deferasirox versus infusional deferoxamine [corrected] for patients with iron overload in South Korea.

Science.gov (United States)

Kim, Jinhyun; Kim, Younhee

2009-01-01

This study aims to conduct an economic evaluation of oral deferasirox (DSX) compared with infusional deferoxamine (DFO) in patients with transfusional iron overload. Depending on the methods for measuring time-cost and convenience associated with the mode of administration, either cost-utility analysis or cost-effectiveness analysis was undertaken. The difference in compliance rate between DSX and DFO was applied. Although the drug cost of DSX was US$124,070 higher than that of DFO (US$96,039 vs. US$220,199), all other costs were lower in patients with DSX than in patients with DFO. In the cost-utility analysis, DSX resulted in US$3197 savings with a gain of 2.63 quality-adjusted life-years per patient. The result of the cost-effectiveness analysis also showed that DSX dominated DFO. With a considerable improvement in convenience and injection time rather than efficacy, DSX is considered as a dominant therapy for patients with iron overload.

24 CFR 85.44 - Termination for convenience.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Termination for convenience. 85.44 Section 85.44 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... § 85.44 Termination for convenience. Except as provided in § 85.43 awards may be terminated in whole or...

Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

Science.gov (United States)

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

Effect of prospective reimbursement on nursing home costs.

Science.gov (United States)

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

A review of the costs and benefits of demand response for electricity in the UK

International Nuclear Information System (INIS)

Bradley, Peter; Leach, Matthew; Torriti, Jacopo

2013-01-01

The recent policy discussion in the UK on the economic case for demand response (DR) calls for a reflection on available evidence regarding its costs and benefits. Existing studies tend to consider the size of investments and returns of certain forms of DR in isolation and do not consider economic welfare effects. From review of existing studies, policy documents, and some simple modelling of benefits of DR in providing reserve for unforeseen events, we demonstrate that the economic case for DR in UK electricity markets is positive. Consideration of economic welfare gains is provided. - Highlights: ► The paper clearly articulates the range of benefits and costs from demand response. ► Estimates for benefits and costs are converted into a broadly comparable basis. ► It is found that a positive case exists for demand response in the UK. ► New quantitative modelling is provided for one UK benefit not found in the literature. ► Economic welfare gain is considered in assessment; other UK papers do not consider such effects.

Development and Evaluation of A Novel and Cost-Effective Approach for Low-Cost NO₂ Sensor Drift Correction.

Science.gov (United States)

Sun, Li; Westerdahl, Dane; Ning, Zhi

2017-08-19

Emerging low-cost gas sensor technologies have received increasing attention in recent years for air quality measurements due to their small size and convenient deployment. However, in the diverse applications these sensors face many technological challenges, including sensor drift over long-term deployment that cannot be easily addressed using mathematical correction algorithms or machine learning methods. This study aims to develop a novel approach to auto-correct the drift of commonly used electrochemical nitrogen dioxide (NO₂) sensor with comprehensive evaluation of its application. The impact of environmental factors on the NO₂ electrochemical sensor in low-ppb concentration level measurement was evaluated in laboratory and the temperature and relative humidity correction algorithm was evaluated. An automated zeroing protocol was developed and assessed using a chemical absorbent to remove NO₂ as a means to perform zero correction in varying ambient conditions. The sensor system was operated in three different environments in which data were compared to a reference NO₂ analyzer. The results showed that the zero-calibration protocol effectively corrected the observed drift of the sensor output. This technique offers the ability to enhance the performance of low-cost sensor based systems and these findings suggest extension of the approach to improve data quality from sensors measuring other gaseous pollutants in urban air.

Risk aversion and uncertainty in cost-effectiveness analysis: the expected-utility, moment-generating function approach.

Science.gov (United States)

Elbasha, Elamin H

2005-05-01

The availability of patient-level data from clinical trials has spurred a lot of interest in developing methods for quantifying and presenting uncertainty in cost-effectiveness analysis (CEA). Although the majority has focused on developing methods for using sample data to estimate a confidence interval for an incremental cost-effectiveness ratio (ICER), a small strand of the literature has emphasized the importance of incorporating risk preferences and the trade-off between the mean and the variance of returns to investment in health and medicine (mean-variance analysis). This paper shows how the exponential utility-moment-generating function approach is a natural extension to this branch of the literature for modelling choices from healthcare interventions with uncertain costs and effects. The paper assumes an exponential utility function, which implies constant absolute risk aversion, and is based on the fact that the expected value of this function results in a convenient expression that depends only on the moment-generating function of the random variables. The mean-variance approach is shown to be a special case of this more general framework. The paper characterizes the solution to the resource allocation problem using standard optimization techniques and derives the summary measure researchers need to estimate for each programme, when the assumption of risk neutrality does not hold, and compares it to the standard incremental cost-effectiveness ratio. The importance of choosing the correct distribution of costs and effects and the issues related to estimation of the parameters of the distribution are also discussed. An empirical example to illustrate the methods and concepts is provided. Copyright 2004 John Wiley & Sons, Ltd

32 CFR 33.44 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Termination for convenience. 33.44 Section 33.44 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... convenience. Except as provided in § 33.43 awards may be terminated in whole or in part only as follows: (a...

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

OpenAIRE

Fast, Shannon M.; Markuzon, Natasha; Gonzalez, Marta C.

2015-01-01

Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social resp...

[A comparison of convenience sampling and purposive sampling].

Science.gov (United States)

Suen, Lee-Jen Wu; Huang, Hui-Man; Lee, Hao-Hsien

2014-06-01

Convenience sampling and purposive sampling are two different sampling methods. This article first explains sampling terms such as target population, accessible population, simple random sampling, intended sample, actual sample, and statistical power analysis. These terms are then used to explain the difference between "convenience sampling" and purposive sampling." Convenience sampling is a non-probabilistic sampling technique applicable to qualitative or quantitative studies, although it is most frequently used in quantitative studies. In convenience samples, subjects more readily accessible to the researcher are more likely to be included. Thus, in quantitative studies, opportunity to participate is not equal for all qualified individuals in the target population and study results are not necessarily generalizable to this population. As in all quantitative studies, increasing the sample size increases the statistical power of the convenience sample. In contrast, purposive sampling is typically used in qualitative studies. Researchers who use this technique carefully select subjects based on study purpose with the expectation that each participant will provide unique and rich information of value to the study. As a result, members of the accessible population are not interchangeable and sample size is determined by data saturation not by statistical power analysis.

Does dependency make a difference? The role of convenience, social influence, facilitating condition and self-efficacy on student's purchase behaviour of smartphone

Science.gov (United States)

Jaganathan, Mathivannan; Mustapa, Azrain Nasyrah; Hasan, Wan Azlina Wan; Mat, Nik Kamariah Nik; Alekam, Jamal Mohammed Esmail

2014-12-01

It is an undeniable fact that penetration level and usage and sales of Smartphone dramatically increased past few years, whereby; it has increased to almost 60 percent of total population. Despite the high penetration of smartphone, previous studies have exhibited inconsistent findings towards understanding the behavioural intention to use smartphone especially among university students. Thus, the purpose of this study is to examine purchasing behaviour of Smartphone among students. From the literature, five antecedents of purchasing behaviour were identified. Each variable is measured using 7-point Likert scale: convenience (10 items), social influence (6 items), self-efficacy (10 items), facilitating condition (11 items), dependency (14 items) and purchasing behaviour (4 items). Using the primary data collection method, 400 questionnaires were distributed to the target respondents of one of the public higher education in the northern region. The responses collected were 350 completed questionnaires representing 87.5 percent response rate. The data were analysed using Structural Equation Modeling (SEM) using AMOS. Confirmatory factor analysis of measurement models indicates adequate goodness or fit after few items were eliminated through modification indices verifications. Therefore, goodness of fit for the generated structural model shows the adequate fit. This study has established four direct significant causal effects and two significant mediating effects: (1) convenience and dependency, (2) social influence and dependency, (3) facilitating condition and purchase behaviour, (4), dependency and purchase behaviour. The significant mediating results are: (1). Dependency mediates the relationship between convenience and purchase behaviour; (2) dependency mediates social influence and purchase behaviour. Thus, findings suggested that convenience, social influence and dependency play a role in determining students purchase behaviour of smartphone. The researchers

Convenience-based food purchase patterns: identification and associations with dietary quality, sociodemographic factors and attitudes.

Science.gov (United States)

Peltner, Jonas; Thiele, Silke

2018-02-01

The present study aimed to derive food purchase patterns considering the convenience level of foods. Associations between identified patterns and dietary quality were analysed, as well as household characteristics associated with the dietary patterns. A Convenience Food Classification Scheme (CFCS) was developed. After classifying basic food groups into the CFCS, the formed groups were used to apply a factor analysis to identify convenience-based food purchase patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between the adherence to the patterns and household characteristic and attitude variables were analysed. The study used representative German food purchase data from 2011. Approximately 12 million purchases of 13 131 households were recorded in these data. Three convenience-based patterns were identified: a low-convenience, a semi-convenience and a ready-to-eat food pattern. Tighter adherence to the semi-convenience pattern was shown to result in the lowest nutrient and highest energy densities. Important factors influencing adherence to the patterns were household size, presence of children and attitudes. Working full-time was negatively associated with adherence to the low-convenience pattern and positively with the ready-to-eat pattern. Convenience foods were an important part of households' food baskets which in some cases led to lower nutritional quality. Therefore, it is important to offer convenience foods higher in nutrient density and lower in energy density. Interventions targeted on enhancing cooking skills could be an effective strategy to increase purchases of unprocessed foods, which, in turn, could also contribute to an improved diet quality.

Rapid response teams: qualitative analysis of their effectiveness.

Science.gov (United States)

Leach, Linda Searle; Mayo, Ann M

2013-05-01

Multidisciplinary rapid response teams focus on patients' emergent needs and manage critical situations to prevent avoidable deaths. Although research has focused primarily on outcomes, studies of the actual team effectiveness within the teams from multiple perspectives have been limited. To describe effectiveness of rapid response teams in a large teaching hospital in California that had been using such teams for 5 years. The grounded-theory method was used to discover if substantive theory might emerge from interview and/or observational data. Purposeful sampling was used to conduct in-person semistructured interviews with 17 key informants. Convenience sampling was used for the 9 observed events that involved a rapid response team. Analysis involved use of a concept or indicator model to generate empirical results from the data. Data were coded, compared, and contrasted, and, when appropriate, relationships between concepts were formed. Results Dimensions of effective team performance included the concepts of organizational culture, team structure, expertise, communication, and teamwork. Professionals involved reported that rapid response teams functioned well in managing patients at risk or in crisis; however, unique challenges were identified. Teams were loosely coupled because of the inconsistency of team members from day to day. Team members had little opportunity to develop relationships or team skills. The need for team training may be greater than that among teams that work together regularly under less time pressure to perform. Communication between team members and managing a crisis were critical aspects of an effective response team.

Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

Science.gov (United States)

Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

2017-11-17

The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.

The cost-effectiveness of biologics for the treatment of rheumatoid arthritis: a systematic review.

Directory of Open Access Journals (Sweden)

Jaana T Joensuu

Full Text Available Economic evaluations provide information to aid the optimal utilization of limited healthcare resources. Costs of biologics for Rheumatoid arthritis (RA are remarkably high, which makes these agents an important target for economic evaluations. This systematic review aims to identify existing studies examining the cost-effectiveness of biologics for RA, assess their quality and report their results systematically.A literature search covering Medline, Scopus, Cochrane library, ACP Journal club and Web of Science was performed in March 2013. The cost-utility analyses (CUAs of one or more available biological drugs for the treatment of RA in adults were included. Two independent investigators systematically collected information and assessed the quality of the studies. To enable the comparison of the results, all costs were converted to 2013 euro.Of the 4890 references found in the literature search, 41 CUAs were included in the current systematic review. While considering only direct costs, the incremental cost-effectiveness ratio (ICER of the tumor necrosis factor inhibitors (TNFi ranged from 39,000 to 1,273,000 €/quality adjusted life year (QALY gained in comparison to conventional disease-modifying antirheumatic drugs (cDMARDs in cDMARD naïve patients. Among patients with an insufficient response to cDMARDs, biologics were associated with ICERs ranging from 12,000 to 708,000 €/QALY. Rituximab was found to be the most cost-effective alternative compared to other biologics among the patients with an insufficient response to TNFi.When 35,000 €/QALY is considered as a threshold for the ICER, TNFis do not seem to be cost-effective among cDMARD naïve patients and patients with an insufficient response to cDMARDs. With thresholds of 50,000 to 100,000 €/QALY biologics might be cost-effective among patients with an inadequate response to cDMARDs. Standardization of multiattribute utility instruments and a validated standard conversion method

48 CFR 49.502 - Termination for convenience of the Government.

Science.gov (United States)

2010-10-01

... convenience of the Government. 49.502 Section 49.502 Federal Acquisition Regulations System FEDERAL... Termination for convenience of the Government. (a) Fixed-price contracts that do not exceed the simplified...-1, Termination for Convenience of the Government (Fixed-Price) (Short Form), in solicitations and...

34 CFR 303.423 - Convenience of proceedings; timelines.

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Convenience of proceedings; timelines. 303.423 Section 303.423 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF... Parents and Children § 303.423 Convenience of proceedings; timelines. (a) Any proceeding for implementing...

Measuring consumer perceptions of online shopping convenience

OpenAIRE

Ferreira, Margarida Bernardo

2016-01-01

The aim of this master thesis is to identify which dimensions of convenience affect consumers’ intention of using online shopping. Also it explores a conceptual model to measuring consumer perceptions of online shopping convenience. This paper contains prospects about online consumer behavior, and the results have important implications for retailers, managers and marketers, related to online shopping strategies. An empirical investigation was carried out to test the hypotheses. In order t...

Course Convenience, Perceived Learning, and Course Satisfaction across Course Formats

Science.gov (United States)

Sanford, Douglas; Ross, Douglas; Rosenbloom, Alfred; Singer, Daniel

2017-01-01

Students' desire for course convenience may lead to their preference for online courses. But in their desire for convenience, are students sacrificing satisfaction or perceived learning? This article investigates the moderating impact of course format on the relationship between convenience and both perceived learning and satisfaction. Moderated…

A Departmental Cost-Effectiveness Model.

Science.gov (United States)

Holleman, Thomas, Jr.

In establishing a departmental cost-effectiveness model, the traditional cost-effectiveness model was discussed and equipped with a distant and deflation equation for both benefits and costs. Next, the economics of costing was examined and program costing procedures developed. Then, the model construct was described as it was structured around the…

Convenience samples and caregiving research: how generalizable are the findings?

Science.gov (United States)

Pruchno, Rachel A; Brill, Jonathan E; Shands, Yvonne; Gordon, Judith R; Genderson, Maureen Wilson; Rose, Miriam; Cartwright, Francine

2008-12-01

We contrast characteristics of respondents recruited using convenience strategies with those of respondents recruited by random digit dial (RDD) methods. We compare sample variances, means, and interrelationships among variables generated from the convenience and RDD samples. Women aged 50 to 64 who work full time and provide care to a community-dwelling older person were recruited using either RDD (N = 55) or convenience methods (N = 87). Telephone interviews were conducted using reliable, valid measures of demographics, characteristics of the care recipient, help provided to the care recipient, evaluations of caregiver-care recipient relationship, and outcomes common to caregiving research. Convenience and RDD samples had similar variances on 68.4% of the examined variables. We found significant mean differences for 63% of the variables examined. Bivariate correlations suggest that one would reach different conclusions using the convenience and RDD sample data sets. Researchers should use convenience samples cautiously, as they may have limited generalizability.

Costs of mounting an immune response during pregnancy in a lizard.

Science.gov (United States)

Meylan, Sandrine; Richard, Murielle; Bauer, Sophie; Haussy, Claudy; Miles, Donald

2013-01-01

Immune defenses are of great benefit to hosts, but reducing the impact of infection by mounting an immune response also entails costs. However, the physiological mechanisms that generate the costs of an immune response remain poorly understood. Moreover, the majority of studies investigating the consequences of an immune challenge in vertebrates have been conducted on mammals and birds. The aim of this study is to investigate the physiological costs of mounting an immune response during gestation in an ectothermic species. Indeed, because ectothermic species are unable to internally regulate their body temperature, the apportionment of resources to homeostatic activities in ectothermic species can differ from that in endothermic species. We conducted this study on the common lizard Zootoca vivipara. We investigated the costs of mounting an immune response by injecting females with sheep red blood cells and quantified the consequences to reproductive performance (litter mass and success) and physiological performance (standard metabolic rate, endurance, and phytohemagglutinin response). In addition, we measured basking behavior. Our analyses revealed that mounting an immune response affected litter mass, physiological performance, and basking behavior. Moreover, we demonstrated that the modulation of an immune challenge is impacted by intrinsic factors, such as body size and condition.

Pengaruh Biaya Corporate Social Responsibility Terhadap Kinerja Keuangan dan Nilai Perusahaan [Influence of Cost against Corporate Social Responsibility, Financial Performance, and Value

Directory of Open Access Journals (Sweden)

Aditya Satya Yudharma

2016-10-01

Full Text Available Corporate social responsibility is becoming increasingly important in Indonesia and many companies get into trouble when they do not care about environmental and social issues. The purpose of this research is to analyze the influence of corporate social responsibility expenditure on the financial performance and value of a firm. The samples used in this study were 56 companies listed in the Indonesia Stock Exchange 2012 and 2013. The samples were chosen using the purposive sampling method based on certain designated criterias. Corporate social responsibility expenditure is measured by employee welfare cost and social expenditure for the community. The financial performance is measured by return on assets (ROA and the firm value is measured by Tobin’s Q ratio. For testing hypothesis, this study used multiple regression analysis. The result of this study showed that the employee welfare cost had a positive effect toward financial performance (ROA and no effect toward firm value (Tobin's Q while social expenditure for community had no effect toward financial performance (ROA and firm value (Tobin’s Q.

Biosimilar medicines and cost-effectiveness

Directory of Open Access Journals (Sweden)

Steven Simoens

2011-02-01

Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost-effectiveness

Allegheny County Supermarkets & Convenience Stores

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Location information for all Supermarkets and Convenience Stores in Allegheny County was produced using the Allegheny County Fee and Permit Data for 2016.

40 CFR 51.355 - Test frequency and convenience.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Test frequency and convenience. 51.355 Section 51.355 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Requirements § 51.355 Test frequency and convenience. (a) The performance standards for I/M programs assume an...

Exploring the relationship between convenience and fish consumption: A cross-cultural study

DEFF Research Database (Denmark)

Olsen, Svein Ottar; Scholderer, Joachim; Brunsø, Karen

2007-01-01

The purpose of the present study is to explore cultural differences in the meaning of convenience and the relationships between convenience, attitudes and fish consumption in five European countries. The results suggest that the meaning of meal convenience is not culture specific, whilst...... the absolute levels of convenience orientation and the perceived inconvenience of fish differ between cultures. Convenience orientation was highest in Poland, followed by Spain, and was lowest in the Netherlands. The relationships between convenience orientation and attitudes towards fish, and convenience...... orientation and fish consumption, were insignificant in most countries. However, convenience orientation was positively related to the perceived inconvenience of fish. Perceived inconvenience of fish was negatively related to both attitudes towards fish and to fish consumption. Together, these results confirm...

Comparison of response rates and cost-effectiveness for a community-based survey: postal, internet and telephone modes with generic or personalised recruitment approaches

Science.gov (United States)

2012-01-01

Background Epidemiological research often requires collection of data from a representative sample of the community or recruitment of specific groups through broad community approaches. The population coverage of traditional survey methods such as mail-outs to residential addresses, and telephone contact via public directories or random-digit-dialing is declining and survey response rates are falling. There is a need to explore new sampling frames and consider multiple response modes including those offered by changes in telecommunications and internet technology. Methods We evaluated response rates and cost-effectiveness for three modes of survey administration (postal invitation/postal survey, postal invitation/internet survey and postal invitation/telephone survey) and two styles of contact approach (personalised and generic) in a community survey of greywater use. Potential respondents were contacted only once, with no follow up of non-responders. Results The telephone survey produced the highest adjusted response rate (30.2%), followed by the personalised postal survey (10.5%), generic postal survey (7.5%) and then the internet survey (4.7% for the personalised approach and 2.2% for the generic approach). There were some differences in household characteristics and greywater use rates between respondents to different survey modes, and between respondents to personalised and generic approaches. These may be attributable to the differing levels of motivations needed for a response, and varying levels of interest in the survey topic among greywater users and non-users. The generic postal survey had the lowest costs per valid survey received (Australian $22.93), followed by the personalised postal survey ($24.75). Conclusions Our findings suggest that postal surveys currently remain the most economic option for population-based studies, with similar costs for personalised and generic approaches. Internet surveys may be effective for specialised groups where email

Metabolic Cost of the Activation of Immune Response in the Fish-Eating Myotis (Myotis vivesi: The Effects of Inflammation and the Acute Phase Response.

Directory of Open Access Journals (Sweden)

Aída Otálora-Ardila

Full Text Available Inflammation and activation of the acute phase response (APR are energetically demanding processes that protect against pathogens. Phytohaemagglutinin (PHA and lipopolysaccharide (LPS are antigens commonly used to stimulate inflammation and the APR, respectively. We tested the hypothesis that the APR after an LPS challenge was energetically more costly than the inflammatory response after a PHA challenge in the fish-eating Myotis bat (Myotis vivesi. We measured resting metabolic rate (RMR after bats were administered PHA and LPS. We also measured skin temperature (Tskin after the LPS challenge and skin swelling after the PHA challenge. Injection of PHA elicited swelling that lasted for several days but changes in RMR and body mass were not significant. LPS injection produced a significant increase in Tskin and in RMR, and significant body mass loss. RMR after LPS injection increased by 140-185% and the total cost of the response was 6.50 kJ. Inflammation was an energetically low-cost process but the APR entailed a significant energetic investment. Examination of APR in other bats suggests that the way in which bats deal with infections might not be uniform.

Effects of non-uniform embedments on earthquake responses of nuclear reactor building

International Nuclear Information System (INIS)

Koyanagi, Y.; Okamoto, S.; Yoshida, K.; Inove, H.

1989-01-01

The nuclear reactor buildings have the portion embedded in soil. In the seismic design of such structures, it is essential to consider the effects of the embedment on the earthquake response. Most studies on these effects, however, assume the uniform embedment, i.e. the depth of the embedment is constant, which is convenient for the design and analysis. The behavior of the earthquake response considering the three-dimensional aspects of non-uniform embedment has not been made clear yet. In this paper, the authors evaluate the effects of the non-uniform embedment in an inclined ground surface on the earthquake response of a nuclear reactor building as illustrated. A typical PWR type reactor building is chosen as an analysis structure model. Four different types of embedment are set up for the comparison study. The three-dimensional analysis is carried out considering the geometry of embedment

41 CFR 105-71.144 - Termination for convenience.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Termination for convenience. 105-71.144 Section 105-71.144 Public Contracts and Property Management Federal Property... Termination for convenience. Except as provided in § 105-71.143 awards may be terminated in whole or in part...

Exploring the relationship between convenience and fish consumption: a cross-cultural study.

Science.gov (United States)

Olsen, Svein Ottar; Scholderer, Joachim; Brunsø, Karen; Verbeke, Wim

2007-07-01

The purpose of the present study is to explore cultural differences in the meaning of convenience and the relationships between convenience, attitudes and fish consumption in five European countries. The results suggest that the meaning of meal convenience is not culture specific, whilst the absolute levels of convenience orientation and the perceived inconvenience of fish differ between cultures. Convenience orientation was highest in Poland, followed by Spain, and was lowest in the Netherlands. The relationships between convenience orientation and attitudes towards fish, and convenience orientation and fish consumption, were insignificant in most countries. However, convenience orientation was positively related to the perceived inconvenience of fish. Perceived inconvenience of fish was negatively related to both attitudes towards fish and to fish consumption. Together, these results confirm some earlier findings that fish is generally perceived as a relatively inconvenient type of food. This study suggests that convenience orientation can be crucial to understanding food choice or behaviour only when critical mediating constructs are explored.

Cost-effectiveness of treatment strategies for BRAF-mutated metastatic melanoma.

Directory of Open Access Journals (Sweden)

Patti Curl

Full Text Available Genetically-targeted therapies are both promising and costly advances in the field of oncology. Several treatments for metastatic melanoma with a mutation in the BRAF gene have been approved. They extend life but are more expensive than the previous standard of care (dacarbazine. Vemurafenib, the first drug in this class, costs $13,000 per month ($207,000 for a patient with median survival. Patients failing vemurafenib are often given ipilimumab, an immunomodulator, at $150,000 per course. Assessment of cost-effectiveness is a valuable tool to help navigate the transition toward targeted cancer therapy.We performed a cost-utility analysis to compare three strategies for patients with BRAF+ metastatic melanoma using a deterministic expected-value decision tree model to calculate the present value of lifetime costs and quality-adjusted life years (QALYs for each strategy. We performed sensitivity analyses on all variables.In the base case, the incremental cost-effectiveness ratio (ICER for vemurafenib compared with dacarbazine was $353,993 per QALY gained (0.42 QALYs added, $156,831 added. The ICER for vemurafenib followed by ipilimumab compared with vemurafenib alone was $158,139. In sensitivity analysis, treatment cost had the largest influence on results: the ICER for vemurafenib versus dacarbazine dropped to $100,000 per QALY gained with a treatment cost of $3600 per month.The cost per QALY gained for treatment of BRAF+ metastatic melanoma with vemurafenib alone or in combination exceeds widely-cited thresholds for cost-effectiveness. These strategies may become cost-effective with lower drug prices or confirmation of a durable response without continued treatment.

SERVICE CONVENIENCE UPT RUMAH SAKIT MATA MASYARAKAT JAWA TIMUR

OpenAIRE

Apriyanti, Selly; Damayanti, Nyoman Anita

2018-01-01

Patient satisfaction is one of the most important thing for a hospital because  patient satisfaction is one of indicators which is assessed in hospital minimum service standards. One of the factors that can affect p atient satisfaction on a service is s ervice convenience, which means patient perception about time and effort related to purchase or use of services offered. The aim of this research was to analyze  service convenience of UPT RSMM Jawa Timur which consists of decision convenience...

The cost-effectiveness, health benefits, and financial costs of new antiviral treatments for hepatitis C virus.

Science.gov (United States)

Rein, David B; Wittenborn, John S; Smith, Bryce D; Liffmann, Danielle K; Ward, John W

2015-07-15

New hepatitis C virus (HCV) treatments deliver higher cure rates with fewer contraindications, increasing demand for treatment and healthcare costs. The cost-effectiveness of new treatments is unknown. We conducted a microsimulation of guideline testing followed by alternative treatment regimens for HCV among the US population aged 20 and older to estimate cases identified, treated, sustained viral response, deaths, medical costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) of different treatment options expressed as discounted lifetime costs and benefits from the healthcare perspective. Compared to treatment with pegylated interferon and ribavirin (PR), and a protease inhibitor for HCV genotype (G) 1 and PR alone for G2/3, treatment with PR and Sofosbuvir (PRS) for G1/4 and treatment with Sofosbuvir and ribavirin (SR) for G2/3 increased QALYs by 555 226, reduced deaths by 80 682, and increased costs by $26.2 billion at an ICER of $47 304 per QALY gained. As compared to PRS/SR, treating with an all oral regimen of Sofosbuvir and Simeprevir (SS) for G1/4 and SR for G2/3, increased QALYs by 1 110 451 and reduced deaths by an additional 164 540 at an incremental cost of $80.1 billion and an ICER of $72 169. In sensitivity analysis, where treatment with SS effectiveness was set to the list price of Viekira Pak and then Harvoni, treatment cost $24 921 and $25 405 per QALY gained as compared to PRS/SR. New treatments are cost-effectiveness per person treated, but pent-up demand for treatment may create challenges for financing. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Coordination and Lock-In: Competition with Switching Costs and Network Effects

OpenAIRE

Farrell, Joseph; Klemperer, Paul

2006-01-01

Switching costs and network effects bind customers to vendors if products are incompatible, locking customers or even markets in to early choices. Lock-in hinders customers from changing suppliers in response to (predictable or unpredictable) changes in efficiency, and gives vendors lucrative ex post market power—over the same buyer in the case of switching costs (or brand loyalty), or over others with network effects. Firms compete ex ante for this ex post power, using penetration ...

Response costs of mammography adherence: Iranian women's perceptions.

Science.gov (United States)

Khodayarian, Mahsa; Mazloomi-Mahmoodabad, Seyed Saied; Lamyian, Minoor; Morowatisharifabad, Mohammad Ali; Tavangar, Hossein

2016-01-01

Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women's awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.

[Cost-effectiveness of addiction care].

Science.gov (United States)

Suijkerbuijk, A W M; van Gils, P F; Greeven, P G J; de Wit, G A

2015-01-01

A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction. To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers. We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (QALY). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs. The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (ICER), remaining below the threshold of € 20,000 per QALY. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the ICER was less than € 20,000 per QALY. Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.

Investigation of the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales.

Science.gov (United States)

Matsumoto, Yuuki; Hoshiko, Michiko; Morimatsu, Yoshitaka; Mori, Mihoko; Kushino, Nanae; Ishitake, Tatsuya

2015-01-01

Fatigue caused by high workload is often responsible for the high attrition among doctors, and has contributed to a disruption in community medicine. In order to address this problem, institutional mechanisms at the hospital level are required. Previous studies have shown that systemic measures at the hospital level and a change in the mindset of patients can help manage the problem. "Convenient visits" refer to emergency visits for non-emergency problems. It is an avoidable cause of high workload on doctors. Convenient visits also refer to emergency consultation for non-emergency symptoms. As this is a new phenomenon, its relationship with doctors' fatigue needs further research. We investigated the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales. We selected 44 hospitals, with >200 beds each, in provincial cities of prefectures with a doctor-population ratio lower than the national average. These cities were considered likely to manifest the phenomenon of 24-hour society and include overworked doctors. Ordinance-designated cities were excluded from this study owing to wide population variability. Three doctors from each hospital were randomly selected from among physicians, surgeons, and pediatricians. We distributed questionnaires (a questionnaire concerning convenient visits, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale) to 132 doctors. Forty-two doctors responded to the survey. The median proportion of convenient visits among emergency visits was 50%. Sixty percent of the doctors surveyed were annoyed by convenient visits. Other doctors indicated good collaboration between the hospitals and communities or that they were not currently annoyed by convenient visits, although they had been annoyed previously. The emotional exhaustion in doctors, who worked in hospitals that did not restrict convenient visits, was significantly higher than in those who worked in hospitals

STRATEGI MARKET ENTRY CONVENIENCE STORE DI INDONESIA

Directory of Open Access Journals (Sweden)

Respati Wulandari

2017-04-01

Full Text Available Penelitian ini bertujuan untuk menganalisa dan melihat strategi yang digunakan pada Convenience Store di Indonesia dengan mengambil 7-Eleven sebagai sumber field study dengan metode orientasi pasar. Pengaruh lifestyle menjadi indikator penunjang dalam perkembangan 7-Eleven ddengan menerapkan beberapa strategi yang mengena di market Indonesia, terutama bagi kalangan muda dimana diketahui memiliki indikasi terpenting dalam siklus lifestyle di Indonesia. Tujuan tercapai dengan mengetahui penerapan strategi yang digunakan sehingga dapat diterapkan dalam menjalankan strategi bisnis pada Convenience Store

Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

Science.gov (United States)

Angevine, Peter D; Berven, Sigurd

2014-10-15

Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

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...

Exploring the relationship between convenience and fish consumption: A cross-cultural study

OpenAIRE

OLSEN, SO; SCHOLDERER, J; BRUNSO, K; Verbeke, Wim

2007-01-01

The purpose of the present study is to explore cultural differences in the meaning of convenience and the relationships between convenience, attitudes and fish consumption in five European countries. The results suggest that the meaning of meal convenience is not culture specific, whilst the absolute levels of convenience orientation and the perceived inconvenience of fish differ between cultures. Convenience orientation was highest in Poland, followed by Spain, and was lowest in the Netherla...

Cost of ventilation and effect of digestive state on the ventilatory response of the tegu lizard.

Science.gov (United States)

Skovgaard, Nini; Wang, Tobias

2004-07-12

We performed simultaneous measurements of ventilation, oxygen uptake and carbon dioxide production in the South American lizard, Tupinambis merianae, equipped with a mask and maintained at 25 degrees C. Ventilation of resting animals was stimulated by progressive exposure to hypercapnia (2, 4 and 6%) or hypoxia (15, 10, 8 and 6%) in inspired gas mixture. This was carried out in both fasting and digesting animals. The ventilatory response to hypercapnia and hypoxia were affected by digestive state, with a more vigorous ventilatory response in digesting animals compared to fasting animals. Hypoxia doubled total ventilation while hypercapnia led to a four-fold increase in total ventilation both accomplished through an increase in tidal volume. Oxygen uptake remained constant during all hypercapnic exposures while there was an increase during hypoxia. Cost of ventilation was estimated to be 17% during hypoxia but less than 1% during hypercapnia. Our data indicate that ventilation can be greatly elevated at a small energetic cost.

Cost effectiveness analysis in radiopharmacy

International Nuclear Information System (INIS)

Carpentier, N.; Verbeke, S.; Ducloux, T.

1999-01-01

Objective: to evaluate the cost effectiveness of radiopharmaceuticals and their quality control. Materials and methods: this retrospective study was made in the Nuclear Medicine Department of the University Hospital of Limoges. Radiopharmaceutical costs were obtained with adding the price of the radiotracer, the materials, the equipments, the labour, the running expenses and the radioisotope. The costs of quality control were obtained with adding the price of labour, materials, equipments, running expenses and the cost of the quality control of 99m Tc eluate. Results: during 1998, 2106 radiopharmaceuticals were prepared in the Nuclear Medicine Department. The mean cost effectiveness of radiopharmaceutical was 1430 francs (846 to 4260). The mean cost effectiveness of quality control was 163 francs (84 to 343). The rise of the radiopharmaceutical cost induced by quality control was 11%. Conclusion: the technical methodology of quality control must be mastered to optimize the cost of this operation. (author)

CT colonography and cost-effectiveness

Energy Technology Data Exchange (ETDEWEB)

Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)

2008-11-15

CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

CT colonography and cost-effectiveness

International Nuclear Information System (INIS)

Mavranezouli, Ifigeneia; East, James E.; Taylor, Stuart A.

2008-01-01

CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

Cost per QALY (quality-adjusted life year and lifetime cost of prolonged mechanical ventilation in Taiwan.

Directory of Open Access Journals (Sweden)

Mei-Chuan Hung

Full Text Available INTRODUCTION: Patients who require prolonged mechanical ventilation (PMV are increasing and producing financial burdens worldwide. This study determines the cost per QALY (quality-adjusted life year, out-of-pocket expenses, and lifetime costs for PMV patients stratified by underlying diseases and cognition levels. METHODS: A nationwide sample of 50,481 patients with continual mechanical ventilation for more than 21 days was collected during 1997-2007. After stratifying the patients according to specific diagnoses, a latent class analysis (LCA was performed to categorise PMV patients with multiple co-morbidities into several homogeneous groups. The survival functions were estimated for individual groups using the Kaplan-Meier method and extrapolated to 300 months through a semi-parametric method. The survival functions were adjusted using an EQ-5D utility value derived from a convenience sample of 142 PMV patients to estimate quality-adjusted life expectancies (QALE. Another convenience sample of 165 patients was used to estimate the out-of-pocket expenses. The lifetime expenditures paid by the single-payer National Health Insurance (NHI system and patients' families were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime. RESULTS: PMV therapy costs more than 100,000 U.S. dollars (USD per QALY for all patients with poor cognition. For patients with partial cognition, PMV therapy costs less than 56,000 USD per QALY for those with liver cirrhosis, intracranial or spinal cord injuries, and 57,000-69,000 USD for patients with multiple co-morbidities under age of 65. The average lifetime cost of PMV was usually below 56,000 USD. The out-of-pocket expenses were often more than one-third of the total cost of treatment. CONCLUSIONS: PMV treatment for patients with poor cognition would cost more than 5 times Taiwan's GDP (gross domestic products, or less cost-effective. The out

Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda.

Science.gov (United States)

Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K

2015-02-01

Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

48 CFR 49.603 - Formats for termination for convenience settlement agreements.

Science.gov (United States)

2010-10-01

... for convenience settlement agreements. 49.603 Section 49.603 Federal Acquisition Regulations System... Formats 49.603 Formats for termination for convenience settlement agreements. The formats to be used for termination for convenience settlement agreements should be substantially as shown in this section (see 49.109...

Development and Evaluation of A Novel and Cost-Effective Approach for Low-Cost NO2 Sensor Drift Correction

Science.gov (United States)

Sun, Li; Westerdahl, Dane; Ning, Zhi

2017-01-01

Emerging low-cost gas sensor technologies have received increasing attention in recent years for air quality measurements due to their small size and convenient deployment. However, in the diverse applications these sensors face many technological challenges, including sensor drift over long-term deployment that cannot be easily addressed using mathematical correction algorithms or machine learning methods. This study aims to develop a novel approach to auto-correct the drift of commonly used electrochemical nitrogen dioxide (NO2) sensor with comprehensive evaluation of its application. The impact of environmental factors on the NO2 electrochemical sensor in low-ppb concentration level measurement was evaluated in laboratory and the temperature and relative humidity correction algorithm was evaluated. An automated zeroing protocol was developed and assessed using a chemical absorbent to remove NO2 as a means to perform zero correction in varying ambient conditions. The sensor system was operated in three different environments in which data were compared to a reference NO2 analyzer. The results showed that the zero-calibration protocol effectively corrected the observed drift of the sensor output. This technique offers the ability to enhance the performance of low-cost sensor based systems and these findings suggest extension of the approach to improve data quality from sensors measuring other gaseous pollutants in urban air. PMID:28825633

Assessing cost-effectiveness of specific LID practice designs in response to large storm events

Science.gov (United States)

Chui, Ting Fong May; Liu, Xin; Zhan, Wenting

2016-02-01

Low impact development (LID) practices have become more important in urban stormwater management worldwide. However, most research on design optimization focuses on relatively large scale, and there is very limited information or guideline regarding individual LID practice designs (i.e., optimal depth, width and length). The objective of this study is to identify the optimal design by assessing the hydrological performance and the cost-effectiveness of different designs of LID practices at a household or business scale, and to analyze the sensitivity of the hydrological performance and the cost of the optimal design to different model and design parameters. First, EPA SWMM, automatically controlled by MATLAB, is used to obtain the peak runoff of different designs of three specific LID practices (i.e., green roof, bioretention and porous pavement) under different design storms (i.e., 2 yr and 50 yr design storms of Hong Kong, China and Seattle, U.S.). Then, life cycle cost is estimated for the different designs, and the optimal design, defined as the design with the lowest cost and at least 20% peak runoff reduction, is identified. Finally, sensitivity of the optimal design to the different design parameters is examined. The optimal design of green roof tends to be larger in area but thinner, while the optimal designs of bioretention and porous pavement tend to be smaller in area. To handle larger storms, however, it is more effective to increase the green roof depth, and to increase the area of the bioretention and porous pavement. Porous pavement is the most cost-effective for peak flow reduction, followed by bioretention and then green roof. The cost-effectiveness, measured as the peak runoff reduction/thousand Dollars of LID practices in Hong Kong (e.g., 0.02 L/103 US s, 0.15 L/103 US s and 0.93 L/103 US s for green roof, bioretention and porous pavement for 2 yr storm) is lower than that in Seattle (e.g., 0.03 L/103 US s, 0.29 L/103 US s and 1.58 L/103 US s for

Managing routine food choices in UK families: the role of convenience consumption.

Science.gov (United States)

Carrigan, Marylyn; Szmigin, Isabelle; Leek, Sheena

2006-11-01

The paper explores the meaning of convenience food for UK mothers, investigating the relationship between mothers and their families' food. The study examines the role of convenience food within the food strategies of contemporary UK families, and aims to elicit consumption meanings in the broader social context of family relationships with food, their rituals, routines and conventions. The findings reveal convenience has multiple meanings for UK women, and that convenience food has been incorporated into reinterpreted versions of homemade and "proper" meals. A hierarchy of acceptable convenience food is presented by the mothers, who tackle complex and conflicting family routines by introducing convenience solutions. Rules of eating have evolved, yet remain essentially controlled by the mother in terms of nutrition. While the traditional model of "proper" food remains aspirational, contemporary family lifestyles require that convenience food become part of the equation.

Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

Directory of Open Access Journals (Sweden)

Joakim Ramsberg

Full Text Available OBJECTIVE: To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression. DESIGN: A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine. The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year. DATA SOURCES: Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources. RESULTS: The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine. CONCLUSION: Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.

Potential of irradiation technique for development of convenience foods in India

International Nuclear Information System (INIS)

Bawa, A.S.; Vibhakara, H.S.

2001-01-01

Full text: One of the important applications of ionising radiation is in the processing and preservation of food articles. An enormous research effort has been directed towards biological testing of irradiated foods for the evaluation of their safety and wholesomeness. Food irradiation has demonstrated several safe technically and economically feasible applications. Radiation processing of foods has the potential to provide mankind with such benefits as elimination of toxic fumigants for insect disinfestation, extended shelf life for refrigerated products, elimination of food borne pathogens and parasites and to provide high quality packaged food with long shelf life at room temperature. Food irradiation has been legally permitted in India and regulation is in place for its commercialization and marketing of irradiated foods. Marked changes in the life style have significantly influenced the growth of convenience foods. Food irradiation is now considered as a safe process, so with increased demand for high quality convenience food, efforts are required to evaluate the effectiveness of irradiation in combination with other processing methods to enhance their safety and shelf life since convenience foods are here to stay and play an even more significant role in the market place in future. Notable progress has been made in many countries in the recent past in the application of low dose irradiation process as combination treatment, synergistically complimentarily. There is a great hope in accelerating the pace of progress in potential application of the irradiation processes to prevent food losses. In view of the sociological changes occurring at a fast pace in our society as well as increased industrialization there is an ample scope for the convenience and processed traditional foods. So with today's demand for high quality convenience foods it is high time that irradiation technology is considered evaluated and popularized for the same

Cost-effectiveness of alternative changes to a national blood collection service.

Science.gov (United States)

Willis, S; De Corte, K; Cairns, J A; Zia Sadique, M; Hawkins, N; Pennington, M; Cho, G; Roberts, D J; Miflin, G; Grieve, R

2018-05-16

To evaluate the cost-effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter-donation interval for donors attending static centres. Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. This study estimated the effect of changes to the blood collection service in England on the annual number of whole-blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost-effective. In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter-donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost-effective change is to extend opening hours for blood collection at static centres. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

48 CFR 809.270 - Qualified products for convenience/labor-saving foods.

Science.gov (United States)

2010-10-01

... convenience/labor-saving foods. 809.270 Section 809.270 Federal Acquisition Regulations System DEPARTMENT OF... 809.270 Qualified products for convenience/labor-saving foods. (a) Each VISN Nutrition and Food Service representative is authorized to establish a common VISN QPL for convenience and labor-saving foods...

49 CFR 1150.23 - Modified certificate of public convenience and necessity.

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Modified certificate of public convenience and..., ACQUIRE, OR OPERATE RAILROAD LINES Modified Certificate of Public Convenience and Necessity § 1150.23 Modified certificate of public convenience and necessity. (a) The operator must file a notice with the...

Costs and cost-effectiveness of malaria control interventions - a systematic review

Directory of Open Access Journals (Sweden)

White Michael T

2011-11-01

Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

The economic impact of state cigarette taxes and smoke-free air policies on convenience stores.

Science.gov (United States)

Huang, Jidong; Chaloupka, Frank J

2013-03-01

To investigate whether increasing state cigarette taxes and/or enacting stronger smoke-free air (SFA) policies have negative impact on convenience store density in a state, a proxy that is determined by store openings and closings, which reflects store profits. State-level business count estimates for convenience stores for 50 states and District of Columbia from 1997 to 2009 were analysed using two-way fixed effects regression techniques that control for state-specific and year-specific determinants of convenience store density. The impact of tax and SFA policies was examined using a quasi-experimental research design that exploits changes in cigarette taxes and SFA policies within a state over time. Taxes are found to be uncorrelated with the density of combined convenience stores and gas stations in a state. Taxes are positively correlated with the density of convenience stores; however, the magnitude of this correlation is small, with a 10% increase in state cigarette taxes associated with a 0.19% (pconvenience stores per million people in a state. State-level SFA policies do not correlate with convenience store density in a state, regardless whether gas stations were included. These results are robust across different model specifications. In addition, they are robust with regard to the inclusion/exclusion of other state-level tobacco control measures and gasoline prices. Contrary to tobacco industry and related organisations' claims, higher cigarette taxes and stronger SFA policies do not negatively affect convenience stores.

Expected consequences of convenience euthanasia perceived by veterinarians in Quebec.

Science.gov (United States)

Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

2017-07-01

In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal's interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian's goal was to respect the animal's interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia.

Cost benefit analysis cost effectiveness analysis

International Nuclear Information System (INIS)

Lombard, J.

1986-09-01

The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

48 CFR 49.601 - Notice of termination for convenience.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Notice of termination for convenience. 49.601 Section 49.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... termination for convenience. (See 49.402-3(g) for notice of termination for default.) ...

On the Trade-off Between Real-time Pricing and the Social Acceptability Costs of Demand Response

DEFF Research Database (Denmark)

da Silva, Hendrigo Batista; Santiago, Leonardo

2018-01-01

on the social acceptability costs of implementing demand response programs, and we discuss the key features of implementing a real-time price to energy. Although the literature acknowledges the existence of a social acceptability cost, it does not propose an explicit approach to dealing with this issue. A model...... for investigating the implications of the social acceptability cost is thus introduced and through it, we discuss thoroughly the joint impact of the elasticity and externality parameters on the tariff design of a demand response program. We explore how the increases in elasticity and in externality effects...... influence price changes in such programs and how the social acceptability cost could be reduced as a function of pricing policies. We conclude by discussing the policy design mechanisms in line with demand elasticity and their role in decreasing price variations to cope with the minimum volatility principle...

Cost-effectiveness analysis of secukinumab for the treatment of active psoriatic arthritis: a Canadian perspective.

Science.gov (United States)

Goeree, Ron; Chiva-Razavi, Sima; Gunda, Praveen; Graham, Christopher N; Miles, LaStella; Nikoglou, Efthalia; Jugl, Steffen M; Gladman, Dafna D

2018-02-01

The study evaluates the cost-effectiveness of secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin (IL)-17A, vs currently licensed biologic treatments in patients with active psoriatic arthritis (PsA) from a Canadian healthcare system perspective. A decision analytic semi-Markov model evaluated the cost-effectiveness of secukinumab 150 mg and 300 mg compared to subcutaneous biologics adalimumab, certolizumab pegol, etanercept, golimumab, and ustekinumab, and intravenous biologics infliximab and infliximab biosimilar in biologic-naive and biologic-experienced patients over a lifetime horizon. The response to treatments was evaluated after 12 weeks by PsA Response Criteria (PsARC) response rates. Non-responders or patients discontinuing initial-line of biologic treatment were allowed to switch to subsequent-line biologics. Model input parameters (Psoriasis Area Severity Index [PASI], Health Assessment Questionnaire [HAQ], withdrawal rates, costs, and resource use) were collected from clinical trials, published literature, and other Canadian sources. Benefits were expressed as quality-adjusted life years (QALYs). An annual discount rate of 5% was applied to costs and benefits. The robustness of the study findings were evaluated via sensitivity analyses. Biologic-naive patients treated with secukinumab achieved the highest number of QALYs (8.54) at the lowest cost (CAD 925,387) over a lifetime horizon vs all comparators. Secukinumab dominated all treatments, except for infliximab and its biosimilar, which achieved minimally more QALYs (8.58). However, infliximab and its biosimilar incurred more costs than secukinumab (infliximab: CAD 1,015,437; infliximab biosimilar: CAD 941,004), resulting in higher cost-effectiveness estimates relative to secukinumab. In the biologic-experienced population, secukinumab dominated all treatments as it generated more QALYs (8.89) at lower costs (CAD 954,692). Deterministic sensitivity analyses

Win some, lose some: parental hypertension and heart rate change in an incentive versus response cost paradigm.

Science.gov (United States)

Hastrup, J L; Johnson, C A; Hotchkiss, A P; Kraemer, D L

1986-11-01

Fowles (1983), citing evidence from separate studies, suggests that both incentive and response cost paradigms increase heart rate and should be subsumed under Gray's (1975) 'appetitive motivational system'. Shock avoidance and loss of reward (response cost) contingencies, while aversive, appear to evoke this motivational system; consequently both should elicit heart rate increases independent of anxiety. The present investigation compared magnitude of heart rate changes observed under conditions of winning and losing money. Results showed: no differences between incentive and response cost conditions; no effect of state anxiety on heart rate in these conditions, despite an elevation of state anxiety on the task day relative to a subsequent relaxation day assessment; and some evidence for the presence under both such appetitive conditions of cardiovascular hyperresponsivity among offspring of hypertensive parents. The results suggest a need for systematic parametric studies of experimental conditions.

41 CFR 101-26.103-2 - Restriction on personal convenience items.

Science.gov (United States)

2010-07-01

... convenience items. 101-26.103-2 Section 101-26.103-2 Public Contracts and Property Management Federal Property... SOURCES AND PROGRAM 26.1-General § 101-26.103-2 Restriction on personal convenience items. Government... type items intended solely for the personal convenience or to satisfy the personal desire of an...

[Convenience foods -- a simple way of healthy cooking].

Science.gov (United States)

Rentsch, N; Mühlemann, P; Baumgartner-Perren, S; Exl-Preysch, B M

2001-09-01

Convenience foods stand for a culinary revolution that commenced just over 100 years ago. The food industry came into being parallel to industrialization and urbanization. Nicolas Appert invented the can at that time and Julius Maggi invented dehydrated soup. Today convenience foods--from powdered spices to ready-to-eat dishes--are prepared using state-of-the-art technology and offer a ubiquitous range of healthy, easy-to-serve foods.

Micro-evolutionary responses and adaptive costs of Caenorhabditis elegans populations exposed to environmental stress

International Nuclear Information System (INIS)

Dutilleul, M.

2013-01-01

The contemporary evolution of organisms is largely dependent on anthropogenic disturbances. In particular, pollution amplifies the intensity or the quantity of selection pressures on populations. However, these changes may have negative effects on the life, growth and reproduction of individuals, the demographics of the population, and its phenotypic and genetic characteristics over generations. Thus, micro-evolutionary changes are likely to occur in response to selection pressures. These phenomenon lead to collateral damages: adaptive costs. For example, a reduction of genetic diversity in a population entails a decrease in its potential to adapt to other stressors. Populations can be more susceptible to many environmental changes, especially with the increase of human activities. Hence in an ecological risk assessment, studying the mechanisms of action and immediate adverse effects of pollutants on organisms is no longer sufficient. It is also necessary to expand our knowledge on the evolution of populations in polluted environment. In this context, our study aims to determine the micro-evolutionary response of Caenorhabditis elegans populations exposed to environmental stressors, and to measure their costs of adaptation. Populations were experimentally exposed for 22 generations to a high concentration of uranium, sodium chloride or an alternation of both these pollutants. The analysis of phenotypic and genetic changes, observed through measures of life history traits, was accomplished using several quantitative genetics techniques. In particular, we confirmed the genetic differentiation between populations with an increase of resistance in populations exposed to different pollutions. The speed of evolutionary responses depended on the conditions of exposure and their effects on the expression of the genetic structure of traits (e.g. G matrix). Micro-evolutionary changes were linked to costs of adaptation, such as reduced fertility in stressful novel

Expected consequences of convenience euthanasia perceived by veterinarians in Quebec

Science.gov (United States)

Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

2017-01-01

In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal’s interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian’s goal was to respect the animal’s interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia. PMID:28698691

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

African Journals Online (AJOL)

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

Co-ordination and Lock-in: Competition with Switching Costs and Network Effects

OpenAIRE

Joseph Farrell; Paul Klemperer

2006-01-01

Switching costs and network effects bind customers to vendors if products are incompatible, locking customers or even markets in to early choices. Lock-in hinders customers from changing suppliers in response to (predictable or unpredictable) changes in effciency, and gives vendors lucrative ex post market power-over the same buyer in the case of switching costs (or brand loyalty), or over others with network effects. Firms compete ex ante for this ex post power, using penetration pricing, in...

Costs and effects in lumbar spinal fusion

DEFF Research Database (Denmark)

Soegaard, Rikke; Christensen, Finn Bjarke; Christiansen, Terkel

2007-01-01

of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted...... areas. Multi-level fusion and surgical technique significantly affected the net-benefit as well. Surprisingly, no correlation was found between treatment costs and treatment effects. Incremental analysis suggested that the probability of posterior instrumentation being cost-effective was limited......Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient...

Cost-Effectiveness and Cost Thresholds of Generic and Brand Drugs in a National Chronic Hepatitis B Treatment Program in China.

Directory of Open Access Journals (Sweden)

Mehlika Toy

Full Text Available Chronic liver disease and liver cancer associated with chronic hepatitis B (CHB are leading causes of death among adults in China. Although newborn hepatitis B immunization has successfully reduced the prevalence of CHB in children, about 100 million Chinese adults remain chronically infected. If left unmanaged, 15-25% will die from liver cancer or liver cirrhosis. Antiviral treatment is not necessary for all patients with CHB, but when it is indicated, good response to treatment would prevent disease progression and reduce disease mortality and morbidity, and costly complications. The aim of this study is to analyze the cost-effectiveness of generic and brand antiviral drugs for CHB treatment in China, and assessing various thresholds at which a highly potent, low resistance antiviral drug would be cost-saving and/or cost-effective to introduce in a national treatment program. We developed a Markov simulation model of disease progression using effectiveness and cost data from the medical literature. We measured life-time costs, quality adjusted life years (QALYs, incremental cost-effectiveness ratios (ICERs, and clinical outcomes. The no treatment strategy incurred the highest health care costs ($12,932-$25,293 per patient, and the worst health outcomes, compared to the antiviral treatment strategies. Monotherapy with either entecavir or tenofovir yielded the most QALYs (14.10-19.02 for both HBeAg-positive and negative patients, with or without cirrhosis. Threshold analysis showed entercavir or tenofovir treatment would be cost saving if the drug price is $32-75 (195-460 RMB per month, highly cost-effective at $62-110 (379-670 RMB per month and cost-effective at $63-120 (384-734 RMB per month. This study can support policy decisions regarding the implementation of a national health program for chronic hepatitis B treatment in China at the population level.

The costs and cost-effectiveness of an integrated sepsis treatment protocol.

Science.gov (United States)

Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

2008-04-01

Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

Estimating the Effective Lower Bound for the Czech National Bank's Policy Rate

OpenAIRE

Kolcunova, Dominika; Havranek, Tomas

2018-01-01

The paper focuses on the estimation of the effective lower bound for the Czech National Bank's policy rate. The effective lower bound is determined by the value below which holding and using cash would be more convenient than deposits with negative yields. This bound is approximated based on storage, the insurance and transportation costs of cash and the costs associated with the loss of the convenience of cashless payments and complemented with the estimate based on interest charges, which p...

Cost-effectiveness thresholds: pros and cons.

Science.gov (United States)

Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

2016-12-01

Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh.

Science.gov (United States)

Pecenka, Clint; Parashar, Umesh; Tate, Jacqueline E; Khan, Jahangir A M; Groman, Devin; Chacko, Stephen; Shamsuzzaman, Md; Clark, Andrew; Atherly, Deborah

2017-07-13

Diarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners. This analysis used Pan American Health Organization's TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates. Over ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted. The discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination

Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

Directory of Open Access Journals (Sweden)

Mitchell Aaron P

2012-07-01

Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

Cost-effectiveness criteria for marine oil spill preventive measures

International Nuclear Information System (INIS)

Vanem, Erik; Endresen, Oyvind; Skjong, Rolf

2008-01-01

Oil tanker accidents resulting in large quantities of oil spills and severe pollution have occurred in the past, leading to major public attention and an international focus on finding solutions for minimising the risks related to such events. This paper proposes a novel approach for evaluating measures for prevention and control of marine oil spills, based on considerations of oil spill risk and cost effectiveness. A cost model that incorporates all costs of a shipping accident has been established and oil tanker spill accidents have been further elaborated as a special case of such accidents. Utilising this model, novel implementation criteria, in terms of the Cost of Averting a Tonne of oil Spilt (CATS), for risk control options aiming at mitigating the environmental risk of accidental oil spills, are proposed. The paper presents a review of previous studies on the costs associated with oil spills from shipping, which is a function of many factors such as location of spill, spill amount, type of oil, etc. However, ships are designed for global trade, transporting different oil qualities. Therefore, globally applicable criteria must average over most of these factors, and the spill amount is the remaining factor that will be used to measure cost effectiveness against. A weighted, global average cleanup cost of USD 16,000/tonne of oil spilt has been calculated, considering the distribution of oil tanker traffic densities. Finally, the criteria are compared with some existing regulations for oil spill prevention, response and compensation (OPA 90)

IDA Cost Research Symposium Held 25 May 1995.

Science.gov (United States)

1995-08-01

Cost System (AMCOS) Data Base, Model CEAC-9 ACEIT /PC-ACDB Training and Support for Army Cost Estimating Requirements CEAC-10 OMA Factors Study...cost and personnel factors. Also developed a more convenient link to ACEIT . [This task appeared in the 1994 catalog as CEAC-8.] Classification...Title: Summary: Classification: Sponsor: Performer: Resources: Schedule: Data Base: Publications: Category: Keywords: ACEIT /PC-ACDB

Convenient synthesis of volatile streptomyces lactones

Digital Repository Service at National Institute of Oceanography (India)

Amonkar, C.P.; Tilve, S.G.; Parameswaran, P.S.

A convenient three-step synthetic approach towards 3-alkyl-5-methyl-2[5H]furanones is described. The steps involved in the synthesis are domino primary alcohol oxidation-Wittig reaction, acid-catalysed lactonisation and isomerisation. This synthetic...

43 CFR 404.55 - Who is responsible for the operation, maintenance, and replacement costs?

Science.gov (United States)

2010-10-01

... Miscellaneous § 404.55 Who is responsible for the operation, maintenance, and replacement costs? You will be responsible for 100 percent of the operation, maintenance, and replacement costs for any rural water facility... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Who is responsible for the operation...

Residential Mobility and Turnout: The Relevance of Social Costs, Timing and Education

DEFF Research Database (Denmark)

Hansen, Jonas Hedegaard

2016-01-01

Residential mobility has substantial negative effects on voter turnout. However, existing studies have been unable to disentangle whether this is due to social costs, informational costs or convenience costs that are related to re-registration. This article analyzes the relevance of the different...... moved from the old neighborhood and it does not matter if citizens change municipality. Thus, the disruption of social ties is the main explanation for the negative effect of moving on turnout. Furthermore, the timing of residential mobility is important as the effect on turnout declines quickly after...... settling down. This illustrates that large events in citizens’ everyday life close to Election Day can distract them from going to the polling station. Finally, residential mobility mostly affects the turnout of less educated citizens. Consequentially, residential mobility increases inequalities in voter...

Cost effective treatment for wet FGD scrubber bleedoff

Energy Technology Data Exchange (ETDEWEB)

Janecek, K.F. [EIMCO Process Equipment Company, Salt Lake City, UT (United States); Kim, J.Y. [Samkook Corporation, Seoul (Korea, Democratic People`s Republic of)

1994-12-31

The dewatering of scrubber bleedoff gypsum is a thoroughly proven technology, whether for production of wallboard grade gypsum or environmentally responsible land fill. Careful review of the technology options will show which one is the most effective for the specific plant site. Likewise, a recipe for wastewater treatment for heavy metals removal can be found that will meet local regulatory limits. EIMCO has worldwide experience in FGD gypsum sludge dewatering and wastewater treatment. Contacting EIMCO can be the most important step toward a practical cost effective system for handling FGD scrubber bleed slurries.

10 CFR 436.18 - Measuring cost-effectiveness.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this section, each Federal agency shall measure cost-effectiveness by combining cost data established under...

Convenience in white-collar crime: A resource perspective

Directory of Open Access Journals (Sweden)

Petter Gottschalk

2017-03-01

Full Text Available White-collar offenders have access to resources that make financial crime convenient. In the rare case of crime suspicion, resources are available in terms of professional attorney work, control over internal investigations, and public relations support. Hiring private investigators at an early stage of potential crime disclosure enables the organization to control the investigation mandate and influence the investigation process and the investigation output. Getting an early start on reconstruction of the past in terms of a fraud examination makes it possible for the suspect and the organization to influence what facts are relevant and how facts might be assessed in terms of possible violations of the penal code. Convenience aspects of private investigations are discussed in this article in terms of five internal investigations, two in the United States (General Motors and Lehman Brothers and three in Norway (Telenor VimpelCom, DNB Bank, and Norwegian Football Association. The aim of this research is to contribute insights into convenience associated with internal private investigations.

Principles and methods of managerial cost-accounting systems.

Science.gov (United States)

Suver, J D; Cooper, J C

1988-01-01

An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

Cost-Effective Fuel Treatment Planning

Science.gov (United States)

Kreitler, J.; Thompson, M.; Vaillant, N.

2014-12-01

The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

Cost-effectiveness of sequenced treatment of rheumatoid arthritis with targeted immune modulators.

Science.gov (United States)

Jansen, Jeroen P; Incerti, Devin; Mutebi, Alex; Peneva, Desi; MacEwan, Joanna P; Stolshek, Bradley; Kaur, Primal; Gharaibeh, Mahdi; Strand, Vibeke

2017-07-01

To determine the cost-effectiveness of treatment sequences of biologic disease-modifying anti-rheumatic drugs or Janus kinase/STAT pathway inhibitors (collectively referred to as bDMARDs) vs conventional DMARDs (cDMARDs) from the US societal perspective for treatment of patients with moderately to severely active rheumatoid arthritis (RA) with inadequate responses to cDMARDs. An individual patient simulation model was developed that assesses the impact of treatments on disease based on clinical trial data and real-world evidence. Treatment strategies included sequences starting with etanercept, adalimumab, certolizumab, or abatacept. Each of these treatment strategies was compared with cDMARDs. Incremental cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for each treatment sequence relative to cDMARDs. The cost-effectiveness of each strategy was determined using a US willingness-to-pay (WTP) threshold of $150,000/QALY. For the base-case scenario, bDMARD treatment sequences were associated with greater treatment benefit (i.e. more QALYs), lower lost productivity costs, and greater treatment-related costs than cDMARDs. The expected ICERs for bDMARD sequences ranged from ∼$126,000 to $140,000 per QALY gained, which is below the US-specific WTP. Alternative scenarios examining the effects of homogeneous patients, dose increases, increased costs of hospitalization for severely physically impaired patients, and a lower baseline Health Assessment Questionnaire (HAQ) Disability Index score resulted in similar ICERs. bDMARD treatment sequences are cost-effective from a US societal perspective.

SHORT COMMUNICATION CONVENIENT AND MILD SYNTHESIS ...

African Journals Online (AJOL)

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*Corresponding author. E-mail: naeimi@kashanu.ac.ir. SHORT COMMUNICATION. CONVENIENT AND MILD SYNTHESIS AND CHARACTERISATION OF. SOME NEW SCHIFF BASES. Hossein Naeimi* and Zahra Sadat Nazifi. Department of Organic Chemistry, Faculty of Chemistry, University of Kashan,. Kashan, 87317 ...

Costs of fear: Behavioral and life-history responses to risk and their demographic consequences vary across species

Science.gov (United States)

LaManna, Joseph A.; Martin, Thomas E.

2016-01-01

Behavioural responses to reduce predation risk might cause demographic ‘costs of fear’. Costs differ among species, but a conceptual framework to understand this variation is lacking. We use a life-history framework to tie together diverse traits and life stages to better understand interspecific variation in responses and costs. We used natural and experimental variation in predation risk to test phenotypic responses and associated demographic costs for 10 songbird species. Responses such as increased parental attentiveness yielded reduced development time and created benefits such as reduced predation probability. Yet, responses to increased risk also created demographic costs by reducing offspring production in the absence of direct predation. This cost of fear varied widely across species, but predictably with the probability of repeat breeding. Use of a life-history framework can aid our understanding of potential demographic costs from predation, both from responses to perceived risk and from direct predation mortality.

Vasa previa screening strategies: a decision and cost-effectiveness analysis.

Science.gov (United States)

Sinkey, R G; Odibo, A O

2018-05-22

The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening. Ultrasound-indicated screening was defined as performing a transvaginal ultrasound at the time of routine anatomy ultrasound in response to one of the following sonographic findings associated with an increased risk of vasa previa: low-lying placenta, marginal or velamentous cord insertion, or bilobed or succenturiate lobed placenta. The primary outcome was cost per quality adjusted life years (QALY) in U.S. dollars. The analysis was from a healthcare system perspective with a willingness to pay (WTP) threshold of $100,000 per QALY selected. One-way and multivariate sensitivity analyses (Monte-Carlo simulation) were performed. This decision-analytic model demonstrated that screening pregnancies conceived by IVF was the most cost-effective strategy with an incremental cost effectiveness ratio (ICER) of $29,186.50 / QALY. Ultrasound-indicated screening was the second most cost-effective with an ICER of $56,096.77 / QALY. These data were robust to all one-way and multivariate sensitivity analyses performed. Within our baseline assumptions, transvaginal ultrasound screening for vasa previa appears to be most cost-effective when performed among IVF pregnancies. However, both IVF and ultrasound-indicated screening strategies fall within contemporary willingness-to-pay thresholds, suggesting that both strategies may be appropriate to apply in clinical practice. This article is protected by copyright. All rights reserved. This

Use of DNA barcoding to reveal species composition of convenience seafood.

Science.gov (United States)

Huxley-Jones, Elizabeth; Shaw, Jennifer L A; Fletcher, Carly; Parnell, Juliette; Watts, Phillip C

2012-04-01

Increased education of consumers can be an effective tool for conservation of commercially harvested marine species when product labeling is accurate and allows an informed choice. However, generic labeling (e.g., as white fish or surimi) and mislabeling of seafood prevents this and may erode consumer confidence in seafood product labels in general. We used DNA barcoding to identify the species composition of two types of convenience seafood (i.e., products processed for ease of consumption): fish fingers (long pieces of fish covered with bread crumbs or batter, n = 241) and seafood sticks (long pieces of cooked fish, n = 30). In products labeled as either white fish or surimi, four teleost species were present. Less than 1.5% of fish fingers with species-specific information were mislabeled. Results of other studies show substantially more mislabeling (e.g., >25%) of teleost products, which likely reflects the lower economic gains associated with mislabeling of convenience seafood compared with whole fillets. In addition to species identification, seafood product labels should be required to contain information about, for example, harvesting practices, and our data indicate that consumers can have reasonable confidence in the accuracy of the labels of convenience seafood and thus select brands on the basis of information about current fisheries practice. ©2012 Society for Conservation Biology.

Healthy convenience: nudging students toward healthier choices in the lunchroom.

Science.gov (United States)

Hanks, Andrew S; Just, David R; Smith, Laura E; Wansink, Brian

2012-08-01

In the context of food, convenience is generally associated with less healthy foods. Given the reality of present-biased preferences, if convenience was associated with healthier foods and less healthy foods were less convenient, people would likely consume healthier foods. This study examines the application of this principle in a school lunchroom where healthier foods were made more convenient relative to less healthy foods. One of two lunch lines in a cafeteria was arranged so as to display only healthier foods and flavored milk. Trained field researchers collected purchase and consumption data before and after the conversion. Mean comparisons were used to identify differences in selection and consumption of healthier foods, less healthy foods and chocolate milk. Sales of healthier foods increased by 18% and grams of less healthy foods consumed decreased by nearly 28%. Also, healthier foods' share of total consumption increased from 33 to 36%. Lastly, we find that students increased their consumption of flavored milk, but flavored milk's share of total consumption did not increase. In a school lunchroom, a convenience line that offered only healthier food options nudged students to consume fewer unhealthy foods. This result has key implications for encouraging healthy behavior in public schools nation wide, cafeterias and other food establishments.

Convenience food in the diet of children and adolescents: consumption and composition.

Science.gov (United States)

Alexy, Ute; Sichert-Hellert, Wolfgang; Rode, Tabea; Kersting, Mathilde

2008-02-01

Despite an increasing trend towards the use of convenience food, there is to date little debate on it in the nutritional sciences. In the present study, we present and evaluate data on consumption frequencies and composition of savoury convenience food in German families using data from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study. The DONALD Study is an ongoing, longitudinal (open cohort) study (started 1985), collecting detailed data on diet, development, and metabolism in infants, children and adolescents. Dietary intake was measured by yearly repeated 3 d weighed dietary records (n 1558) in 554 subjects (278 boys; 276 girls), 3-18 years old, between 2003 and 2006. A total of 1345 (86%) 3 d dietary records mentioned consumption of at least one convenience food. Convenience food consumption (percentage of total food intake, g/d) increased with age from approximately 3% in the 3-8 year olds to 7% in 14-18-year-old boys and 5% in 14-18-year-old girls (P Convenience foods contributed more to total fat (g/d) (P convenience-food products recorded by our sample had on average fourteen ingredients; 4% were flavourings and 16% were food additives. In conclusion, convenience foods were widely consumed by our sample of German children and adolescents and their consumption increased with age. The composition of convenience food was characterised by a high fat content and a high number of flavourings and food additives.

How rebates, copayments, and administration costs affect the cost-effectiveness of osteoporosis therapies.

Science.gov (United States)

Ferko, Nicole C; Borisova, Natalie; Airia, Parisa; Grima, Daniel T; Thompson, Melissa F

2012-11-01

Because of rising drug expenditures, cost considerations have become essential, necessitating the requirement for cost-effectiveness analyses for managed care organizations (MCOs). The study objective is to examine the impact of various drug-cost components, in addition to wholesale acquisition cost (WAC), on the cost-effectiveness of osteoporosis therapies. A Markov model of osteoporosis was used to exemplify different drug cost scenarios. We examined the effect of varying rebates for oral bisphosphonates--risedronate and ibandronate--as well as considering the impact of varying copayments and administration costs for intravenous zoledronate. The population modeled was 1,000 American women, > or = 50 years with osteoporosis. Patients were followed for 1 year to reflect an annual budget review of formularies by MCOs. The cost of therapy was based on an adjusted WAC, and is referred to as net drug cost. The total annual cost incurred by an MCO for each drug regimen was calculated using the net drug cost and fracture cost. We estimated cost on a quality adjusted life year (QALY) basis. When considering different rebates, results for risedronate versus ibandronate vary from cost-savings (i.e., costs less and more effective) to approximately $70,000 per QALY. With no risedronate rebate, an ibandronate rebate of approximately 65% is required before cost per QALY surpasses $50,000. With rebates greater than 25% for risedronate, irrespective of ibandronate rebates, results become cost-saving. Results also showed the magnitude of cost savings to the MCO varied by as much as 65% when considering no administration cost and the highest coinsurance rate for zoledronate. Our study showed that cost-effectiveness varies considerably when factors in addition to the WAC are considered. This paper provides recommendations for pharmaceutical manufacturers and MCOs when developing and interpreting such analyses.

Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

Directory of Open Access Journals (Sweden)

Jukes Matthew CH

2008-09-01

Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

Assessing the value of mepolizumab for severe eosinophilic asthma: a cost-effectiveness analysis.

Science.gov (United States)

Whittington, Melanie D; McQueen, R Brett; Ollendorf, Daniel A; Tice, Jeffrey A; Chapman, Richard H; Pearson, Steven D; Campbell, Jonathan D

2017-02-01

Adding mepolizumab to standard treatment with inhaled corticosteroids and controller medications could decrease asthma exacerbations and use of long-term oral steroids in patients with severe disease and increased eosinophils; however, mepolizumab is costly and its cost effectiveness is unknown. To estimate the cost effectiveness of mepolizumab. A Markov model was used to determine the incremental cost per quality-adjusted life year (QALY) gained for mepolizumab plus standard of care (SoC) and for SoC alone. The population, adults with severe eosinophilic asthma, was modeled for a lifetime time horizon. A responder scenario analysis was conducted to determine the cost effectiveness for a cohort able to achieve and maintain asthma control. Over a lifetime treatment horizon, 23.96 exacerbations were averted per patient receiving mepolizumab plus SoC. Avoidance of exacerbations and decrease in long-term oral steroid use resulted in more than $18,000 in cost offsets among those receiving mepolizumab, but treatment costs increased by more than $600,000. Treatment with mepolizumab plus SoC vs SoC alone resulted in a cost-effectiveness estimate of $386,000 per QALY. To achieve cost effectiveness of approximately $150,000 per QALY, mepolizumab would require a more than 60% price discount. At current pricing, treating a responder cohort yielded cost-effectiveness estimates near $160,000 per QALY. The estimated cost effectiveness of mepolizumab exceeds value thresholds. Achieving these thresholds would require significant discounts from the current list price. Alternatively, treatment limited to responders improves the cost effectiveness toward, but remains still slightly above, these thresholds. Payers interested in improving the efficiency of health care resources should consider negotiations of the mepolizumab price and ways to predict and assess the response to mepolizumab. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

Individualized cost-effective conventional ovulation induction treatment in normogonadotrophic anovulatory infertility (WHO group 2).

Science.gov (United States)

Eijkemans, Marinus J C; Polinder, Suzanne; Mulders, Annemarie G M G J; Laven, Joop S E; Habbema, J Dik F; Fauser, Bart C J M

2005-10-01

Conventional treatment in normogonadotrophic anovulatory infertility (WHO 2) consists of clomiphene citrate (CC), followed by exogenous gonadotrophins (FSH) and IVF. Response to these treatments may be predicted on the basis of individual patient characteristics. We aimed to devise a patient-tailored, cost-effective treatment algorithm involving the above-mentioned treatment modalities, based on individual patient characteristics. Sixteen prognostic groups are defined, according to the presence or absence of: age >30 years, amenorrhea, elevated androgen levels and obesity. The chances of response with each of the three treatments were calculated using prediction models. Treatment costs were based on the data of 240 patients visiting a specialist academic fertility unit. Outcome was an ongoing pregnancy within 12 months after initiation of treatment. The costs per pregnancy of three different strategies were compared, with a threshold for cost-effectiveness of 10 000. The strategy CC + FSH + IVF compared with FSH + IVF generated more pregnancies against lower costs. Compared with CC + IVF, it also produced more pregnancies, but at higher costs. For costs per pregnancy were less than 10 000. For women >30 years old, costs per pregnancy were 25 000 and over 200 000, when presenting with normal or elevated androgen levels, respectively. The conventional treatment protocol is efficient for women aged 30 years old with elevated androgen levels, FSH may be skipped.

48 CFR 1649.101-71 - FEHBP termination for convenience clause.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true FEHBP termination for convenience clause. 1649.101-71 Section 1649.101-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL... CONTRACTS General Principles 1649.101-71 FEHBP termination for convenience clause. The clause set forth in...

Public Attitudes toward Stuttering in Turkey: Probability versus Convenience Sampling

Science.gov (United States)

Ozdemir, R. Sertan; St. Louis, Kenneth O.; Topbas, Seyhun

2011-01-01

Purpose: A Turkish translation of the "Public Opinion Survey of Human Attributes-Stuttering" ("POSHA-S") was used to compare probability versus convenience sampling to measure public attitudes toward stuttering. Method: A convenience sample of adults in Eskisehir, Turkey was compared with two replicates of a school-based,…

The effects of reinforcement and response-cost on a delayed response task in children with attention deficit hyperactivity disorder: a research note.

Science.gov (United States)

Solanto, M V

1990-07-01

Children with attention deficit hyperactivity disorder are more inattentive, active, and impulsive than normal children. Some researchers have postulated that these symptoms can all be explained as a result of reduced sensitivity to reinforcement. In order to evaluate this hypothesis, we tested 20 ADD-H children and 18 matched normal controls, 4 1/2-11 years of age, on a delayed response task, a measure of impulsiveness, under conditions of positive reinforcement, and punishment in the form of response-cost. The contingencies each improved performance compared to baseline but did not differ significantly from each other. Neither contingency affected the groups differentially, thus failing to provide support for the reinforcement hypothesis.

Resuscitation of neonates at 23 weeks' gestational age: a cost-effectiveness analysis.

Science.gov (United States)

Partridge, J Colin; Robertson, Kathryn R; Rogers, Elizabeth E; Landman, Geri Ottaviano; Allen, Allison J; Caughey, Aaron B

2015-01-01

Resuscitation of infants at 23 weeks' gestation remains controversial; clinical practices vary. We sought to investigate the cost effectiveness of resuscitation of infants born 23 0/7-23 6/7 weeks' gestation. Decision-analytic modeling comparing universal and selective resuscitation to non-resuscitation for 5176 live births at 23 weeks in a theoretic U.S. cohort. Estimates of death (77%) and disability (64-86%) were taken from the literature. Maternal and combined maternal-neonatal utilities were applied to discounted life expectancy to generate QALYs. Incremental cost-effectiveness ratios were calculated, discounting costs and QALYs. Main outcomes included number of survivors, their outcome status and incremental cost-effectiveness ratios for the three strategies. A cost-effectiveness threshold of $100 000/QALY was utilized. Universal resuscitation would save 1059 infants: 138 severely disabled, 413 moderately impaired and 508 without significant sequelae. Selective resuscitation would save 717 infants: 93 severely disabled, 279 moderately impaired and 343 without significant sequelae. For mothers, non-resuscitation is less expensive ($19.9 million) and more effective (127 844 mQALYs) than universal resuscitation ($1.2 billion; 126 574 mQALYs) or selective resuscitation ($845 million; 125 966 mQALYs). For neonates, both universal and selective resuscitation were cost-effective, resulting in 22 256 and 15 134 nQALYS, respectively, versus 247 nQALYs for non-resuscitation. In sensitivity analyses, universal resuscitation was cost-effective from a maternal perspective only at utilities for neonatal death permissive response to parental requests for aggressive intervention at 23 weeks' gestation.

Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

NARCIS (Netherlands)

Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M

2017-01-01

The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the

Convenience food with environmentally-sustainable attributes: A consumer perspective.

Science.gov (United States)

Stranieri, Stefanella; Ricci, Elena Claire; Banterle, Alessandro

2017-09-01

The use of chemicals in agriculture poses risks on both human health and the environment. Regulatory measures, both mandatory and voluntary, have been introduced to promote a reduction in the use of pesticides. The proliferation of such standards is related to the gradual shift of consumer preferences towards food with reduced negative health and environmental impacts. Beside consumer demand for sustainable food products, convenience food is also assuming an increasingly important role in developed countries. Among such products, minimally-processed vegetables are showing a growing positive trend, but their production has also negative effects on the environment. The goal of this study is to investigate the interaction between environmentally-friendly and healthy convenience food, and to investigate the determinants behind the purchase of healthy convenience food products with environmentally-sustainable attributes, focusing on minimally-processed vegetables labelled with voluntary standards related to integrated agriculture. To do so, we started from the Theory of Planned Behaviour and tested the efficacy of an extended model by considering also other variables which were found to affect significantly food choices. Data were collected by means of face-to-face interviews with 550 consumers in charge of grocery shopping in the metropolitan area of Milan, in northern Italy. Structural equation modelling was performed to analyse the relative importance of the constructs on consumer behaviour. Results confirm the relations of Ajzen's theory and reveal positive relations with consumer food shopping habits, food-related environmental behaviour, gender, income and knowledge. A negative relation with agricultural practices concern also emerges, highlighting that the most concerned consumers may prefer other more stringent environmental certifications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cost-effectiveness Analysis for Technology Acquisition.

Science.gov (United States)

Chakravarty, A; Naware, S S

2008-01-01

In a developing country with limited resources, it is important to utilize the total cost visibility approach over the entire life-cycle of the technology and then analyse alternative options for acquiring technology. The present study analysed cost-effectiveness of an "In-house" magnetic resonance imaging (MRI) scan facility of a large service hospital against outsourcing possibilities. Cost per unit scan was calculated by operating costing method and break-even volume was calculated. Then life-cycle cost analysis was performed to enable total cost visibility of the MRI scan in both "In-house" and "outsourcing of facility" configuration. Finally, cost-effectiveness analysis was performed to identify the more acceptable decision option. Total cost for performing unit MRI scan was found to be Rs 3,875 for scans without contrast and Rs 4,129 with contrast. On life-cycle cost analysis, net present value (NPV) of the "In-house" configuration was found to be Rs-(4,09,06,265) while that of "outsourcing of facility" configuration was Rs-(5,70,23,315). Subsequently, cost-effectiveness analysis across eight Figures of Merit showed the "In-house" facility to be the more acceptable option for the system. Every decision for acquiring high-end technology must be subjected to life-cycle cost analysis.

Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

Directory of Open Access Journals (Sweden)

Smita Nayak

Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

Science.gov (United States)

Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

2010-01-01

Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The

Who deserves health care? The effects of causal attributions and group cues on public attitudes about responsibility for health care costs.

Science.gov (United States)

Gollust, Sarah E; Lynch, Julia

2011-12-01

This research investigates the impact of cues about ascriptive group characteristics (race, class, gender) and the causes of ill health (health behaviors, inborn biological traits, social systemic factors) on beliefs about who deserves society's help in paying for the costs of medical treatment. Drawing on data from three original vignette experiments embedded in a nationally representative survey of American adults, we find that respondents are reluctant to blame or deny societal support in response to explicit cues about racial attributes--but equally explicit cues about the causal impact of individual behaviors on health have large effects on expressed attitudes. Across all three experiments, a focus on individual behavioral causes of illness is associated with increased support for individual responsibility for health care costs and lower support for government-financed health insurance. Beliefs about social groups and causal attributions are, however, tightly intertwined. We find that when groups suffering ill health are defined in racial, class, or gender terms, Americans differ in their attribution of health disparities to individual behaviors versus biological or systemic factors. Because causal attributions also affect health policy opinions, varying patterns of causal attribution may reinforce group stereotypes and undermine support for universal access to health care.

Dandelion (Taraxacum Officinale Wigg. S.L. Is A Convenient Object For Genetic Monitoring Of Environmental Pollution

Directory of Open Access Journals (Sweden)

Nina V Reutova

2006-09-01

Full Text Available It is proposed to use dandelion (Taraxacum officinale Wigg. s.l. for testing of mutagenic effects of environmental pollutants. This widespread species is convenient for genetic monitoring. It is sensitive to various types of pollutants (heavy metals, products of combustion and processing of oil. T. officinale appeared to be a convenient, simple in using and inexpensive object for genetic monitoring of environmental pollution. anaphase-telophase method is recomended for this purpose.

Embracing the convenient care concept.

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Ferris, Allison H; McAndrew, Thomas M; Shearer, Debra; Donnelly, Gloria F; Miller, Howard A

2010-01-01

The landscape of primary care medicine is rapidly changing. The decline in interest, both in primary care fields and students choosing these career paths, has left a vacuum in the health care system that must be filled. One of the recent developments has been the birth of "convenient care centers," also known as "retail clinics." This form of health care delivery has mostly been entrepreneurial and based in retail organizations, such as drug stores. These walk-in clinics provide basic medical care for minor common medical conditions, such as sore throat, urinary tract infection, the common cold, and ear infections. Much of this care is provided not by physicians, but by nurse practitioners or physician assistants. After seeing the success of the earliest of these clinics, MinuteClinic by CVS, many other businesses joined the venture, and retail clinics popped up in Wal-Mart, Target, and many local grocery stores. Gradually, hospital systems, physician groups, and managed care companies have also entered the market, sometimes partnering with retail outlets, such as the local grocery store or Wal-Mart, and less often, starting a stand-alone facility. Only 12% of retail clinics are owned by hospital systems or physician groups, while 73% are owned by CVS, Walgreens, or Target. There is even a national nonprofit organization called the Convenient Care Association, started in 2006, and based in Philadelphia, PA. This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several "express care" clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of

Response costs of mammography adherence: Iranian women’sperceptions

Directory of Open Access Journals (Sweden)

Mahsa Khodayarian

2016-06-01

Conclusion: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women’s awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.

Smart device-based testing for medical students in Korea: satisfaction, convenience, and advantages

Directory of Open Access Journals (Sweden)

Eun Young Lim

2017-04-01

Full Text Available The aim of this study was to investigate respondents’ satisfaction with smart device-based testing (SBT, as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M score (M= 3.75, standard deviation [SD]= 0.69, while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07. No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer.

Evaluating Drug Cost per Response with SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus.

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Lopez, Janice M S; Macomson, Brian; Ektare, Varun; Patel, Dipen; Botteman, Marc

2015-09-01

The sodium-glucose cotransporter 2 (SGLT2) inhibitors, which include canagliflozin, dapagliflozin, and empagliflozin, represent a new class of antihyperglycemic agents. Few studies have assessed their cost per response, with "cost per response" being the total cost of a select drug, divided by the resulting change in glycated hemoglobin (HbA1c) levels. To examine the drug cost of SGLT2 inhibitors per a reduction in placebo-adjusted 1% HbA1c in patients with type 2 diabetes mellitus who received treatment during 26 weeks with canagliflozin, dapagliflozin, or empagliflozin. The drug cost per response for each of the 3 agents individually was assessed based on data from a subset of clinical trials discussed in the prescribing information for each drug that were all placebo-controlled studies evaluating each drug as monotherapy, dual therapy (combined with metformin), and triple therapy (combined with metformin and a sulfonylurea) in patients with uncontrolled, type 2 diabetes mellitus. The US 2015 wholesale acquisition cost for each drug was used to calculate each drug's treatment costs over 26 weeks. The average cost per response for each drug was defined as the prescription drug cost of each SGLT2 inhibitor, divided by the average, placebo-adjusted HbA1c reduction at 26 weeks. The drug cost per unit dose was the same for canagliflozin (100 mg or 300 mg), dapagliflozin (5 mg or 10 mg), and empagliflozin (10 mg or 25 mg), at $11.43. The drug cost per placebo-adjusted 1% HbA1c reduction varied by agent and by dose, as a result of the differences in the treatment responses for each of the 3 drugs. The costs per response for canagliflozin 100 mg as monotherapy, dual therapy, and triple therapy regimens ranged from $2286 to $3355, and for canagliflozin 300 mg, from $1793 to $2702. The costs per response for dapagliflozin 5 mg as monotherapy and dual therapy (triple therapy was not available at the time of the study) ranged from $4161 to $5201; the cost for dapagliflozin

Grab a Cup, Fill It Up! An Intervention to Promote the Convenience of Drinking Water and Increase Student Water Consumption During School Lunch.

Science.gov (United States)

Kenney, Erica L; Gortmaker, Steven L; Carter, Jill E; Howe, M Caitlin W; Reiner, Jennifer F; Cradock, Angie L

2015-09-01

We evaluated a low-cost strategy for schools to improve the convenience and appeal of drinking water. We conducted a group-randomized, controlled trial in 10 Boston, Massachusetts, schools in April through June 2013 to test a cafeteria-based intervention. Signage promoting water and disposable cups were installed near water sources. Mixed linear regression models adjusting for clustering evaluated the intervention impact on average student water consumption over 359 lunch periods. The percentage of students in intervention schools observed drinking water during lunch nearly doubled from baseline to follow-up compared with controls (+ 9.4%; P convenience by providing cups can increase student water consumption.

Modeling of response, socioeconomic, and natural resource damage costs for hypothetical oil spill scenarios in San Francisco Bay

International Nuclear Information System (INIS)

Etkin, D.S.; French McCay, D.; Whittier, N.; Sankaranarayanan, S.; Jennings, J.

2002-01-01

A study was conducted to determine the influence of oil type, spill size, response strategy and location factors on oil spill response costs, with particular reference to the cost benefits of the use of dispersants. Modeling has been conducted for a hypothetical oil spill in San Francisco Bay to determine biological impacts, damages to natural resources and response costs. The SIMAP modeling software by the Applied Science Associates was used to model 3 spill sizes (20, 50 and 95 percentile by volume) and 4 types of oil (gasoline, diesel, heavy fuel oil, and crude oil). Response costs, natural resource damages and socioeconomic impact were determined based on spill trajectory and fate. Mechanical recovery-based operations carry higher response costs than dispersant-based operations. Response costs for diesel and gasoline spills make up 20 per cent of the total costs, compared to 43 per cent for crude and heavy fuel oil spills. Damages to natural resources are higher for spills of toxic lighter fuels such as gasoline and diesel because gasoline has a greater impact on the water column with less shoreline oiling, resulting in more damages to natural resources. Heavier oils have a greater impact on shorelines and higher response and socioeconomic costs. Although socioeconomic costs varied by location, they tend to be greater than response costs and natural resource damage costs. Proportions of the different costs were described with reference to various spill factors. Socioeconomic costs are 61, 76, 45 and 53 per cent respectively for gasoline, diesel, crude oil, and heavy fuel oil spills. 27 refs., 23 tabs., 5 figs

household responses to malaria: cost implications in anantigha area ...

African Journals Online (AJOL)

DJFLEX

A study of household responses in terms of types and costs of treatment of malaria was ... of people will form baseline data for more research in the control of malaria in the ... They only resort to health centres after failure of .... standards.

Geography and Electronic Commerce: Measuring Convenience, Selection, and Price

OpenAIRE

Chris Forman; Anindya Ghose; Avi Goldfarb

2006-01-01

We develop a formal model of online-offline retail channel substitution to identify three factors that drive consumers to purchase online: convenience, selection, and price. This model builds hypotheses on how features of offline retail supply impact online purchasing. We then examine how the local availability of offline retail options drives use of the online channel and consequently how the convenience, selection, and price advantages of the online channel may vary by geographic location. ...

"Bird in the hand" cash was more effective than prize draws in increasing physician questionnaire response.

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Drummond, Frances J; O'Leary, Eamonn; O'Neill, Ciaran; Burns, Richeal; Sharp, Linda

2014-02-01

To investigate the effects of two monetary incentives on response rates to postal questionnaires from primary care physicians (PCPs). The PCPs were randomized into three arms (n=550 per arm), namely (1) €5 sent with the questionnaire (cash); (2) entry into a draw on return of completed questionnaire (prize); or (3) no incentive. Effects of incentives on response rates and item nonresponse were examined, as was cost-effectiveness. Response rates were significantly higher in the cash (66.1%; 95% confidence interval [CI]: 61.9, 70.4%) and prize arms (44.8%; 95% CI: 40.1, 49.3%) compared with the no-incentive arm (39.9%; 95% CI: 35.4, 44.3%). Adjusted relative risk of response was 1.17 (95% CI: 1.02, 1.35) and 1.68 (95% CI: 1.48, 1.91) in the prize and cash arms, respectively, compared with the no-incentive group. Costs per completed questionnaire were €9.85, €11.15, and €6.31 for the cash, prize, and no-incentive arms, respectively. Compared with the no-incentive arm, costs per additional questionnaire returned in the cash and prize arms were €14.72 and €37.20, respectively. Both a modest cash incentive and entry into a prize draw were effective in increasing response rates. The cash incentive was most effective and the most cost-effective. Where it is important to maximize response, a modest cash incentive may be cost-effective. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future

Directory of Open Access Journals (Sweden)

Marianne Harris

2012-01-01

Full Text Available In the early years of the highly active antiretroviral therapy (HAART era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine and drugs from new classes (raltegravir and maraviroc for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.

Cost-Effectiveness Analysis of Isavuconazole vs. Voriconazole as First-Line Treatment for Invasive Aspergillosis.

Science.gov (United States)

Harrington, Rachel; Lee, Edward; Yang, Hongbo; Wei, Jin; Messali, Andrew; Azie, Nkechi; Wu, Eric Q; Spalding, James

2017-01-01

Invasive aspergillosis (IA) is associated with a significant clinical and economic burden. The phase III SECURE trial demonstrated non-inferiority in clinical efficacy between isavuconazole and voriconazole. No studies have evaluated the cost-effectiveness of isavuconazole compared to voriconazole. The objective of this study was to evaluate the costs and cost-effectiveness of isavuconazole vs. voriconazole for the first-line treatment of IA from the US hospital perspective. An economic model was developed to assess the costs and cost-effectiveness of isavuconazole vs. voriconazole in hospitalized patients with IA. The time horizon was the duration of hospitalization. Length of stay for the initial admission, incidence of readmission, clinical response, overall survival rates, and experience of adverse events (AEs) came from the SECURE trial. Unit costs were from the literature. Total costs per patient were estimated, composed of drug costs, costs of AEs, and costs of hospitalizations. Incremental costs per death avoided and per additional clinical responders were reported. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted. Base case analysis showed that isavuconazole was associated with a $7418 lower total cost per patient than voriconazole. In both incremental costs per death avoided and incremental costs per additional clinical responder, isavuconazole dominated voriconazole. Results were robust in sensitivity analysis. Isavuconazole was cost saving and dominant vs. voriconazole in most DSA. In PSA, isavuconazole was cost saving in 80.2% of the simulations and cost-effective in 82.0% of the simulations at the $50,000 willingness to pay threshold per additional outcome. Isavuconazole is a cost-effective option for the treatment of IA among hospitalized patients. Astellas Pharma Global Development, Inc.

Physical, mental, and cognitive function in a convenience sample of centenarians in Australia.

Science.gov (United States)

Richmond, Robyn L; Law, Jenaleen; Kay-Lambkin, Frances

2011-06-01

To examine the physical, mental, and cognitive function of centenarians. Descriptive study using a structured questionnaire and convenience sampling. Residential care facilities and private dwellings in Australia. A convenience sample of 188 centenarians. The Hospital Anxiety and Depression Scale (HADS) screened for anxiety and depression. The Katz Index of Independence in Activities of Daily Living (Katz ADL) was used to assess functional status. The Quality of Life Scale was used to assess quality of life. The Mini-Mental State Examination (MMSE) was used to screen for dementia. Structured responses were obtained for living arrangement, marital status, social relationships, and supports. Centenarians had regular contact with friends (59%), neighbors (62%), and families (72%); 54% were religious and 43.5% had received social supports. Average MMSE and Katz ADL scores were 21.5 and 3.7, respectively; 45% had scores on the MMSE indicative of dementia, 10% indicated anxiety and 14% depression on the HADS. Participants with poor ratings of health experienced higher rates of anxiety and depression than their healthier counterparts. In this convenience sample of Australian centenarians, anxiety and depression was relatively nonexistent, and most reported a high quality of life. This was despite objective deterioration in functional status, paralleling the aging process, and high dependence on others for everyday tasks. Potentially, this is suggestive of a unique ability within the sample to adapt to aging and its limitations. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Collaborative Capability in Coworking Spaces: Convenience Sharing or Community Building?

Directory of Open Access Journals (Sweden)

Marcelo F. Castilho

2017-12-01

Full Text Available This study explores the development of collaborative capability in coworking spaces. It is based on the perception of collaboration among 31 coworking founders, community managers, and coworkers of those spaces. In-depth interviews around the meaning of collaboration and its challenges were conducted in 14 coworking spaces located in six Asian countries. A set of factors was identified and a model was proposed based on a set of four dimensions: enabling knowledge sharing, enhancing a creative field, enhancing an individual action for the collective, and supporting a collective action to an effective execution. The “Convenience Sharing” and “Community Building” coworking types based on Capdevila (2014 suggest different conditions under which collaborative capability develops. Convenience Sharing coworking spaces tend to foster collaborative capability through knowledge sharing and effective execution, whereas Community Building coworking spaces tend to foster collaborative capability by enhancing a creative field and individual action for the collective. Overall, this study contributes to a theoretical model for coworking spaces to help coworking founders and community managers make strategic decisions. The findings suggest that collaborative capability in coworking spaces depends on the interlacing of a set of factors along four dimensions that relate in varying degrees of intensity to a two-fold coworking space typology.

Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

Science.gov (United States)

Baio, Gianluca

2014-05-20

Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

Impact of Workplace and Other Convenient Vehicle Charging

Energy Technology Data Exchange (ETDEWEB)

Levinson, Rebecca Sobel [Sandia National Lab. (SNL-CA), Livermore, CA (United States); West, Todd H. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

2017-07-01

This work uses market analysis and simulation to explore the potential impact of workplace and similarly convenient away-from-home charging infrastructure (AFHCI) in reducing US light duty vehicle (LDV) petroleum use and greenhouse gas emissions. The ParaChoice model simulates the evolution of LDV sales, fuel use, and emissions through 2050, considering consumer responses to different options of electric range extension made available through AFHCI, fraction of the population with access, and delay in infrastructure implementation. Results indicate that providing a greater fraction of the population access to level 1 AFHCI for a full workday may provide more benefit than providing level 2 charging to a lesser fraction. This result holds even considering the fraction of the population without at-home charging. Moreover, delays in infrastructure implementation have no substantial drawbacks for long term petroleum use reduction and EV adoption, though delays will impact short term gains.

Cost-effectiveness Analysis with Influence Diagrams.

Science.gov (United States)

Arias, M; Díez, F J

2015-01-01

Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

Cost-effective analysis of PET application in NSCLC

International Nuclear Information System (INIS)

Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang

2006-01-01

Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

Energetic and developmental costs of mounting an immune response in greenfinches (Carduelis chloris)

NARCIS (Netherlands)

Amat, Juan A.; Aguilera, Eduardo; Visser, G. Henk

It is assumed that there is a trade-off between the costs allocated to mounting an immune defence and those allocated to costly functions such as breeding and moulting. The physiological basis for this is that mounting an immune response to pathogen challenge has energetic and/or nutrient costs

Adding value to laboratory medicine: a professional responsibility.

Science.gov (United States)

Beastall, Graham H

2013-01-01

Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to 'add value' to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic 'SCIENCE'. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine.

Convenience stores and the marketing of foods and beverages through product assortment.

Science.gov (United States)

Sharkey, Joseph R; Dean, Wesley R; Nalty, Courtney

2012-09-01

Product assortment (presence and variety) is a key in-store marketing strategy to influence consumer choice. Quantifying the product assortment of healthier and less-healthy foods and beverages in convenience stores can inform changes in the food environment. To document product assortment (i.e., presence and variety of specific foods and beverages) in convenience stores. Observational survey data were collected onsite in 2011 by trained promotora-researchers in 192 convenience stores. Frequencies of presence and distributions of variety were calculated in 2012. Paired differences were examined using the Wilcoxon matched-pairs signed-rank test. Convenience stores displayed a large product assortment of sugar-sweetened beverages (median 86.5 unique varieties); candy (76 varieties); salty snacks (77 varieties); fried chips (44 varieties); cookies and pastries (19 varieties); and frozen sweets (21 varieties). This compared with 17 varieties of non-sugar sweetened beverages and three varieties of baked chips. The Wilcoxon signed-rank test confirmed a (p<0.001) greater variety of sugar-sweetened than non-sugar-sweetened beverages, and of fried chips compared with baked chips. Basic food items provided by convenience stores included milk (84% of stores); fresh fruit (33%); fresh vegetables (35%); canned vegetables (78%); white bread (71%); and deli-style packaged meat (57%). Healthier versions of milk, canned fruit, canned tuna, bread, and deli-style packaged meat were displayed in 17%-71% of convenience stores. Convenience stores in this area provide a greater assortment of less-healthy compared with healthier foods and beverages. There are opportunities to influence consumer food choice through programs that alter the balance between healthier and less-healthy foods and beverages in existing convenience stores that serve rural and underserved neighborhoods and communities. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan.

Science.gov (United States)

Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe

2018-07-01

Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

Cost-effectiveness of response evaluation after chemoradiation in patients with advanced oropharyngeal cancer using 18F-FDG-PET-CT and/or diffusion-weighted MRI.

Science.gov (United States)

Greuter, Marjolein Je; Schouten, Charlotte S; Castelijns, Jonas A; de Graaf, Pim; Comans, Emile Fi; Hoekstra, Otto S; de Bree, Remco; Coupé, Veerle Mh

2017-04-11

Considerable variation exists in diagnostic tests used for local response evaluation after chemoradiation in patients with advanced oropharyngeal cancer. The yield of invasive examination under general anesthesia (EUA) with biopsies in all patients is low and it may induce substantial morbidity. We explored four response evaluation strategies to detect local residual disease in terms of diagnostic accuracy and cost-effectiveness. We built a decision-analytic model using trial data of forty-six patients and scientific literature. We estimated for four strategies the proportion of correct diagnoses, costs concerning diagnostic instruments and the proportion of unnecessary EUA indications. Besides a reference strategy, i.e. EUA for all patients, we considered three imaging strategies consisting of 18 FDG-PET-CT, diffusion-weighted MRI (DW-MRI), or both 18 FDG-PET-CT and DW-MRI followed by EUA after a positive test. The impact of uncertainty was assessed in sensitivity analyses. The EUA strategy led to 96% correct diagnoses. Expected costs were €468 per patient whereas 89% of EUA indications were unnecessary. The DW-MRI strategy was the least costly strategy, but also led to the lowest proportion of correct diagnoses, i.e. 93%. The PET-CT strategy and combined imaging strategy were dominated by the EUA strategy due to respectively a smaller or equal proportion of correct diagnoses, at higher costs. However, the combination of PET-CT and DW-MRI had the highest sensitivity. All imaging strategies considerably reduced (unnecessary) EUA indications and its associated burden compared to the EUA strategy. Because the combined PET-CT and DW-MRI strategy costs only an additional €927 per patient, it is preferred over immediate EUA since it reaches the same diagnostic accuracy in detecting local residual disease while leading to substantially less unnecessary EUA indications. However, if healthcare resources are limited, DW-MRI is the strategy of choice because of lower

Perceived Convenience, Compatibility, and Media Richness Contribute Significantly toDedicated E-book Reader Acceptance. A Review of: Lai, J.-Y., & Chang, C.-Y. (2011. User attitudes toward dedicated e-book readers for reading: The effects of convenience, compatibility and media richness. Online Information Review, 35(4, 558-580.

Directory of Open Access Journals (Sweden)

Theresa S. Arndt

2012-06-01

Full Text Available Objective – Investigates the effects ofperceived convenience, compatibility andmedia richness on users’ attitudes towarddedicated e-book readers.Design – Convenience sample survey.Setting – Taiwanese university.Subjects – A total of 288 students at the seniorsecondary (5%, four-year university (78%,and graduate student (17% levels. Malefemaleparticipation was approximately equal.Methods – Students completed a 23-itemsurvey on dedicated e-book readers, withquestions on perceived usefulness, perceivedease of use, intention to use, convenience,compatibility, and media richness. Data wasanalyzed using the partial least squaresstatistical technique.Main Results – Users state an increasedintention to use dedicated e-book readers ifthey perceive the technology to be compatiblewith what they desire in a “book,” if the devicedelivers rich media content, and if the device isconvenient. Compatibility was found tosignificantly affect perceived ease of use, andwas found to be the strongest influence onintent to use a dedicated e-book reader.Compatibility, media richness andconvenience also increased the perceivedusefulness of dedicated e-book readers.Conclusion – Users will prefer dedicated e-book readers that are compatible with their preferences in a “book,” that deliver media-rich content, and that they find convenient. The study has implications for the design and development of e-book reading devices.

A model to estimate the cost effectiveness of the indoorenvironment improvements in office work

Energy Technology Data Exchange (ETDEWEB)

Seppanen, Olli; Fisk, William J.

2004-06-01

Deteriorated indoor climate is commonly related to increases in sick building syndrome symptoms, respiratory illnesses, sick leave, reduced comfort and losses in productivity. The cost of deteriorated indoor climate for the society is high. Some calculations show that the cost is higher than the heating energy costs of the same buildings. Also building-level calculations have shown that many measures taken to improve indoor air quality and climate are cost-effective when the potential monetary savings resulting from an improved indoor climate are included as benefits gained. As an initial step towards systemizing these building level calculations we have developed a conceptual model to estimate the cost-effectiveness of various measures. The model shows the links between the improvements in the indoor environment and the following potential financial benefits: reduced medical care cost, reduced sick leave, better performance of work, lower turn over of employees, and lower cost of building maintenance due to fewer complaints about indoor air quality and climate. The pathways to these potential benefits from changes in building technology and practices go via several human responses to the indoor environment such as infectious diseases, allergies and asthma, sick building syndrome symptoms, perceived air quality, and thermal environment. The model also includes the annual cost of investments, operation costs, and cost savings of improved indoor climate. The conceptual model illustrates how various factors are linked to each other. SBS symptoms are probably the most commonly assessed health responses in IEQ studies and have been linked to several characteristics of buildings and IEQ. While the available evidence indicates that SBS symptoms can affect these outcomes and suspects that such a linkage exists, at present we can not quantify the relationships sufficiently for cost-benefit modeling. New research and analyses of existing data to quantify the financial

Health indicators: eliminating bias from convenience sampling estimators.

Science.gov (United States)

Hedt, Bethany L; Pagano, Marcello

2011-02-28

Public health practitioners are often called upon to make inference about a health indicator for a population at large when the sole available information are data gathered from a convenience sample, such as data gathered on visitors to a clinic. These data may be of the highest quality and quite extensive, but the biases inherent in a convenience sample preclude the legitimate use of powerful inferential tools that are usually associated with a random sample. In general, we know nothing about those who do not visit the clinic beyond the fact that they do not visit the clinic. An alternative is to take a random sample of the population. However, we show that this solution would be wasteful if it excluded the use of available information. Hence, we present a simple annealing methodology that combines a relatively small, and presumably far less expensive, random sample with the convenience sample. This allows us to not only take advantage of powerful inferential tools, but also provides more accurate information than that available from just using data from the random sample alone. Copyright © 2011 John Wiley & Sons, Ltd.

Cost-effectiveness and the socialization of health care.

Science.gov (United States)

Musgrove, P

1995-01-01

The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

Future Estimation of Convenience Living Facilities Withdrawal due to Population Decline all Over Japan from 2010 TO 2040 - Focus on Supermarkets, Convenience Stores and Drugstores

Science.gov (United States)

Nishimoto, Yuka; Akiyama, Yuki; Shibasaki, Ryosuke

2016-06-01

Population explosion is considered to be one of the most crucial problems in the world. However, in Japan, the opposite problem: population decline has become serious now. Japanese population is estimated to decrease by twenty millions in 2040. This negative situation will cause to increase areas where many residents cannot make a daily living all over Japan because many convenience living facilities such as supermarkets, convenience stores and drugstores will be difficult to maintain their market area population due to future population decline. In our research, we used point data of convenience living facilities developed by address geocoding of digital telephone directory and point data of future population projection developed by distribution of Japanese official population projection data proportionally among the building volume of digital residential map, which can monitor building volumes all over Japan. In conclusion, we estimated that various convenience living facilities in Japan will shrink and close by population decline in near future. In particular, it is cleared that approximately 14.7% of supermarkets will be possible to withdraw all over Japan by 2040. In addition, it is cleared that over 40% of supermarkets in some countryside prefectures will be possible to withdraw by 2040. Thus, we estimated future distributions of convenience living facilities that cannot maintain their market area population due to future population decline. Moreover, we estimated the number of people that they will become inconvenience in buying fresh foods.

FUTURE ESTIMATION OF CONVENIENCE LIVING FACILITIES WITHDRAWAL DUE TO POPULATION DECLINE ALL OVER JAPAN FROM 2010 TO 2040 - FOCUS ON SUPERMARKETS, CONVENIENCE STORES AND DRUGSTORES

Directory of Open Access Journals (Sweden)

Y. Nishimoto

2016-06-01

Full Text Available Population explosion is considered to be one of the most crucial problems in the world. However, in Japan, the opposite problem: population decline has become serious now. Japanese population is estimated to decrease by twenty millions in 2040. This negative situation will cause to increase areas where many residents cannot make a daily living all over Japan because many convenience living facilities such as supermarkets, convenience stores and drugstores will be difficult to maintain their market area population due to future population decline. In our research, we used point data of convenience living facilities developed by address geocoding of digital telephone directory and point data of future population projection developed by distribution of Japanese official population projection data proportionally among the building volume of digital residential map, which can monitor building volumes all over Japan. In conclusion, we estimated that various convenience living facilities in Japan will shrink and close by population decline in near future. In particular, it is cleared that approximately 14.7% of supermarkets will be possible to withdraw all over Japan by 2040. In addition, it is cleared that over 40% of supermarkets in some countryside prefectures will be possible to withdraw by 2040. Thus, we estimated future distributions of convenience living facilities that cannot maintain their market area population due to future population decline. Moreover, we estimated the number of people that they will become inconvenience in buying fresh foods.

Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

DEFF Research Database (Denmark)

Mäkelä, Mika J; Backer, Vibeke; Hedegaard, Morten

2013-01-01

Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age...... and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation......, adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD...

48 CFR 52.249-2 - Termination for Convenience of the Government (Fixed-Price).

Science.gov (United States)

2010-10-01

... Convenience of the Government (Fixed-Price). 52.249-2 Section 52.249-2 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.249-2 Termination for Convenience of the Government (Fixed-Price). As prescribed in 49.502(b)(1)(i), insert the following clause: Termination for Convenience of the Government...

Notification: Purchase Card and Convenience Check Audit

Science.gov (United States)

Project #OA-FY13-0116, April 11, 2013. The U.S. Environmental Protection Agency, Office of Inspector General, is beginning the fieldwork phase of its audit of the agency’s purchase card and convenience check programs.

Combining the role of convenience and consideration set size in explaining fish consumption in Norway.

Science.gov (United States)

Rortveit, Asbjorn Warvik; Olsen, Svein Ottar

2009-04-01

The purpose of this study is to explore how convenience orientation, perceived product inconvenience and consideration set size are related to attitudes towards fish and fish consumption. The authors present a structural equation model (SEM) based on the integration of two previous studies. The results of a SEM analysis using Lisrel 8.72 on data from a Norwegian consumer survey (n=1630) suggest that convenience orientation and perceived product inconvenience have a negative effect on both consideration set size and consumption frequency. Attitude towards fish has the greatest impact on consumption frequency. The results also indicate that perceived product inconvenience is a key variable since it has a significant impact on attitude, and on consideration set size and consumption frequency. Further, the analyses confirm earlier findings suggesting that the effect of convenience orientation on consumption is partially mediated through perceived product inconvenience. The study also confirms earlier findings suggesting that the consideration set size affects consumption frequency. Practical implications drawn from this research are that the seafood industry would benefit from developing and positioning products that change beliefs about fish as an inconvenient product. Future research for other food categories should be done to enhance the external validity.

Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

DEFF Research Database (Denmark)

Søgaard, Rikke; Laurberg, Ida; Christensen, Finn B

2008-01-01

Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full......-scale economic evaluation, including extra-hospital effects such as service utilization in the primary health care sector and return-to-work, is conducted. The objective of this study was to conduct such evaluation i.e. investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen...... with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion...

FIRM SIZE EFFECTS ON TRANSACTION COSTS

NARCIS (Netherlands)

NOOTEBOOM, B

1993-01-01

Associated with effects of scale, scope, experience and learning there are effects of firm size on transaction costs; in the stages of contact, contract and control. These effects are due to ''threshold costs'' in setting up contacts, contracts and governance schemes, and to differences with respect

The cost-effectiveness of direct-to-consumer advertising for prescription drugs.

Science.gov (United States)

Atherly, Adam; Rubin, Paul H

2009-12-01

In this paper we use published information to analyze the economic value of Direct to Consumer Advertising (DTCA). The reviewed research finds that DTCA leads to increased demand for the advertised drug and that the effect of the drug tends to be class-wide rather than product specific. There is weak evidence that DTCA may increase compliance and improve clinical outcomes. However, there is little research on the effect of DTCA on inappropriate prescribing or on the characteristics of patients who respond to treatment. On net, if the advertised drugs are cost effective on average and the patients using the drugs in response to the advertisement are similar to other users, DTCA is likely cost effective. Overall, the literature to date is consistent with the idea that DTCA is beneficial, but further research is needed before definitive conclusions can be drawn.

Cost-effectiveness of rotavirus vaccination in Albania.

Science.gov (United States)

Ahmeti, Albana; Preza, Iria; Simaku, Artan; Nelaj, Erida; Clark, Andrew David; Felix Garcia, Ana Gabriela; Lara, Carlos; Hoestlandt, Céline; Blau, Julia; Bino, Silvia

2015-05-07

Rotavirus vaccines have been introduced in several European countries but can represent a considerable cost, particularly for countries that do not qualify for any external financial support. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into Albania's national immunization program and to inform national decision-making by improving national capacity to conduct economic evaluations of new vaccines. The TRIVAC model was used to assess vaccine impact and cost-effectiveness. The model estimated health and economic outcomes attributed to 10 successive vaccinated birth cohorts (2013-2022) from a government and societal perspective. Epidemiological and economic data used in the model were based on national cost studies, and surveillance data, as well as estimates from the scientific literature. Cost-effectiveness was estimated for both the monovalent (RV1) and pentavalent vaccines (RV5). A multivariate scenario analysis (SA) was performed to evaluate the uncertainty around the incremental cost-effectiveness ratios (ICERs). With 3% discounting of costs and health benefits over the period 2013-2022, rotavirus vaccination in Albania could avert 51,172 outpatient visits, 14,200 hospitalizations, 27 deaths, 950 disability-adjusted life-years (DALYs), and gain 801 life-years. When both vaccines were compared to no vaccination, the discounted cost per DALY averted was US$ 2008 for RV1 and US$ 5047 for RV5 from a government perspective. From the societal perspective the values were US$ 517 and US$ 3556, respectively. From both the perspectives, the introduction of rotavirus vaccine to the Albanian immunization schedule is either cost-effective or highly cost-effective for a range of plausible scenarios. In most scenarios, including the base-case scenario, the discounted cost per DALY averted was less than three times the gross domestic product (GDP) per capita. However, rotavirus vaccination was not cost-effective when rotavirus cases

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

Science.gov (United States)

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

2009-04-01

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

Cost-effectiveness of monitoring free flaps.

Science.gov (United States)

Subramaniam, Shiva; Sharp, David; Jardim, Christopher; Batstone, Martin D

2016-06-01

Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

Analisis Industri pada Ritel Convenience Store: Kasus 7-Eleven (Sevel

Directory of Open Access Journals (Sweden)

Son Wandrial

2013-05-01

Full Text Available 7-Eleven, a Japanese retailer is very popular and loved in Jakarta. 7-Eleven or commonly abbreviated to Sevel is now reaping a lot of fans because of the concept of 7-Eleven Indonesia, found only in Indonesia. With the rising middle classes in Indonesia, 7-Eleven becomes a luxurious place for hanging-out but affordable. Consequently, it is attracting the interest of investors to make such a kind of convenience store like Sevel, and it is likely the competition in this sector will be increasingly fierce. PT. Modern’s initial plans are to focus onopening stores in Jakarta, targeting densely-populated commercial and office areas, to offer Indonesian workersa convenient place to shop for lunch, snacks, and emergency items. The company’s goal is to focus on opening stores in Jakarta in its first years of operation. Other major cities, such as Bandung, Semarang, and Surabaya offer for future expansion opportunities. The objective of this article is to describe the competitive condition in convenience store industries using Porter’s Five Forces model. Although the competition is fierce andunfavorable industry condition, Sevel is still leading and dominating the convenience store market in Indonesia.

Cost-effectiveness of root caries preventive treatments.

Science.gov (United States)

Schwendicke, Falk; Göstemeyer, Gerd

2017-01-01

With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of rheumatoid arthritis].

Science.gov (United States)

Salinas-Escudero, Guillermo; Vargas-Valencia, Juan; García-García, Erika Gabriela; Munciño-Ortega, Emilio; Galindo-Suárez, Rosa María

2013-01-01

to conduct cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of moderate or severe rheumatoid arthritis in patients with previous unresponse to immune selective anti-inflammatory derivatives failure. a pharmacoeconomic model based on decision analysis to assess the clinical outcome after giving etanercept, infliximab, adalimumab or tocilizumab to treat moderate or severe rheumatoid arthritis was employed. Effectiveness of medications was assessed with improvement rates of 20 % or 70 % of the parameters established by the American College of Rheumatology (ACR 20 and ACR 70). the model showed that etanercept had the most effective therapeutic response rate: 79.7 % for ACR 20 and 31.4 % for ACR 70, compared with the response to other treatments. Also, etanercept had the lowest cost ($149,629.10 per patient) and had the most cost-effective average ($187,740.40 for clinical success for ACR 20 and $476,525.80 for clinical success for ACR 70) than the other biologic therapies. we demonstrated that treatment with etanercept is more effective and less expensive compared to the other drugs, thus making it more efficient therapeutic option both in terms of means and incremental cost-effectiveness ratios for the treatment of rheumatoid arthritis.

Cost of Convenience Food Booklet

OpenAIRE

Sagers, Diana

2005-01-01

Making wise food choices is particularly important for families on limited incomes. Today’s supermarket has thousands of foods to choose from. Penny-wise shoppers consider many factors when selecting groceries.

Structural relations in the effect of convenience food satisfaction and quality of life according to dietary style: Comparative study of singles in metropolitan area of Korea, Japan and China.

Science.gov (United States)

Kim, Boram; Joo, Nami

2014-06-01

Due to recent changes in social structure, single-person households are on the rise worldwide and therefore the interest in the quality of life of singles is increasing, but the research on the relationships related to their diet-related quality of life is scarce. This research analyzes the structural relations in the effect of convenience food satisfaction and quality of life according to dietary style of Korean, Japanese and Chinese singles. The targets of this study were Korean, Japanese, and Chinese singles, identified as adults between the ages of 25 and 54, having economic capabilities or working and living alone, either legally or in actuality having no partner. A statistical analysis was conducted using SPSS12.0 for Windows and SEM using AMOS 5.0 statistics package. The reliability of these findings was supported by a Cronbach's alpha coefficient of 0.6 and higher for all the factors. In an attempt to study the level of satisfaction with convenience food in accordance to dietary style and the quality of life of singles, a structural equation model was constructed and analyzed. Of the three countries, regarding the effect of dietary style on singles' quality of life, the convenience-oriented style was found to have a negative effect on Korean singles' overall quality of life, but a positive effect on Japanese singles' overall quality of life, and a negative effect on Chinese singles' positive psychological aspect of quality of life. In addition, although Chinese singles have a high level of interest in health, they have an overall high level of satisfaction regarding fast food and its nutritional value. The number of singles in Korea, Japan, and China has been consistently increasing in recent years, and there is a need for continuous interest in their healthy dietary lifestyles in terms of convenience, economy, and taste.

Structural relations in the effect of convenience food satisfaction and quality of life according to dietary style: Comparative study of singles in metropolitan area of Korea, Japan and China

Science.gov (United States)

Kim, Boram

2014-01-01

BACKGROUND/OBJECTIVES Due to recent changes in social structure, single-person households are on the rise worldwide and therefore the interest in the quality of life of singles is increasing, but the research on the relationships related to their diet-related quality of life is scarce. This research analyzes the structural relations in the effect of convenience food satisfaction and quality of life according to dietary style of Korean, Japanese and Chinese singles. SUBJECTS/METHODS The targets of this study were Korean, Japanese, and Chinese singles, identified as adults between the ages of 25 and 54, having economic capabilities or working and living alone, either legally or in actuality having no partner. A statistical analysis was conducted using SPSS12.0 for Windows and SEM using AMOS 5.0 statistics package. The reliability of these findings was supported by a Cronbach's alpha coefficient of 0.6 and higher for all the factors. In an attempt to study the level of satisfaction with convenience food in accordance to dietary style and the quality of life of singles, a structural equation model was constructed and analyzed. RESULTS Of the three countries, regarding the effect of dietary style on singles' quality of life, the convenience-oriented style was found to have a negative effect on Korean singles' overall quality of life, but a positive effect on Japanese singles' overall quality of life, and a negative effect on Chinese singles' positive psychological aspect of quality of life. In addition, although Chinese singles have a high level of interest in health, they have an overall high level of satisfaction regarding fast food and its nutritional value. CONCLUSIONS The number of singles in Korea, Japan, and China has been consistently increasing in recent years, and there is a need for continuous interest in their healthy dietary lifestyles in terms of convenience, economy, and taste. PMID:24944777

Effects of a preceptorship programme on turnover rate, cost, quality and professional development.

Science.gov (United States)

Lee, Tso-Ying; Tzeng, Wen-Chii; Lin, Chia-Huei; Yeh, Mei-Ling

2009-04-01

The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development. A high turnover rate of nurses is a common global problem. How to improve nurses' willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well-designed preceptorship programmes could possibly decrease turnover rates and improve professional development. A quasi-experimental research design was used. First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi-experimental design was used to evaluate the preceptorship programme. Data on new nurses' turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor's teaching and preceptor's perception were measured. After conducting the preceptorship programme, the turnover rate was 46.5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50-0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance. The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses. Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.

10 CFR 455.63 - Cost-effectiveness testing.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.63 Cost-effectiveness testing. (a... paragraph (a) of this section, if the State plan requires the cost effectiveness of an energy conservation...

Time perspectives and convenience food consumption among teenagers in Vietnam: The dual role of hedonic and healthy eating values.

Science.gov (United States)

Olsen, Svein Ottar; Tuu, Ho Huy

2017-09-01

This study uses the subscales of Consideration of Future Consequences (CFC) to explore the effects of future (CFC-future) and immediate (CFC-immediate) on convenience food consumption among teenagers in Vietnam. Furthermore, we investigate the mediating and dual role of hedonic and healthy eating values in the relationships between CFCs and convenience food consumption. Survey data from 451 teenagers in Central Vietnam and structural equation modelling were used to test the relationships in a proposed theoretical model. The results indicate that while CFC-immediate and hedonic eating value has a positive direct effect, CFC-future and healthy eating value has a negative direct effect on convenience food consumption. The findings also reveal that both CFC-immediate and CFC-future have positive effects on hedonic and healthy eating values. However, this study argues and tests the relative importance of the direct (asymmetric) effects of time perspectives on eating values, and finds that while CFC-future dominate in explaining healthy eating values, CFC-immediate dominate in explaining hedonic eating values. Copyright © 2017 Elsevier Ltd. All rights reserved.

The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey.

Science.gov (United States)

Gajic, Aleksandra; Cameron, David; Hurley, Jeremiah

2012-12-01

We present the results of a randomized experiment to test the effectiveness and cost-effectiveness of response incentives for a stated-preference survey of a general community population. The survey was administered using a mixed-mode approach, in which community members were invited to participate using a traditional mailed letter using contact information for a representative sample of the community; but individuals completed the survey via the web, which exploited the advantages of electronic capture. Individuals were randomized to four incentive groups: (a) no incentive, (b) prepaid cash incentive ($2), (c) a low lottery (10 prizes of $25) and (d) a high lottery (2 prizes of $250). Letters of invitation were mailed to 3,000 individuals. In total, 405 individuals (14.4%) contacted the website and 277 (9.8%) provided complete responses. The prepaid cash incentive generated the highest contact and response rates (23.3 and 17.3%, respectively), and no incentive generated the lowest (9.1 and 5.7%, respectively). The high lottery, however, was the most cost-effective incentive for obtaining completed surveys: compared with no incentive, the incremental cost-effectiveness ratio (ICER) per completed survey for high lottery was $13.89; for prepaid cash, the ICER was $18.29. This finding suggests that the preferred response incentive for community-based, stated-preference surveys is a lottery with a small number of large prizes.

Cost-effectiveness of tubal patency tests.

Science.gov (United States)

Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J

2013-04-01

Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013

A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted.

Directory of Open Access Journals (Sweden)

Peter J Neumann

Full Text Available Calculating the cost per disability-adjusted life years (DALYs averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution.We conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases "disability-adjusted" or "DALY". Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000-2009 and 2010-2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low to 7 (high, and examined the correlation between diseases researched and the burden of disease in different world regions.We identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%, followed by non-communicable diseases (28%. A high proportion of studies evaluated primary prevention strategies (59%. Pharmaceutical interventions were commonly assessed (32% followed by immunizations (28%. Adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included

Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

Science.gov (United States)

Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

2013-01-01

Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

Investigating the role of personal and context-related factors in convenience foods consumption.

Science.gov (United States)

Contini, Caterina; Boncinelli, Fabio; Gerini, Francesca; Scozzafava, Gabriele; Casini, Leonardo

2018-07-01

In the scenario of food consumptions, we witness the consumer's growing consideration for the "convenience" attribute. Our study intends to understand the consumer behaviour towards convenience-processed foods by analysing in a single model the role of beliefs, personal traits, social influence and market availability. We applied a Structural Equation Model (SEM) to a representative sample of 426 Italian consumers. The results show a correlation between intention to consume convenience-processed foods and social influence, market availability and several personal traits, suggesting strategies for the development of the convenience food market. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali.

Science.gov (United States)

Somda, Zana C; Meltzer, Martin I; Perry, Helen N; Messonnier, Nancy E; Abdulmumini, Usman; Mebrahtu, Goitom; Sacko, Massambou; Touré, Kandioura; Ki, Salimata Ouédraogo; Okorosobo, Tuoyo; Alemu, Wondimagegnehu; Sow, Idrissa

2009-01-08

Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Over the period studied (2002-2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country. This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali

Directory of Open Access Journals (Sweden)

Touré Kandioura

2009-01-01

Full Text Available Abstract Background Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR. This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR. Methods We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles. Results Over the period studied (2002–2005, the average cost to implement the IDSR program in Eritrea was $0.16 per capita, $0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from $35,899 to $69,920 at the region level, $10,790 to $13,941 at the district level, and $1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines, service availability, distance, and the epidemiological profile of the country. Conclusion This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.

Ebola in the Netherlands, 2014–2015 : Costs of preparedness and response

NARCIS (Netherlands)

Suijkerbuijk, A.W.M.; Swaan, C.M.; Mangen, M.J.J.; Polder, J.J.; Timen, A.; Ruijs, W.L.M.

2018-01-01

The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the

Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India.

OpenAIRE

Floyd, Katherine; Arora, V. K.; Murthy, K. J. R.; Lonnroth, Knut; Singla, Neeta; Akbar, Y.; Zignol, Matteo; Uplekar, Mukund

2006-01-01

OBJECTIVE: To assess the cost and cost-effectiveness of the Public-Private Mix DOTS (PPM-DOTS) strategy for tuberculosis (TB) control in India. METHODS: We collected data on the costs and effects of pilot PPM-DOTS projects in Delhi and Hyderabad using documentary data and interviews. The cost of PPM-DOTS was compared with public sector DOTS (i.e. DOTS delivered through public sector facilities only) and non-DOTS treatment in the private sector. Costs for 2002 in US$ were assessed for the publ...

Clinical benefits, costs, and cost-effectiveness of neonatal intensive care in Mexico.

Directory of Open Access Journals (Sweden)

Jochen Profit

2010-12-01

Full Text Available Neonatal intensive care improves survival, but is associated with high costs and disability amongst survivors. Recent health reform in Mexico launched a new subsidized insurance program, necessitating informed choices on the different interventions that might be covered by the program, including neonatal intensive care. The purpose of this study was to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico.A cost-effectiveness analysis was conducted using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the Ministry of Health in Mexico and World Health Organization price lists, supplemented with published studies from other countries as needed. The model estimated changes in clinical outcomes, life expectancy, disability-free life expectancy, lifetime costs, disability-adjusted life years (DALYs, and incremental cost-effectiveness ratios (ICERs for neonatal intensive care compared to no intensive care. Uncertainty around the results was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. In the base-case analysis, neonatal intensive care for infants born at 24-26, 27-29, and 30-33 weeks gestational age prolonged life expectancy by 28, 43, and 34 years and averted 9, 15, and 12 DALYs, at incremental costs per infant of US$11,400, US$9,500, and US$3,000, respectively, compared to an alternative of no intensive care. The ICERs of neonatal intensive care at 24-26, 27-29, and 30-33 weeks were US$1,200, US$650, and US$240, per DALY averted, respectively. The findings were robust to variation in parameter values over wide ranges in sensitivity analyses

Gedanken Experiments in Educational Cost Effectiveness

Science.gov (United States)

Brudner, Harvey J.

1978-01-01

Discusses the effectiveness of cost determining techniques in education. The areas discussed are: education and management; cost-effectiveness models; figures of merit determination; and the implications as they relate to the areas of audio-visual and computer educational technology. (Author/GA)

78 FR 75441 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Science.gov (United States)

2013-12-11

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits Notice of Applications for Certificates of Public Convenience and... Novermber 30, 2013. The following Applications for Certificates of Public Convenience and Necessity and...

78 FR 68134 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Science.gov (United States)

2013-11-13

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits Notice of Applications for Certificates of Public Convenience and... October 26, 2013. The following Applications for Certificates of Public Convenience and Necessity and...

78 FR 25782 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Science.gov (United States)

2013-05-02

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits Notice of Applications for Certificates of Public Convenience and... April 20, 2013. The following Applications for Certificates of Public Convenience and Necessity and...

78 FR 19354 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Science.gov (United States)

2013-03-29

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits Notice of Applications for Certificates of Public Convenience and... March 16, 2013. The following Applications for Certificates of Public Convenience and Necessity and...

Competencies of Reconfiguration in Product Development – The Case of Convenience Food

OpenAIRE

Voigt, Tim; Kuhl, Rainer

2008-01-01

Convenience food is characterized by a value added to the product core that corresponds to fast changing consumer needs. Thus, convenience food can be considered as an example of one of the most innovative product categories in the domain of the food industry. Concerning innovative activities the prevailing perception of convenience food is that all decisive impulses are coming from the market e.g. are driven by the power of demand. If so, than food producers have the chance to react on these...

[Incremental cost effectiveness of multifocal cataract surgery].

Science.gov (United States)

Pagel, N; Dick, H B; Krummenauer, F

2007-02-01

Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

Cost-effective treatment for the couple with infertility.

Science.gov (United States)

Van Voorhis, B J; Syrop, C H

2000-12-01

Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated.

49 CFR 639.21 - Determination of cost-effectiveness.

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

34 CFR 300.515 - Timelines and convenience of hearings and reviews.

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Timelines and convenience of hearings and reviews. 300.515 Section 300.515 Education Regulations of the Offices of the Department of Education (Continued... and Children § 300.515 Timelines and convenience of hearings and reviews. (a) The public agency must...

Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010.

LENUS (Irish Health Repository)

Bennett, Kathleen

2009-01-01

OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000\\/LYG), followed by the statins for secondary prevention (< euro 6500\\/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000\\/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure.

The ideology of convenience. Canned foods in women's magazines (Flanders, 1945-1960).

Science.gov (United States)

Geyzen, Anneke

2015-11-01

This paper investigates the communication of canned foods in Flanders between 1945 and 1960. It forwards the antinomy between convenience and care as theoretical framework, it uses three women's magazines as source material, and it subjects this material to the technique of close reading. The results show that the discursive construction of canned foods differs according to the ideology of the magazines. Whereas the agrarian periodical discarded canned foods as careless convenience that menaced the idea of the good housewife, the socialist and the commercial publications undeniably accepted them as caring convenience that could facilitate the household chores of working women. The analysis, thus, deals with the ideological aspect of convenience food, an aspect that has only rarely been examined. Copyright © 2015 Elsevier Ltd. All rights reserved.

Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?

Science.gov (United States)

Gartner, Coral E; Barendregt, Jan J; Wallace, Angela; Hall, Wayne D

2012-04-01

We used epidemiological modelling to assess whether nicotine vaccines would be a cost-effective way of preventing smoking uptake in adolescents. We built an epidemiological model using Australian data on age-specific smoking prevalence; smoking cessation and relapse rates; life-time sex-specific disability-adjusted life years lived for cohorts of 100,000 smokers and non-smokers; government data on the costs of delivering a vaccination programme by general practitioners; and a range of plausible and optimistic estimates of vaccine cost, efficacy and immune response rates based on clinical trial results. We first estimated the smoking uptake rates for Australians aged 12-19 years. We then used these estimates to predict the expected smoking prevalence in a birth cohort aged 12 in 2003 by age 20 under (i) current policy and (ii) different vaccination scenarios that varied in cost, initial vaccination uptake, yearly re-vaccination rates, efficacy and a favourable vaccine immune response rate. Under the most optimistic assumptions, the cost to avert a smoker at age 20 was $44,431 [95% confidence interval (CI) $40,023-49,250]. This increased to $296,019 (95% CI $252,307-$355,930) under more plausible scenarios. The vaccine programme was not cost-effective under any scenario. A preventive nicotine vaccination programme is unlikely to be cost-effective. The total cost of a universal vaccination programme would be high and its impact on population smoking prevalence negligible. For these reasons, such a programme is unlikely to be publicly funded in Australia or any other developed country. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Skin conductance response to the pain of others predicts later costly helping.

Directory of Open Access Journals (Sweden)

Grit Hein

Full Text Available People show autonomic responses when they empathize with the suffering of another person. However, little is known about how these autonomic changes are related to prosocial behavior. We measured skin conductance responses (SCRs and affect ratings in participants while either receiving painful stimulation themselves, or observing pain being inflicted on another person. In a later session, they could prevent the infliction of pain in the other by choosing to endure pain themselves. Our results show that the strength of empathy-related vicarious skin conductance responses predicts later costly helping. Moreover, the higher the match between SCR magnitudes during the observation of pain in others and SCR magnitude during self pain, the more likely a person is to engage in costly helping. We conclude that prosocial motivation is fostered by the strength of the vicarious autonomic response as well as its match with first-hand autonomic experience.

Low-Cost Chemical-Responsive Adhesive Sensing Chips.

Science.gov (United States)

Tan, Weirui; Zhang, Liyuan; Shen, Wei

2017-12-06

Chemical-responsive adhesive sensing chip is a new low-cost analytical platform that uses adhesive tape loaded with indicator reagents to detect or quantify the target analytes by directly sticking the tape to the samples of interest. The chemical-responsive adhesive sensing chips can be used with paper to analyze aqueous samples; they can also be used to detect and quantify solid, particulate, and powder analytes. The colorimetric indicators become immediately visible as the contact between the functionalized adhesives and target samples is made. The chemical-responsive adhesive sensing chip expands the capability of paper-based analytical devices to analyze solid, particulate, or powder materials via one-step operation. It is also a simpler alternative way, to the covalent chemical modification of paper, to eliminate indicator leaching from the dipstick-style paper sensors. Chemical-responsive adhesive chips can display analytical results in the form of colorimetric dot patterns, symbols, and texts, enabling clear understanding of assay results by even nonprofessional users. In this work, we demonstrate the analyses of heavy metal salts in silica powder matrix, heavy metal ions in water, and bovine serum albumin in an aqueous solution. The detection is one-step, specific, sensitive, and easy-to-operate.

The Cost-Effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing

Directory of Open Access Journals (Sweden)

Bogavac-Stanojevic Natasa

2017-09-01

Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with

Convenience: Så tag på gourmetrestaurant

DEFF Research Database (Denmark)

Grunert, Klaus G.

2006-01-01

Vil De have en særlig oplevelse med convenience food? Så vil jeg anbefale, at De booker et bord på en gourmet-restaurant og bestiller en menu surprise med en tilsvarende vinmenu. Så behøver man slet ikke at lave mad. Man behøver ikke engang at tænke over, hvad man ønsker at spise eller drikke...

Cost-effectiveness analysis of sandhill crane habitat management

Science.gov (United States)

Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

2013-01-01

Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

Training effectiveness vs. cost effectiveness: The next millennium challenge

International Nuclear Information System (INIS)

Coe, Richard P.

2003-01-01

With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

[Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine].

Science.gov (United States)

Gockel, Ines; Lange, Undine Gabriele; Schürmann, Olaf; Jansen-Winkeln, Boris; Sibbel, Rainer; Lyros, Orestis; von Dercks, Nikolaus

2018-04-12

Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors are gold standards of gastroesophageal reflux treatment. On account of limited resources and increasing healthcare needs and costs, in this analysis, not only optimal medical results, but also superiority in health economics of these 2 methods are evaluated. We performed an electronic literature survey in MEDLINE, PubMed, Cochrane Library, ISRCTN (International Standard Randomization Controlled Trial Number) as well as in the NHS Economic Evaluation Database, including studies published until 1/2017. Only studies considering the effect size of QALY (Quality-Adjusted Life Years) (with respect to different quality of life-scores) as primary outcome comparing laparoscopic fundoplication and medical therapy were included. Criteria of comparison were ICER (Incremental Cost-Effectiveness Ratio) and ICUR (Incremental Cost-Utility Ratio). Superiority of the respective treatment option for each publication was worked out. In total, 18 comparative studies were identified in the current literature with respect to above-mentioned search terms, qualifying for the defined inclusion criteria. Six studies were finally selected for analyses. Out of 6 publications, 3 showed superiority of laparoscopic fundoplication over long-term medical management based on current cost-effectiveness data. Limitations were related to different time intervals, levels of evidence of studies and underlying resources/costs of analyses, healthcare systems and applied quality of life instruments. Future prospective, randomized trials should examine this comparison in greater detail. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.

Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

Science.gov (United States)

Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

2009-11-01

We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

48 CFR 52.249-4 - Termination for Convenience of the Government (Services) (Short Form).

Science.gov (United States)

2010-10-01

... Convenience of the Government (Services) (Short Form). 52.249-4 Section 52.249-4 Federal Acquisition... CONTRACT CLAUSES Text of Provisions and Clauses 52.249-4 Termination for Convenience of the Government... convenience of the Government, limit termination settlement charges to services rendered before the date of...

30 CFR 885.22 - When and how can my grant be terminated for convenience?

Science.gov (United States)

2010-07-01

... convenience? 885.22 Section 885.22 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... § 885.22 When and how can my grant be terminated for convenience? Either you or we may terminate the grant for convenience following the procedures in 43 CFR part 12. ...

Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review.

Science.gov (United States)

Arbel, Leor T; Hsu, Edmund; McNally, Keegan

2017-08-23

Clostridium difficile ( C. difficile ) is a common cause of antibiotic--associated diarrhea (AAD), being responsible for 15--25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management.

Tuition fees and sunk-cost effects

NARCIS (Netherlands)

Ketel, N.; Linde, J.; Oosterbeek, H.; van der Klaauw, B.

2016-01-01

This article reports on a field experiment testing for sunk-cost effects in an education setting. Students signing up for extra-curricular tutorial sessions randomly received a discount on the tuition fee. The sunk-cost effect predicts that students who pay more will attend more tutorial sessions,

Determination of several families of phytochemicals in different pre-cooked convenience vegetables: effect of lifetime and cooking.

Science.gov (United States)

Alarcón-Flores, M Isabel; Hernández-Sánchez, Francisco; Romero-González, Roberto; Plaza-Bolaños, Patricia; Martínez Vidal, J Luis; Garrido Frenich, Antonia

2014-11-01

Phytochemicals content, including several families such as phenolic acids, isoflavones, flavones, flavonols, isothiocyanates, and glucosinolates, was determined in pre-cooked convenience vegetables by ultra high performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry (UHPLC-QqQ-MS/MS). It was observed that there is not a common behavior of the individual concentration of phytochemicals during the lifetime and cooking of the matrix, and compounds change their concentration without a specific trend. It was observed that neither lifetime nor cooking process have significant effects on the total content of phytochemicals except in broccoli, although some changes in the individual content of the target compounds were observed, suggesting that interconversion processes could be performed during the lifetime and/or cooking process of the product.

Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis.

Science.gov (United States)

Gomez, G B; Dowdy, D W; Bastos, M L; Zwerling, A; Sweeney, S; Foster, N; Trajman, A; Islam, M A; Kapiga, S; Sinanovic, E; Knight, G M; White, R G; Wells, W A; Cobelens, F G; Vassall, A

2016-12-01

Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered 'real world' constraints such as sub-optimal guideline adherence. From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating 'real world' constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries' GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

Convenience store visits by US adolescents: Rationale for healthier retail environments.

Science.gov (United States)

Sanders-Jackson, Ashley; Parikh, Nina M; Schleicher, Nina C; Fortmann, Stephen P; Henriksen, Lisa

2015-07-01

Given interest in the public health impact of convenience stores, it is surprising that so little is known about the popularity of these destinations for youth. We surveyed 2772 adolescents (age 13-16) from a nationally representative web panel of US households. Nearly half (47.5%) of adolescents reported visiting convenience stores at least weekly. Significant risk factors for frequent visits were age, being African-American, living in rural areas and in areas with higher levels of neighborhood deprivation. With approximately 4.1 million US adolescents visiting convenience stores at least weekly, new policies and other interventions are needed to promote a healthier retail environment for youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

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)

Environmental Cost Accounting – Assessing the Environmental Responsibility Effort

Directory of Open Access Journals (Sweden)

Florian Marcel Nuțǎ

2012-05-01

Full Text Available The paper’s aim is to evaluate different approaches of environmental cost accounting used aroundthe world. One of the main issues of modern enterprise is to affirm its responsible behavior and to connect itwith a positive economic benefit for the shareholders. Practically the management systems must find a way toaddress all the stakeholders’ interests and needs.

Cost-effective conservation planning: lessons from economics.

Science.gov (United States)

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

Directory of Open Access Journals (Sweden)

Femke Jansen

2016-01-01

Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

Plenary III–04: Responses to Drug Costs: Year Three of the Medicare Part D Program

OpenAIRE

Fung, Vicki; Reed, Mary; Hsu, John

2010-01-01

Background/Aims: Many Medicare Part D beneficiaries face substantial prescription drug cost-sharing. In the first year of the program, many beneficiaries reported substantial drug use changes in response to the coverage gap. In response, an increasing number of plans offer generic drug coverage during the gap. We compared responses to Part D costs among beneficiaries with generic-only gap coverage and full gap coverage in 2008, the third year of the Part D program.

A cost-efficient and reliable energy management of a micro-grid using intelligent demand-response program

International Nuclear Information System (INIS)

Safamehr, Hossein; Rahimi-Kian, Ashkan

2015-01-01

Providing a cost-efficient and reliable energy is one of the main issues in human societies of the 21st century. In response to this demand, new features of micro grid technology have provided huge potentials, specifically by the capability of having an interactive coordination between energy suppliers and consumers. Accordingly, this paper offers an improved model for achieving an optimal Demand Response programing. To solve the proposed multi-objective optimization problem, Artificial Bee Colony algorithm and quasi-static technique are utilized. The considered objectives in this paper are minimizing the overall cost of energy consumption and also improving the technical parameters of micro grid over a time horizon. This optimization is subject to several constraints such as satisfying the energy balance and the operating constraints of each energy supply sources. Manageable load or load as source is another enabling feature existing in smart energy networks, which is considered in this paper and its effect on cost reduction and reliability improvement is studied. Trying to examine the performance of the proposed Demand Response Programing in real conditions, the uncertainties are also analyzed by stochastic methods. The results show significant improvements which are obtained by applying just intelligent programming and management. - Highlights: • This paper presents a cost-efficient and reliable energy management of a micro-grid. • New models of battery and manageable loads are formulated. • Artificial Bee Colony algorithm is used to solve the optimization problem. • Quasi-static technique is used to simplify the solving procedure. • The uncertainties are also analyzed by stochastic methods.

Engineering a responsive, low cost, tactical satellite, TACSAT-1

Science.gov (United States)

Hurley, M.; Duffey, T.; Huffine, Christopher; Weldy, Ken; Clevland, Jeff; Hauser, Joe

2004-11-01

The Secretary of Defense's Office of Force Transformation (OFT) is currently undertaking an initiative to develop a low-cost, responsive, operationally relevant space capability using small satellites. The Naval Research Laboratory (NRL) is tasked to be program manger for this initiative, which seeks to make space assets and capabilities available to operational users. TacSat-1 is the first in a series of small satellites that will result in rapid, tailored, and operationally relevant experimental space capabilities for tactical forces. Components of the resulting tactical architecture include a highly automated small satellite bus, modular payloads, common launch and payload interfaces, tasking and data dissemination using the SIPRNET (Secret Internet Protocol Routing Network), and low cost, rapid response launches. The overall goal of TacSat-1 is to demonstrate the utility of a broader complementary business model and provide a catalyst for energizing DoD and industry in the operational space area. This paper first provides a brief overview of the TacSat- 1 experiment and then discusses the engineering designs and practices used to achieve the aggressive cost and schedule goals. Non-standard approaches and engineering philosophies that allowed the TacSat-1 spacecraft to be finished in twelve months are detailed and compared with "normal" satellite programs where applicable. Specific subsystem design, integration and test techniques, which contributed to the successful completion of the TacSat-1 spacecraft, are reviewed. Finally, lessons learned are discussed.

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

Science.gov (United States)

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

2017-09-01

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

Proton exchange membrane fuel cell for cooperating households: A convenient combined heat and power solution for residential applications

International Nuclear Information System (INIS)

Cappa, Francesco; Facci, Andrea Luigi; Ubertini, Stefano

2015-01-01

In this paper we compare the technical and economical performances of a high temperature proton exchange membrane fuel cell with those of an internal combustion engine for a 10 kW combined heat and power residential application. In a view of social innovation, this solution will create new partnerships of cooperating families aiming to reduce the energy consumption and costs. The energy system is simulated through a lumped model. We compare, in the Italian context, the total daily operating cost and energy savings of each system with respect to the separate purchase of electricity from the grid and production of the thermal energy through a standard boiler. The analysis is carried out with the energy systems operating with both the standard thermal tracking and an optimized management. The latter is retrieved through an optimization methodology based on the graph theory. We show that the internal combustion engine is much more affected by the choice of the operating strategy with respect to the fuel cell, in terms long term profitability. Then we conduct a net present value analysis with the aim of evidencing the convenience of using a high temperature proton exchange membrane fuel cell for cogeneration in residential applications. - Highlights: • Fuel cells are a feasible and economically convenient solution for residential CHP. • Control strategy is fundamental for the economical performance of a residential CHP. • Flexibility is a major strength of the fuel cell CHP.

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)

The metabolic cost of mounting an immune response in male brown anoles (Anolis sagrei).

Science.gov (United States)

Cox, Christian L; Peaden, Robert T; Cox, Robert M

2015-09-09

The tradeoff between reproduction and survival is central to life-history theory and is thought to reflect underlying energetic tradeoffs between reproduction and self-maintenance. Immune responses to parasites and pathogens are important components of self-maintenance in many species, but whether these defenses impose significant energetic costs has only been tested in a handful of organisms. We tested for a metabolic cost of mounting an immune response in the male brown anole (Anolis sagrei), a lizard in which we have previously shown that reproduction causes a marked reduction in immune response to the novel antigen phytohaemagglutinin (PHA). We treated captive male anoles with a subcutaneous injection of either PHA, which induces an immune response that manifests as localized swelling, or saline vehicle as a control. Prior to injection and at 24, 48, and 72 hr post-injection, we measured swelling at the site of injection and whole-animal resting metabolic rate (RMR) using stop-flow respirometry. Although we detected a robust swelling response to PHA at 24, 48, and 72 hr post-injection, mean RMR did not differ between treatments at any of these time points. However, within the PHA treatment group, RMR increased with the extent of swelling, suggesting a variable metabolic cost that scales with the magnitude of the induced immune response. Although individual anoles varied considerably in the extent to which they responded to PHA challenge, our results suggest that an immune response can impose a substantial metabolic cost (potentially as much as 63% above baseline RMR) for individuals that do respond maximally. J. Exp. Zool. 9999A:XX-XX, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Is expanding Medicare coverage cost-effective?

Directory of Open Access Journals (Sweden)

Muennig Peter

2005-03-01

Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

A Systematic Review of the Cost-Effectiveness of Biologics for Ulcerative Colitis.

Science.gov (United States)

Stawowczyk, Ewa; Kawalec, Paweł

2018-04-01

assessments were also performed for adalimumab (50%) and golimumab (31%). Only three analyses were conducted for vedolizumab, whereas no relevant studies were found for etrolizumab and tofacitinib. The reporting quality of the included economic analyses was assessed as high, with an average score of 21 points per 24 maximum possible (range 14-23 points according to the ISPOR CHEERS statement checklist). In the case of most analyses, quality-adjusted life-years were used as a clinical outcome, and endpoints such as remission, response and mucosal healing were less common. The higher clinical effectiveness (based on response rates) of biological treatment over non-biological treatments was presented in revealed analyses. The incremental cost-utility ratios for biologics, compared with standard care, varied significantly between the studies and ranged from US$36,309 to US$456,979. The lowest value was obtained for infliximab and the highest for the treatment scheme including infliximab 5 mg/kg and infliximab 10 mg/kg + adalimumab. The change of utility weights and clinical parameters had the most significant influence on the results of the analysis; the variable related to surgery was the least sensitive. Limited data on the cost-effectiveness of UC therapy were identified. In the majority of studies, the lack of cost-effectiveness was revealed for biologics, which was associated with their high costs. Clinical outcomes are transferable to other countries and could be generalized; however, cost inputs are country-specific and therefore limit the transferability and generalizability of conclusions. The key drivers and variables that showed the greatest effect on the analysis results were utility weights and clinical parameters.

Grid Integration of Aggregated Demand Response, Part 2: Modeling Demand Response in a Production Cost Model

Energy Technology Data Exchange (ETDEWEB)

Hummon, Marissa [National Renewable Energy Lab. (NREL), Golden, CO (United States); Palchak, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Denholm, Paul [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jorgenson, Jennie [National Renewable Energy Lab. (NREL), Golden, CO (United States); Olsen, Daniel J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Matson, Nance [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rose, Cody [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dudley, Junqiao [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goli, Sasank [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ma, Ookie [U.S. Dept. of Energy, Washington, DC (United States)

2013-12-01

This report is one of a series stemming from the U.S. Department of Energy (DOE) Demand Response and Energy Storage Integration Study. This study is a multi-national-laboratory effort to assess the potential value of demand response (DR) and energy storage to electricity systems with different penetration levels of variable renewable resources and to improve our understanding of associatedmarkets and institutions. This report implements DR resources in the commercial production cost model PLEXOS.

Speedy's Convenience, Inc., Speedy's Truck Stop: NN0031001

Science.gov (United States)

NPDES permit for Speedy’s Convenience, Inc., authorizing the discharge of treated groundwater to receiving surface water in an unnamed wash which eventually drains to the Puerco River near Lupton in Apache County, Arizona.

Cost accounting and oil spills

International Nuclear Information System (INIS)

Peck, J.B.; Dufour, B.; Peck, V.P.

1996-01-01

Financial costs of an oil spill were considered. The control measures taken by Maritime Bureau Inc., in the San Juan oil spill were used as an example of how chaotic influences were minimized, how stability to the management team, structured under the Incident Command System (ICS) model, was provided, and how as a result of these actions, effective cost control was established. The importance of precise knowledge of operating costs was stressed as a basis for taking policy measures and for the evaluation of the short-term success of an oil spill clean-up operation. Staff responsibilities and management needs were described. Performance evaluation, as an important part of crisis cost accounting, was highlighted. Incident costs and response effectiveness comparisons were given for 13 oil spill incidents, including the EXXON VALDEZ affair. 4 tabs., 2 figs

Leveraging Technology to Reduce Patient Transaction Costs.

Science.gov (United States)

Edlow, Richard C

2015-01-01

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

Structural relations of convenience food satisfaction and quality of life according to dietary style: Focusing on singles in metropolitan area of Korea.

Science.gov (United States)

Kim, Boram; Joo, Nami

2014-10-01

Although the issues of singles' dietary style and quality of life are becoming important due to the increasing number of singles with economic power, little research has been conducted to date on singles' use of convenience food and quality of life in relation to their dietary style. Thus, the present study intends to provide basic data to improve the quality of life by determining the current status of the use of convenience food and explicating its relationship with quality of life through analyzing the dietary lifestyles of the singles. The targets of this study were singles, identified as adults between the ages of 25 and 54, living alone, either legally or in actuality having no partner. A statistical analysis of 208 surveys from Seoul, respectively, was conducted using SPSS12.0 for Windows and SEM using AMOS 5.0 statistics package. The convenience-oriented was shown to have a significant positive effect on convenience food satisfaction. HMR satisfaction was found to have a significant effect on positive psychological satisfaction and the convenience-oriented was found to have a significant negative effect on all aspects of quality of life satisfaction. There must be persistent development of food industries considering the distinctive characteristics of the lives of singles in order to satisfy their needs and improve the quality of their lives.

Global cost-effectiveness of GDM screening and management

DEFF Research Database (Denmark)

Weile, Louise K K; Kahn, James G; Marseille, Elliot

2015-01-01

a systematic search and abstraction of cost-effectiveness and cost-utility studies from 2002 to 2014. We standardized all findings to 2014 US dollars. We found that cost-effectiveness ratios varied widely. Most variation was found to be due to differences in geographic setting, diagnostic criteria...... and intervention approaches, and outcomes (e.g., inclusion or exclusion of long-term type 2 diabetes risk and associated costs). We concluded that incorporation of long-term benefits of GDM screening and treatment has huge impact on cost-effectiveness estimates. Based on the large methodological heterogeneity...

10 CFR 436.13 - Presuming cost-effectiveness results.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

Cost-effectiveness analysis and innovation.

Science.gov (United States)

Jena, Anupam B; Philipson, Tomas J

2008-09-01

While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

A cost effective CO2 strategy

DEFF Research Database (Denmark)

, a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily...... by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...

Organizational Perspectives on Rapid Response Team Structure, Function, and Cost: A Qualitative Study.

Science.gov (United States)

Smith, Patricia L; McSweeney, Jean

Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics. The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost. It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.

Cost-Effectiveness of Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection: A Literature Review

Science.gov (United States)

Arbel, Leor T; McNally, Keegan

2017-01-01

Clostridium difficile (C. difficile) is a common cause of antibiotic-­associated diarrhea (AAD), being responsible for 15­-25% of all AAD cases. The purpose of this literature review is to determine the cost-effectiveness of fecal microbiota transplantation (FMT) and how it compares in this regard to the standard treatments of choice for recurrent C. difficile infection (CDI). The review of the literature along with the evaluation of three comparative cost effective analyses yielded findings consistent with the view that FMT is the most cost-effective option in treating recurrent CDI. There are some (but considerably less) data indicating that FMT may be a cost effective strategy in treating initial CDI, as well. The superior cost-effectiveness of FMT as compared to the preferred standards of treatment for recurrent CDI suggest FMT use should become more integrated in routine clinical practice. Increased utilization of FMTs would allow for better control of this increasingly problematic disease as well as lower costs associated with its management. PMID:29067223

The social dilemma structure of climate change mitigation: individual responses and effects on action

OpenAIRE

Bӧgelein, Sandra

2015-01-01

Abstract Climate change mitigation constitutes a social dilemma, a conflict between personal and collective outcomes. Behaviours that result in personal benefits (e.g. travelling quickly, conveniently and cheaply by plane) also result in a collective cost in the form of climate change. Behavioural theories and evidence suggest this social dilemma structure significantly influences behaviour. This thesis aims to understand how the social dilemma structure of climate change mitigation affect...

48 CFR 1652.249-71 - FEHBP termination for convenience of the government-negotiated benefits contracts.

Science.gov (United States)

2010-10-01

... convenience of the government-negotiated benefits contracts. 1652.249-71 Section 1652.249-71 Federal... convenience of the government—negotiated benefits contracts. As prescribed in section 1649.101-71, the following clause shall be inserted in all FEHBP contracts. FEHBP Termination for Convenience of the...

Effects of cost metric on cost-effectiveness of protected-area network design in urban landscapes.

Science.gov (United States)

Burkhalter, J C; Lockwood, J L; Maslo, B; Fenn, K H; Leu, K

2016-04-01

A common goal in conservation planning is to acquire areas that are critical to realizing biodiversity goals in the most cost-effective manner. The way monetary acquisition costs are represented in such planning is an understudied but vital component to realizing cost efficiencies. We sought to design a protected-area network within a forested urban region that would protect 17 birds of conservation concern. We compared the total costs and spatial structure of the optimal protected-area networks produced using three acquisition-cost surrogates (area, agricultural land value, and tax-assessed land value). Using the tax-assessed land values there was a 73% and 78% cost savings relative to networks derived using area or agricultural land value, respectively. This cost reduction was due to the considerable heterogeneity in acquisition costs revealed in tax-assessed land values, especially for small land parcels, and the corresponding ability of the optimization algorithm to identify lower-cost parcels for inclusion that had equal value to our target species. Tax-assessed land values also reflected the strong spatial differences in acquisition costs (US$0.33/m(2)-$55/m(2)) and thus allowed the algorithm to avoid inclusion of high-cost parcels when possible. Our results add to a nascent but growing literature that suggests conservation planners must consider the cost surrogate they use when designing protected-area networks. We suggest that choosing cost surrogates that capture spatial- and size-dependent heterogeneity in acquisition costs may be relevant to establishing protected areas in urbanizing ecosystems. © 2015 Society for Conservation Biology.

Cost-effectiveness of osteo-odonto keratoprosthesis in Singapore.

Science.gov (United States)

Dong, Di; Tan, Anna; Mehta, Jodhbir S; Tan, Donald; Finkelstein, Eric Andrew

2014-01-01

To determine the long-term cost-effectiveness of osteo-odonto keratoprosthesis (OOKP) relative to no treatment among patients with end-stage corneal and ocular surface diseases in Singapore. Cost-effectiveness analysis based on data from a retrospective cohort study. From a health system perspective, we calculated the incremental cost-effectiveness ratio of OOKP treatment relative to no treatment over a 30-year horizon, based on data from a cohort of 23 patients who underwent OOKP surgery between 2004 and 2009 at Singapore National Eye Centre. Preoperative and postoperative vision-related quality-of-life values were estimated from patients' visual outcomes and were used to calculate the gain in quality-adjusted life years (QALYs) resulting from OOKP treatment. Unsubsidized costs for surgery, consultations, examinations, medications, follow-up visits, and treatments for complications were retrieved from patients' bills to estimate the total costs associated with OOKP treatment. Sensitivity analyses were conducted to test the robustness of the model. Over a 30-year period, OOKP treatment, compared with no treatment, improved QALYs by 3.991 among patients with end-stage corneal and ocular surface diseases at an additional cost of S$67 840 (US$55 150), resulting in an incremental cost-effectiveness ratio of S$17 000/QALY (US$13 820/QALY). Based on commonly cited cost-effectiveness benchmarks, the OOKP is a cost-effective treatment for patients with end-stage corneal and ocular surface diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

Directory of Open Access Journals (Sweden)

Williams Brian G

2005-12-01

Full Text Available Abstract Background The HIV epidemic has caused a dramatic increase in tuberculosis (TB in East and southern Africa. Several strategies have the potential to reduce the burden of TB in high HIV prevalence settings, and cost and cost-effectiveness analyses can help to prioritize them when budget constraints exist. However, published cost and cost-effectiveness studies are limited. Methods Our objective was to compare the cost, affordability and cost-effectiveness of seven strategies for reducing the burden of TB in countries with high HIV prevalence. A compartmental difference equation model of TB and HIV and recent cost data were used to assess the costs (year 2003 US$ prices and effects (TB cases averted, deaths averted, DALYs gained of these strategies in Kenya during the period 2004–2023. Results The three lowest cost and most cost-effective strategies were improving TB cure rates, improving TB case detection rates, and improving both together. The incremental cost of combined improvements to case detection and cure was below US$15 million per year (7.5% of year 2000 government health expenditure; the mean cost per DALY gained of these three strategies ranged from US$18 to US$34. Antiretroviral therapy (ART had the highest incremental costs, which by 2007 could be as large as total government health expenditures in year 2000. ART could also gain more DALYs than the other strategies, at a cost per DALY gained of around US$260 to US$530. Both the costs and effects of treatment for latent tuberculosis infection (TLTI for HIV+ individuals were low; the cost per DALY gained ranged from about US$85 to US$370. Averting one HIV infection for less than US$250 would be as cost-effective as improving TB case detection and cure rates to WHO target levels. Conclusion To reduce the burden of TB in high HIV prevalence settings, the immediate goal should be to increase TB case detection rates and, to the extent possible, improve TB cure rates, preferably

Understanding Cost-Effectiveness of Energy Efficiency Programs

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Discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

Cost-effectiveness of Tofacitinib in the Treatment of Moderate to Severe Rheumatoid Arthritis in South Korea.

Science.gov (United States)

Lee, Min-Young; Park, Sun-Kyeong; Park, Sun-Young; Byun, Ji-Hye; Lee, Sang-Min; Ko, Su-Kyoung; Lee, Eui-Kyung

2015-08-01

This study evaluated the cost-effectiveness of introducing tofacitinib, an oral Janus kinase inhibitor, to the treatment of Korean patients with rheumatoid arthritis (RA) and an inadequate response to conventional disease-modifying antirheumatic drugs. In this cost-utility analysis model, patients transitioned through treatment sequences based on Korean guidelines for RA patients with inadequate response to conventional disease-modifying antirheumatic drugs. Lifetime health-related quality of life and costs were evaluated. Characteristics of the model cohort were based on those reported by the Oral Rheumatoid Arthritis phase 3 triaL (ORAL) Standard randomized Controlled trial of tofacitinib or adalimumab versus placebo. Efficacy was assessed using American College of Rheumatology response rates, converted to the changes in Health Assessment Questionnaire-Disability Index (HAQ-DI) scores, based on tofacitinib clinical trials data. Published clinical trial data on discontinuation rates of the indicated drugs were incorporated in the model. The HAQ-DI scores were mapped onto utility values to calculate outcomes in terms of quality-adjusted life-years (QALYs); HAQ-DI-to-utility (EuroQoL 5D) mapping was based on data from 5 tofacitinib clinical trials. Costs were analyzed from a societal perspective, with values expressed in 2013 Korean won (KRW). Cost-effectiveness is presented in terms of incremental cost-effectiveness ratios (ICERs). One-way sensitivity analyses were performed to assess the robustness of the model. First-line tofacitinib used before the standard of care (base-case analysis) increased both treatment costs and QALYs gained versus the standard-of-care treatment sequence, resulting in an ICER of KRW 13,228,910 per QALY. Tofacitinib also increased costs and QALYs gained when incorporated as a second-, third-, or fourth-line therapy. The inclusion of first-line tofacitinib increased the duration of active immunomodulatory therapy from 9.4 to 13.2 years

Cost-effective data storage/archival subsystem for functional PACS

Science.gov (United States)

Chen, Y. P.; Kim, Yongmin

1993-09-01

Not the least of the requirements of a workable PACS is the ability to store and archive vast amounts of information. A medium-size hospital will generate between 1 and 2 TBytes of data annually on a fully functional PACS. A high-speed image transmission network coupled with a comparably high-speed central data storage unit can make local memory and magnetic disks in the PACS workstations less critical and, in an extreme case, unnecessary. Under these circumstances, the capacity and performance of the central data storage subsystem and database is critical in determining the response time at the workstations, thus significantly affecting clinical acceptability. The central data storage subsystem not only needs to provide sufficient capacity to store about ten days worth of images (five days worth of new studies, and on the average, about one comparison study for each new study), but also supplies images to the requesting workstation in a timely fashion. The database must provide fast retrieval responses upon users' requests for images. This paper analyzes both advantages and disadvantages of multiple parallel transfer disks versus RAID disks for short-term central data storage subsystem, as well as optical disk jukebox versus digital recorder tape subsystem for long-term archive. Furthermore, an example high-performance cost-effective storage subsystem which integrates both the RAID disks and high-speed digital tape subsystem as a cost-effective PACS data storage/archival unit are presented.

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

Science.gov (United States)

Jian-xun, Qi; Dedong, Sun

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

Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention.

Science.gov (United States)

Wisløff, Torbjørn; Atar, Dan

2016-01-01

Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel-and more recently, ticagrelor-has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI.

High-Speed Train Stop-Schedule Optimization Based on Passenger Travel Convenience

OpenAIRE

Dingjun Chen; Shaoquan Ni; Chang’an Xu; Hongxia Lv; Simin Wang

2016-01-01

The stop-schedules for passenger trains are important to the operation planning of high-speed trains, and they decide the quality of passenger service and the transportation efficiency. This paper analyzes the specific manifestation of passenger travel convenience and proposes the concepts of interstation accessibility and degree of accessibility. In consideration of both the economic benefits of railway corporations and the travel convenience of passengers, a multitarget optimization model i...

Reactive control processes contributing to residual switch cost and mixing cost across the adult lifespan.

Science.gov (United States)

Whitson, Lisa R; Karayanidis, Frini; Fulham, Ross; Provost, Alexander; Michie, Patricia T; Heathcote, Andrew; Hsieh, Shulan

2014-01-01

In task-switching paradigms, performance is better when repeating the same task than when alternating between tasks (switch cost) and when repeating a task alone rather than intermixed with another task (mixing cost). These costs remain even after extensive practice and when task cues enable advanced preparation (residual costs). Moreover, residual reaction time mixing cost has been consistently shown to increase with age. Residual switch and mixing costs modulate the amplitude of the stimulus-locked P3b. This mixing effect is disproportionately larger in older adults who also prepare more for and respond more cautiously on these "mixed" repeat trials (Karayanidis et al., 2011). In this paper, we analyze stimulus-locked and response-locked P3 and lateralized readiness potentials to identify whether residual switch and mixing cost arise from the need to control interference at the level of stimulus processing or response processing. Residual mixing cost was associated with control of stimulus-level interference, whereas residual switch cost was also associated with a delay in response selection. In older adults, the disproportionate increase in mixing cost was associated with greater interference at the level of decision-response mapping and response programming for repeat trials in mixed-task blocks. These findings suggest that older adults strategically recruit greater proactive and reactive control to overcome increased susceptibility to post-stimulus interference. This interpretation is consistent with recruitment of compensatory strategies to compensate for reduced repetition benefit rather than an overall decline on cognitive flexibility.

Cost-effectiveness and pricing of antibacterial drugs.

Science.gov (United States)

Verhoef, Talitha I; Morris, Stephen

2015-01-01

Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

A systematic review of the cost and cost effectiveness of treatment for multidrug-resistant tuberculosis.

Science.gov (United States)

Fitzpatrick, Christopher; Floyd, Katherine

2012-01-01

Around 0.4 million cases of multidrug-resistant tuberculosis (MDR-TB) occur each year. Only a small fraction of these cases are treated according to international guidelines. Evidence relevant to decisions about whether to scale-up treatment for MDR-TB includes cost and cost-effectiveness data. Up to 2010, no systematic review of this evidence has been available. Our objective was to conduct a systematic review of the cost and cost effectiveness of treatment for MDR-TB and synthesize the available data. We searched for papers published or prepared for publication in peer-review journals and grey literature using search terms in five languages: English, French, Portuguese, Russian and Spanish. From an initial set of 420 studies, four were included, from Peru, the Philippines, Estonia and Tomsk Oblast in the Russian Federation. Results on costs, effectiveness and cost effectiveness were extracted. Assessment of the quality of each economic evaluation was guided by two existing checklists around which there is broad consensus. Costs were adjusted to a common year of value (2005) to remove distortions caused by inflation, and calculated in two common currencies: $US and international dollars (I$), to standardize for purchasing power parity. Data from the four identified studies were then synthesized using probabilistic sensitivity analysis, to appraise the likely cost and cost effectiveness of MDR-TB treatment in other settings, relative to WHO benchmarks for assessing whether or not an intervention is cost effective. Best estimates are provided as means, with 5th and 95th percentiles of the distributions. The cost per patient for MDR-TB treatment in Estonia, Peru, the Philippines and Tomsk was $US10 880, $US2423, $US3613 and $US14 657, respectively. Best estimates of the cost per disability-adjusted life-year (DALY) averted were $US598 (I$960), $US163 (I$291), $US143 (I$255) and $US745 (I$1059), respectively. The main influences on costs were (i) the model of care

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Science.gov (United States)

2011-01-01

Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Directory of Open Access Journals (Sweden)

Vos Theo

2011-05-01

Full Text Available Abstract Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention. Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

Science.gov (United States)

Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

2011-05-13

Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious

48 CFR 52.249-1 - Termination for Convenience of the Government (Fixed-Price) (Short Form).

Science.gov (United States)

2010-10-01

... Convenience of the Government (Fixed-Price) (Short Form). 52.249-1 Section 52.249-1 Federal Acquisition... CONTRACT CLAUSES Text of Provisions and Clauses 52.249-1 Termination for Convenience of the Government... Convenience of the Government (Fixed-Price) (Short Form) (APR 1984) The Contracting Officer, by written notice...

Data Sets Replicas Placements Strategy from Cost-Effective View in the Cloud

Directory of Open Access Journals (Sweden)

Xiuguo Wu

2016-01-01

Full Text Available Replication technology is commonly used to improve data availability and reduce data access latency in the cloud storage system by providing users with different replicas of the same service. Most current approaches largely focus on system performance improvement, neglecting management cost in deciding replicas number and their store places, which cause great financial burden for cloud users because the cost for replicas storage and consistency maintenance may lead to high overhead with the number of new replicas increased in a pay-as-you-go paradigm. In this paper, towards achieving the approximate minimum data sets management cost benchmark in a practical manner, we propose a replicas placements strategy from cost-effective view with the premise that system performance meets requirements. Firstly, we design data sets management cost models, including storage cost and transfer cost. Secondly, we use the access frequency and the average response time to decide which data set should be replicated. Then, the method of calculating replicas’ number and their store places with minimum management cost is proposed based on location problem graph. Both the theoretical analysis and simulations have shown that the proposed strategy offers the benefits of lower management cost with fewer replicas.

The impact of residential demand response on the costs of a fossil-free system reserve

DEFF Research Database (Denmark)

Katz, Jonas; Balyk, Olexandr; Hevia Koch, Pablo Alejandro

2016-01-01

In order to achieve a better understanding of the system value of residential demand response, we study the potential impact of flexible demand on the costs of system reserves in a fossil-free electricity supply. Comparing these costs with traditional means of regulation our analysis aims...... to contribute to determining the least-cost options for regulation in a fossil-free power system. We extend an existing energy system model with demand response and reserve modelling and analyse the impact for the case of Denmark in 2035 to reflect a system based on renewable resources for electricity...

Controlling Campylobacter in the chicken meat chain - Cost-effectiveness and cost-utility analysis

NARCIS (Netherlands)

Mangen MJJ; Havelaar AH; Nauta MJ; Koeijer AA de; Wit GA de; LEI; Animal Sciences Group; PZO; MGB

2005-01-01

The aim of this study was the estimation of cost-effectiveness and cost-utility of various interventions to control Campylobacter contamination of broiler meat. The relative risk, the intervention costs, the disease burden (expressed in Disability Adjusted Live Years (DALYs)) and the

Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom

Directory of Open Access Journals (Sweden)

Muthukumar M

2017-04-01

Full Text Available Madhusubramanian Muthukumar,1 Kamal Desai,1 Seye Abogunrin,2 Timothy Harrower,3 Sylvie Gabriel,4 Jerome Dinet5 1Modelling and Simulation, 2Meta Research, Evidera, London, 3Royal Devon and Exeter NHS Foundation Trust, Exeter, UK; 4Global Market Access and Pricing, 5Health Economics and Outcomes Research (Global, Ipsen Pharma, Boulogne-Billancourt, France Background: Cervical dystonia (CD involves painful involuntary contraction of the neck and shoulder muscles and abnormal posture in middle-aged adults. Botulinum neurotoxin type A (BoNT-A is effective in treating CD but little is known about its associated cost-effectiveness.Objective: To evaluate the cost-effectiveness of abobotulinumtoxinA for treating CD from the UK payer perspective.Methods: A Markov model was developed to evaluate the cost-effectiveness of abobotulinumtoxinA versus best supportive care (BSC in CD, with a lifetime horizon and health states for response, nonresponse, secondary nonresponse, and BSC in patients with CD (mean age: 53 years; 37% male. Clinical improvement measured using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS was mapped to utility using data from a randomized trial of abobotulinumtoxinA. Health care resource use, costs, and other inputs were from the British National Formulary, Personal Social Services Research Unit, published literature, or expert opinion. Costs and outcomes were discounted at 3.5% per annum.Results: In the base case, the incremental lifetime quality-adjusted life-years (QALYs gained from abobotulinumtoxinA arm versus BSC was 0.253 per patient, whereas the incremental cost was £7,160, leading to an incremental cost-effectiveness ratio (ICER of £30,468 per QALY. One-way sensitivity analyses showed that these results were sensitive to the proportion of responders to abobotulinumtoxinA at first injection, duration between injections, the number of reinjections allowed among primary nonresponders, and any difference in

A cost-effectiveness and cost-utility analysis of radiosurgery vs. resection for single-brain metastases

International Nuclear Information System (INIS)

Mehta, Minesh; Noyes, William; Craig, Bruce; Lamond, John; Auchter, Richard; French, Molly; Johnson, Mark; Levin, Allan; Badie, Behnam; Robbins, Ian; Kinsella, Timothy

1997-01-01

Purpose: The median survival of well-selected patients with single-brain metastases treated with whole-brain irradiation and resection or radiosurgery is comparable, although a randomized trial of these two modalities has not been performed. In this era of cost containment, it is imperative that health-care professionals make fiscally prudent decisions. The present environment necessitates a critical appraisal of apparently equi-efficacious therapeutic modalities, and it is within this context that we present a comparison of the actual costs of resection and radiosurgery for brain metastases. Methods and Materials: Survival and quality of life outcome data for radiation alone or with surgery were obtained from two randomized trials, and radiosurgical results were obtained from a multiinstitutional analysis that specifically evaluated patients meeting surgical criteria. Only linear accelerator radiosurgery data were considered. Cost analysis was performed from a societal view point, and the following parameters were evaluated: actual cost, cost ratios, cost effectiveness, incremental cost effectiveness, cost utility, incremental cost utility, and national cost burden. The computerized billing records for all patients undergoing resection or radiosurgery for single-brain metastases from January 1989 to July 1994 were reviewed. A total of 46 resections and 135 radiosurgery procedures were performed. During the same time period, 454 patients underwent whole-brain radiation alone. An analysis of the entire bill was performed for each procedure, and each itemized cost was assigned a proportionate figure. The relative cost ratios of resection and radiosurgery were compared using the Wilcoxon rank sum test. Cost effectiveness of each modality, defined as the cost per year of median survival, was evaluated. Incremental cost effectiveness, defined as the additional cost per year of incremental gain in median survival, compared to the next least expensive modality, was also

Analytical Solutions of Fractional Differential Equations Using the Convenient Adomian Series

Directory of Open Access Journals (Sweden)

Xiang-Chao Shi

2014-01-01

Full Text Available Due to the memory trait of the fractional calculus, numerical or analytical solution of higher order becomes very difficult even impossible to obtain in real engineering problems. Recently, a new and convenient way was suggested to calculate the Adomian series and the higher order approximation was realized. In this paper, the Adomian decomposition method is applied to nonlinear fractional differential equation and the error analysis is given which shows the convenience.

Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial.

Science.gov (United States)

Audrey, Suzanne; Cooper, Ashley R; Hollingworth, William; Metcalfe, Chris; Procter, Sunita; Davis, Adrian; Campbell, Rona; Gillison, Fiona; Rodgers, Sarah E

2015-02-18

Physical inactivity increases the risk of many chronic diseases including coronary heart disease, type 2 diabetes and some cancers. It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this. An opportunity for working adults to accumulate the recommended activity levels is through the daily commute. Employees will be recruited from workplaces in south-west England and south Wales. In the intervention arm, workplace Walk-to-Work promoters will be recruited and trained. Participating employees will receive Walk-to-Work materials and support will be provided through four contacts from the promoters over 10 weeks. Workplaces in the control arm will continue with their usual practice. The intervention will be evaluated by a cluster randomized controlled trial including economic and process evaluations. The primary outcome is daily minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes are: overall physical activity; sedentary time; modal shift away from private car use during the commute; and physical activity/MVPA during the commute. Accelerometers, GPS receivers and travel diaries will be used at baseline and one year follow-up. Questionnaires will be used at baseline, immediately post intervention, and one year follow-up. The process evaluation will examine the context, delivery and response to the intervention from the perspectives of employers, Walk-to-Work promoters and employees using questionnaires, descriptive statistics, fieldnotes and interviews. A cost-consequence study will include employer, employee and health service costs and outcomes. Time and consumables used in implementing the intervention will be measured. Journey time, household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees. Presenteeism, absenteeism, employee wellbeing and health service use will be recorded. Compared

Cost-effectiveness of Chlamydia antibody tests in subfertile women.

Science.gov (United States)

Fiddelers, A A A; Land, J A; Voss, G; Kessels, A G H; Severens, J L

2005-02-01

For the evaluation of tubal function, Chlamydia antibody testing (CAT) has been introduced as a screening test. We compared six CAT screening strategies (five CAT tests and one combination of tests), with respect to their cost-effectiveness, by using IVF pregnancy rate as outcome measure. A decision analytic model was developed based on a source population of 1715 subfertile women. The model incorporates hysterosalpingography (HSG), laparoscopy and IVF. To calculate IVF pregnancy rates, costs, effects, cost-effectiveness and incremental costs per effect of the six different CAT screening strategies were determined. pELISA Medac turned out to be the most cost-effective CAT screening strategy (15 075 per IVF pregnancy), followed by MIF Anilabsystems (15 108). A combination of tests (pELISA Medac and MIF Anilabsystems; 15 127) did not improve the cost-effectiveness of the single strategies. Sensitivity analyses showed that the results are robust for changes in the baseline values of the model parameters. Only small differences were found between the screening strategies regarding the cost-effectiveness, although pELISA Medac was the most cost-effective strategy. Before introducing a particular CAT test into clinical practice, one should consider the effects and consequences of the entire screening strategy, instead of only the diagnostic accuracy of the test used.

Cost effectiveness and efficiency in assistive technology service delivery.

Science.gov (United States)

Warren, C G

1993-01-01

In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

Short-term responses of Dutch vacationers to a sharp increase in transport costs

NARCIS (Netherlands)

van Cranenburgh, S.

2016-01-01

This paper investigates vacationers’ short-term responses to a sharp increase in transport costs. It aims to (1) acquire an understanding of the relative popularity of the different types of responses among vacationers and (2) explore whether there are distinct market segments of vacationers that

Cost effectiveness analysis of indoor radon control measures

International Nuclear Information System (INIS)

Fujimoto, Kenzo

1989-01-01

The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

A cost-effectiveness analysis of shipboard telemedicine.

Science.gov (United States)

Stoloff, P H; Garcia, F E; Thomason, J E; Shia, D S

1998-01-01

The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness. To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements. A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology. If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost-effective

Exposure-response functions for health effects of air pollutants based on epidemiological findings

Energy Technology Data Exchange (ETDEWEB)

Aunan, K

1995-10-01

The objective of this report is to provide exposure-response functions for health effects and air pollution, which can be used in cost-effectiveness analyses of abatement measures. When cost-effective abatement strategies for air pollution are analyzed, and when air quality standards are set, it is important to have quantitative knowledge about health damage. In spite of their shortcomings, epidemiological studies provide a sound basis for exposure-response functions because they involve a random cross section of the population. In this report the exposure-response functions apply to the relation between air pollutant concentrations and relative effect frequencies, and involve the following health effect end-points: acute and chronic respiratory symptoms in children and adults, asthma episodes in children and adults, eye irritations, headache, lung damage in children, excess mortality, lung cancer incidence. The effects are attributed to one indicator component, which in many cases is particles, but for some effects NO{sub 2}, SO{sub 2}, O{sub 3}, or CO. A calculation procedure is suggested which makes it possible to estimate excess annual symptom-days for short-term effects using the annual average concentration. 103 refs., 1 table

Cost-effectiveness of emergency contraception options over 1 year.

Science.gov (United States)

Bellows, Brandon K; Tak, Casey R; Sanders, Jessica N; Turok, David K; Schwarz, Eleanor B

2018-05-01

The copper intrauterine device is the most effective form of emergency contraception and can also provide long-term contraception. The levonorgestrel intrauterine device has also been studied in combination with oral levonorgestrel for women seeking emergency contraception. However, intrauterine devices have higher up-front costs than oral methods, such as ulipristal acetate and levonorgestrel. Health care payers and decision makers (eg, health care insurers, government programs) with financial constraints must determine if the increased effectiveness of intrauterine device emergency contraception methods are worth the additional costs. We sought to compare the cost-effectiveness of 4 emergency contraception strategies-ulipristal acetate, oral levonorgestrel, copper intrauterine device, and oral levonorgestrel plus same-day levonorgestrel intrauterine device-over 1 year from a US payer perspective. Costs (2017 US dollars) and pregnancies were estimated over 1 year using a Markov model of 1000 women seeking emergency contraception. Every 28-day cycle, the model estimated the predicted number of pregnancy outcomes (ie, live birth, ectopic pregnancy, spontaneous abortion, or induced abortion) resulting from emergency contraception failure and subsequent contraception use. Model inputs were derived from published literature and national sources. An emergency contraception strategy was considered cost-effective if the incremental cost-effectiveness ratio (ie, the cost to prevent 1 additional pregnancy) was less than the weighted average cost of pregnancy outcomes in the United States ($5167). The incremental cost-effectiveness ratios and probability of being the most cost-effective emergency contraception strategy were calculated from 1000 probabilistic model iterations. One-way sensitivity analyses were used to examine uncertainty in the cost of emergency contraception, subsequent contraception, and pregnancy outcomes as well as the model probabilities. In 1000 women

Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India.

Directory of Open Access Journals (Sweden)

Rakesh Aggarwal

Full Text Available Availability of directly-acting antivirals (DAAs has changed the treatment landscape of hepatitis C virus (HCV infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective.A previously-validated, mathematical model was adapted to the HCV-infected population in India to compare the outcomes of no treatment versus treatment with DAAs. Model parameters were estimated from published studies. Cost-effectiveness of HCV treatment using available DAAs was calculated, using a payer's perspective. We estimated quality-adjusted life years (QALYs, disability-adjusted life years (DALYs, total costs, and incremental cost-effectiveness ratio of DAAs versus no treatment. One-way and probabilistic sensitivity analyses were conducted.Compared with no treatment, the use of generic DAAs in Indian HCV patients would increase the life expectancy by 8.02 years, increase QALYs by 3.89, avert 19.07 DALYs, and reduce the lifetime healthcare costs by $1,309 per-person treated. Treatment became cost-effective within 2 years, and cost-saving within 10 years of its initiation overall and within 5 years in persons with cirrhosis. Treating 10,000 HCV-infected persons could prevent 3400-3850 decompensated cirrhosis, 1800-2500 HCC, and 4000-4550 liver-related deaths. The results were sensitive to the costs of DAAs, pre- and post-treatment diagnostic tests and management of cirrhosis, and quality of life after sustained virologic response.Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective.

26 CFR 1.119-1 - Meals and lodging furnished for the convenience of the employer.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Meals and lodging furnished for the convenience... Income § 1.119-1 Meals and lodging furnished for the convenience of the employer. (a) Meals—(1) In..., and (ii) the meals are furnished for the convenience of the employer. The question of whether meals...

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

Science.gov (United States)

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

Rapid and Convenient Separation of Chitooligosaccharides by Ion-Exchange Chromatography

Science.gov (United States)

Wu, Yuxiao; Lu, Wei-Peng; Wang, Jianing; Gao, Yunhua; Guo, Yanchuan

2017-12-01

Pervious methods for separation of highly purified chitooligosaccharides was time-consuming and labor-intensive, which limited the large-scale production. This study developed a convenient ion-exchange chromatography using the ÄKTA™ avant 150 chromatographic system. Five fractions were automatically collected under detecting the absorption at 210 nm. The fractions were analyzed by high-performance liquid chromatography. It proved that they primarily comprised chitobiose, chitotriose, chitotetraose, chitopentaose, and chitohexaose, respectively, with chromatographic purities over 90%. The separation process was rapid, convenient and could be monitored on-line, which would be benefit for the mass production of chitooligosaccharides.

Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach.

Science.gov (United States)

Gandjour, Afschin; Müller, Dirk

2014-10-01

One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

Comparing the Cost-Effectiveness of Campaigns Delivered via Various Combinations of Television and Online Media.

Science.gov (United States)

Allom, Vanessa; Jongenelis, Michelle; Slevin, Terry; Keightley, Stacey; Phillips, Fiona; Beasley, Sarah; Pettigrew, Simone

2018-01-01

Reflecting the increasing prevalence of online media, many mass media health campaigns are now delivered using both television (TV) and online media formats. The aim of this study was to evaluate a smoking cessation mass media campaign according to the cost-effectiveness of the various combinations of TV and online media formats to inform future media buying decisions. A quasi-experimental interrupted time series approach was employed. The campaign was delivered in seven 1-week bursts using TV, online video (OV), or online display (OD) (e.g., banner ads) formats in isolation and in various combinations over a 13-week period. Campaign bursts were separated by "off-weeks" in which no campaign materials were delivered. Assessed outcomes were the number of campaign response "events" recorded (campaign web page views, calls to a smoking cessation telephone service, and registrations for smoking cessation services). The cost-effectiveness of each individual and combined media format condition in terms of these outcome variables was calculated using attributed production and broadcasting costs. Overall, OD alone was found to be the most cost-effective means of achieving the nominated campaign outcomes, followed by a combination of OV and OD and a combination of TV and OV. The use of TV in isolation was the least cost-effective. The results of this evaluation indicate that online media constitute a promising means of enhancing the cost-effectiveness of smoking cessation campaigns. Future research assessing a broader range of outcomes, especially smoking cessation, is needed to provide a more comprehensive account of the cost-effectiveness of various campaign media.

The marginal cost of public funds

DEFF Research Database (Denmark)

Kleven, Henrik Jacobsen; Kreiner, Claus Thustrup

2006-01-01

This paper extends the theory and measurement of the marginal cost of public funds (MCF) to account for labor force participation responses. Our work is motivated by the emerging consensus in the empirical literature that extensive (participation) responses are more important than intensive (hours...... of work) responses. In the modelling of extensive responses, we argue that it is crucial to account for the presence of non-convexities created by fixed work costs. In a non-convex framework, tax and transfer reforms give rise to discrete participation responses generating first-order effects...

78 FR 20372 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits; Notice of...

Science.gov (United States)

2013-04-04

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits; Notice of Applications for Certificates of Public Convenience and... March 23, 2013 The following Applications for Certificates of Public Convenience and Necessity and...

Cost of childhood diarrhoea in rural South Africa: exploring cost-effectiveness of universal zinc supplementation.

Science.gov (United States)

Chhagan, Meera K; Van den Broeck, Jan; Luabeya, Kany-Kany Angelique; Mpontshane, Nontobeko; Bennish, Michael L

2014-09-01

To describe the cost of diarrhoeal illness in children aged 6-24 months in a rural South African community and to determine the threshold prevalence of stunting at which universal Zn plus vitamin A supplementation (VAZ) would be more cost-effective than vitamin A alone (VA) in preventing diarrhoea. We conducted a cost analysis using primary and secondary data sources. Using simulations we examined incremental costs of VAZ relative to VA while varying stunting prevalence. Data on efficacy and societal costs were largely from a South African trial. Secondary data were from local and international published sources. The trial included children aged 6-24 months. The secondary data sources were a South African health economics survey and the WHO-CHOICE (CHOosing Interventions that are Cost Effective) database. In the trial, stunted children supplemented with VAZ had 2·04 episodes (95 % CI 1·37, 3·05) of diarrhoea per child-year compared with 3·92 episodes (95 % CI 3·02, 5·09) in the VA arm. Average cost of illness was $Int 7·80 per episode (10th, 90th centile: $Int 0·28, $Int 15·63), assuming a minimum standard of care (oral rehydration and 14 d of therapeutic Zn). In simulation scenarios universal VAZ had low incremental costs or became cost-saving relative to VA when the prevalence of stunting was close to 20 %. Incremental cost-effectiveness ratios were sensitive to the cost of intervention and coverage levels. This simulation suggests that universal VAZ would be cost-effective at current levels of stunting in parts of South Africa. This requires further validation under actual programmatic conditions.

Costs of telaprevir-based triple therapy for hepatitis C: $189,000 per sustained virological response.

Science.gov (United States)

Bichoupan, Kian; Martel-Laferriere, Valerie; Sachs, David; Ng, Michel; Schonfeld, Emily A; Pappas, Alexis; Crismale, James; Stivala, Alicia; Khaitova, Viktoriya; Gardenier, Donald; Linderman, Michael; Perumalswami, Ponni V; Schiano, Thomas D; Odin, Joseph A; Liu, Lawrence; Moskowitz, Alan J; Dieterich, Douglas T; Branch, Andrea D

2014-10-01

In registration trials, triple therapy with telaprevir (TVR), pegylated interferon (Peg-IFN), and ribavirin (RBV) achieved sustained virological response (SVR) rates between 64% and 75%, but the clinical effectiveness and economic burdens of this treatment in real-world practice remain to be determined. Records of 147 patients who initiated TVR-based triple therapy at the Mount Sinai Medical Center (May-December 2011) were reviewed. Direct medical costs for pretreatment, on-treatment, and posttreatment care were calculated using data from Medicare reimbursement databases, RED Book, and the Healthcare Cost and Utilization Project database. Costs are presented in 2012 U.S. dollars. SVR (undetectable hepatitis C virus [HCV] RNA 24 weeks after the end of treatment) was determined on an intention-to-treat basis. Cost per SVR was calculated by dividing the median cost by the SVR rate. Median age of the 147 patients was 56 years (interquartile range [IQR] = 51-61), 68% were male, 19% were black, 11% had human immunodeficiency virus/HCV coinfection, 36% had advanced fibrosis/cirrhosis (FIB-4 scores ≥3.25), and 44% achieved an SVR. The total cost of care was $11.56 million. Median cost of care was $83,721 per patient (IQR = $66,652-$98,102). The median cost per SVR was $189,338 (IQR = $150,735-$221,860). Total costs were TVR (61%), IFN (24%), RBV (4%), adverse event management (8%), professional fees (2%), and laboratory tests (1%). TVR and Peg-IFN accounted for 85% of costs. Pharmaceutical prices and the low (44%) SVR rate, in this real-world study, were major contributors to the high cost per SVR. © 2014 by the American Association for the Study of Liver Diseases.

Recruitment of mental health survey participants using Internet advertising: content, characteristics and cost effectiveness.

Science.gov (United States)

Batterham, Philip J

2014-06-01

Postal and telephone survey research is threatened by declining response rates and high cost. Online recruitment is becoming more popular, although there is little empirical evidence about its cost-effectiveness or the representativeness of online samples. There is also limited research on optimal strategies for developing advertising content for online recruitment. The present study aimed to assess these aspects of online recruitment. Two mental health surveys used advertisements within a social network website (Facebook) to recruit adult Australian participants. The initial survey used advertisements linking directly to an external survey website, and recruited 1283 participants at $9.82 per completed survey. A subsequent survey used advertisements linking to a Facebook page that featured links to the external survey, recruiting 610 participants at $1.51 per completion. Both surveys were more cost-effective than similar postal surveys conducted previously, which averaged $19.10 per completion. Online and postal surveys both had somewhat unrepresentative samples. However, online surveys tended to be more successful in recruiting hard-to-reach populations. Advertising using "problem" terminology was more effective than "positive" terminology, while there was no significant effect of altruistic versus self-gain terminology. Online recruitment is efficient, flexible and cost-effective, suggesting that online recruitment has considerable potential for specific research designs. Copyright © 2014 John Wiley & Sons, Ltd.

Cost-effectiveness of rotavirus vaccination in Turkey

Directory of Open Access Journals (Sweden)

Tulin Koksal

2017-10-01

Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections.

Conceptualization of convenience euthanasia as an ethical dilemma for veterinarians in Quebec.

Science.gov (United States)

Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

2017-03-01

Companion animal welfare in our society has become increasingly important, yet many healthy animals are euthanized in veterinary facilities. How is it possible to explain the simultaneous presence of these opposing views of obligation toward animals? The goal of this study was to describe convenience euthanasia of companion animals as experienced by veterinarians in order to understand their thought processes. A qualitative study was undertaken to analyze the results of interviews of 14 veterinarians. The study showed that veterinarians interviewed assessed convenience euthanasia based mainly on their subjective evaluation of the owner-animal bond. As most owner-animal bonds stem from an anthropocentric point of view, decisions on convenience euthanasia were taken mostly by considering the veterinarian's and the client/owner's interests.

78 FR 76701 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Science.gov (United States)

2013-12-18

... DEPARTMENT OF TRANSPORTATION Office of the Secretary Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits Notice of Applications for Certificates of Public Convenience and... December 7, [[Page 76702

Cost-effectiveness of private umbilical cord blood banking.

Science.gov (United States)

Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

2009-10-01

To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

Cost-Effectiveness of Old and New Technologies for Aneuploidy Screening.

Science.gov (United States)

Sinkey, Rachel G; Odibo, Anthony O

2016-06-01

Cost-effectiveness analyses allow assessment of whether marginal gains from new technology are worth increased costs. Several studies have examined cost-effectiveness of Down syndrome (DS) screening and found it to be cost-effective. Noninvasive prenatal screening also appears to be cost-effective among high-risk women with respect to DS screening, but not for the general population. Chromosomal microarray (CMA) is a genetic sequencing method superior to but more expensive than karyotype. In light of CMAs greater ability to detect genetic abnormalities, it is cost-effective when used for prenatal diagnosis of an anomalous fetus. This article covers methodology and salient issues of cost-effectiveness. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost effectiveness of Tuberculosis Treatment from the Patients ...

African Journals Online (AJOL)

... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

Cost-effectiveness in fall prevention for older women.

Science.gov (United States)

Hektoen, Liv F; Aas, Eline; Lurås, Hilde

2009-08-01

The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

75 FR 53999 - Office of the Secretary: Notice of Applications for Certificates of Public Convenience and...

Science.gov (United States)

2010-09-02

... Public Convenience and Necessity and Foreign Air Carrier Permits Filed Under Subpart B (Formerly Subpart Q) Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air... following Applications for Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits...

78 FR 63273 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Science.gov (United States)

2013-10-23

... Public Convenience and Necessity and Foreign Air Carrier Permits Filed Under Subpart B (Formerly Subpart Q) Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air... following Applications for Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits...

Food choices and diet costs: an economic analysis.

Science.gov (United States)

Drewnowski, Adam; Darmon, Nicole

2005-04-01

Obesity in the United States is a socioeconomic issue. It is related to limited social and economic resources and may be linked to disparities in access to healthy foods. Added sugars and added fats are far more affordable than are the recommended "healthful" diets based on lean meats, whole grains, and fresh vegetables and fruit. There is an inverse relationship between energy density of foods (kJ/g) and energy cost ($/MJ), such that energy-dense grains, fats, and sweets represent the lowest-cost dietary options to the consumer. Good taste, high convenience, and the low cost of energy-dense foods, in conjunction with large portions and low satiating power, may be the principal reasons for overeating and weight gain. Financial disparities in access to healthier diets may help explain why the highest rates of obesity and diabetes are found among minorities and the working poor. If so, then encouraging low-income households to consume more costly foods is not an effective strategy for public health. What is needed is a comprehensive policy approach that takes behavioral nutrition and the economics of food choice into account.

The Cost-Effectiveness of NBPTS Teacher Certification

Science.gov (United States)

Yeh, Stuart S.

2010-01-01