WorldWideScience

Sample records for term sustainable cost

  1. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    Science.gov (United States)

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed.

  2. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility

    Energy Technology Data Exchange (ETDEWEB)

    LeBlance, R.J.; Allain, C.J.; Laughton, P.J.; Henry, J.G.

    2003-07-01

    The Greater Moncton Sewerage Commission's 115 000 m{sup 3}/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Universite de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and ''cumulative effects'' as part of the overall biosolids management strategy is also discussed. (author)

  3. Rapid and sustained cost management

    International Nuclear Information System (INIS)

    Hanson, D.

    2009-01-01

    Accenture helps clients develop comprehensive, process-driven strategies for rapid and sustained cost management that leverage deep insights and analytics. This approach enables companies to gain operating cost advantages by rationalizing, simplifying and automating current operating capabilities. It drives structural cost advantages by optimizing business mix, capital structure, organizational structure and geographic presence. This paper discussed how successful companies achieve high performance during times of economic turmoil. It also discussed the value of the winner's strategy in terms of rapid and sustained cost management (RSCM). It discussed how Accenture operates and its leveraged capabilities, improved efficiency, margins and cash flow while maintaining customer service levels. Building structural advantage and the Accenture difference were also discussed. It was concluded that RSCM is one vital way that Accenture can help companies achieve success. 4 figs

  4. Assessment of nuclear energy cost competitiveness against alternative energy sources in Romania envisaging the long-term national energy sustainability

    International Nuclear Information System (INIS)

    Margeanu, C. A.

    2016-01-01

    The paper includes some of the results obtained by RATEN ICN Pitesti experts in the IAEA.s Collaborative Project INPRO-SYNERGIES. The case study proposed to evaluate and analyze the nuclear capacity development and increasing of its share in the national energy sector, envisaging the long term national and regional energy sustainability by keeping collaboration options open for the future while bringing solutions to short/medium-term challenges. The following technologies, considered as future competing technologies for electric energy generation in Romania, were selected: nuclear technology (represented by PHWR CANDU Units 3 and 4 - CANDU new, advanced HWR - Adv. HWR, and advanced PWR - Adv. PWR) and, as alternative energy sources, classical technology (represented by Coal-fired power plant using lignite fossil fuel, with carbon capture - Coal_new, and Gas-fired power plant operating on combined cycle, with carbon capture - Gas_new). The study included assessment of specific economic indicators, sensitivity analyses being performed on Levelised Unit Energy Cost (LUEC) variation due to different perturbations (e.g. discount rate, overnight costs, etc). Robustness indices (RI) of LUEC were also calculated by considering simultaneous variation of input parameters for the considered power plants. The economic analyses have been performed by using the IAEA.s NEST program. The study results confirmed that in Romania, under the national specific conditions defined, electricity produced by nuclear power plants is cost competitive against coal and gas fired power plants electricity. The highest impact of considered perturbations on LUEC has been observed for capital intensive technologies (nuclear technologies) comparatively with the classic power plants, especially for discount rate changes. (authors)

  5. Sustainability at no Cost

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen

    The presentation is dealing with some basic concept around the whole economy, and what are really the costs and the benefits. A distinction is made between professional economy, driven by money (GDP), and the amateur economy, driven by love, affection, etc. within the families, among friends, in ...

  6. Costing systems design for sustainability

    Directory of Open Access Journals (Sweden)

    Mihaela TURTUREA

    2013-10-01

    Full Text Available The aim of this article is to present an overall image of the way Accounting responds to nowadays user’s needs in relation to the quantification of the impact companies have towards the environment. Regarding this, there have been analyzed concepts like sustainable development, environmental accounting, environmental costs and there have been presented the main progress towards environmental cost identification and measurement from the perspective of Activity Based Costing system. To provide an overall image of this concepts, there have been used as research methodology methods the documentation from literature review, analysis, synthesis and comparison.

  7. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program.

    Directory of Open Access Journals (Sweden)

    Emmanuel Njeuhmeli

    Full Text Available Voluntary medical male circumcision (VMMC has been shown to be an effective prevention strategy against HIV infection in males [1-3]. Since 2007, the President's Emergency Plan for AIDS Relief (PEPFAR has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10-14 years old over the long term or integrating early infant male circumcision (EIMC into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0, of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4-5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation.

  8. Long-term governance for sustainability

    International Nuclear Information System (INIS)

    Martell, M.

    2007-01-01

    Meritxell Martell spoke of the long-term aspects of radioactive waste management. She pointed out that decision-making processes need to be framed within the context of sustainability, which means that a balance should be sought between scientific considerations, economic aspects and structural conditions. Focusing on structural aspects, Working Group 3 of COWAM-Spain came to the conclusion that the activity of the regulator is a key factor of long-term management. Another finding is that from a sustainability perspective multi-level governance is more effective for coping with the challenges of radioactive waste management than one tier of government-making decisions. The working group also felt that the current Local Information Committees need to evolve towards more institutionalized and legitimized mechanisms for long-term involvement. Ms. Martell introduced a study comparing the efficiency of economic instruments to advance sustainable development in nuclear communities vs. municipalities in mining areas. The study found that funds transferred to nuclear zones had become a means to facilitate local acceptance of nuclear facilities rather than a means to promote socio-economic development. Another finding is that economic instruments are not sufficient guarantees of sustainable development by themselves; additional preconditions include leadership, vision and entrepreneur-ship on the part of community leaders, private or public investments, among others. Finally, Ms. Martell summarised the challenges faced by the Spanish radioactive waste management programme, which include the need for strategic thinking, designing the future in a participatory fashion, and working with local and regional governments and citizens to devise mechanisms for social learning, economic development and environmental protection. (author)

  9. Compatibility of Corporate Sustainability with a Cost Leadership Strategy

    OpenAIRE

    Bouvrain, Stanislas; Sarka, Darius

    2015-01-01

    BACKGROUND Exploring literature about corporate sustainability and cost leadership strategy and to study the collusion of the two concepts through the case of Ikea. AIM Researching whether firms can align corporate sustainability approach to doing business on the imperatives of a cost leadership strategy. The contribution aims to provide guidance on choosing appropriate sustainability activities within the context of cost leadership strategy. Furthermore, it should be noted that this paper se...

  10. Long term impacts of international outsourcing of manufacturing on sustainability

    DEFF Research Database (Denmark)

    Moosavirad, Seyed Hamed; Kara, Sami; Hauschild, Michael Zwicky

    2014-01-01

    International outsourcing seems to be a cost efficient way of production. However, there are serious concerns about its long term impacts on the environmental, social and economic sustainability. This paper aims to quantify these impacts by using input output analysis, linear programming and system......% international outsourcing scenario and the baseline scenario due to their differences in production technologies. © 2014 CIRP....... dynamics in a case study including European electrical industry (outsourcer), Chinese electrical industry (outsourcee) and their main suppliers. Results depict the differences related to the total CO2 emissions, the number of employees and the gross value added of these two regions between a 10...

  11. Export growth, energy costs, and sustainable supply chains

    Science.gov (United States)

    2010-11-01

    The report examines sustainable supply chains in North America and the role played by rail intermodal : operations in lowering ten-mile fuel and emission costs. It examines whether current systems favor imports : over exports a current complaint ...

  12. Pharmaceutical cost-containment policies and sustainability: recent Irish experience.

    Science.gov (United States)

    Kenneally, Martin; Walshe, Valerie

    2012-01-01

    Our objective is to review and assess the main pharmaceutical cost-containment policies used in Ireland in recent years, and to highlight how a policy that improved fiscal sustainability but worsened economic sustainability could have improved both if an option-based approach was implemented. The main public pharmaceutical cost-containment policy measures including reducing the ex-factory price of drugs, pharmacy dispensing fees and community drug scheme coverage, and increasing patient copayments are outlined along with the resulting savings. We quantify the cost implications of a new policy that restricts the entitlement to free prescription drugs of persons older than 70 years and propose an alternative option-based policy that reduces the total cost to both the state and the patient. This set of policy measures reduced public spending on community drugs by an estimated €380m in 2011. The policy restricting free prescription drugs for persons older than 70 years, though effective in reducing public cost, increased the total cost of the drugs supplied. The policy-induced cost increase stems from a fees anomaly between the two main community drugs schemes which is circumvented by our alternative option-based policy. Our findings highlight the need for policymakers, even when absorbed with reducing cost, to design cost-containment policies that are both fiscally and economically sustainable. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Unveiling scientific communities about sustainability and innovation. A bibliometric journey around sustainable terms

    DEFF Research Database (Denmark)

    Franceschini, Simone; Faria, Lourenco; Jurowetzki, Roman

    2016-01-01

    Literature about the relationship between innovation and sustainability has skyrocketed in the last two decades and new terms have appeared. However, only very few bibliometric analyses have reviewed some of these terms (eco-innovation, environmental innovation, green innovation, and sustainable ...

  14. Economics of solar energy: Short term costing

    Science.gov (United States)

    Klee, H.

    The solar economics based on life cycle costs are refuted as both imaginary and irrelevant. It is argued that predicting rates of inflation and fuel escalation, expected life, maintenance costs, and legislation over the next ten to twenty years is pure guesswork. Furthermore, given the high mobility level of the U.S. population, the average consumer is skeptical of long run arguments which will pay returns only to the next owners. In the short term cost analysis, the house is sold prior to the end of the expected life of the system. The cash flow of the seller and buyer are considered. All the relevant factors, including the federal tax credit and the added value of the house because of the solar system are included.

  15. Sustainable cost reduction by lean management in metallurgical processes

    Directory of Open Access Journals (Sweden)

    A. V. Todorut

    2016-10-01

    Full Text Available This paper focuses on the need for sustainable cost reduction in the metallurgical industry by applying Lean Management (LM tools and concepts in metallurgical production processes leading to increased competitiveness of corporations in a global market. The paper highlights that Lean Management is a novel way of thinking, adapting to change, reducing waste and continuous improvement, leading to sustainable development of companies in the metallurgical industry. The authors outline the main Lean Management instruments based on recent scientific research and include a comparative analysis of other tools, such as Sort, Straighten, Shine, Standardize, Sustain (5S, Visual Management (VM, Kaizen, Total Productive Maintenance (TPM, Single-Minute Exchange of Dies (SMED, leading to a critical appraisal of their application in the metallurgical industry.

  16. Unveiling scientific communities about sustainability and innovation. A bibliometric journey around sustainable terms

    DEFF Research Database (Denmark)

    Franceschini, Simone; Faria, Lourenco; Jurowetzki, Roman

    2016-01-01

    innovation), and they concluded that such terms are mostly interchangeable. These findings surprise in light of the different positions shown in the innovation for sustainability debate. Our bibliometric analysis tracks meanings and communities associated with these four terms and indicates some overlaps......, especially between eco-innovation and environmental innovation. However, we found relevant differences of meanings and communities that reflect the different positions in the innovation for sustainability debate....

  17. Can the Clean Development Mechanism attain both cost-effectiveness and sustainable development objectives?

    International Nuclear Information System (INIS)

    Kolshus, Hans H; Vevatne, Jonas; Torvanger, Asbjoern; Aunan, Kristin

    2001-06-01

    The Clean Development Mechanism (CDM), as defined in the Kyoto Protocol, has two objectives: to promote sustainable development in host developing countries, and to improve global cost-effectiveness by assisting developed countries in meeting their Kyoto targets. The aim of this paper is to explore the background of the CDM and discuss to what extent its current design allows it to achieve its dual objective. The first part of the paper is a literature review that includes descriptions of the flexibility mechanisms under the Kyoto Protocol; the CDM's market potential, and the issues of cost-effectiveness and sustainable development. In the second part of the paper, we discuss to what extent there is a conflict between cost-effectiveness and sustain ability, and whether the two objectives of the CDM can be achieved simultaneously. We develop a set of indicators to evaluate non-carbon benefits of CDM projects on the environment, development, and. equity, and show how these indicators can be used in practice by looking at case studies of CDM project candidates in the energy sector from Brazil and China. We demonstrate that for some CDM projects there is a trade-off between cost-effectiveness, in terms of a low quota price, and a high score on sustain ability indicators. We have reason to believe that the size of the CDM market in some studies is over-estimated since transaction costs and the challenge of promoting sustainable development are not fully accounted for. Also, we find that the proposed set of indicators can be a necessary tool to assure that sustain ability impacts of CDM projects are taken into consideration. (author)

  18. Can the Clean Development Mechanism attain both cost-effectiveness and sustainable development objectives?

    Energy Technology Data Exchange (ETDEWEB)

    Kolshus, Hans H; Vevatne, Jonas; Torvanger, Asbjoern; Aunan, Kristin

    2001-06-01

    The Clean Development Mechanism (CDM), as defined in the Kyoto Protocol, has two objectives: to promote sustainable development in host developing countries, and to improve global cost-effectiveness by assisting developed countries in meeting their Kyoto targets. The aim of this paper is to explore the background of the CDM and discuss to what extent its current design allows it to achieve its dual objective. The first part of the paper is a literature review that includes descriptions of the flexibility mechanisms under the Kyoto Protocol; the CDM's market potential, and the issues of cost-effectiveness and sustainable development. In the second part of the paper, we discuss to what extent there is a conflict between cost-effectiveness and sustain ability, and whether the two objectives of the CDM can be achieved simultaneously. We develop a set of indicators to evaluate non-carbon benefits of CDM projects on the environment, development, and. equity, and show how these indicators can be used in practice by looking at case studies of CDM project candidates in the energy sector from Brazil and China. We demonstrate that for some CDM projects there is a trade-off between cost-effectiveness, in terms of a low quota price, and a high score on sustain ability indicators. We have reason to believe that the size of the CDM market in some studies is over-estimated since transaction costs and the challenge of promoting sustainable development are not fully accounted for. Also, we find that the proposed set of indicators can be a necessary tool to assure that sustain ability impacts of CDM projects are taken into consideration. (author)

  19. Governance and Citizens' Engagement in Terms of Local Sustainable Development

    Directory of Open Access Journals (Sweden)

    Agnieszka Sobol

    2015-01-01

    Full Text Available Local sustainable development emphasizes the role of a community. One of the key prerequisite of this process is therefore participation of inhabitants. Nevertheless traditional way of managing cities does not work very well in terms of public engagement. Local sustainable development requires both i.e. governance mechanisms introduced by the local authorities and positive reaction of inhabitants for the invitation for cooperation. The paper is intended to explore some critical issues and dimensions of governance and citizens' engagement in terms of local sustainable development. It shows the general outlook on the most relevant conditions, factors, problems and barriers of this process in Poland. It presents experiences of the city of Rybnik in its work towards public engagement in local development.

  20. Social cost benefit analysis of sustainable industrial areas

    International Nuclear Information System (INIS)

    Blom, M.J.; Schroten, A.

    2010-05-01

    In restructuring a industrial park many different interests are involved, such as space, business climate, environmental quality or landscape. The social cost-benefit analysis (SCBA) is a tool for mapping all current and future pros and cons (expressed in Euros) of a restructuring project for society as a whole as objective as possible. The SCBA manual for sustainable industrial parks describes how an SCBA can be performed and how the results could accommodate decisions made. SCBA pilots have been carried out for restructuring projects in four Dutch municipalities: Katwijk, Rijnwoude, Hardinxveld-Giessendam and Westland. [nl

  1. LCA and external costs in comparative assessment of electricity chains. Decision support for sustainable electricity provision?

    International Nuclear Information System (INIS)

    Voss, A.

    2002-01-01

    The provision of energy and electricity plays an important role in a country's economic and environmental performance and the sustainability of its development. Sustainable development of the energy and electricity sector depends on finding ways of meeting energy service demands of the present generation that are economically viable, environmentally sound, and socially acceptable and do not jeopardize the ability of future generations to meet their own energy needs. Life Cycle Assessment (LCA) and external cost valuation are considered to offer opportunities to assist energy policy in a comprehensive comparative evaluation of electricity supply options with regard to the different dimensions of sustainable energy provision as well as in the implementation of appropriate internalization strategies. The paper addresses life cycle assessment and external cost analysis carried out for selected electricity systems of interest under German conditions. Results from a comprehensive comparative assessment of various electricity supply options with regard to their environmental impacts, health risks, raw materials requirements as well as their resulting external cost will be summarised. The use of LCA based indicators for assessing the relative sustainability of electricity systems and the use of total (internal plus external) cost assessment as measure of economic and environmental efficiency of energy systems will be discussed. Open problems related to life cycle analysis of energy chains and the assessment of environmental damage costs are critically reviewed, to illustrate how in spite of existing uncertainties the state of the art results may provide helpful energy policy decision support. The paper starts with some remarks on what the concept of sustainability in terms of energy systems means. (author)

  2. Financial sustainability in municipal solid waste management--costs and revenues in Bahir Dar, Ethiopia.

    Science.gov (United States)

    Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

    2014-02-01

    Providing good solid waste management (SWM) services while also ensuring financial sustainability of the system continues to be a major challenge in cities of developing countries. Bahir Dar in northwestern Ethiopia outsourced municipal waste services to a private waste company in 2008. While this institutional change has led to substantial improvement in the cleanliness of the city, its financial sustainability remains unclear. Is the private company able to generate sufficient revenues from their activities to offset the costs and generate some profit? This paper presents a cost-revenue analysis, based on data from July 2009 to June 2011. The analysis reveals that overall costs in Bahir Dar's SWM system increased significantly during this period, mainly due to rising costs related to waste transportation. On the other hand, there is only one major revenue stream in place: the waste collection fee from households, commercial enterprises and institutions. As the efficiency of fee collection from households is only around 50%, the total amount of revenues are not sufficient to cover the running costs. This results in a substantial yearly deficit. The results of the research therefore show that a more detailed cost structure and cost-revenue analysis of this waste management service is important with appropriate measures, either by the privates sector itself or with the support of the local authorities, in order to enhance cost efficiency and balance the cost-revenues towards cost recovery. Delays in mitigating the evident financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value

  3. Sustainability of biomass electricity systems. An estimate of costs, macro-economic and environmental impacts

    International Nuclear Information System (INIS)

    Van den Broek, R

    2001-01-01

    Since the 1990s there has been a renewal of interest in the possibility of sustainable generating energy from biomass, an interest driven in part by the climate issue. Other motives are the search for alternatives for parts of Western agriculture and progress in the technological feasibility of efficiently producing high-quality energy from biomass. World-wide this renewed interest has led to a clear increase in research, demonstration and commercial implementation of biomass energy systems. A recent thesis concludes that biomass can contribute to all aspects of sustainability. In the context of sustainable development (often viewed as a concept having economic, social and ecological dimensions), the central question asked by this Ph.D. research is: How do biomass electricity systems compare to fossil-fuel systems and to the land-use that they may replace, in terms of costs, macro-economic and environmental impacts. This article presents a number of conclusions

  4. FOREIGN TRADE TEACHING ACTIVITY: DECIDING BETWEEN COST AND SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Cristiano Henrique Antonelli da Veiga

    2015-03-01

    Full Text Available The world debate focused on preserving the environment, such a s that held during the United Nations Conference on Sustainable Development, Rio +20, in conjunction with Brazil’s growing foreign trade requires a study of all these topics in management courses. The central premise of this paper is to investigate the systematization of trade concepts through the use of business games. Two asymmetric scenarios for exporting and importing teams were developed using action research and qualitative data analysis. The longitudinal study was conducted on four separate, sequential classes from the Foreign Trade discipline of two universities from southern Brazilian. The students were able to discuss a variety of foreign trade topics and interact autonomously among themselves using business games that stimulate business negotiations through role playing dynamics, demonstrating that this teaching strategy can be used as a foreign trade teaching support tool. The final proposal was to change the game scenarios to focus on the decision between lowest costs and sustainable manufacturing processes without losing the aspects developed previously. The results showed that students’ decisions are more linked to their prior personal environmental concepts than to competition strategies developed for the company.

  5. SUSTAINABILITY COST ACCOUNTING - PART 1: A MONETARY PROCEDURE TO EVALUATE THE SUSTAINABILITY OF TECHNOLOGIES IN THE SOUTH AFRICAN PROCESS INDUSTRY

    Directory of Open Access Journals (Sweden)

    A. C. Brent

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: The development and management of new technologies is fundamental to the manufacturing sector as a core operational initiative. Managers of a new technology are increasingly pressurised to consider the economic, environmental, and social impacts associated with the life cycle of the technology (and product during decision-making – i.e. the overall sustainability of the technology. At present, there is no consensus on a methodology to incorporate externalities – for example, environmental and social impacts at macro-level, for which a company is (typically not held financially liable – into management practices. This paper introduces the Sustainability Cost Accounting (SCA procedure, whereby externalities (burdens and benefits are translated into financial terms to assess the overall sustainability performance of a developed technology in the process industry.

    AFRIKAANSE OPSOMMING: ‘n Sentrale operasionele initiatief van die vervaardigings-industrie is die ontwikkeling en bestuur van nuwe tegnologieë. Bestuurders van nuwe tegnologieë word toenemend onder druk geplaas om die ekonomiese-, omgewings-, en sosiale impakte, wat verwant is aan die lewenssiklus van ‘n tegnologie (of produk, in ag te neem tydens besluitneming ten opsigte van die globale volhoudbaarheid van die tegnologie. Op hierdie stadium is daar geen konsensus oor die metodologie wat gevolg moet word om eksterne faktore – bv. omgewings- en sosiale impakte op makrovlak, waarvoor ‘n maatskappy tipies nie aanspreeklik gehou word nie – te inkorporeer in die bestuurpraktyk. Hierdie artikel stel die Volhoudbaarheid Kosterekeningkunde (VKR prosedure voor, waarvolgens die oorgrote volhoudbare prestasie, in terme van eksterne voor- en nadele van ‘n ontwikkelde tegnologie, in die prosesindustrie ge-assesseer kan word in finansiële terme.

  6. Program Evaluation in Cost Benefit Terms.

    Science.gov (United States)

    Tanner, C. Kenneth

    This paper advances a model, called the expected opportunity loss model, for curriculum evaluation. This decision-making technique utilizes subjective data by ranking courses according to their expected contributions to the primary objective of the total program. The model also utilizes objective data in the form of component costs, and differs…

  7. Sustainability of Rainwater Harvesting System in terms of Water Quality

    Directory of Open Access Journals (Sweden)

    Sadia Rahman

    2014-01-01

    Full Text Available Water is considered an everlasting free source that can be acquired naturally. Demand for processed supply water is growing higher due to an increasing population. Sustainable use of water could maintain a balance between its demand and supply. Rainwater harvesting (RWH is the most traditional and sustainable method, which could be easily used for potable and nonpotable purposes both in residential and commercial buildings. This could reduce the pressure on processed supply water which enhances the green living. This paper ensures the sustainability of this system through assessing several water-quality parameters of collected rainwater with respect to allowable limits. A number of parameters were included in the analysis: pH, fecal coliform, total coliform, total dissolved solids, turbidity, NH3–N, lead, BOD5, and so forth. The study reveals that the overall quality of water is quite satisfactory as per Bangladesh standards. RWH system offers sufficient amount of water and energy savings through lower consumption. Moreover, considering the cost for installation and maintenance expenses, the system is effective and economical.

  8. Sustainability cost accounting, Part 1: A Monetary procedure to evaluate the sustainability of technologies in the South African process industry

    CSIR Research Space (South Africa)

    Brent, AC

    2006-11-01

    Full Text Available impacts at macro-level, for which a company is (typically) not held financially liable – into management practices. This paper introduces the Sustainability Cost Accounting (SCA) procedure, whereby externalities (burdens and benefits) are translated...

  9. Cost benefit analysis, sustainability and long-lived radioactive waste management

    International Nuclear Information System (INIS)

    Berkhout, F.

    1994-01-01

    The objective of this paper is to examine how far the sustainability concept and the technique of cost-benefit analysis (CBA) can be applied to the problem of radioactive waste management. The paper begins with a slightly altered definition of the problem to the one carried in the Nea's background document (Nea 1994). A preliminary attempt is then be made to ascribe burdens to the various phases of long-lived radioactive waste management. The appropriateness of CBA and the sustainability concept for making decisions about long-term waste management policy is then discussed. The author ends with some conclusions about the appropriateness of systematic assessment approaches in the political process of constructing social consent for technological decisions. (O.L.). 12 refs., 1 tab

  10. Short-term marginal costs in French agriculture

    OpenAIRE

    Latruffe, Laure; LETORT, Elodie

    2011-01-01

    The paper investigates short-term marginal costs in French agriculture for field cropping, beef cattle, and dairy farms during the period 1995-2006. The multi-input multi-output Symmetric Generalised MacFadden cost function is used, with three variable inputs (crop-specific, animal-specific, energy costs), four outputs and three quasi-fixed inputs. Results indicate that marginal costs are on average lower for crop farms than for livestock samples. However, for crop farms, Common Agricultural ...

  11. GREEN COSTS IN CONTEXT OF SUSTAINABLE DEVELOPMENT TRENDS

    Directory of Open Access Journals (Sweden)

    ZEFINESCU CARMEN-VERONICA

    2015-06-01

    Full Text Available The paper aims an analysis of the role of the information provided by the accounting of environmental resources in the context of sustainable development. The impact of economic organizations on the natural environment and society tends to become increasingly important to managers, generating a number of risks which a company must face, the necessary information in substantiation of managerial decisions which must be included in the financial reporting. In the present circumstances consumers show a higher interest in products and services which take into account the environmental protection. Thus, economic organizations are determined to report information about such characteristics of their products and services. It is estimated that green accounting must take into account the consequences of company activities on the natural environment accounting, as well as management actions taken by the company to avoid such incidents. Green accounting involves the aggregation of information in order to assess the costs and risks of natural disasters. Thus, criteria which allow to establish costs belonging to the natural environment must be found. Anti-pollution investments involve the restructuring of the entire production process, in order to avoid antipoluate emissions during the production process. Accounting takes into account resource consumption which has a price. Consumption of natural resources is considered to be free and is not included in the production cost. The policy pursued by some enterprises to reduce consumption of natural resources considered free is noticed. The existence of a conceptual framework for accounting for the environmental accounting becomes necessary in the current economic context. Thus, the accountants will have support for developing an environmental accounting. The UN has developed a conceptual framework and methods of assessing and accounting consequences of the activities of companies upon the natural environment. The

  12. Financial sustainability in municipal solid waste management – Costs and revenues in Bahir Dar, Ethiopia

    Energy Technology Data Exchange (ETDEWEB)

    Lohri, Christian Riuji, E-mail: christian.lohri@eawag.ch; Camenzind, Ephraim Joseph, E-mail: ephraimcamenzind@hotmail.com; Zurbrügg, Christian, E-mail: christian.zurbruegg@eawag.ch

    2014-02-15

    financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented.

  13. Financial sustainability in municipal solid waste management – Costs and revenues in Bahir Dar, Ethiopia

    International Nuclear Information System (INIS)

    Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

    2014-01-01

    financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented

  14. Short-Term Lifestyle Strategies for Sustaining Cognitive Status

    Science.gov (United States)

    Morris, John N.; Steel, Knight; Strout, Kelley A.; Fries, Brant E.; Moore, Alice; Garms-Homolová, Vjenka

    2016-01-01

    Cognitive decline impacts older adults, particularly their independence. The goal of this project was to increase understanding of how short-term, everyday lifestyle options, including physical activity, help an older adult sustain cognitive independence. Using a secondary analysis of lifestyle choices, we drew on a dataset of 4,620 community-dwelling elders in the US, assessed at baseline and one year later using 2 valid and reliable tools, the interRAI Community Health Assessment and the interRAI Wellness tool. Decline or no decline on the Cognitive Performance Scale was the dependent variable. We examined sustaining one's status on this measure over a one-year period in relation to key dimensions of wellness through intellectual, physical, emotional, social, and spiritual variables. Engaging in physical activity, formal exercise, and specific recreational activities had a favorable effect on short-term cognitive decline. Involvement with computers, crossword puzzles, handicrafts, and formal education courses also were protective factors. The physical and intellectual domains of wellness are prominent aspects in protection from cognitive decline. Inherent in these two domains are mutable factors suitable for targeted efforts to promote older adult health and well-being. PMID:27891520

  15. Short-Term Lifestyle Strategies for Sustaining Cognitive Status

    Directory of Open Access Journals (Sweden)

    Elizabeth P. Howard

    2016-01-01

    Full Text Available Cognitive decline impacts older adults, particularly their independence. The goal of this project was to increase understanding of how short-term, everyday lifestyle options, including physical activity, help an older adult sustain cognitive independence. Using a secondary analysis of lifestyle choices, we drew on a dataset of 4,620 community-dwelling elders in the US, assessed at baseline and one year later using 2 valid and reliable tools, the interRAI Community Health Assessment and the interRAI Wellness tool. Decline or no decline on the Cognitive Performance Scale was the dependent variable. We examined sustaining one’s status on this measure over a one-year period in relation to key dimensions of wellness through intellectual, physical, emotional, social, and spiritual variables. Engaging in physical activity, formal exercise, and specific recreational activities had a favorable effect on short-term cognitive decline. Involvement with computers, crossword puzzles, handicrafts, and formal education courses also were protective factors. The physical and intellectual domains of wellness are prominent aspects in protection from cognitive decline. Inherent in these two domains are mutable factors suitable for targeted efforts to promote older adult health and well-being.

  16. Sustainability strategies for real-estates. Thinking long-term and shoulder entrepreneurial responsibility; Nachhaltigkeitsstrategien fuer Immobilien. Langfristig denken und unternehmerische Verantwortung wahrnehmen

    Energy Technology Data Exchange (ETDEWEB)

    Kaeding, Uta; Sigg, Rene [Intep - Integrale Planung GmbH, Hamburg (Germany); Intep - Integrale Planung GmbH, Muenchen (Germany)

    2011-07-01

    On the basis of their corporate strategy and sustainability strategy responsible companies set suitable objectives for their real-estate portfolio. The companies recognized that sustainable real-estates offer long-term economic advantages and reduced risks. For the development and conversion of a sustainability strategy for real-estates innovative tools and aids are available today which make the life cycle costs or the surplus value of sustainable real-estates transparent.

  17. Designing Energy Supply Chains with the P-graph Framework under Cost Constraints and Sustainability Considerations

    Science.gov (United States)

    A computer-aided methodology for designing sustainable supply chains is presented using the P-graph framework to develop supply chain structures which are analyzed using cost, the cost of producing electricity, and two sustainability metrics: ecological footprint and emergy. They...

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

    International Nuclear Information System (INIS)

    Cross, P.S.

    1990-01-01

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

  19. Sustainable Technologies and Social Costs for Eliminating Contamination of an Aquifer

    Directory of Open Access Journals (Sweden)

    Mario Schirmer

    2010-07-01

    Full Text Available This case study deals with long-term contamination of the Leuna aquifer, which is intended to be restored using sustainable technologies financed by the state. The contamination can only be solved using active rather than passive intervention, because the aquifer has an extraordinarily low natural attenuation capacity for the specific pollutants. Due to the longevity of the contamination source, the groundwater treatment technology that was chosen for the site must operate for a minimum of 20 years but probably much longer. Since the polluter-pay principle cannot be applied, the estimated dynamic primary remediation costs must be accepted as a political or social cost, which must be paid by current and future generations.

  20. Economics of Sustainable Technologies : Private and Public Costs and Benefits

    NARCIS (Netherlands)

    Krozer, Yoram; Abraham, Martin

    2017-01-01

    This article is focused on the economics of sustainable technologies from the mainstream and heterodox perspectives. The aim is to present major concepts, methodologies, and debates for public use. The paper is focused on decision making aiming at the development and use of sustainable technologies.

  1. Moving towards Sustainability in Food Chains: Dealing with Costs and Benefits

    Directory of Open Access Journals (Sweden)

    Gerhard Schiefer

    2015-01-01

    Full Text Available Sustainability concerns are receiving increasingly attention by society and in turn, the food sector and consumers as the food sector’s final customers. Investments towards improvements in sustainability along the chain are usually not evenly distributed along the chain which affects the balance in the distribution of costs and returns. Transparency is a means for supporting an appropriate link between costs and returns. Various alternatives are being discussed. The chapter utilizes a case study approach for elaborating on the possibilities of regaining costs through price premiums, the communication of sustainability to consumers and the cooperation through horizontal and vertical networking alternatives that could support developments towards sustainability through gains in efficiency and concerted engagements in dealing with sustainability, costs and returns along the chain

  2. Cost considerations for long-term ecological monitoring

    Science.gov (United States)

    Caughlan, L.; Oakley, K.L.

    2001-01-01

    For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost

  3. The High Rise Low Cost Housing : Sustainable Neighbourhood Elements (Green Elements) in Malaysia

    Science.gov (United States)

    Wahi, Noraziah; Mohamad, Ismail; Mohamad Zin, Rosli; Munikanan, Vikneswaran; Junaini, Syahrizan

    2018-03-01

    The sustainable development is a vital measure to alleviate the greenhouse gas effect, global warming and any other environment issues. The sustainable neighbourhood concept is not new in Malaysia, However, the concept still needs attention and awareness from the stakeholders. This paper discusses on the sustainable neighbourhood elements specifically green elements application on the high rise low cost housing in Malaysia. Malaysia should have focused sustainable neighbourhood planning and design especially on the high rise low cost housing therefore the future generation can be benefited from this type development.

  4. Long-term sustainability of bio-components production

    Directory of Open Access Journals (Sweden)

    Souček Ivan

    2012-01-01

    Full Text Available Biofuels play an increasingly important role in motor fuel market. The list of biofuels (bio-components in accordance with EU legislations contains a number of substances not widely used in the market. Traditionally these include: fatty acid methyl esters (FAME, in the Czech Republic methyl ether of rape seed oil and bioethanol (also ethyl terc. buthyl ether ETBE, based on bioethanol. The availability and possible utilizations of bio-component fuels in Czech Republic and Serbia are discussed. Additional attention is paid on the identification of the possibilities to improve effectiveness of rape seeds cultivation and utilization of by-products from FAME production (utilization of sew, rape-meal and glycerol which will allow fulfilment of the sustainability criteria for the first generation biofuels. The new approaches on renewable co-processing are commented. The concept of 3E (emissions, energy demand, and economics is introduced specifying three main attributes for effective production of FAME production in accordance with legal compliances. Bio-components price change is analyzed in comparison to the price of motor fuels, identifying possible (speculative crude price break-even point at the level of 149-176 USD/bbl at which point bio-fuels would become economically cost effective for the use by refiners.

  5. Server Operation and Virtualization to Save Energy and Cost in Future Sustainable Computing

    Directory of Open Access Journals (Sweden)

    Jun-Ho Huh

    2018-06-01

    Full Text Available Since the introduction of the LTE (Long Term Evolution service, we have lived in a time of expanding amounts of data. The amount of data produced has increased every year with the increase of smart phone distribution in particular. Telecommunication service providers have to struggle to secure sufficient network capacity in order to maintain quick access to necessary data by consumers. Nonetheless, maintaining the maximum capacity and bandwidth at all times requires considerable cost and excessive equipment. Therefore, to solve such a problem, telecommunication service providers need to maintain an appropriate level of network capacity and to provide sustainable service to customers through a quick network development in case of shortage. So far, telecommunication service providers have bought and used the network equipment directly produced by network equipment manufacturers such as Ericsson, Nokia, Cisco, and Samsung. Since the equipment is specialized for networking, which satisfied consumers with their excellent performances, they are very costly because they are developed with advanced technologies. Moreover, it takes much time due to the purchase process wherein the telecommunication service providers place an order and the manufacturer produces and delivers. Accordingly, there are cases that require signaling and two-way data traffic as well as capacity because of the diversity of IoT devices. For these purposes, the need for NFV (Network Function Virtualization is raised. Equipment virtualization is performed so that it is operated on an x86-based compatible server instead of working on the network equipment manufacturer’s dedicated hardware. By operating in some compatible servers, it can reduce the wastage of hardware and cope with the change thanks to quick hardware development. This study proposed an efficient system of reducing cost in network server operation using such NFV technology and found that the cost was reduced by 24

  6. Asset sustainability index : quick guide : proposed metrics for the long-term financial sustainability of highway networks.

    Science.gov (United States)

    2013-04-01

    "This report provides a Quick Guide to the concept of asset sustainability metrics. Such metrics address the long-term performance of highway assets based upon expected expenditure levels. : It examines how such metrics are used in Australia, Britain...

  7. Baumol's Cost Disease and the Sustainability of the Welfare State

    DEFF Research Database (Denmark)

    Andersen, Torben M.; Kreiner, Claus T.

    2017-01-01

    If productivity increases more slowly for services than for manufactured goods, then services suffer from Baumol's cost disease and tend to become relatively more costly over time. Since the welfare state in all countries is an important supplier of tax financed services, this translates into a f......If productivity increases more slowly for services than for manufactured goods, then services suffer from Baumol's cost disease and tend to become relatively more costly over time. Since the welfare state in all countries is an important supplier of tax financed services, this translates...

  8. Improving the long-term sustainability of health aid: are Global Health Partnerships leading the way?

    Science.gov (United States)

    Dodd, Rebecca; Lane, Christopher

    2010-09-01

    Over the last decade development assistance for health has more than doubled. This increase provides an unprecedented opportunity to scale up health services, and in doing so, achieve the health Millennium Development Goals. However, sustaining scaling up will in turn require sustainable donor support until domestic health financing can substitute for it. The provision of long-term predictable finance is of particular concern in health because the bulk of costs are recurrent and many interventions require sustained, multi-year support to be successful. This is also true for health systems strengthening efforts. As the bulk of new aid resources flow through Global Health Partnerships (GHPs), their ability to make long-term commitments is critical to health systems development. In order to better understand the constraints that prevent development partners from making long-term commitments of health aid, the World Health Organization reviewed the practices of seven major health partners in committing development assistance funds over the long term. The review found increasing evidence of long-term commitments of aid for health in each of the seven agencies. The GHPs and their funders have been at the forefront of this trend, pioneering many of the new approaches. The study concludes that all partners have scope to improve the duration of aid within existing rules and regulations, and that the main constraints to doing so are political. Predictability is even more of a concern in current global economic circumstances, as access to resources begins to be squeezed. In this context it is important that we learn from GHPs, which have successfully tested innovative approaches to both raising and disbursing health funds. The prospects for change associated with the new administration in the United States-the largest health donor and the most unpredictable, but also a major supporter of GHPs-make this task even more urgent.

  9. Innovation, Cooperation, and the Perceived Benefits and Costs of Sustainable Agriculture Practices

    Directory of Open Access Journals (Sweden)

    Mark Lubell

    2011-12-01

    Full Text Available A central goal of most sustainable agriculture programs is to encourage growers to adopt practices that jointly provide economic, environmental, and social benefits. Using surveys of outreach professionals and wine grape growers, we quantify the perceived costs and benefits of sustainable viticulture practices recommended by sustainability outreach and certification programs. We argue that the mix of environmental benefits, economic benefits, and economic costs determine whether or not a particular practice involves decisions about innovation or cooperation. Decision making is also affected by the overall level of knowledge regarding different practices, and we show that knowledge gaps are an increasing function of cost and a decreasing function of benefits. How different practices are related to innovation and cooperation has important implications for the design of sustainability outreach programs. Cooperation, innovation, and knowledge gaps are issues that are likely to be relevant for the resilience and sustainability of many different types of social-ecological systems.

  10. Long-term scenarios for sustainable energy use in Germany

    International Nuclear Information System (INIS)

    Fischedick, M.; Nitsch, J.; Lechtenboehmer, S.; Hanke, T.; Barthel, C.; Jungbluth, C.; Assmann, D.; Brueggen, T. vor der; Trieb, F.; Nast, M.; Langniss, O.; Brischke, L.A.

    2002-01-01

    The study was able to show, and explain vividly through scenarios describing change processes, that a sustainable use of energy (aimed, among other things, at reducing CO 2 emissions by 80% by 2050 compared with 1990 levels) is technically feasible, economically viable, compatible with farther-reaching objectives of energy policy (e.g. supply security), and does not, in spite of the substantial need for change, present the players involved with any insurmountable problems but, rather, constitutes both a challenge and an opportunity. Such a development is possible only if the efforts launched to give momentum to the increased use of renewable energy sources are continued consistently, the impending need for replacement and renewal within the generation system is consistently utilised for increasing efficiency and a reorientation mainly towards combined heat and power production, and energy saving is made a new focal point of energy policy. Furthermore, with regard to long-term infrastructure requirements (decentralisation, new fuels), the necessary decisions must be prepared at an early stage and sufficiently robust lines of development must be identified and followed. (orig.) [de

  11. Long Term Cost Efficiency through Green Management Control Systems

    OpenAIRE

    Vukania Adda, Nancy; Qin, Xiaochen

    2012-01-01

    Title: Long term cost efficiency through green management control systems.Authors: Nancy Vukania &Xiaochen QinSupervisor: Åsa Karin-EngstrandBackground: The worldwide financial crisis of 2008 has reconfigured the economic turf leading to a more uncertain and turbulent playing field – a greater challenge for business strategy and the quest for optimization- The oil price hike of 2008 (Furlong 2010)1 caused its rippling effect to affect various cost categories including energy, labor and lo...

  12. Levee Setbacks: An Innovative, Cost Effective, and Sustainable Solution for Improved Flood Risk management

    Science.gov (United States)

    2017-06-30

    ER D C/ EL S R- 17 -3 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management En vi...EL SR-17-3 June 2017 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management David L. Smith...alternative view point is necessary. ERDC/EL SR-17-3 4 Levee setbacks are a relatively recent innovation in Corps flood risk management practice

  13. Analyzing Primary Social Studies Curriculum of Turkey in Terms of UNESCO Educational for Sustainable Development Theme

    OpenAIRE

    Elvan YALÇINKAYA

    2013-01-01

    These three terms have been used at website of UNESCO: Sustainable development(SD), education for sustainable development (ESD) and the United Nations Decade ofEducation for Sustainable Development (DESD). In this website, it is mentioned that thethree terms have the same goal; creating abetter world for this generation and futuregenerations of all living things on planet Earth. The aim of this study is to analyzePrimary Social Studies Curriculum of Turkeyin terms of UNESCO ESD Theme. Datawas...

  14. Medium-term marginal costs in competitive generation power markets

    International Nuclear Information System (INIS)

    Reneses, J.; Centeno, E.; Barquin, J.

    2004-01-01

    The meaning and significance of medium-term marginal costs for a generation company in a competitive power market in analysed. A methodology to compute and decompose medium-term generation marginal costs in a competitive environment is proposed. The methodology is based on a market equilibrium model. The aim is to provide a useful tool for generation companies so that they can manage their resources in an optimal way, helping them with their operation, decision-making processes, asset valuations or contract assessments. (author)

  15. Evaluation of sustainable walk-up flats in terms of urban housing renewal in coastal area

    Science.gov (United States)

    Septanti, D.; Kisnarini, R.; Setyawan, W.; Utami, ASPR

    2018-03-01

    Urban housing renewal aims to get added value while maintaining the sustainability of its environmental function and quality [4]. This research discusses the urban renewal which is done by rebuilding the affected area with walk-up flats. There are four aspects to be considered in achieving sustainability, namely: environmental, social, economic, and cultural [14]. This study is focused on cultural aspect. Sustainable walk-up flats, viewed from the micro context perspective, can later be used as one of the terms of reference in assessing the success of urban renewal projects in Indonesia. Especially in coastal areas, it becomes more challenging because coastal communities have different characteristics and the existing urban renewal flats are not necessarily appropriate for the coastal community. The methods used in this study are explorative, descriptive, ex- post, cross-sectional and synchronic evaluation. This research describes the characteristics of citizens, activities at home and the environment. Thus, the conclusions which are drawn by deductive reasoning are done using frequency, mean, etc. A mixed research method is applied combining with the analysis of quantitative and qualitative data collection and interpretation, including determining quantitative indicators and space design attributes, and qualitative user needs. This research is located in Surabaya as a sample of coastal cities with urban and environmental problems. The results of this study are the findings of indicators, directions, and concepts for Sustainable Housing Development in Coastal Areas which further can be made as scientific recommendation (to support the Housing Theory and Urban Renewal) and contribute to practical guidelines for sustainable low-cost walk-up flats in coastal areas.

  16. Sustainable Living in Long-Term Care: For People with Dementia/Alzheimer's

    Science.gov (United States)

    Simmons, Daniela

    2011-01-01

    Nonhome-based long-term care sustainable living arrangements for elderly people with Alzheimer's is presented. Characteristics contributing to sustainability are discussed. The ultimate goal in sustainable design for older adult communities is a people-centered model of care in environments that improve their quality of life. Without sustainable…

  17. GREEN CONCEPTS AND MATERIAL FLOW COST ACCOUNTING APPLICATION FOR COMPANY SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Rochman Marota

    2017-02-01

    Full Text Available Health equipment and furniture become a complementary factor for good health services to the communities. Management of health equipment and furniture is started by manufacturers within the industry scope and sustainable business processes. This study aimed to apply green concepts and MFCA at PT XYZ, and to analyze their effects on the dimensions of the company sustainability. To measure the effects of green concepts and MFCA on the dimensions of corporate sustainability, a multiple regression analysis was used. The analysis showed that they gave significant effects from the results of the F test, t test and probability test. From these results, a number of suggestions for improvement of production process performance as managerial implications for maintaining the stability of the company sustainability index were formulated.Keywords: efficiency and effectiveness of production cost, green concepts, the company sustainability, material flow cost accounting

  18. The Costs of Using Draft Animals for Sustainable Agricultural ...

    African Journals Online (AJOL)

    The area with tradition in cattle keeping has advantage of low cost by 39% less as compared to area with little tradition. It was concluded that animal traction technology is more suitable both socially and economically viable for farmers with tradition in animal keeping. Other technologies such as the use of single axle tractors ...

  19. Quantifying the external cost of oil consumption within the context of sustainable development

    International Nuclear Information System (INIS)

    Abdel Sabour, S.A.

    2005-01-01

    The concept of sustainability implies that the flow of services derived from the use of natural capital must be constant over time and should be obtained at a constant price. For a depletable resource such as oil, the future generations are highly impacted due to the consumption behavior of the current generation. Since the ultimate oil stock within the Earth declines with cumulative consumption, excessive consumption of oil now reduces the availability of oil for future needs. Moreover, since oil reserves are normally extracted in the order of ascending cost and descending quality, excessive consumption of relatively high-quality, cheap oil reserves by the current generation raises the cost at which future generations can meet their needs of oil and hence imposes an external cost on the future generations. This study aims to quantify the external cost of consuming a barrel of oil within the context of sustainable development. An option-pricing model is developed to quantify this external cost assuming that the external cost of consuming a barrel of oil now equals the value of the option to get a barrel of oil in the future at the same current cost. Then, the total cost of consuming a barrel of oil now, that should be used in lifecycle costing to design more sustainable products, is the summation of the oil price and the external cost

  20. Evaluating strategies for sustainable intensification of US agriculture through the Long-Term Agroecosystem Research network

    Science.gov (United States)

    Spiegal, S.; Bestelmeyer, B. T.; Archer, D. W.; Augustine, D. J.; Boughton, E. H.; Boughton, R. K.; Cavigelli, M. A.; Clark, P. E.; Derner, J. D.; Duncan, E. W.; Hapeman, C. J.; Harmel, R. D.; Heilman, P.; Holly, M. A.; Huggins, D. R.; King, K.; Kleinman, P. J. A.; Liebig, M. A.; Locke, M. A.; McCarty, G. W.; Millar, N.; Mirsky, S. B.; Moorman, T. B.; Pierson, F. B.; Rigby, J. R.; Robertson, G. P.; Steiner, J. L.; Strickland, T. C.; Swain, H. M.; Wienhold, B. J.; Wulfhorst, J. D.; Yost, M. A.; Walthall, C. L.

    2018-03-01

    Sustainable intensification is an emerging model for agriculture designed to reconcile accelerating global demand for agricultural products with long-term environmental stewardship. Defined here as increasing agricultural production while maintaining or improving environmental quality, sustainable intensification hinges upon decision-making by agricultural producers, consumers, and policy-makers. The Long-Term Agroecosystem Research (LTAR) network was established to inform these decisions. Here we introduce the LTAR Common Experiment, through which scientists and partnering producers in US croplands, rangelands, and pasturelands are conducting 21 independent but coordinated experiments. Each local effort compares the outcomes of a predominant, conventional production system in the region (‘business as usual’) with a system hypothesized to advance sustainable intensification (‘aspirational’). Following the logic of a conceptual model of interactions between agriculture, economics, society, and the environment, we identified commonalities among the 21 experiments in terms of (a) concerns about business-as-usual production, (b) ‘aspirational outcomes’ motivating research into alternatives, (c) strategies for achieving the outcomes, (d) practices that support the strategies, and (e) relationships between practice outreach and adoption. Network-wide, concerns about business as usual include the costs of inputs, opportunities lost to uniform management approaches, and vulnerability to accelerating environmental changes. Motivated by environmental, economic, and societal outcomes, scientists and partnering producers are investigating 15 practices in aspirational treatments to sustainably intensify agriculture, from crop diversification to ecological restoration. Collectively, the aspirational treatments reveal four general strategies for sustainable intensification: (1) reducing reliance on inputs through ecological intensification, (2) diversifying management

  1. Cost Based Value Stream Mapping as a Sustainable Construction Tool for Underground Pipeline Construction Projects

    Directory of Open Access Journals (Sweden)

    Murat Gunduz

    2017-11-01

    Full Text Available This paper deals with application of Value Stream Mapping (VSM as a sustainable construction tool on a real construction project of installation of underground pipelines. VSM was adapted to reduce the high percentage of non-value-added activities and time wastes during each construction stage and the paper searched for an effective way to consider the cost for studied construction of underground pipeline. This paper is unique in its way that it adopts cost implementation of VSM to improve the productivity in underground pipeline projects. The data was observed and collected from site during construction, indicating the cycle time, value added and non-value added of each construction stage. The current state was built based on these details. This was an eye-opening exercise and a process management tool as a trigger for improvement. After the current state assessment, a future state is attempted by Value Stream Mapping tool balancing the resources using a Line of Balance (LOB technique. Moreover, a sustainable cost estimation model was developed during current state and future state to calculate the cost of underground pipeline construction. The result shows a cost reduction of 20.8% between current and future states. This reflects the importance of the cost based Value Stream Mapping in construction as a sustainable measurement tool. This new tool could be utilized in construction industry to add the sustainability and effective cost management.

  2. Construction cost prediction model for conventional and sustainable college buildings in North America

    Directory of Open Access Journals (Sweden)

    Othman Subhi Alshamrani

    2017-03-01

    Full Text Available The literature lacks in initial cost prediction models for college buildings, especially comparing costs of sustainable and conventional buildings. A multi-regression model was developed for conceptual initial cost estimation of conventional and sustainable college buildings in North America. RS Means was used to estimate the national average of construction costs for 2014, which was subsequently utilized to develop the model. The model could predict the initial cost per square feet with two structure types made of steel and concrete. The other predictor variables were building area, number of floors and floor height. The model was developed in three major stages, such as preliminary diagnostics on data quality, model development and validation. The developed model was successfully tested and validated with real-time data.

  3. BUSINESS VALUATION IN TERMS OF INDICATORS OF SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Leontina Pavaloaia

    2013-03-01

    Full Text Available The indexes regarding the sustainable development have an important role in the decision-making process and that is why several bodies and institutions are concerned about their development. This fact happens not only at macro-level, but also at micro-level, the entities being encouraged to take into account the sustainable development principles and to relate its individual performances to the environment in which they operate (local, regional, global. The usage of the indexes regarding the sustainable development offers information regarding the evolution in time helps at identifying the possibilities of improving the activity and the weaknesses; they can be used in order to establish and achieve the objectives, the values being easily communicated both within and outside the company. A main disadvantage is the aggregation level, which hinders comparisons. This paper analyzes the information regarding the sustainable development published by the companies ranked at the Stock Exchange of Bucharest in the 1st category and the subsidiaries of 30 national companies.

  4. Life Cycle Costing in Sustainability Assessment—A Case Study of Remanufactured Alternators

    Directory of Open Access Journals (Sweden)

    Annekatrin Lehmann

    2011-11-01

    Full Text Available Sustainability is on the international agenda, and is a driver for industry in international competition. Sustainability encompasses the three pillars: environment, society and economy. To prevent shifting of burden, the whole life cycle needs to be taken into account. For the environmental dimension of sustainability, life cycle assessment (LCA has been practiced for a while and is a standardized method. A life cycle approach for the social and economic pillars of sustainability needs to be further developed. This paper investigates the application of life cycle costing (LCC as part of a wider sustainability assessment where also social life cycle assessment (SLCA and LCA are combined. LCA-type LCC is applied on a case study of remanufactured alternators. Remanufacturing of automobile parts is a fast growing important business with large potential for cost and resource savings. Three design alternatives for the alternator and three locations for the remanufacturing plant are evaluated. The remanufacturer perspective and the user perspective are investigated. The results for the LCA-type LCC show that the largest cost for the remanufacturer is the new parts replacing old warn parts. However, the user cost, and therein especially, cost for fuel used for the alternator’s power production dominates and should be the focus for further improvement. In conducting the case study, it was revealed that the connection between the LCA-type LCC results and the economic dimension of sustainability needs to be further investigated and defined. For this purpose, areas of protection for life cycle sustainability assessment and LCA-type LCC in particular need further development.

  5. THE KNOWLEDGE OF ROMANIAN AGRICULTURE IN TERMS OF SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Iuliana DOBRE

    2013-01-01

    Full Text Available Agriculture, a key component of the structure of economic branches, should be addressed directly related to the maintenance of natural resources and their exploitation in a controlled way or the enhancement of their own, without resorting to inconsistent stimulus elements that can in time generate dysfunctions in products and the environment. Looking at things from this perspective, there is a need for a sustainable agriculture approach, given its social, ecological and economic representativeness, with active and continuous character.

  6. Sustainability.

    Science.gov (United States)

    Chang, Chein-Chi; DiGiovanni, Kimberly; Mei, Ying; Wei, Li

    2016-10-01

    This review on Sustainability covers selected 2015 publications on the focus of Sustainability. It is divided into the following sections : • Sustainable water and wastewater utilities • Sustainable water resources management • Stormwater and green infrastructure • Sustainability in wastewater treatment • Life cycle assessment (LCA) applications • Sustainability and energy in wastewater industry, • Sustainability and asset management.

  7. Long-term cost targets for nuclear energy

    International Nuclear Information System (INIS)

    Rogner, H.H.; McDonald, A.

    2004-01-01

    In 2000 the International Atomic Energy Agency (IAEA) began the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) to help guide nuclear R and D strategies targeted on anticipated mid-century energy system needs. One part of INPRO seeks to develop cost targets for new designs to be competitive in mid-century markets. The starting point was the 40 scenarios of the Special Report on Emissions Scenarios (SRES) of the Intergovernmental Panel on Climate Change. This paper summarizes four of the SRES scenarios, one from each of the four SRES scenario families. It discusses their implications for nuclear energy, including cost targets, and develops for each an 'aggressive nuclear' variant. The aggressive nuclear variants estimate the potential market for nuclear energy if, by improving faster than assumed by the SRES authors, nuclear energy can make inroads into vulnerable market shares projected for its competitors. In addition to projected demands for nuclear generated electricity, hydrogen and heat, the aggressive variants include prospective demand for nuclear desalination and use in upgrading fossil fuels. The paper then presents learning rates and implied cost targets consistent with the aggressive nuclear variants of the SRES scenarios. One provocative initial result is that many of the scenarios with substantial nuclear expansion do not seem to require big reductions in nuclear investment costs. One interpretation discussed at the end of the paper highlights the difference between cost reductions consistent with long-term energy system optimization based on perfect foresight, and cost reductions necessary to attract private investment in today's 'deregulating' and uncertain energy markets. (orig.)

  8. Evaluation of nuclear power development scenarios in romania envisaging the long-term national energy sustainability

    International Nuclear Information System (INIS)

    Margeanu, C.; Apostol, M.; Visan, I.; Prodea, I.

    2015-01-01

    The paper summarizes the results of RATEN ICN Pitesti experts' activities in the IAEA's Collaborative Project INPRO-SYNERGIES. Romanian study proposes to evaluate and analyze development of the nuclear capacity and increasing of its share in national energy sector, envisaging the long term national and regional energy sustainability by keeping options open for the future while bringing solutions to short/medium-term challenges. The study focused on the modelling of national NES (Nuclear Energy System) development on short and medium-term (time horizon 2050), considering the existing NFC (Nuclear Fuel Cycle) infrastructure and legislation, provisions of strategic documents in force and including also the possibility of regional collaboration regarding U/fresh fuel supply and SF (Spent Fuel) storage, as services provided at international market prices. The energy system modelling was realized by using the IAEA's MESSAGE program. The study results offer a clear image and also the possible answer to several key questions regarding: potential of nuclear energy to participate with an important share in national energy mix, in conditions of cost competitiveness, safety and security of supply; impact on national energy mix portfolio of capacities and electricity production; impact on Uranium domestic resources; economic projection/investments needed for new nuclear capacities addition; fresh fuel requirements for nuclear capacities; SF annually discharged and transferred to interim wet storage for cooling; SF volume in interim dry storage, etc. (authors)

  9. Sustainable development at tax-deductible costs or how to assure sustainable development by one’s way of living

    Directory of Open Access Journals (Sweden)

    Willem Adrianus de Bruijn

    2006-08-01

    Full Text Available The purpose of this paper is to demonstrate that an imperative demand for an existence in harmony with Nature is created when the costs incurred for such an existence can be deducted from taxable income. All reasonable consumers who pay income taxes will then be driven to buy tax-deductible products. Producers will have to satisfy this demand. They will also have to justify their products’ characteristics, which assure sustainable development and to identify the costs which are associated with these qualities. The consumer needs to know which percentage of the purchase price he paid corresponds with the environmental cost free quality of the merchandise, in order for him to deduct the consequent amount from his taxable income. The theory underlying the deductibility of costs of living from taxable income is based on the following three assumptions: The goal of development is constantly determined by the purchases of consumers. Currently, the only goal with which consumers spend their income seems to be the one of consuming more. The recurring ecological crises reveal that it is impossible to continue to consume more of limited resources without eventually exhausting them. One of the functions of the consumer in the economy is to maintain a way of living which assures sustainable development. The principle of efficiency of economy, according to which the efficient place to manage any cost is at the source of the revenues which costs sustain. This paper also presents a practical and feasible application of our ideas. The creation of a way of living qualifies as research if it is achieved within the context of a scientific project with the cooperation of, in particular, academic institutions. Such a project could be operated within the context of the UNECE 1998 Aarhus Convention on Access to Information, Public Participation in Decision-making and Access to Justice in Environmental Matters, signed by Romania on 25 June 1998 and already ratified

  10. Technologies for sustainable energy development in the long term. Proceedings

    DEFF Research Database (Denmark)

    Sønderberg Petersen, Leif; Larsen, Hans Hvidtfeldt

    2005-01-01

    The Risø International Energy Conference took place 23 - 25 May 2005 and the aim of the conference was to present and discuss new developments and trends in energy technologies which may make major contributions to sustainable energy developments in thecoming decades. The conference addressed R......&D related to the individual technologies as well as their integration into the local, regional and global energy systems. The proceedings are prepared from papers presented at the conference and received withcorrections, if any, until the final deadline on 15 June 2005....

  11. RED BULL: the Long term Business Sustainable Plan

    OpenAIRE

    Dhanasarnsombati, Tas

    2011-01-01

    According to number of studies shows that food and beverage market is one of the most sustainable markets of them all. As majority of super-power supermarkets continue to increase their profits, proven that despite either the up or down-turn of the economic situations, food and beverage always will be the basic need to everyone. However with the food and beverage products keep emerging though out rapidly into the market, leaving consumers with numbers of choices to choose to purchase. In the ...

  12. Sustainability of Long-term Care: Puzzling Tasks Ahead for Policy-Makers.

    Science.gov (United States)

    Mosca, Ilaria; van der Wees, Philip J; Mot, Esther S; Wammes, Joost J G; Jeurissen, Patrick P T

    2016-08-17

    The sustainability of long-term care (LTC) is a prominent policy priority in many Western countries. LTC is one of the most pressing fiscal issues for the growing population of elderly people in the European Union (EU) Member States. Country recommendations regarding LTC are prominent under the EU's European Semester. This paper examines challenges related to the financial- and organizational sustainability of LTC systems in the EU. We combined a targeted literature review and a descriptive selected country analysis of: (1) public- and private funding; (2) informal care and externalities; and (3) the possible role of technology in increasing productivity. Countries were selected via purposive sampling to establish a cohort of country cases covering the spectrum of differences in LTC systems: public spending, private funding, informal care use, informal care support, and cash benefits. The aging of the population, the increasing gap between availability of informal care and demand for LTC, substantial market failures of private funding for LTC, and fiscal imbalances in some countries, have led to structural reforms and enduring pressures for LTC policy-makers across the EU. Our exploration of national policies illustrates different solutions that attempt to promote fairness while stimulating efficient delivery of services. Important steps must be taken to address the sustainability of LTC. First, countries should look deeper into the possibilities of complementing public- and private funding, as well as at addressing market failures of private funding. Second, informal care externalities with spill-over into neighboring policy areas, the labor force, and formal LTC workers, should be properly addressed. Thirdly, innovations in LTC services should be stimulated to increase productivity through technology and process innovations, and to reduce costs. The analysis shows why it is difficult for EU Member State governments to meet all their goals for sustainable LTC

  13. An ethical dimension to sustainable restoration and long-term management of contaminated areas

    International Nuclear Information System (INIS)

    Oughton, Deborah; Forsberg, Ellen-Marie; Bay, Ingrid; Kaiser, Matthias; Howard, Brenda

    2004-01-01

    Experience after the Chernobyl accident has shown that restoration strategies need to consider a wide range of different issues to ensure the long-term sustainability of large and varied contaminated areas. Thus, the criteria by which we evaluate countermeasures need to be extended from simple cost-benefit effectiveness and radiological protection standards to a more integrated, holistic approach, including social and ethical aspects. Within the STRATEGY project, the applicability of many countermeasures is being critically assessed using a wide range of criteria. Attention is being given to issues such as practicability, feasibility, capacity and environmental side-effects, as well as social factors such as public perceptions of risk, communication of information and the need for dialogue and consultation with affected communities, and ethical aspects such as informed consent and the fair distribution of costs and doses. Although such socio-ethical factors are now the subject of a substantial field of research, there has been little attempt to integrate them in a practical context for decision makers. Within this paper, we specifically consider the ethical aspects of restoration strategies and suggest practical means by which these can be taken into account in the decision making process, introducing a value matrix. The paper covers two critical areas: evaluation of individual countermeasures, and use of the matrix to ensure transparent and systematic consideration of values in selection of a restoration strategy

  14. Surplus, Scarcity and Soil Fertility in Pre-Industrial Austrian Agriculture—The Sustainability Costs of Inequality

    Directory of Open Access Journals (Sweden)

    Michael Gizicki-Neundlinger

    2017-02-01

    Full Text Available This paper takes a Long-Term Socio-Ecological Research (LTSER perspective to integrate important aspects of social inequality into Socio-Ecological Metabolism (SEM research. SEM has dealt with biophysical features of pre-industrial agricultural systems from a largely apolitical perspective, neglecting social relations and conditions of peasant production and reproduction. One of the politically and economically most important manorial systems in Early Modern Austria (Grundherrschaft Grafenegg serves as a case study to reconstruct the unequal distribution of central resources between ruling landlords and subjected peasants. We show that peasant land use systems generated small surpluses only, whereas landlords enjoyed significant economies of scale. Furthermore, we explore what these conditions of landlord surplus and peasant scarcity implied for their respective agro-ecological sustainability. Finally, we argue that within pre-industrial agrarian systems sustainability costs of inequality were severely limiting margins for agricultural intensification and growth of peasant economies.

  15. A Sustainable Outsourcing Strategy Regarding Cost, Capacity Flexibility, and Risk in a Textile Supply Chain

    Directory of Open Access Journals (Sweden)

    Shaheen Sardar

    2016-03-01

    Full Text Available The textile industry achieves economic benefits through outsourcing to low cost markets. Today, reshoring is an emerging trend due to rising cost and unemployment concerns. This problem is primarily due to an industry-wide focus on economic benefits only. Cost saving is a basic reason for international outsourcing while domestic outsourcing provides capacity flexibility. Moreover, outsourcing risk has a major impact on strategic location of the production destinations. Therefore, the merging of capacity flexibility and outsourcing risk comprises a sustainable outsourcing strategy. This paper suggests a sustainable outsourcing strategy in which a textile manufacturer outsources to international markets for cost savings and outsources to the domestic market for capacity flexibility. The manufacturer reserves some capacity with domestic suppliers, and pays a unit penalty cost if this capacity flexibility is not utilized. The manufacturer seeks minimum risk in international markets. Operational cost, penalty cost, and outsourcing risk are considered to be objective functions. Decisions include the assignment of contracts to suitable facilities, the quantity of each contract, and allocation of reserved capacity flexibility among domestic suppliers. Multi-objective problem of this research was solved using three variants of goal programming. Several insights are proposed for outsourcing decision making in the current global environment.

  16. Compromise between Short- and Long-Term Financial Sustainability: A Hybrid Model for Supporting R&D Decisions

    Directory of Open Access Journals (Sweden)

    Kao-Yi Shen

    2017-03-01

    Full Text Available The debate of “short-termism” has gained increasing interests from various fields, ranging from management to economics; it mainly concerns the decisions or actions taken by businesses that might yield short-term returns at the cost of long-term value or sustainability. Previous studies have highlighted this dilemma faced by managers, mainly from the pressure of capital markets or short-sighted shareholders who crave for immediate financial outcomes; intelligent decision aids that can compromise between the short- and long-term financial sustainability, based on a company’s policy, are highly needed. Therefore, the aim of this study is to develop a multiple-rule-based hybrid decision model to support management teams on prioritizing new R&D projects, considering the financial prospects in dual timeframes (i.e., short- and long-term for sustainability. Furthermore, in the presence of business uncertainty and the limited knowledge of managers on new projects, the intuitionistic fuzzy technique is incorporated. A case of selecting new R&D projects for an IC design company is illustrated using the proposed approach, and the financial data from a group of public-listed IC stocks from Taiwan are inducted to form the decision model. The findings not only support the IC design company to select new projects but also provide business insights to facilitate the understandings of this controversial issue in managerial practice.

  17. Cost Accounting as a Possible Solution for Financial Sustainability of Croatian Public Hospitals

    Directory of Open Access Journals (Sweden)

    Ivana Dražić Lutilsky

    2016-12-01

    Full Text Available The purpose of this paper is to present the current usage of cost accounting methodology in Croatian public hospitals through conducted empirical research and to provide opinions of accountants and financial officers regarding possible implementation of cost accounting methodology in public hospitals. In the paper, the authors analyze the accounting system in Croatian public hospitals, identifying the flaws of the current accounting system with regard to the recording and allocation of costs. National healthcare systems of different European countries provide a theoretical background for the usage of accrual accounting basis and cost accounting methodologies, showing better governance and financial sustainability of public hospitals which have introduced cost accounting methodology. The conducted empirical research shows that accountants and financial officers believe that the healthcare system in Croatia is ready for a change in the current accounting system based on the modified accrual basis through the implementation of accrual accounting basis and full costing approach to cost allocation. Full costing approach is also known as activity-based accounting method for cost allocation. The authors also recommend some initial steps for implementation of the new cost accounting system in Croatian public hospitals.

  18. IMPROVING BIOMASS LOGISTICS COST WITHIN AGRONOMIC SUSTAINABILITY CONSTRAINTS AND BIOMASS QUALITY TARGETS

    Energy Technology Data Exchange (ETDEWEB)

    J. Richard Hess; Kevin L. Kenney; Christopher T. Wright; David J. Muth; William Smith

    2012-10-01

    Equipment manufacturers have made rapid improvements in biomass harvesting and handling equipment. These improvements have increased transportation and handling efficiencies due to higher biomass densities and reduced losses. Improvements in grinder efficiencies and capacity have reduced biomass grinding costs. Biomass collection efficiencies (the ratio of biomass collected to the amount available in the field) as high as 75% for crop residues and greater than 90% for perennial energy crops have also been demonstrated. However, as collection rates increase, the fraction of entrained soil in the biomass increases, and high biomass residue removal rates can violate agronomic sustainability limits. Advancements in quantifying multi-factor sustainability limits to increase removal rate as guided by sustainable residue removal plans, and mitigating soil contamination through targeted removal rates based on soil type and residue type/fraction is allowing the use of new high efficiency harvesting equipment and methods. As another consideration, single pass harvesting and other technologies that improve harvesting costs cause biomass storage moisture management challenges, which challenges are further perturbed by annual variability in biomass moisture content. Monitoring, sampling, simulation, and analysis provide basis for moisture, time, and quality relationships in storage, which has allowed the development of moisture tolerant storage systems and best management processes that combine moisture content and time to accommodate baled storage of wet material based upon “shelf-life.” The key to improving biomass supply logistics costs has been developing the associated agronomic sustainability and biomass quality technologies and processes that allow the implementation of equipment engineering solutions.

  19. Sustainability of Long-term Care: Puzzling Tasks Ahead for Policy-Makers

    Directory of Open Access Journals (Sweden)

    Ilaria Mosca

    2017-04-01

    Full Text Available Background The sustainability of long-term care (LTC is a prominent policy priority in many Western countries. LTC is one of the most pressing fiscal issues for the growing population of elderly people in the European Union (EU Member States. Country recommendations regarding LTC are prominent under the EU’s European Semester. Methods This paper examines challenges related to the financial- and organizational sustainability of LTC systems in the EU. We combined a targeted literature review and a descriptive selected country analysis of: (1 public- and private funding; (2 informal care and externalities; and (3 the possible role of technology in increasing productivity. Countries were selected via purposive sampling to establish a cohort of country cases covering the spectrum of differences in LTC systems: public spending, private funding, informal care use, informal care support, and cash benefits. Results The aging of the population, the increasing gap between availability of informal care and demand for LTC, substantial market failures of private funding for LTC, and fiscal imbalances in some countries, have led to structural reforms and enduring pressures for LTC policy-makers across the EU. Our exploration of national policies illustrates different solutions that attempt to promote fairness while stimulating efficient delivery of services. Important steps must be taken to address the sustainability of LTC. First, countries should look deeper into the possibilities of complementing public- and private funding, as well as at addressing market failures of private funding. Second, informal care externalities with spill-over into neighboring policy areas, the labor force, and formal LTC workers, should be properly addressed. Thirdly, innovations in LTC services should be stimulated to increase productivity through technology and process innovations, and to reduce costs. Conclusion The analysis shows why it is difficult for EU Member State

  20. The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

    Science.gov (United States)

    Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

    2015-01-01

    PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

  1. The cost of sustaining a patient-centered medical home: experience from 2 states.

    Science.gov (United States)

    Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

    2015-09-01

    As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

  2. Early Stage Design Decisions: The Way to Achieve Sustainable Buildings at Lower Costs

    Directory of Open Access Journals (Sweden)

    Luís Bragança

    2014-01-01

    Full Text Available The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle.

  3. Early stage design decisions: the way to achieve sustainable buildings at lower costs.

    Science.gov (United States)

    Bragança, Luís; Vieira, Susana M; Andrade, Joana B

    2014-01-01

    The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle.

  4. Early Stage Design Decisions: The Way to Achieve Sustainable Buildings at Lower Costs

    Science.gov (United States)

    Bragança, Luís; Vieira, Susana M.; Andrade, Joana B.

    2014-01-01

    The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle. PMID:24578630

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  6. Nursing unit leaders' influence on the long-term sustainability of evidence-based practice improvements.

    Science.gov (United States)

    Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

    2016-04-01

    To describe how actions of nursing unit leaders influenced the long-term sustainability of a best practice guidelines (BPG) program on inpatient units. Several factors influence the initial implementation of evidence-based practice improvements in nursing, with leadership recognized as essential. However, there is limited knowledge about enduring change, including how frontline nursing leaders influence the sustainability of practice improvements over the long term. A qualitative descriptive case study included 39 in-depth interviews, observations, and document reviews. Four embedded nursing unit subcases had differing levels of program sustainability at 7 years (average) following implementation. Higher levels of BPG sustainability occurred on units where formal leadership teams used an integrated set of strategies and activities. Two key strategies were maintaining priorities and reinforcing expectations. The coordinated use of six activities (e.g., discussing, evaluating, integrating) promoted the continuation of BPG practices among staff. These leadership processes, fostering exchange and learning, contributed to sustainability-promoting environments characterized by teamwork and accountability. Unit leaders are required to strategically orchestrate several overlapping and synergistic efforts to achieve long-term sustainability of BPG-based practice improvements. As part of managing overall unit performance, unit leaders may influence practice improvement sustainability by aligning vision, strategies, and activities. © 2015 John Wiley & Sons Ltd.

  7. Compromising Long-Term Sustainability for Short-Term Profit Maximization: Unethical Business Practice

    Directory of Open Access Journals (Sweden)

    Doorasamy Mishelle

    2016-01-01

    Full Text Available The current environmental challenges caused by the dependence on nonrenewable energy, increased waste disposal, the toxic emissions created by operational activities, and also the scarce supply of water are so complex and important that it requires immediate attention. Strict environmental legislation, market pressures, and urgent need for sustainability have given businesses no option but to ensure that they do all that is possible to ensure that their business operations are sustainable. This paper addresses the underlying factors that determine the extent to which organizations adopt sustainable business practices and cleaner production techniques and technologies. It had been concluded that ethics is linked to sustainable business practices, because the objectives of both these concepts are to think about doing what’s right for others and the world, including the environment. According to the organizational corporate compliance regulations, a company’s commitment to ethical business and sustainable business practices should be detailed in their policy handbook and communicated to all employees within the company (Sustainability Report 2013/2014.

  8. Quantifying the Short-Term Costs of Conservation Interventions for Fishers at Lake Alaotra, Madagascar.

    Directory of Open Access Journals (Sweden)

    Andrea P C Wallace

    Full Text Available Artisanal fisheries are a key source of food and income for millions of people, but if poorly managed, fishing can have declining returns as well as impacts on biodiversity. Management interventions such as spatial and temporal closures can improve fishery sustainability and reduce environmental degradation, but may carry substantial short-term costs for fishers. The Lake Alaotra wetland in Madagascar supports a commercially important artisanal fishery and provides habitat for a Critically Endangered primate and other endemic wildlife of conservation importance. Using detailed data from more than 1,600 fisher catches, we used linear mixed effects models to explore and quantify relationships between catch weight, effort, and spatial and temporal restrictions to identify drivers of fisher behaviour and quantify the potential effect of fishing restrictions on catch. We found that restricted area interventions and fishery closures would generate direct short-term costs through reduced catch and income, and these costs vary between groups of fishers using different gear. Our results show that conservation interventions can have uneven impacts on local people with different fishing strategies. This information can be used to formulate management strategies that minimise the adverse impacts of interventions, increase local support and compliance, and therefore maximise conservation effectiveness.

  9. On the transition to sustainability: an analysis of the costs of school feeding compared with the costs of primary education.

    Science.gov (United States)

    Bundy, Donald; Burbano, Carmen; Gelli, Aulo; Risley, Claire; Neeser, Kristie

    2011-09-01

    The current food, fuel, and financial crises have highlighted the importance of school feeding programs both as a social safety net for children living in poverty and food insecurity, and as part of national educational policies and plans. To examine the costs of school feeding, in terms of both the absolute cost per child and the cost per child relative to overall education expenditure and gross domestic product (GDP) in low-, middle-, and high-income countries. Data on the costs of school feeding in different countries were collected from multiple sources, including World Food Programme project data, reports from government ministries, and, where such searches failed, newspaper articles and other literature obtained from internet searches. Regression models were then used to analyze the relationships between school feeding costs, the per capita costs of primary education and GDP per capita. School feeding programs in low-income countries exhibit large variations in cost, with concomitant opportunities for cost containment. As countries get richer, however, school feeding costs become a much smaller proportion of the investment in education. The per capita costs of feeding relative to education decline nonlinearly with increasing GDP. These analyses suggest that the main reason for this decline in the relative cost of school feeding versus primary education is a greatly increased investment per child in primary education as GDP rises, but a fairly flat investment in food. The analyses also show that there appears to be a transitional discontinuity at the interface between the lower- and middle-income countries, which tends to coincide with changes in the capacity of governments to take over the management and funding of programs. Further analysis is required to define these relationships, but an initial conclusion is that supporting countries to maintain an investment in school feeding through this transition may emerge as a key role for development partners.

  10. The STRATEGY project: decision tools to aid sustainable restoration and long-term management of contaminated agricultural ecosystems.

    Science.gov (United States)

    Howard, B J; Beresford, N A; Nisbet, A; Cox, G; Oughton, D H; Hunt, J; Alvarez, B; Andersson, K G; Liland, A; Voigt, G

    2005-01-01

    The STRATEGY project (Sustainable Restoration and Long-Term Management of Contaminated Rural, Urban and Industrial Ecosystems) aimed to provide a holistic decision framework for the selection of optimal restoration strategies for the long-term sustainable management of contaminated areas in Western Europe. A critical evaluation was carried out of countermeasures and waste disposal options, from which compendia of state-of-the-art restoration methods were compiled. A decision support system capable of optimising spatially varying restoration strategies, that considered the level of averted dose, costs (including those of waste disposal) and environmental side effects was developed. Appropriate methods of estimating indirect costs associated with side effects and of communicating with stakeholders were identified. The importance of stakeholder consultation at a local level and of ensuring that any response is site and scenario specific were emphasised. A value matrix approach was suggested as a method of addressing social and ethical issues within the decision-making process, and was designed to be compatible with both the countermeasure compendia and the decision support system. The applicability and usefulness of STRATEGY outputs for food production systems in the medium to long term is assessed.

  11. The STRATEGY project: decision tools to aid sustainable restoration and long-term management of contaminated agricultural ecosystems

    International Nuclear Information System (INIS)

    Howard, B.J.; Beresford, N.A.; Nisbet, A.; Cox, G.; Oughton, D.H.; Hunt, J.; Alvarez, B.; Andersson, K.G.; Liland, A.; Voigt, G.

    2005-01-01

    The STRATEGY project (Sustainable Restoration and Long-Term Management of Contaminated Rural, Urban and Industrial Ecosystems) aimed to provide a holistic decision framework for the selection of optimal restoration strategies for the long-term sustainable management of contaminated areas in Western Europe. A critical evaluation was carried out of countermeasures and waste disposal options, from which compendia of state-of-the-art restoration methods were compiled. A decision support system capable of optimising spatially varying restoration strategies, that considered the level of averted dose, costs (including those of waste disposal) and environmental side effects was developed. Appropriate methods of estimating indirect costs associated with side effects and of communicating with stakeholders were identified. The importance of stakeholder consultation at a local level and of ensuring that any response is site and scenario specific were emphasised. A value matrix approach was suggested as a method of addressing social and ethical issues within the decision-making process, and was designed to be compatible with both the countermeasure compendia and the decision support system. The applicability and usefulness of STRATEGY outputs for food production systems in the medium to long term is assessed

  12. Reducing transport costs and improving sustainability simultaneously through horizontal logistics collaboration: a case study

    OpenAIRE

    Van Lier, Tom; Macharis, Cathy; Caris, An; Vrenken, Huub

    2010-01-01

    In this paper the potential of a more systematic bundling of the outbound freight flows out of three neighboring distribution centers (DCs) of the same company, each specialized in a specific product category and each using a separate planning system, is investigated. Most of the outbound flows are currently still transported by truck, so one way to simultaneously achieve lower transport costs and more sustainable logistics is through supply chain collaboration in outbound logistics. This pap...

  13. 48 CFR 1552.211-73 - Level of effort-cost-reimbursement term contract.

    Science.gov (United States)

    2010-10-01

    ...-reimbursement term contract. 1552.211-73 Section 1552.211-73 Federal Acquisition Regulations System... Provisions and Clauses 1552.211-73 Level of effort—cost-reimbursement term contract. As prescribed in 1511.011-73, insert the following contract clause in cost-reimbursement term contracts including cost...

  14. Evaluating strategies for sustainable intensification of U.S. agriculture through the Long-Term Agroecosystem Research network

    Science.gov (United States)

    Sustainable intensification is an emerging model for agriculture designed to reconcile accelerating global demand for agricultural products with long-term environmental stewardship. Defined here as increasing agricultural production while maintaining or improving environmental quality, sustainable i...

  15. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    Science.gov (United States)

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  16. Activity-Based Costing Using Multicriteria Drivers: An Accounting Proposal to Boost Companies Toward Sustainability

    Directory of Open Access Journals (Sweden)

    Heitor F. Marinho Neto

    2018-05-01

    Full Text Available Recognizing that natural environment is reaching its maximum limits in providing resources and diluting the waste generated by human production systems, efforts toward more sustainable production systems are mandatory to secure the development of future generations. For this purpose, changing the productivity model adopted by companies that are almost exclusively rooted on circulating money to generate profit, named business as usual, is an important issue. In this sense, an alternative would be establishing the relationship of stocks and flows of energy, material, and information with environmental, economic and social outcomes, thus resulting in new accounting approaches. This work aims to propose an activity-based costing (ABC based on multicriteria drivers including economic, emissions, and emergy (with an “m” values. The proposed ABC costing allocates each one of the multicriteria drivers into a specific part of the sustainability conceptual model, in an attempt to embrace a holistic perspective and allow for a sustainable-based decision, rather than considering purely economic drivers. The goal programming (GP method is considered so as to support a decision based on multicriteria aspects. Results show that the proposed accounting approach known as ABCsustain allows for decisions toward a company's sustainability by acting on both the amount and kind of a company's product that should be managed, as well as on the effective increase of a specific company's activity or process. The proposed ABCsustain could make the insertion of environmental issues into companies strategic planning more effective. It is expected that environmental issues go beyond a simple diagnoses and begin to be considered as action in factum in the companies' decisions toward achieving a more sustainable world system.

  17. Alternative windpower ownership structures: Financing terms and project costs

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, R.; Kahn, E.

    1996-05-01

    Most utility-scale renewable energy projects in the United States are developed and financed by private renewable energy companies. Electric output is then sold to investor-owned and public utilities under long-term contracts. Limited partnerships, sale/leaseback arrangements, and project-financing have historically been the dominant forms of finance in the windpower industry, with project-finance taking the lead more recently. Although private ownership using project-finance is still the most popular form of windpower development, alternative approaches to ownership and financing are becoming more prevalent. U.S. public and investor-owned electric utilities (IOUs) have begun to participate directly in windpower projects by owning and financing their own facilities rather than purchasing windpower from independent non-utility generators (NUGs) through power purchase agreements (PPAs). In these utility-ownership arrangements, the wind turbine equipment vendor/developer typically designs and constructs a project under a turnkey contract for the eventual project owner (the utility). The utility will also frequently sign an operations and maintenance (O&M) contract with the project developer/equipment vendor. There appear to be a number of reasons for utility involvement in recent and planned U.S. wind projects. One important claim is that utility ownership and self-finance provides substantial cost savings compared to contracting with private NUGs to supply wind-generated power. In this report, we examine that assertion.

  18. Towards sustainable groundwater use: Setting long-term goals, backcasting, and managing adaptively

    Science.gov (United States)

    Gleeson, T.; Alley, W.M.; Allen, D.M.; Sophocleous, M.A.; Zhou, Y.; Taniguchi, M.; Vandersteen, J.

    2012-01-01

    The sustainability of crucial earth resources, such as groundwater, is a critical issue. We consider groundwater sustainability a value-driven process of intra- and intergenerational equity that balances the environment, society, and economy. Synthesizing hydrogeological science and current sustainability concepts, we emphasize three sustainability approaches: setting multigenerational sustainability goals, backcasting, and managing adaptively. As most aquifer problems are long-term problems, we propose that multigenerational goals (50 to 100 years) for water quantity and quality that acknowledge the connections between groundwater, surface water, and ecosystems be set for many aquifers. The goals should be set by a watershed- or aquifer-based community in an inclusive and participatory manner. Policies for shorter time horizons should be developed by backcasting, and measures implemented through adaptive management to achieve the long-term goals. Two case histories illustrate the importance and complexity of a multigenerational perspective and adaptive management. These approaches could transform aquifer depletion and contamination to more sustainable groundwater use, providing groundwater for current and future generations while protecting ecological integrity and resilience. ?? 2011, The Author(s). Ground Water ?? 2011, National Ground Water Association.

  19. Concepts for Life Cycle Cost Control Required to Achieve Space Transportation Affordability and Sustainability

    Science.gov (United States)

    Rhodes, Russel E.; Zapata, Edgar; Levack, Daniel J. H.; Robinson, John W.; Donahue, Benjamin B.

    2009-01-01

    Cost control must be implemented through the establishment of requirements and controlled continually by managing to these requirements. Cost control of the non-recurring side of life cycle cost has traditionally been implemented in both commercial and government programs. The government uses the budget process to implement this control. The commercial approach is to use a similar process of allocating the non-recurring cost to major elements of the program. This type of control generally manages through a work breakdown structure (WBS) by defining the major elements of the program. If the cost control is to be applied across the entire program life cycle cost (LCC), the approach must be addressed very differently. A functional breakdown structure (FBS) is defined and recommended. Use of a FBS provides the visibifity to allow the choice of an integrated solution reducing the cost of providing many different elements of like function. The different functional solutions that drive the hardware logistics, quantity of documentation, operational labor, reliability and maintainability balance, and total integration of the entire system from DDT&E through the life of the program must be fully defined, compared, and final decisions made among these competing solutions. The major drivers of recurring cost have been identified and are presented and discussed. The LCC requirements must be established and flowed down to provide control of LCC. This LCC control will require a structured rigid process similar to the one traditionally used to control weight/performance for space transportation systems throughout the entire program. It has been demonstrated over the last 30 years that without a firm requirement and methodically structured cost control, it is unlikely that affordable and sustainable space transportation system LCC will be achieved.

  20. Classification of EU Countries in Terms of the Level of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Stec Małgorzata

    2017-01-01

    Full Text Available This article has classified the EU countries in terms of the level of sustainable development. The study was based on main sustainability indicators developed by Eurostat. In empirical research, one of the methods used was Cluster Analysis - Ward's method. Grouping methods make it possible to distinguish countries with a similar level of sustainability which is particularly useful for monitoring the progress of individual EU countries in implementation of the Sustainable Development Strategy. For specific groups of countries, appropriate control instruments and strategies can be proposed. The research period is 2016. As a result of the research, 6 clusters of countries were obtained. For specific groups of countries, their characteristics were defined.

  1. Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

    Science.gov (United States)

    Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

    2003-01-01

    To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

  2. Long-term storage of radioactive waste: IAEA perspectives on safety and sustainability

    International Nuclear Information System (INIS)

    Rowat, J.H.; Louvat, D.; Metcalf, P.E.

    2006-01-01

    As the amounts of radioactive waste in surface storage have increased, concern has grown over the safety and sustainability of storage in the long term. In response to increasing concerns, the International Atomic Energy Agency (IAEA) has included an action to address the safety implications of the long-term storage (LTS) of radioactive waste in its action plan for waste safety; the action plan was endorsed by the IAEA's Member States in 2001. In 2003, the IAEA published a position paper on the safety and sustainability of LTS as part fulfilment of the action in question. A key theme of the position paper is the contrast of safety and sustainability implications of LTS with those of disposal. The present paper provides a summary of the position paper, describes current IAEA activities that deal with the subject of LTS, and discusses findings from the 2004 Cordoba symposium on disposal of low activity radioactive waste that pertain to LTS. (author)

  3. Catalysing low cost green technologies for sustainable water service delivery in Kenya: Feasibility Study Report

    DEFF Research Database (Denmark)

    Ndirangu, Wangai; Schaer, Caroline

    2017-01-01

    Since 1974, the government of Kenya has recognised water supplies as critical for poverty reduction and development. Kenya’s economic and social development Vision 2030 emphasises the need for adequate and sustainable provision of water supply and sanitation services, with a target to achieve...... universal access by 2030. However, thus far most water development targets have not been achieved. Improvement has been much slower in rural and low income urban areas, and the current funding level is inadequate to achieve universal access by 2030. Over the years, official effort have been complemented...... to planning, standards and operations and maintenance, including source and cost of energy in rural and peri-urban water supplies is a key challenge to functionality and sustainability....

  4. Negotiated Settlements: Long-term Profits and Costs

    Directory of Open Access Journals (Sweden)

    G. Kent Fellows

    2012-05-01

    Full Text Available Over the last 20 years, utility regulators have relaxed their oversight of cost-ofservice regulation and this holds true for Alberta, where such regulation determines the fees associated with oil and gas pipeline usage. The traditional method has been for regulators to issue binding decisions on a firm’s cost of service after taking evidence at a formal hearing. Many regulators now prefer to encourage parties to settle a cost-of-service agreement through a negotiated settlement, which the regulator then approves. This process not only saves the cost of a hearing, it also permits firms and consumers to trade costs and benefits, settling on a final price more favourable to both. The author details how this arrangement can negatively impact future consumers by allowing the firm to defer the true burden of its depreciation expenses in return for inflated capital costs. Such a settlement lowers prices for the present but saddles future consumers with higher prices.

  5. Long-term sustainability of the landscape in new climatic conditions

    Science.gov (United States)

    Kubeckova, D.; Krocova, S.

    2017-10-01

    The long-term sustainability of the landscape and its natural environment must be the decisive task of the public administration and, in the wider concept, of every citizen. In new climatic conditions, this need has intensified. The following article suggests in a basic scope whether the above-mentioned task can be accomplished, and what means of solution should be used.

  6. A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

    International Nuclear Information System (INIS)

    Oksay, Serhan; Iseri, Emre

    2011-01-01

    Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: → This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. → The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. → The paradigm shift towards renewable energy policies could provide Turkey

  7. A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

    Energy Technology Data Exchange (ETDEWEB)

    Oksay, Serhan, E-mail: serhano@khas.edu.t [Kadir Has University, Department of Business Administration (Turkey); Iseri, Emre, E-mail: eiseri@khas.edu.t [Kadir Has University, Department of International Relations, Cibali Campus, Kadir Has Caddesi 34083, Istanbul (Turkey)

    2011-05-15

    Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: {yields} This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. {yields} The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. {yields} The paradigm shift towards renewable energy policies could

  8. The effects of fabric type, fabric width and model type on the cost of unit raw material in terms of apparel

    Science.gov (United States)

    Bilgiç, H.; Duru Baykal, P.

    2017-10-01

    The cost of the fabric which is the raw material of apparel constitutes approximately the half of the total product cost. So, it is highly important that the fabric should be used with the greatest productivity. Cost analysis are of great importance in terms of competitiveness of readymade clothing and apparel sector both in national and international markets. The proximity of costs to international average and the average cost of the countries that are competitors of Turkey in clothing market is essential for Turkey to sustain its effect in textile sector. In the contrary case, the sector won’t be able to maintain its competitive capacity sustainably [1].The main cost elements of textile and apparel sector consist of raw material, labor, energy and financing [2].

  9. Product platform considerations on a project that develops sustainable low-cost housing for townships

    DEFF Research Database (Denmark)

    Wörösch, Michael; Bonev, Martin; Mortensen, Niels Henrik

    Construction companies in Denmark are often working with profit margins as little as 1-3% in situations where they deliver high-end buildings to the local market. Even though customers are willing to pay a premium price for high quality, construction companies earn very little on their products...... their new owners the possibility to take a loan in their building which is expected to contribute to more businesses being started up and thereby strengthening the domestic economy. As a consequence of this, additional research is needed in how to further optimize the economy of sustainable low-cost housing...

  10. The concretization of the term sustainable spatial development for the assessment of child and juvenile awareness

    Directory of Open Access Journals (Sweden)

    Tadeja Zupančič

    2009-01-01

    Full Text Available The following article is targeted at the comprehensive co-shaping of the conditions required for the active education on the effective and concrete contributions to sustainable development, with the emphasis based on the built environment or architecture. It defines the role of education on the built environment or architecture within the concept of sustainable development, determines the grounds for adjusting the methods of delivering architectural contents and defines the educational contents along with their presentations with regards to the developmental abilities of the public, which is targeted. It presents the deliberation on objectifying the term sustainable spatial development, for the assessment of child and juvenile awareness of “sustainable architecture” topics as well as determining childcare workers and teachers adequate qualifications to provide the knowledge in the field of the built environment, in relation to sustainable environment. Concretisation signifies the selection and visualisation of actual topical occurrences in physical space for a specific targeted public (the article provides representative models. It also contributes to the development of “cultural” dimension of spatial development sustainability. The efforts made to strive towards the lifelong learning of architecture and its influence on our everyday lives and our future.

  11. Sustainability Life Cycle Cost Analysis of Roof Waterproofing Methods Considering LCCO2

    Directory of Open Access Journals (Sweden)

    Sangyong Kim

    2013-12-01

    Full Text Available In a construction project, selection of an appropriate method in the planning/design stage is very important for ensuring effective project implementation and success. Many companies have adopted the life cycle cost (LCC method, one of the methods for analyzing economic efficiency, for appropriate decision-making in the basic/detailed design stage by estimating overall costs and expenses generated over the entire project. This paper presents an LCC method for calculating the LCC of CO2 (LCCO2, based on materials committed during the lifecycle of a structure for each roof waterproofing method and adding this cost to the LCC for comparative analysis. Thus, this technique presents the LCC that includes the cost of CO2 emission. The results show that in terms of initial construction cost, asphalt waterproofing had the highest CO2 emission cost, followed by sheet waterproofing. LCCO2 did not greatly influence the initial construction cost and maintenance cost, as it is relatively smaller than the LCC. However, when the number of durable years was changed, the LCC showed some changes.

  12. Public financing of the Medicare program will make its uniform structure increasingly costly to sustain.

    Science.gov (United States)

    Baicker, Katherine; Shepard, Mark; Skinner, Jonathan

    2013-05-01

    The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the "one-size-fits-all" Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product. Our framework highlights the key trade-offs between Medicare spending and economic prosperity.

  13. External costs in the global energy optimization models. A tool in favour of sustain ability

    International Nuclear Information System (INIS)

    Cabal Cuesta, H.

    2007-01-01

    The aim of this work is the analysis of the effects of the GHG external costs internalization in the energy systems. This may provide a useful tool to support decision makers to help reaching the energy systems sustain ability. External costs internalization has been carried out using two methods. First, CO 2 externalities of different power generation technologies have been internalized to evaluate their effects on the economic competitiveness of these present and future technologies. The other method consisted of analysing and optimizing the global energy system, from an economic and environmental point of view, using the global energy optimization model generator, TIMES, with a time horizon of 50 years. Finally, some scenarios regarding environmental and economic strategic measures have been analysed. (Author)

  14. Analysis on long-term perspectives of sustainable nuclear energy towards global warming protection

    International Nuclear Information System (INIS)

    Yamazawa, M.; Ichimura, E.; Shibata, Y.; Kobayashi, K.; Wajima, T.

    1998-01-01

    Study of long-term perspectives of the nuclear power generation was made from the point of views of both CO 2 emission constraints and sustainability of nuclear energy. To this end, STREAM (Semi-empirical TRiple E Analysis Model) program, as a social model, has been developed by Tokyo Electric Power Co. and Hitachi, Ltd. Using this program, long-term world demands of primary and nuclear energy were deduced, in view of the protection against the global warming due to the CO 2 gas accumulation. The inevitable conclusion has been drawn that nuclear energy plays an indispensable role in the reduction of green house effect. Evaluations were then made on conditions that the nuclear power system would be the long-term major sustainable energy source. (author)

  15. Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch.

    Science.gov (United States)

    Pittman, D W; Parker, J S; Getz, B R; Jackson, C M; Le, T-A P; Riggs, S B; Shay, J M

    2012-01-01

    We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.

  16. An Integrated Modeling Approach to Evaluate and Optimize Data Center Sustainability, Dependability and Cost

    Directory of Open Access Journals (Sweden)

    Gustavo Callou

    2014-01-01

    Full Text Available Data centers have evolved dramatically in recent years, due to the advent of social networking services, e-commerce and cloud computing. The conflicting requirements are the high availability levels demanded against the low sustainability impact and cost values. The approaches that evaluate and optimize these requirements are essential to support designers of data center architectures. Our work aims to propose an integrated approach to estimate and optimize these issues with the support of the developed environment, Mercury. Mercury is a tool for dependability, performance and energy flow evaluation. The tool supports reliability block diagrams (RBD, stochastic Petri nets (SPNs, continuous-time Markov chains (CTMC and energy flow (EFM models. The EFM verifies the energy flow on data center architectures, taking into account the energy efficiency and power capacity that each device can provide (assuming power systems or extract (considering cooling components. The EFM also estimates the sustainability impact and cost issues of data center architectures. Additionally, a methodology is also considered to support the modeling, evaluation and optimization processes. Two case studies are presented to illustrate the adopted methodology on data center power systems.

  17. Impact of automatic calibration techniques on HMD life cycle costs and sustainable performance

    Science.gov (United States)

    Speck, Richard P.; Herz, Norman E., Jr.

    2000-06-01

    Automatic test and calibration has become a valuable feature in many consumer products--ranging from antilock braking systems to auto-tune TVs. This paper discusses HMDs (Helmet Mounted Displays) and how similar techniques can reduce life cycle costs and increase sustainable performance if they are integrated into a program early enough. Optical ATE (Automatic Test Equipment) is already zeroing distortion in the HMDs and thereby making binocular displays a practical reality. A suitcase sized, field portable optical ATE unit could re-zero these errors in the Ready Room to cancel the effects of aging, minor damage and component replacement. Planning on this would yield large savings through relaxed component specifications and reduced logistic costs. Yet, the sustained performance would far exceed that attained with fixed calibration strategies. Major tactical benefits can come from reducing display errors, particularly in information fusion modules and virtual `beyond visual range' operations. Some versions of the ATE described are in production and examples of high resolution optical test data will be discussed.

  18. A cost of long-term memory in Drosophila

    OpenAIRE

    Mery, Frederic; Kawecki, Tadeusz J.

    2005-01-01

    Two distinct forms of consolidated associative memory are known in Drosophila: long-term memory and so-called anesthesia-resistant memory. Long-term memory is more stable, but unlike anesthesia-resistant memory, its formation requires protein synthesis. We show that flies induced to form long-term memory become more susceptible to extreme stress (such as desiccation). In contrast, induction of anesthesia-resistant memory had no detectable effect on desiccation resistance. This finding may hel...

  19. A sustainable scenario for Venezuelan power generation sector in 2050 and its costs

    International Nuclear Information System (INIS)

    Bautista, Santiago

    2012-01-01

    The present research study used the quantitative approach to analyze the present and future situation of the Venezuelan power generation sector; to achieve that, the total energy generation costs and GHG emissions of four scenarios in 2050 were estimated and compared, considering two demand groups, high and low demand. For each demand scenario, two supply matrix were considered, a generation matrix based on the existing national power generation plans and trends (these scenarios were referred as BAU) and a configuration based on the renewable energy resources available in Venezuela and without the use of either nuclear or CCS technologies, and these scenarios are referred as Sustainable Scenarios (SUS). In the first section, the present situation is presented, followed by an explanation of the applied methodology and the implemented tools. In the third and fourth sections the available recourses and the applied basic assumptions for the four of scenarios are presented and discussed, respectively, followed by the results. In this study it is shown that Venezuela has all the resources it needs to achieve sustainable development in the power generation sector. It is also proved that an energy efficiency improvement is the easiest path to reduce GHG emissions. - Highlights: ► Venezuela has enough energy resources to supply the energy require for its development. ► A sustainable scenario is posible in Venezuelan power generation sector in 2050. ► The sustainable scenario is technically possible without nuclear power or carbon capture storage technologies. ► The impact over the depleatable resources is higher under the BAU assumptions.

  20. Holistic countermeasures evaluation and the sustainable restoration and long-term management of contaminated rural, urban and industrial ecosystems

    International Nuclear Information System (INIS)

    Beresford, N.A.; Wright, S.M.; Barnett, C.L.; Howard, B.J.; Cox, G.; Crout, N.M.J.

    2002-01-01

    Emergency planning as conducted by most national authorities is often focussed upon short-term response (few days - weeks) and addresses issues such as the need for evacuation, problems associated with 1 31I and immediate requirements for restrictions on food and water. There is limited systematic consideration of the long-term management of contaminated areas to ensure their sustainability. Experience following the Chernobyl accident, most especially within the countries of the former Soviet Union (fSU) but also in Scandinavia and the United Kingdom, have demonstrated that countermeasures may have to be employed for a number of decades. The evaluation criteria for the many countermeasures which have been developed needs to be extended from simply effectiveness and radiological protection criteria to a more integrated, holistic approach. Specifically, there needs to be an assessment as to whether countermeasures: can be practically applied; incur considerable direct or side-effect costs; have significant environmental side-effects; and are acceptable to society. In addition, suitable approaches for successfully communicating with a wide range of stake holders must be explored. This is an essential step in developing a decision framework and avoiding problems previously experienced in emergency management. This paper presents results from an ongoing project (see www.strategy-ec.org.uk) to develop a framework for the identification of strategies for the sustainable management of contaminated urban, rural and industrial areas

  1. Strategic research on the sustainable development cost of manufacturing industry under the background of carbon allowance and trade policy

    Science.gov (United States)

    Ma, Zhongmin; Cheng, Mengting; Wang, Mei

    2017-08-01

    The important subjects of energy consumption and carbon emission are manufacturing enterprises, with the deepening of international cooperation, and the implementation of carbon limit and trade policy, costs of manufacturing industry will rise sharply. How can the manufacturing industry survive in this reform, and it has to be a problem that the managers of the manufacturing industry need to solve. This paper analyses sustainable development cost connotation and value basis on the basis of sustainable development concept, discusses the influence of carbon allowance and trade policy for cost strategy of manufacturing industry, thinks that manufacturing industry should highlight social responsibility and realize maximization of social value, implement cost strategy the sustainable development, and pointed out the implementation way.

  2. Productivity, quality and sustainability of winter wheat underlong-term conventional and organic management in Switzerland

    DEFF Research Database (Denmark)

    Mayer, Jochen; Gunst, Lucie; Mäder, Paul

    2015-01-01

    Long-term sustainability and high resource use efficiency are major goals for high quality baking wheatproduction throughout the world. Present strategies are low input systems such as organic agriculture orimproved conventional systems (integrated). The fertilisation level and strategy, crop...... was fertilised exclusively minerally at level 2 (CONMIN)and a control remained unfertilised (NOFERT). We compared crop yields, baking quality parameters, thenitrogen use efficiency and the effect of maize and potatoes as preceding crops obtained between 2003and 2010 along with long-term soil sustainability......-bers of ears per m2and the thousand kernel weight. The apparent nitrogen use efficiency decreased withincreasing N fertilisation. Doubling the organic fertilisation in the organic systems only slightly improvedwheat grain yields but was not able to improve grain baking quality, due to low mineral N additions...

  3. Analysis of the Italian generic medicines retail market: recommendations to enhance long-term sustainability.

    Science.gov (United States)

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2015-02-01

    Italy is among the European countries with the lowest uptake of generic medicines. This paper provides a perspective on the Italian generic medicines retail market. Fast market entrance of generic medicines in Italy is hindered by several factors: the existence of Complementary Protection Certificates in the past, the large market for copies and multiple cases of patent linkage. Prices of generic medicines in Italy are low compared to other European countries. To contain pharmaceutical expenditure, pharmaceutical companies are currently forced to pay back in case of overspending, which disproportionally penalizes small and fast growing companies, to which most generic companies belong to. Current demand-side policies do not successfully stimulate the use of generic medicines. The current market environment surrounding the Italian generic medicines retail market (i.e., low prices, low volumes) threatens its long-term sustainability. Recommendations to enhance the long-term sustainability of the Italian generic medicines retail market round off this perspective paper.

  4. Testing Affine Term Structure Models in Case of Transaction Costs

    NARCIS (Netherlands)

    Driessen, J.J.A.G.; Melenberg, B.; Nijman, T.E.

    1999-01-01

    In this paper we empirically analyze the impact of transaction costs on the performance of affine interest rate models. We test the implied (no arbitrage) Euler restrictions, and we calculate the specification error bound of Hansen and Jagannathan to measure the extent to which a model is

  5. Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

    Science.gov (United States)

    Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

    2013-01-01

    Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain

  6. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers.

    Science.gov (United States)

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2018-03-01

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer's perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = -0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1-3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.

  7. Building a Sustainable Society: The Necessity to Change the Term 'Consumer'

    Directory of Open Access Journals (Sweden)

    Sabrina Chakori

    2017-10-01

    Full Text Available The profit-seeking system leads to many negative environmental impacts. Within this economic system, consumption reflects an important relationship between humans and nature. However, despite the growing international attention to environmental sustainability, our society does not necessarily acknowledge consumerism as the cause of global environmental degradation. Deconstructing the consumption culture and redefining what determines well-being, this paper will attempt to provide a comprehensive overview of the existing definition of people in the economic system. Many authors have defined our role in the economy; however, in terms of customer, citizen-consumer, and socially conscious consumer, most of the literature in this domain remains rooted in consumerism. Consumerism cannot be fixed with further consumerism; therefore this paper discusses the importance of reclaiming our identity and the need to define new terms for people in a new economic system. Any new terms should integrate interests and responsibilities that go beyond simple utility maximization. Moving beyond the term “consumer” will change our worldview. This cultural transformation may help facilitate long-term environmental sustainability.

  8. Marine Corps Readiness: The Costs of First-Term Dependency

    Science.gov (United States)

    2000-01-01

    Marines always get the job done, and the Marines are the masters of unfailing alchemy which converts unoriented youths into proud, self-reliant...tempo, marriage, stress, pregnancy, divorce, finances , dependent 27 services, substance abuse, and other factors as they affect individual enlistees...especially in localities with high off base housing costs. Finances and housing problems are at the root of many other problems which service

  9. Long term warranty and after sales service concept, policies and cost models

    CERN Document Server

    Rahman, Anisur

    2015-01-01

    This volume presents concepts, policies and cost models for various long-term warranty and maintenance contracts. It offers several numerical examples for estimating costs to both the manufacturer and consumer. Long-term warranties and maintenance contracts are becoming increasingly popular, as these types of aftersales services provide assurance to consumers that they can enjoy long, reliable service, and protect them from defects and the potentially high costs of repairs. Studying long-term warranty and service contracts is important to manufacturers and consumers alike, as offering long-term warranty and maintenance contracts produce additional costs for manufacturers / service providers over the product’s service life. These costs must be factored into the price, or the manufacturer / dealer will incur losses instead of making a profit. On the other hand, the buyer / consumer needs to weigh the cost of maintaining it over its service life and to decide whether or not these policies are worth purchasing....

  10. Dutch environmental policy up for revision. Towards a cost-effective, sustainable society. Part 1

    International Nuclear Information System (INIS)

    Van Dorp, H.W.; Schmitz, H.

    2009-01-01

    In a series of two articles an important energy formula is used to discuss current Dutch environmental policy and calculations are made based on 7.2 million dwellings. Normally, everyone who has an opinion on energy and carbon dioxide emissions should know this formula and be able to apply it. The second article discusses climate policy and provides a comparison of the social cost at new housing level for both policy lines. More specifically, the investment effectiveness of carbon dioxide in the soil near Barendrecht and Geleen is discussed as well as the annual investments in the 220 and 380 kV high tension grid. Moreover, some recommendations and necessary policy adjustments to strengthen the competitive edge of the SMB compared to large energy companies and to realize an affordable and sustainable society are provided [nl

  11. Netherlands climate policy to be revised. Towards a cost-effective, sustainable society

    International Nuclear Information System (INIS)

    Van Dorp, H.W.; Schmitz, H.

    2009-01-01

    This is the second article in a series of two. The first article addresses current Dutch energy policy by means of an important energy formula and calculations were made based on 7.2 million Dutch dwellings. This article addresses climate policy with a comparison of the social cost on the level of new housing construction of both policy lines. More specifically, the investment effect of carbon dioxide storage in the soil in Barendrecht and Geleen, both Netherlands, is discussed as well as the annual investment in the 220 and 380 kV high voltage grid. Some recommendations and necessary policy adjustments are suggested that will strengthen the competitive edge of the SMBs compared to large energy companies and will help realize a truly affordable sustainable society [nl

  12. SUSTAINABILITY COST ACCOUNTING - PART 2: A CASE STUDY IN THE SOUTH AFRICAN PROCESS INDUSTRY

    Directory of Open Access Journals (Sweden)

    A.C. Brent

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: A Sustainability Cost Accounting (SCA procedure has been introduced that expresses the impacts on sustainable development associated with a developed technology, by means of a common financial denominator. This paper uses a case study to demonstrate and assess the SCA procedure, which considers the construction and operation of a hypothetical Gas-to-Liquid (GTL fuelmanufacturing facility at a specific location in South Africa. The SCA indicators show that the negative environmental impacts associated with the GTL technology outweigh the internal economic benefits for the company. However, a net positive social benefit is associated with the technology, which decision-makers should consider with respect of the overall sustainability of the technology. Certain limitations of the SCA procedure are highlighted, and recommendations are made to develop such a methodology further.

    AFRIKAANSE OPSOMMING: ’n Volhoubaarheid Koste-Rekeningkunde prosedure (VKR word voorgestel waarvolgens die impakte van ’n ontwikkelde tegnologie op volhoubaarheid in ’n gemeenskaplike finansiële waarde aangegee kan word. ’n Gevallestudie word hier gebruik om die VKR-prosedure te demonstreer. Die gevallestudie beskryf die konstruksie en bedryf van ’n hipotetiese Gas-tot-Vloeistof brandstofvervaardigingsfasiliteit (GTV in ‘n spesifieke area van Suid-Afrika. Die VKR-indikators dui aan dat die negatiewe omgewingsimpakte van die GTV tegnologie tot ‘n geringe mate groter is as die interne ekonomiese voordele vir die maatskappy. Die tegnologie het wel oorwegende positiewe sosiale voordele wat besluitnemers in ag moet neem wanneer die globale volhoubaarheid van die tegnologie ge-assesseer word. Sekere beperkinge van die VKR-prosedure word uitgelig en voorstelle word gemaak om dié tipe metodologie verder te ontwikkel.

  13. I Evolution of Environmental Costs Discolsur: A Study in Cellulose and Paper Companies - Members of Corporate Sustainability Index - CSI

    Directory of Open Access Journals (Sweden)

    Daniel Fonseca

    2016-07-01

    Full Text Available This research aimed to analyse, in relation to previous studies, the evolution of classification and disclosure of environmental costs on cellulose and paper companies listed on the CSI. The research, of a descriptive, documentary and qualitative nature, was based on content analysis of financial statements, accompanying notes, management reports and sustainability reports in the fiscal years 2010 to 2014. The results indicate that companies show environmental costs mainly in a qualitative way and of the positive type. The most part of this information is contained in the sustainability report. As to the classification, the highlighted environmental costs are of these types, (a prevention costs; (b internal failure costs; (c indirect costs; (d internal costs; (e costs for contingencies; (f potentially hidden costs; (g image and relationship costs, though not by these names. These results demonstrate a change, compared to previous studies on the quality and quantity of disclosure of environmental costs. It is suggested for future research the broadening of samples for other organizational activity sectors, with the aim of possible understanding of the Brazilian environment.

  14. Estimated costs of Sustaining Agricultural Production Through Erosional Control and Replenishment of Nutrient Losses in Kenya

    International Nuclear Information System (INIS)

    Onyango, J.W.

    1999-01-01

    Soil erosion is one of the major causes of nutrient depletion in sub-Saharan Africa. Highlights of losses from erosion can be used to explain why agricultural production in this region is not sustainable. annual macronutrient losses were calculated from experimental results at 8 sites in Kenya between 1986 and 1990. these losses were used along with the current local prices of fertiliser to estimate the annual national budget required for there replenishment. On average, 5.72, 29.3 and 0.82 kg ha -1 yr -1 of N, P and K, respectively, were lost annually. These losses are determined by soil types, slope, crop cover characteristics and rainfall amounts. soil losses can be reduced by terracing, contour farming and intercropping to improve crop cover. These efforts reduce the adverse effects of sporadic rainfall on fragile soil types. in order to ensure sustainability however, control measures have to be supplemented by national additions of 64 000 t, 323 000 t and 10 000 t of N, P and K respectively per year. The equivalent costs of these fertilisers will be Ksh 1,408 Ksh 8721 Ksh 220 million for the respective nutrients. This would require a total of some US$256 million (Ksh 10 349 million) annually from the national budget

  15. The impact of sustainability criteria on the costs and potentials of bioenergy production. An exploration of the impact of the implementation of sustainability criteria on the costs and potential of bioenergy production, applied for case studies in Brazil and Ukraine

    International Nuclear Information System (INIS)

    Smeets, E.; Faaij, A.; Lewandowski, I.

    2005-02-01

    The goal of this study is to make a first attempt to analyse the impact on the potential (quantity) and the costs (per unit) of bioenergy that the compliance with various sustainability criteria brings along. The nature of this work is exploratory. Because of the broad set of issues covered very little work has been published on which we could build. Ukraine and Brazil are used as case studies, because both regions are identified as promising bioenergy producers. This study is part of the FAIR Biotrade project, which is aimed to identify and quantify the impact of sustainability criteria on the potential of bioenergy. Previous work includes an identification of sustainability criteria relevant for bioenergy, an assessment of the environmental and economic costs of long distance biotrade and an assessment of bioenergy production potentials in 2050 in various world regions. In section 2 the approach is presented which is used to select and quantify the impact of sustainability criteria on bioenergy production. In section 3 the selection of the various sustainability criteria is described in detail, followed by a detailed description of how the various socials, ecological and economical sustainability criteria are operationalised. In section 4 (intermediate) results are presented for each sustainability criterium. In section 5 final results are presented, followed by a discussion and by conclusions (section 6)

  16. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

  17. A strategic decision-making model considering the social costs of carbon dioxide emissions for sustainable supply chain management.

    Science.gov (United States)

    Tseng, Shih-Chang; Hung, Shiu-Wan

    2014-01-15

    Incorporating sustainability into supply chain management has become a critical issue driven by pressures from governments, customers, and various stakeholder groups over the past decade. This study proposes a strategic decision-making model considering both the operational costs and social costs caused by the carbon dioxide emissions from operating such a supply chain network for sustainable supply chain management. This model was used to evaluate carbon dioxide emissions and operational costs under different scenarios in an apparel manufacturing supply chain network. The results showed that the higher the social cost rate of carbon dioxide emissions, the lower the amount of the emission of carbon dioxide. The results also suggested that a legislation that forces the enterprises to bear the social costs of carbon dioxide emissions resulting from their economic activities is an effective approach to reducing carbon dioxide emissions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Principles of the long-term sustainable development strategy of the SOCAR

    International Nuclear Information System (INIS)

    Akhundov, M.M.

    2002-01-01

    Full text: SOCAR intends to radically change its Health, Safety and Environmental Policy and to build it on the basis of Sustainable Development principles. Sustainable Development principles have been developed and accepted by the world community after the need of sensible prospects of its development has been recognized. The International Conference has initiated international discussions of the sustainable development issues for the Protection of Environment, which has hosted by UNESCO in Stockholm in 1968. Later, in 1972 the UN Environmental Conference was held in Stockholm, with the participation of 113 countries, which established a special structure- United Nations Environmental Programme (UNEP). Later, in 1993, at the UN World Conference for Human Rights, which was held in Vienna, following a discussions by the country leaders and representatives of civil society a provision was developed, which stated that no development could be long-term in the absence of full respect to human rights. SOCAR has just started to implement strategy and intends to continue its policy in this direction. In the future, SOCAR s business shall be carried out with account to the balance of economical, social and environmental components. SOCAR shall continue the development of required systems, instruments and indicators of management for achieving the goals of sustainable development

  19. Wind power planning: assessing long-term costs and benefits

    International Nuclear Information System (INIS)

    Kennedy, Scott

    2005-01-01

    In the following paper, a new and straightforward technique for estimating the social benefit of large-scale wind power production is presented. The social benefit is based upon wind power's energy and capacity services and the avoidance of environmental damages. The approach uses probabilistic load duration curves to account for the stochastic interaction between wind power availability, electricity demand, and conventional generator dispatch. The model is applied to potential offshore wind power development to the south of Long Island, NY. If natural gas combined cycle and integrated gasifier combined cycle (IGCC) are the alternative generation sources, wind power exhibits a negative social benefit due to its high capacity cost and the relatively low emissions of these advanced fossil-fuel technologies. Environmental benefits increase significantly if charges for CO 2 emissions are included. Results also reveal a diminishing social benefit as wind power penetration increases. The dependence of wind power benefits on CO 2 charges, and capital costs for wind turbines and IGCC plant is also discussed. The methodology is intended for use by energy planners in assessing the social benefit of future investments in wind power

  20. Music in the mountains: creating sustainable therapy programs from short-term missions

    Directory of Open Access Journals (Sweden)

    Rachel Foxell

    2015-01-01

    Full Text Available This field report describes the experiences of a Registered Music Therapist (RMT living, working, and musicking1 during a short-term health mission to Northern India. Using a sustainability approach, collaboration with several local and global health organisations resulted in the development of a therapeutic music program for children with disabilities. Disability is a complex phenomenon, and in rural areas of India, disability is viewed as a foundation for shame and exclusion. The Community-based project, Samvedna, oversees the therapy, healthcare, and education of over 100 children with a disability in remote villages and is heavily involved in disability advocacy in the area. Sustainable programs are more effective for individuals and communities in both the short and long term. RMTs and other health professionals can be instrumental in setting up sustainable programs, such as teaching specific skills and knowledge to local teams, provided there is thorough preparation and ongoing collaboration to determine the priorities and expectations of the program.

  1. Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania.

    Directory of Open Access Journals (Sweden)

    Henry Brink

    Full Text Available It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR, the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul

  2. Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania.

    Science.gov (United States)

    Brink, Henry; Smith, Robert J; Skinner, Kirsten; Leader-Williams, Nigel

    2016-01-01

    It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo) trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR), the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul of the system in

  3. The medium-term sustainability of organisational innovations in the national health service

    Directory of Open Access Journals (Sweden)

    Finn Rachael

    2011-03-01

    Full Text Available Abstract Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion

  4. The medium-term sustainability of organisational innovations in the national health service

    Science.gov (United States)

    2011-01-01

    Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion Through comparison and

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

    Science.gov (United States)

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

    1998-07-01

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

  6. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers

    OpenAIRE

    Col?n-Emeric, Cathleen; Toles, Mark; Cary, Michael P.; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A.

    2016-01-01

    Background Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. Methods In eight facilities, we cond...

  7. Optimizing long-term investments for a sustainable development of the ASEAN power system

    International Nuclear Information System (INIS)

    Huber, Matthias; Roger, Albert; Hamacher, Thomas

    2015-01-01

    The electricity consumption in the ASEAN (Association of East Asian Nations) region is one of the fastest growing in the world and will lead to a dramatic increase in greenhouse gas emissions in the next decades. A decarbonization of the region's electricity supply is thus a very important measure when taking action on global climate change. This paper defines cost-optimal pathways towards a sustainable power system in the region by employing linear optimization. The proposed model simultaneously optimizes the required capacities and the hourly operation of generation, transmission, and storage. The obtained results show that all different kinds of renewable sources will have to be utilized, while none of them should have a share of more than one third. The findings give reason for setting up an ASEAN power grid, as it enables the transportation of electricity from the best sites to load centers and leads to a balancing of the fluctuations from wind and solar generation. We suggest fostering a diversified extension of renewables and to elaborate on political and technical solutions that enable the build up an transnational supergrid. - Highlights: • Article presents an optimization model of the ASEAN power system with high temporal and spatial resolution. • Cost-optimal investment options for achieving a sustainable electricity system are explored. • All types of renewable energies have to be employed while none of them should provide more than one third of overall supply. • Large transcontinental transmission grids will be crucial for a cost-minimal decarbonization of the ASEAN electricity sector

  8. Are Development Projects Pursuing Short-Term Benefits at the Expense of Sustainability?

    Directory of Open Access Journals (Sweden)

    Yigezu Yigezu

    2017-10-01

    Full Text Available When evaluated purely on financial grounds, most developmental interventions targeting the livestock sector exhibit a positive impact. This study also provides empirical evidence that a project which provided loans to livestock producers in Syria succeeded in increasing the annual farm income and reducing the income risk. However, these annual benefits were accompanied by a reduction in technical efficiency which, unabated, may compound over the years and compromise the livestock enterprise’s sustainability. The development lesson from these findings is that misguided interventions with well-known short-term livelihoods benefits could, in the long run, hurt the very sector which they aim to support.

  9. Ecological strategies for long-term sustainability of the Malaysian ricefield agroecosystem

    International Nuclear Information System (INIS)

    Mashhor Mansor

    2002-01-01

    Ecological concepts should be imposed in ricefield agroecosystem so that a long-term sustainability as well as a sound environmental condition could be achieved. Although several problems are envisaged, thus can be overcome by adopting various techniques which are based on ecological principles. Fundamental issues which involve biodiversity, environment and economic activities should be addressed. In the ricefield agroecosystem the water regime also plays a major role particularly in determining the temporal aspects of the ricefield niche. Different seasons in this case, the dry and wet can have different types of food webs. (Author)

  10. Sustainable development: five structural milestones for the next five-year term

    International Nuclear Information System (INIS)

    Demailly, Damien; Treyer, Sebastien; Levai, David; Laurans, Yann; Rochette, Julien

    2017-05-01

    The energy transition, climate change, biodiversity, agriculture... the French President, the government and the new majority appointed by the 2017 elections will need to make some important decisions about sustainable development over the next five-year term. Their agenda will be marked in particular by five key events, not only in France, but also at the European and international levels. These five events will be opportunities to adapt the French economy to the major challenges of the 21. century, those of a regulated globalization, combining prosperity, social protection and environmental protection

  11. Short and middle term outcome of radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation

    International Nuclear Information System (INIS)

    Okamoto, Mitsunori; Sueda, Takashi; Hashimoto, Masaki; Fukuda, Yukihiro; Iwamoto, Akimichi; Matsumoto, Takeshi; Shintani, Yumiko; Iwasaki, Toshitaka; Kinoshita, Hiroki

    2009-01-01

    The aim of this study was to assess short and middle term outcome of radiofrequency catheter ablation for drug-refractory paroxysmal and sustained atrial fibrillation. Subjects were 30 patients of atrial fibrillation (19 paroxysmal, 11 sustained) who underwent extensive pulmonary vein isolation from January 2007 to August 2009 in our department. Twenty three men and seven women, aged from 44 to 76 years, were enrolled. Follow-up period was one to 32 months. Drug free success was 33%, but symptoms and electrocardiogram (EGG) findings were improved in 93 % of the patients by administration of anti-arrhythmic agents. Five of the six patients with bradycardia-tachycardia syndrome was free from pacemaker implantation. Left ventricular ejection fraction was improved in two patients with dilated cardiomyopathy (DCM)-like left ventricular dysfunction. One case had cardiac tamponade and transient ST elevation due to right coronary air embolism were observed in two cases. There were no death and no cerebrovascular events during the procedures and follow-up periods. In conclusion, radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation in our department may be highly acceptable new method for improving the symptoms and clinical signs of the patients. (author)

  12. Transitions to Sustainable Development. New Directions in the Study of Long Term Transformative Change

    International Nuclear Information System (INIS)

    Grin, J.; Rotmans, J.; Schot, J.; Geels, F.; Loorbach, D.

    2010-01-01

    Over the past few decades, there has been a growing concern about the social and environmental risks which have come along with the progress achieved through a variety of mutually intertwined modernization processes. In recent years these concerns are transformed into a widely-shared sense of urgency, partly due to events such as the various pandemics threatening livestock, and increasing awareness of the risks and realities of climate change, and the energy and food crises. This sense of urgency includes an awareness that our entire social system is in need of fundamental transformation. But like the earlier transition between the 1750s and 1890s from a pre-modern to a modern industrial society, this second transition is also a contested one. Sustainable development is only one of many options. This book addresses the issue on how to understand the dynamics and governance of the second transition dynamics in order to ensure sustainable development. It will be necessary reading for students and scholars with an interest in sustainable development and long-term transformative change.

  13. Transitions to Sustainable Development. New Directions in the Study of Long Term Transformative Change

    Energy Technology Data Exchange (ETDEWEB)

    Grin, J. [Department of Political Science, University of Amsterdam, Amsterdam (Netherlands); Rotmans, J. [Sustainability Transitions and Transition Management, Erasmus University Rotterdam, Rotterdam (Netherlands); Schot, J. [Eindhoven University of Technology, Eindhoven (Netherlands); Geels, F. [Science Policy Research Unit SPRU, University of Sussex, Brighton (United Kingdom); Loorbach, D. [Dutch Research Institute for Transitions Drift, Erasmus University Rotterdam, Rotterdam (Netherlands)

    2010-07-01

    Over the past few decades, there has been a growing concern about the social and environmental risks which have come along with the progress achieved through a variety of mutually intertwined modernization processes. In recent years these concerns are transformed into a widely-shared sense of urgency, partly due to events such as the various pandemics threatening livestock, and increasing awareness of the risks and realities of climate change, and the energy and food crises. This sense of urgency includes an awareness that our entire social system is in need of fundamental transformation. But like the earlier transition between the 1750s and 1890s from a pre-modern to a modern industrial society, this second transition is also a contested one. Sustainable development is only one of many options. This book addresses the issue on how to understand the dynamics and governance of the second transition dynamics in order to ensure sustainable development. It will be necessary reading for students and scholars with an interest in sustainable development and long-term transformative change.

  14. Feature bindings are maintained in visual short-term memory without sustained focused attention.

    Science.gov (United States)

    Delvenne, Jean-François; Cleeremans, Axel; Laloyaux, Cédric

    2010-01-01

    Does the maintenance of feature bindings in visual short-term memory (VSTM) require sustained focused attention? This issue was investigated in three experiments, in which memory for single features (i.e., colors or shapes) was compared with memory for feature bindings (i.e., the link between the color and shape of an object). Attention was manipulated during the memory retention interval with a retro-cue, which allows attention to be directed and focused on a subset of memory items. The retro-cue was presented 700 ms after the offset of the memory display and 700 ms before the onset of the test display. If the maintenance of feature bindings - but not of individual features - in memory requires sustained focused attention, the retro-cue should not affect memory performance. Contrary to this prediction, we found that both memory for feature bindings and memory for individual features were equally improved by the retro-cue. Therefore, this finding does not support the view that the sustained focused attention is needed to properly maintain feature bindings in VSTM.

  15. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Directory of Open Access Journals (Sweden)

    Emily R Mangone

    Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

  16. Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

    Science.gov (United States)

    Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

    2016-01-01

    There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

  17. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    Holland, van Berry J.; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

  18. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2017-01-01

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

  19. Beyond waste: new sustainable fillers from fly ashes stabilization, obtained by low cost raw materials

    Directory of Open Access Journals (Sweden)

    N. Rodella

    2016-09-01

    Full Text Available A sustainable economy can be achieved only by assessing processes finalized to optimize the use of resources. Waste can be a relevant source of energy thanks to energy-from-waste processes. Concerns regarding the toxic fly ashes can be solved by transforming them into resource as recycled materials. The commitment to recycle is driven by the need to conserve natural resources, reduce imports of raw materials, save landfill space and reduce pollution. A new method to stabilize fly ash from Municipal Solid Waste Incinerator (MSWI at room temperature has been developed thanks to COSMOS-RICE LIFE+ project (www.cosmos-rice.csmt.eu. This process is based on a chemical reaction that occurs properly mixing three waste fly ashes with rice husk ash, an agricultural by-product. COSMOS inert can replace critical raw materials (i.e. silica, fluorspar, clays, bentonite, antimony and alumina as filler. Moreover the materials employed in the stabilization procedure may be not available in all areas. This paper investigates the possibility of substituting silica fume with corresponding condensed silica fume and to substitute flue-gas desulfurization (FGD residues with low-cost calcium hydroxide powder. The removal of coal fly ash was also considered. The results will be presented and a possible substitution of the materials to stabilize fly ash will be discussed.

  20. Costs of long-term carrying of extra mass in a songbird

    NARCIS (Netherlands)

    Atema, E.; Van Noordwijk, A.J.; Boonekamp, J. J.; Verhulst, S.

    2016-01-01

    Iteroparous organisms face a trade-off between reproduction and survival but knowledge of whether, how and when costs of long-term increases in workload are paid is scant. We increased locomotion costs for a whole year by equipping male great tits with a backpack during breeding, removing the

  1. Another look at trading costs and short-term reversal profits

    NARCIS (Netherlands)

    W.A. de Groot (Wilma); J.J. Huij (Joop); W. Zhou (Weili)

    2012-01-01

    textabstractSeveral studies report that abnormal returns associated with short-term reversal investment strategies diminish once trading costs are taken into account. We show that the impact of trading costs on the strategies' profitability can largely be attributed to excessively trading in small

  2. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

    Science.gov (United States)

    Stumbo, Scott P; Ford, James H; Green, Carla A

    2017-11-01

    A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of

  3. Global long-term cost dynamics of offshore wind electricity generation

    NARCIS (Netherlands)

    Gernaat, David E H J; Van Vuuren, Detlef P.; Van Vliet, Jasper; Sullivan, Patrick; Arent, Douglas J.

    2014-01-01

    Using the IMAGE/TIMER (The Targets IMage Energy Regional) long-term integrated assessment model, this paper explores the regional and global potential of offshore wind to contribute to global electricity production. We develop long-term cost supply curve for offshore wind, a representation of the

  4. Long-term sustainability of microbial-induced CaCO3 precipitation in aqueous media.

    Science.gov (United States)

    Gat, Daniella; Ronen, Zeev; Tsesarsky, Michael

    2017-10-01

    Microbially induced CaCO 3 precipitation (MICP) via urea hydrolysis is an emerging technique for soil amelioration, building materials rehabilitation and pollutants sequestration amongst other various environmental applications. The successful application of MICP requires the sustainability of the precipitated CaCO 3 ; to which the fate of ammonia, the main by-product of ureolysis, is potentially significante. Ammonia volatilization and biological ammonia oxidation both induce a pH decrease, which, in turn, might cause CaCO 3 dissolution. To examine the potential effect of accumulated ammonia on precipitated CaCO 3 , we conducted a long-term MICP batch experiment, using environmental enrichment cultures of ureolytic bacteria. Here we show that CaCO 3 precipitation was completed within 15-27 days, along with a rise in ammonium concentration. Following completion of ureolysis and precipitation, ammonium concentrations decreased, leading to a pH decrease. About 30 days after precipitation was completed, as much as 30% CaCO 3 dissolution, was observed. A two-step model, describing urea hydrolysis followed by the removal of ammonia from the precipitation solution, predicted CaCO 3 dissolution due to ammonia volatilization. We suggest that ureolytic MICP might result in ammonia volatilization, leading to significant CaCO 3 dissolution. These results provide basic insights into the sustainability of ureolytic MICP and should further encourage removal of the accumulated ammonia from the treated site. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Assessment of the turkey’s electric power policies in terms of sustainability

    Directory of Open Access Journals (Sweden)

    Atis Selcuk

    2014-01-01

    Full Text Available This study, using statistical data published by the Turkish Electricity Transmission Company, analyzes key parameters such as installed capacity and energy demand growth rates, investment plans and emission rates, taking into consideration the expected increase in use through the year 2023. The results of the analyses were compared to relevant data from around the world. The weight of domestic - and especially renewable - resources in investment plans for the next 10 years was discussed. Recommendations for an investment plan to support sustainable development in Turkey are listed. Consequently, the lack of investment in domestic and renewable energy projects decreases the competitive power of Turkey vis-à-vis Organisation for Economic Co-Operation and Development countries in terms of many parameters. For a sustainable development, the country must make significant changes in its foreign-dependent energy production policies. Any future policies must encourage supplying local resources to meet the continuously increasing demand. Qualifications for incentive mechanisms applied to investments in renewable energy should be developed. The impact of the private sector on the installation of new plants must also be increased by quickly completing the privatization process.

  6. RECAP, Replacement Energy Cost for Short-Term Reactor Plant Shut-Down

    International Nuclear Information System (INIS)

    VanKuiken, J.C.; Daun, C.J.; Jusko, M.J.

    1995-01-01

    1 - Description of program or function: RECAP (Replacement Energy Cost Analysis Package) determines the replacement energy costs associated with short-term shutdowns or de-ratings of one or more nuclear reactors. Replacement energy cost refers to the change in generating-system production cost that results from shutting down a reactor. The cost calculations are based on the seasonal, unit-specific cost estimates for 1988-1991 for all 117 nuclear electricity-generating units in the U.S. RECAP is menu-driven, allowing the user to define specific case studies in terms of parameters such as the units to be included, the length and timing of the shutdown or de-rating period, the unit capacity factors, and the reference year for reporting cost results. In addition to simultaneous shutdown cases, more complicated situations, such as overlapping shutdown periods or shutdowns that occur in different years, can be examined through use of a present-worth calculation option. 2 - Method of solution: The user selects a set of units for analysis, defines a shutdown (or de-rating) period, and specifies any planned maintenance outages, delays in unit start-ups, or changes in default capacity factors. The program then determines which seasonal cost numbers to apply, estimates total and daily costs, and makes the appropriate adjustments for multiple outages if they are encountered. The change in production cost is determined from the difference between the total variable costs (variable fuel cost, variable operation and maintenance cost, and purchased energy cost) when the reactor is available for generation and when it is not. Changes in reference-year dollars are based on gross national product (GNP) price deflators or on optional use inputs. Once RECAP has completed the initial cost estimates for a case study (or series of case studies), present-worth analysis can be conducted using different reference-year dollars and discount rates, as specified by the user. The program uses

  7. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Scott P. Stumbo

    2017-11-01

    Full Text Available Abstract Background A greater understanding of the factors that influence long-term sustainment of quality improvement (QI initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. Methods We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007–2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. Results We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1 finding alignment between business- and client-centered practices; (2 staff engagement early in QI process added legitimacy which facilitated sustainment; (3 commitment to integrating data into monitoring practices and the identification of a data champion; and (4 adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1 lack of evidence of impact on business practices led to discontinuation; (2 disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3 no data integration into overall business practices and no identified data champion; and (4 high staff turnover. In addition, we found that many agencies’ current use of NIATx methods and tools suggested a legacy effect that might improve

  8. Robotic Observatory System Design-Specification Considerations for Achieving Long-Term Sustainable Precision Performance

    Science.gov (United States)

    Wray, J. D.

    2003-05-01

    The robotic observatory telescope must point precisely on the target object, and then track autonomously to a fraction of the FWHM of the system PSF for durations of ten to twenty minutes or more. It must retain this precision while continuing to function at rates approaching thousands of observations per night for all its years of useful life. These stringent requirements raise new challenges unique to robotic telescope systems design. Critical design considerations are driven by the applicability of the above requirements to all systems of the robotic observatory, including telescope and instrument systems, telescope-dome enclosure systems, combined electrical and electronics systems, environmental (e.g. seeing) control systems and integrated computer control software systems. Traditional telescope design considerations include the effects of differential thermal strain, elastic flexure, plastic flexure and slack or backlash with respect to focal stability, optical alignment and angular pointing and tracking precision. Robotic observatory design must holistically encapsulate these traditional considerations within the overall objective of maximized long-term sustainable precision performance. This overall objective is accomplished through combining appropriate mechanical and dynamical system characteristics with a full-time real-time telescope mount model feedback computer control system. Important design considerations include: identifying and reducing quasi-zero-backlash; increasing size to increase precision; directly encoding axis shaft rotation; pointing and tracking operation via real-time feedback between precision mount model and axis mounted encoders; use of monolithic construction whenever appropriate for sustainable mechanical integrity; accelerating dome motion to eliminate repetitive shock; ducting internal telescope air to outside dome; and the principal design criteria: maximizing elastic repeatability while minimizing slack, plastic deformation

  9. Australia's TERN: Building, Sustaining and Advancing Collaborative Long Term Ecosystem Research Networks

    Science.gov (United States)

    HEld, A. A.; Phinn, S. R.

    2012-12-01

    TERN is Australia's Terrestrial Ecosystem Research Network (www.tern.org.au) is one of several environmental data collection, storage and sharing projects developed through the government's research infrastructure programs 2008-2014. This includes terrestrial and coastal ecosystem data collection infrastructure across multiple disciplines, hardware, software and processes used to store, analyse and integrate data sets. TERN's overall objective is to build the collaborations, infrastructure and programs to meet the needs of ecosystem science communities in Australia in the long term, through institutional frameworks necessary to establish a national terrestrial ecosystem site and observational network, coordinated networks enabling cooperation and operational experience; public access to quality assured and appropriately licensed data; and allowing the terrestrial ecosystem research community to define and sustain the terrestrial observing paradigm into the longer term. This paper explains how TERN was originally established, and now operates, along with plans to sustain itself in the future. TERN is implemented through discipline/technical groups referred to as "TERN Facilities". Combined, the facilities provide observations of surface mass and energy fluxes over key ecosystems, biophysical remote sensing data, ecological survey plots, soils information, and coastal ecosystems and associated water quality variables across Australia. Additional integrative facilities cover elements of ecoinformatics, data-scaling and modelling, and linking science to management. A central coordination and portal facility provides meta-data storage, data identification, legal and licensing support. Data access, uploading, meta-data generation, DOI attachment and licensing is completed at each facility's own portal level. TERN also acts as the open-data repository of choice for Australian scientists required to publish their data. Several key lessons we have learnt, will be presented

  10. EDF - Activity and sustainable development 2011 - electricity, choices on the long term

    International Nuclear Information System (INIS)

    2012-05-01

    This publication notably contains a set of articles about choices on the long term related to electricity production and distribution. Different aspects are addressed: arbitration (the diversity of the French energy mix), grids (investments and evolution towards smart grids), electricity cost (for households and for industry), nuclear energy (actions and results regarding safety and availability, the EPR project), renewable energies, the design and construction of a dam (Nam Theun 2) in Thailand with an important human development dimension in the project, thermal energy (the future of flame-based power stations using gas or biomass for example), and EDF's commercial policy

  11. The Cost of Sustainability in Higher Education: Staff and Student Views of a Campus Food Culture

    Science.gov (United States)

    Shaw, Amy; Capetola, Teresa; Lawson, Justin T.; Henderson-Wilson, Claire; Murphy, Berni

    2018-01-01

    Purpose: This study aims to investigate the sustainability of the food culture at Deakin University and to determine what the barriers to increasing the sustainability of food on the Burwood campus may be. Design/methodology/approach: An online survey of staff and students from the Faculty of Health at the Burwood campus of Deakin University (n =…

  12. Long-term cost-effectiveness of disease management in systolic heart failure.

    Science.gov (United States)

    Miller, George; Randolph, Stephen; Forkner, Emma; Smith, Brad; Galbreath, Autumn Dawn

    2009-01-01

    Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF. We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial. We used data generated from the trial (starting population distributions, resource utilization, mortality rates, and transition probabilities) in a Markov model to project results of continuing the disease management program for the patients' lifetimes. Outputs included distribution of illness severity, mortality, resource consumption, and the cost of resources consumed. Both cost and effectiveness were discounted at a rate of 3% per year. Cost-effectiveness was computed as cost per quality-adjusted life year (QALY) gained. Model results were validated against trial data and indicated that, over their lifetimes, patients experienced a lifespan extension of 51 days. Combined discounted lifetime program and medical costs were $4850 higher in the disease management group than the control group, but the program had a favorable long-term discounted cost-effectiveness of $43,650/QALY. These results are robust to assumptions regarding mortality rates, the impact of aging on the cost of care, the discount rate, utility values, and the targeted population. Estimation of the clinical benefits and financial burden of disease management can be enhanced by model-based analyses to project costs and effectiveness. Our results suggest that disease management of heart failure patients can be cost-effective over the long term.

  13. Solar Irradiance Measurements Using Smart Devices: A Cost-Effective Technique for Estimation of Solar Irradiance for Sustainable Energy Systems

    Directory of Open Access Journals (Sweden)

    Hussein Al-Taani

    2018-02-01

    Full Text Available Solar irradiance measurement is a key component in estimating solar irradiation, which is necessary and essential to design sustainable energy systems such as photovoltaic (PV systems. The measurement is typically done with sophisticated devices designed for this purpose. In this paper we propose a smartphone-aided setup to estimate the solar irradiance in a certain location. The setup is accessible, easy to use and cost-effective. The method we propose does not have the accuracy of an irradiance meter of high precision but has the advantage of being readily accessible on any smartphone. It could serve as a quick tool to estimate irradiance measurements in the preliminary stages of PV systems design. Furthermore, it could act as a cost-effective educational tool in sustainable energy courses where understanding solar radiation variations is an important aspect.

  14. REVERSE LOGISTICS OF PACKAGING AS A SUSTAINABLE STRATEGY FOR COST REDUCTION: A STUDY IN A BOTTLER BEVERAGES

    Directory of Open Access Journals (Sweden)

    Laryssa Guedes de Oliveira

    2013-09-01

    Full Text Available This paper aims to examine the possibility of reducing production costs with the implementation of a program of reverse logistics packaging. Therefore we conducted a literature review focusing on reverse logistics, sustainability, packaging and glass recycling. The research was conducted through a descriptive case study, conducted from a survey and a semi structured interview. The study was developed in a beverage bottler, the Engarrafamento Coroa, a company that adopts in its bottling system using bottles purchased from recycling cooperatives. The results indicate that by reverse logistics is possible to reduce costs and environmental impact associated with the pollution and waste of materials, and provides revenue generation.

  15. Communication on energy: who pays for the long-term costs of nuclear power

    International Nuclear Information System (INIS)

    Jeffery, J.W.

    1987-01-01

    The question in the title arises in making a fair comparison between a coal-fired station, which has no long-term costs, and a nuclear station, whose large long-term costs are discounted into insignificance by the present method of calculation. This problem was raised by the present author in his evidence to the Sizewell Inquiry, and has recently been discussed by the House of Commons Select Committee on Energy, who expressed grave disquiet that 'the costs of decommissioning become almost irrelevant to the current economics of nuclear power'. The present article analyses the bizarre effects of long-term discounting, and suggests a method of making a fair and symmetrical comparison between coal-fired and nuclear stations. (author)

  16. DOE-NE Light Water Reactor Sustainability Program and EPRI Long-Term Operations Program. Joint Research and Development Plan

    International Nuclear Information System (INIS)

    Williams, Don

    2014-01-01

    Nuclear power has contributed almost 20% of the total amount of electricity generated in the United States over the past two decades. High capacity factors and low operating costs make nuclear power plants (NPPs) some of the most economical power generators available. Further, nuclear power remains the single largest contributor (nearly 70%) of non-greenhouse gas-emitting electric power generation in the United States. Even when major refurbishments are performed to extend operating life, these plants continue to represent cost-effective, low-carbon assets to the nation's electrical generation capability. By the end of 2014, about one-third of the existing domestic fleet will have passed their 40th anniversary of power operations, and about one-half of the fleet will reach the same 40-year mark within this decade. Recognizing the challenges associated with pursuing extended service life of commercial nuclear power plants, the U.S. Department of Energy's (DOE) Office of Nuclear Energy [NE] and the Electric Power Research Institute (EPRI) have established separate but complementary research and development programs (DOE-NE's Light Water Reactor Sustainability [LWRS] Program and EPRI's Long-Term Operations [LTO] Program) to address these challenges. To ensure that a proper linkage is maintained between the programs, DOE-NE and EPRI executed a memorandum of understanding in late 2010 to @@@establish guiding principles under which research activities (between LWRS and LTO) could be coordinated to the benefit of both parties.@@@ This document represents the third annual revision to the initial version (March 2011) of the plan as called for in the memorandum of understanding.

  17. DOE-NE Light Water Reactor Sustainability Program and EPRI Long-Term Operations Program. Joint Research and Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Don

    2014-04-01

    Nuclear power has contributed almost 20% of the total amount of electricity generated in the United States over the past two decades. High capacity factors and low operating costs make nuclear power plants (NPPs) some of the most economical power generators available. Further, nuclear power remains the single largest contributor (nearly 70%) of non-greenhouse gas-emitting electric power generation in the United States. Even when major refurbishments are performed to extend operating life, these plants continue to represent cost-effective, low-carbon assets to the nation’s electrical generation capability. By the end of 2014, about one-third of the existing domestic fleet will have passed their 40th anniversary of power operations, and about one-half of the fleet will reach the same 40-year mark within this decade. Recognizing the challenges associated with pursuing extended service life of commercial nuclear power plants, the U.S. Department of Energy’s (DOE) Office of Nuclear Energy (NE) and the Electric Power Research Institute (EPRI) have established separate but complementary research and development programs (DOE-NE’s Light Water Reactor Sustainability [LWRS] Program and EPRI’s Long-Term Operations [LTO] Program) to address these challenges. To ensure that a proper linkage is maintained between the programs, DOE-NE and EPRI executed a memorandum of understanding in late 2010 to “establish guiding principles under which research activities (between LWRS and LTO) could be coordinated to the benefit of both parties.” This document represents the third annual revision to the initial version (March 2011) of the plan as called for in the memorandum of understanding.

  18. 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.

  19. An introduction to constructed wetlands (reed beds) sustainable low cost wastewater treatment plants

    International Nuclear Information System (INIS)

    Ahmad, M.I.

    2005-01-01

    The use of 'conventional' wastewater treatment technology (trickling filters and activated sludge) in developing countries has often been unsuccessful due to high cost, complex operating requirements and expensive maintenance procedures. Typical examples of such projects are wastewater plants in Islamabad and Karachi. Actually the conventional systems, such as trickling filters and activated sludge plants were developed to address the concerns about organic pollution of natural water bodies in western temperate climates, rather than the reduction of organic matter as well as pathogens which is often a priority in developing countries. Pakistan, being a developing country cannot and should not follow the western technology blindly but needs the use of a ppropriate technology . Appropriate technology is defined as a treatment system which meets the following criteria: Affordable: Total amount costs, including capital, operation, maintenance and depreciation are within the user's ability to pay. Operable: Operation of the system is possible with locally available labor and support. Reliable: Effluent quality requirements can be met consistently. Currently there are a limited number of appropriate technologies for small communities, which should be considered by a community and their designers. These include conventional and non-conventional systems such as stabilization ponds or lagoons, slow sand filters, land treatment systems, and wetlands (natural or constructed). The non-conventional systems often utilize 'ecological' treatment mechanism (such as aquatic systems or wetlands) and do not have the mechanical parts or energy requirements of conventional systems. Waste Stabilization Ponds are one such solution but sometimes are constrained by land availability, topography, and are not environment friendly. In such locations, natural or constructed wetlands (Reed Beds) could provide an alternative technology. It is what we call a LOW technology, rather than HI TECH

  20. Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

    Science.gov (United States)

    Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

    2014-04-25

    To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

  1. [Economic Short-Term Cost Model for Stereotactic Radiotherapy of Neovascular AMD].

    Science.gov (United States)

    Neubauer, A S; Reznicek, L; Minartz, C; Ziemssen, F

    2016-08-01

    Stereotactic radiation therapy (Oraya, OT) is available as a second line therapy for patients who, despite intensive anti-VEGF therapy for neovascular AMD, do not show an improvement in CNV. As OT is expensive (5,308 €), the short term economics for starting this therapy were investigated. A short-term cost model was set up in MS Excel with a two year time horizon. On the basis of the data of the randomised, controlled INTREPID pivotal trial and current treatment practice in Germany, the costs were compared of conventional anti-VEGF therapy, with or without a single OT treatment. Patients with an active lesion after initial anti-VEGF therapy and a maximum lesion diameter ≤ 4 mm were included. Modeled cost components/aspects were direct savings from injection number, control follow-up examinations and aids, as well as anti-VEGF switches. Costs for Germany were employed and a univariate sensitivity analysis was performed to address the existing uncertainty. For the patients with a maximum AMD lesion diameter ≤ 4 mm and a macula volume > 7.4 mm(3), the INTREPID trial showed a mean reduction of 3.68 intravitreal injections for 16 Gy radiation versus sham over a time period of 2 years. These 3.68 IVM result in ~ 4,500 € direct cost savings. Moreover, due to the higher response rate with 16 Gy radiation, the number of follow-up visits and aids can be reduced, which results in savings between 207 € and 1,224 € over 2 years. After radiation, fewer anti-VEGF switches for low or non-responders are expected, which is modeled to result in ~ 1.7 fewer injections over 2 years. Due to overall fewer injections, fewer endophthalmitis cases would be expected. However, endophthalmitis and microvascular abnormalities, which can be observed in a few cases, are associated with low or non-quantifiable costs in this cost-cost comparison model. In summary, cost reductions of between 6,400 and 8,500 € are predicted in the model over two years

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

    Directory of Open Access Journals (Sweden)

    Korenromp Eline L

    2012-03-01

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

  3. Long-Term Sustainable Development of Tourism in South Tyrol: An Analysis of Tourists’ Perception

    Directory of Open Access Journals (Sweden)

    Katia Laura Sidali

    2017-10-01

    Full Text Available Although sustainable tourism concepts are gaining in importance everywhere, related research is quite fragmented with many studies concentrating on environmental sustainability. Seeking to contribute to the general discussion, we first examine the perceptions of sustainability among tourists using a best–worst scaling method applied to important aspects of sustainable tourism. Our results show that experiencing nature in an intense and profound way is considered the most important aspect of sustainable tourism whereas grappling with the culture of the host region is perceived as the least important aspect of sustainable tourism in our sample. Second, we analyze if socio-demographic and/or other factors have significant implications for the propensity to increase expenditures for sustainable holiday offers. Applying a simple regression model, we can show that age has a significant and positive impact on the propensity to spend more on a sustainable holiday offer such as overnight stays in an accommodation that is carbon-neutral. Other socio-demographic variables such as gender, education, and income are not significant. Moreover, hotel stars and average expenditures per person per night are significant and have a positive effect on the propensity to spend more on carbon-neutral housing. Two simple policy implications can be drawn: (1 sustainable tourism experiences should prioritize landscape and natural beauty; and (2 sustainable tourism offers are best suited for higher-priced and/or higher starred hotels.

  4. Wineries Evaluation of Costs and Benefits of Sustainability Certification Program: The Case of Terra Vitis in France.

    Science.gov (United States)

    Jourjon, Frederique; Chou, Hsia-Chi; Gezart, Anna; Kadison, Amy E; Martinat, Lea; Pomarici, Eugenio; Vecchio, Riccardo

    2016-01-01

    The current paper analyses the evaluation of the costs and benefits of French wineries (N=69) participating in the sustainability program Terra Vitis, a widespread environmental certification scheme within the French wine industry. An online questionnaire was sent to all Terra Vitis participants, in order to analyse the evaluation of economic costs and benefits (together with environmental benefits) as perceived by wineries. Our findings reveal that older participants in the scheme (over 5 years), firms with higher export share (>40% of annual turnover) and cooperative wineries tend to be keener to assign a positive evaluation to the benefits/costs ratio in both the vineyard and the winery. In the context of increasing concerns regarding the economic and environmental performance of the French agricultural sector, such findings and also the patent research could be useful for policy makers and entrepreneurs in defining mainstream normative and corporate strategies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. The cost of treatment failure: resource use and costs incurred by hepatitis C virus genotype 1-infected patients who do or do not achieve sustained virological response to therapy.

    Science.gov (United States)

    Backx, M; Lewszuk, A; White, J R; Cole, J; Sreedharan, A; van Sanden, S; Diels, J; Lawson, A; Neal, K R; Wiselka, M J; Ito, T; Irving, W L

    2014-03-01

    Chronic hepatitis C virus (HCV) infection places a considerable economic burden on health services. Cost-effectiveness analyses of antiviral treatment for patients with chronic HCV infection are dependent on assumptions about cost reductions following sustained virological response (SVR) to therapy. This study quantified the medium-term difference in health resource usage and costs depending on treatment outcome. Retrospective chart review of patients with HCV genotype 1 infection who had received at least 2 months pegylated interferon and ribavirin therapy, with known treatment outcome was conducted. Disease status was categorized as chronic hepatitis, cirrhosis or decompensated liver disease. Health resource use was documented for each patient in each disease state. Unit costs were from the NHS 'Payment by Results' database and the British National Formulary. One hundred and ninety three patients (108 SVR, 85 non-SVR) with mean follow-up of 3.5 (SVR) and 4.9 (non-SVR) years were enrolled. No SVR patient progressed to a more severe liver disease state. Annual transition rates for non-SVR patients were 7.4% (chronic hepatitis to cirrhosis) and 4.9% (cirrhosis to decompensated liver disease). By extrapolation of modelled data over a 5-year post-treatment period, failure of patients with chronic hepatitis to achieve SVR was associated with a 13-fold increase (roughly £2300) in costs, whilst for patients who were retreated, the increase was 56-fold, equating to more than £10 000. Achievement of an SVR has significant effects on health service usage and costs. This work provides real-life data for future cost-effectiveness analyses related to the treatment for chronic HCV infection. © 2013 John Wiley & Sons Ltd.

  6. Costs and Benefits of a Shared Digital Long-Term Preservation System

    Directory of Open Access Journals (Sweden)

    Esa-Pekka Keskitalo

    2011-10-01

    Full Text Available This paper describes the cost-benefit analysis of digital long-term preservation (LTP that was carried out in the context of the Finnish National Digital Library Project (NDL in 2010. The analysis was based on the assumption that as many as 200 archives, libraries, and museums will share an LTP system. The term ‘system’ shall be understood as encompassing not only information technology, but also human resources, organizational structures, policies and funding mechanisms. The cost analysis shows that an LTP system will incur, over the first 12 years, cumulative costs of €42 million, i.e. an average of €3.5 million per annum. Human resources and investments in information technology are the major cost factors. After the initial stages, the analysis predicts annual costs of circa €4 million. The analysis compared scenarios with and without a shared LTP system. The results indicate that a shared system will have remarkable benefits. At the development and implementation stages, a shared system shows an advantage of €30 million against the alternative scenario consisting of five independent LTP solutions. During the later stages, the advantage is estimated at €10 million per annum. The cumulative cost benefit over the first 12 years would amount to circa €100 million.

  7. Costs, Benefits and Challenges of Sustainable Livestock Intensification in a Major Deforestation Frontier in the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Edenise Garcia

    2017-01-01

    Full Text Available Extensive livestock production is a major deforestation driver in the Brazilian Amazon. This study presents an assessment of the economic and environmental feasibility of sustainable livestock intensification in São Félix do Xingu municipality, a deforestation frontier with an area of more than 8.5 million hectares, and home to the largest cattle herd in Brazil. Proposed intensification was limited to approximately three animal units per hectare to avoid negative environmental impacts. Transition costs to sustainable cattle intensification were estimated for thirteen pilot farms taking into account adoption of good agriculture practices, pasture maintenance/restoration, and restoration of environmental liabilities. To move to sustainable intensification practices, a mean total annual investment of US$1335/ha ± US$619/ha would be necessary, varying from US$750 to US$2595/ha. Internal rate of return and net present value estimates indicated that the sustainable livestock intensification approach proposed was profitable in farms with more than 400 hectares of pastureland, but not in those where the pasture areas were smaller than 150 hectares. Livestock sustainable intensification also had the potential to promote social and environmental benefits, including a 54% increase in the number of contract workers, improvement of landowners’ managerial skills, and workers’ training, in addition to avoiding emission of 1.9 Mt CO2eq and sequestration of 0.36 Mt CO2eq. We conclude that the sustainable intensification of pasture areas has the potential to prevent further deforestation in the Amazon while generating social and other environmental benefits.

  8. Adjustment in property space markets: taking long-term leases and transaction costs seriously

    NARCIS (Netherlands)

    Englund, P.; Gunnelin, Å.; Hendershott, P.H.; Söderberg, B.

    2008-01-01

    Markets for property space adjust only gradually because tenants and landlords are constrained by long-term leases and transaction and information costs. Not only do rents adjust slowly, but space occupancy, which depends on historical rents, often differs from demand at current rent. This creates

  9. 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

  10. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD

    NARCIS (Netherlands)

    Hoogendoorn, Martine; Feenstra, Talitha L.; Hoogenveen, Rudolf T.; Rutten-van Molken, Maureen P. M. H.

    Background The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). Methods A systematic review was performed of randomised controlled trials on smoking cessation interventions in

  11. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD

    NARCIS (Netherlands)

    M. Hoogendoorn (Martine); T.L. Feenstra (Talitha); R.T. Hoogenveen (Rudolf); M.P.M.H. Rutten-van Mölken (Maureen)

    2010-01-01

    textabstractBackground: The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). Methods: A systematic review was performed of randomised controlled trials on smoking cessation

  12. Long-term Sustainability of Fracture Conductivity in Geothermal Systems using Proppants

    Energy Technology Data Exchange (ETDEWEB)

    Earl D Mattson; Ghanashyam Neupane; Mitchell Plummer; Clay Jones; Joe Moore

    2016-02-01

    Long-term sustainability of fracture conductivity is critical for commercial success of engineered geothermal system (EGS) and hydrogeothermal field sites. The injection of proppants has been suggested as a means to enhance the conductivity in these systems. Several studies have examined the chemical behavior of proppants that are not at chemical equilibrium with the reservoir rock and water. These studies have suggested that in geothermal systems, geochemical reactions can lead to enhance proppant dissolution and deposition alteration minerals. We hypothesize that proppant dissolution will decrease the strength of the proppant and can potentially reduce the conductivity of the fracture. To examine the geomechanical strength of proppants, we have performed modified crushing tests of proppants and reservoir rock material that was subjected to geothermal reservoir temperature conditions. The batch reactor experiments heated crushed quartz monzonite rock material, proppants (either quartz sand, sintered bauxite or kryptospheres) with Raft River geothermal water to 250 ºC for a period of 2 months. Solid and liquid samples were shipped to University of Utah for chemical characterization with ICP-OES, ICP-MS, and SEM. A separate portion of the rock/proppant material was subjected to a modified American Petroleum Institute ISO 13503-2 proppant crushing test. This test is typically used to determine the maximum stress level that can be applied to a proppant pack without the occurrence of unacceptable proppant crushing. We will use the test results to examine potential changes in proppant/reservoir rock geomechanical properties as compared to samples that have not been subjected to geothermal conditions. These preliminary results will be used to screen the proppants for long term use in EGS and hot hydrogeothermal systems.

  13. Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum Haya

    2011-08-01

    Full Text Available Abstract Background This study of chronically ill patients with schizophrenia aimed to identify patients who achieve sustained favorable long-term outcome - when the outcome incorporates severity of symptoms, level of functioning, and use of acute care services - and to identify the best baseline predictors of achieving this sustained favorable long-term outcome. Methods Using data from the United States Schizophrenia Care and Assessment Program (US-SCAP (N = 2327, a large 3-year prospective, multisite, observational study of individuals treated for schizophrenia in the US, a hierarchical cluster analysis was performed to group patients based upon baseline symptom severity. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS scores, level of functioning, and use of acute care services. Level of functioning reflected patient-reported productivity and clinician-rated occupational role functioning. Use of acute care services reflected self-reported psychiatric hospitalization and emergency service use. Change of health state was determined over the 3-year period. A patient was classified as having a sustained favorable long-term outcome if their health state values had the closest distance to the defined "best baseline cluster" at each point over the length of the study. Stepwise logistic regression was used to determine baseline predictors of sustained favorable long-term outcome. Results At baseline, 5 distinct health state clusters were identified, ranging from "best" to "worst." Of 1635 patients with sufficient data, only 157 (10% experienced sustained favorable long-term outcome during the 2-years postbaseline. The baseline predictors associated with sustained favorable long-term outcome included better quality of life, more daily activities, patient-reported clearer thinking from medication, better global functioning, being employed, not being a victim of a crime, not having received individual therapy, and not

  14. Comparative assessment of different energy sources and their potential role in long-term sustainable energy mix

    International Nuclear Information System (INIS)

    Kagramanian, V.S.

    2001-01-01

    In the debate on sustainable energy future, the role of nuclear power is a contentious issue. Many, who are outside of the nuclear community, do not even consider nuclear, because of public concerns on nuclear safety, radioactive waste and non-proliferation issues. For example, the United Nations Development Program, in its document Energy After Rio does not suggest a specific role for nuclear power except in the most doubtful of terms. On the contrary, most nuclear organisations and related industries see nuclear power as the only mature carbon-free electricity generating option that can be deployed even on a much larger scale than today. This paper analyses the potential role of nuclear power in the context of the global sustainable energy future. The fundamental features of sustainable energy development are examined in terms of the following compatibility constraints: Demand driven compatibility; Natural resource compatibility; Environmental compatibility; Geopolitical compatibility; and Economic compatibility

  15. Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

    Directory of Open Access Journals (Sweden)

    Evan S. Cole

    2016-09-01

    Full Text Available Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%. Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0, lengths of stay (61 versus 38 days, costs (US$143,898 versus US$115,056, but fewer discharges to the community (28.4% versus 51.8%. Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that

  16. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers.

    Science.gov (United States)

    Colón-Emeric, Cathleen; Toles, Mark; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A

    2016-07-16

    Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. In eight facilities, we conducted 15 focus groups with 83 staff who had participated in at least one intervention session. Where possible, separate groups were conducted with direct care staff and managers. An interview guide probed for staff perceptions of intervention salience and sustainability. Framework analysis of coded transcripts was used to distill insights about sustainability related to intervention features, organizational context, and external supports. Staff described important factors for intervention sustainability that are particularly challenging in LTC. Because of the tremendous diversity in staff roles and education level, interventions should balance complexity and simplicity, use a variety of delivery methods and venues (e.g., group and individual sessions, role-play/storytelling), and be inclusive of many work positions. Intervention customizability and flexibility was particularly prized in this unpredictable and resource-strapped environment. Contextual features noted to be important include addressing the frequent lack of trust between direct care staff and managers and ensuring that direct care staff directly observe manager participation and support for the program. External supports suggested to be useful for sustainability include formalization of changes into facility routines, using "train the trainer" approaches and refresher sessions. High staff turnover is common in LTC, and providing materials for new staff orientation was reported to be important for sustainability. When designing or

  17. Modeling and analysis of long-term energy scenarios for sustainable strategies of Ethiopia

    Energy Technology Data Exchange (ETDEWEB)

    Senshaw, Dereje Azemraw

    2014-04-15

    Despite robust economic growth, Ethiopia is one of the countries with poor energy accesses. Contributing factors are poor availability of energy, unreliable and insufficient quality of energy, and insufficient policy. Recognizing that energy access and security are indispensable to economic transformation, Ethiopia needs to cope with key challenges related to energy security, climate change mitigation and also diversification of energy supply. In order to achieve these targets and strive towards sustainable energy for all, Ethiopia's energy system requires a major transformation. The main achievement of this research has been the development of alternative energy options under different conditions for Ethiopia up to 2050. To identify an energy pathway that would meet Ethiopia's energy needs in a sustainable manner, three scenarios are considered: the business-as usual (BAU), moderate shift (Scenario1) and the advanced shift scenario (Scenario 2). The scenarios were developed, quantified and analyzed using a bottom-up model for Long Term Alternative Energy Planning (LEAP). These scenarios represent a range of energy policy measures that Ethiopia could adopt to achieve its sustainable development goals. The BAU scenario reflects a continuation of the current policy trend and considers on economic growth rate of 7%, while Scenario 1 and Scenario 2 represent moderate and advanced levels of commitment in economic growth, energy diversity and reduction of energy import dependency and CO{sub 2} emissions limits, respectively. The scenario analysis shows that the primary energy requirements for Ethiopia's socio-economic development will increase sharply over the period (2010-2050) in all three scenarios. BAU, Scenario 1 and Scenario 2 show an expected to growth at annual rates of 4.1, 4.9 and 5.7% respectively. If the current policy trends (as represented by BAU) continue, the total energy demand in Ethiopia is expected to reach 6,553 Petajoule (PJ) by 2050

  18. Modeling and analysis of long-term energy scenarios for sustainable strategies of Ethiopia

    International Nuclear Information System (INIS)

    Senshaw, Dereje Azemraw

    2014-04-01

    Despite robust economic growth, Ethiopia is one of the countries with poor energy accesses. Contributing factors are poor availability of energy, unreliable and insufficient quality of energy, and insufficient policy. Recognizing that energy access and security are indispensable to economic transformation, Ethiopia needs to cope with key challenges related to energy security, climate change mitigation and also diversification of energy supply. In order to achieve these targets and strive towards sustainable energy for all, Ethiopia's energy system requires a major transformation. The main achievement of this research has been the development of alternative energy options under different conditions for Ethiopia up to 2050. To identify an energy pathway that would meet Ethiopia's energy needs in a sustainable manner, three scenarios are considered: the business-as usual (BAU), moderate shift (Scenario1) and the advanced shift scenario (Scenario 2). The scenarios were developed, quantified and analyzed using a bottom-up model for Long Term Alternative Energy Planning (LEAP). These scenarios represent a range of energy policy measures that Ethiopia could adopt to achieve its sustainable development goals. The BAU scenario reflects a continuation of the current policy trend and considers on economic growth rate of 7%, while Scenario 1 and Scenario 2 represent moderate and advanced levels of commitment in economic growth, energy diversity and reduction of energy import dependency and CO 2 emissions limits, respectively. The scenario analysis shows that the primary energy requirements for Ethiopia's socio-economic development will increase sharply over the period (2010-2050) in all three scenarios. BAU, Scenario 1 and Scenario 2 show an expected to growth at annual rates of 4.1, 4.9 and 5.7% respectively. If the current policy trends (as represented by BAU) continue, the total energy demand in Ethiopia is expected to reach 6,553 Petajoule (PJ) by 2050 from

  19. Riding The Waves Of Quality Improvement : Sustainability and spread in a Dutch quality improvement program for long-term care

    NARCIS (Netherlands)

    S.S. Slaghuis (Sarah)

    2016-01-01

    markdownabstractIncreasingly, sustainability and spread have become part and parcel of organizational strategy in health care. This applies in particular to organizations in the long-term care sector, which faces an increasing care demand, ageing population and labor shortage. Unfortunately,

  20. Short-Term Memory Performances during Sustained Wakefulness in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

    Science.gov (United States)

    Greneche, Jerome; Krieger, Jean; Bertrand, Frederic; Erhardt, Christine; Maumy, Myriam; Tassi, Patricia

    2011-01-01

    Both working and immediate memories were assessed every 4 h by specific short-term memory tasks over sustained wakefulness in 12 patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) and 10 healthy controls. Results indicated that OSAHS patients exhibited lower working memory performances than controls on both backward digit span and…

  1. Collaborative testing for key-term definitions under representative conditions: Efficiency costs and no learning benefits.

    Science.gov (United States)

    Wissman, Kathryn T; Rawson, Katherine A

    2018-01-01

    Students are expected to learn key-term definitions across many different grade levels and academic disciplines. Thus, investigating ways to promote understanding of key-term definitions is of critical importance for applied purposes. A recent survey showed that learners report engaging in collaborative practice testing when learning key-term definitions, with outcomes also shedding light on the way in which learners report engaging in collaborative testing in real-world contexts (Wissman & Rawson, 2016, Memory, 24, 223-239). However, no research has directly explored the effectiveness of engaging in collaborative testing under representative conditions. Accordingly, the current research evaluates the costs (with respect to efficiency) and the benefits (with respect to learning) of collaborative testing for key-term definitions under representative conditions. In three experiments (ns = 94, 74, 95), learners individually studied key-term definitions and then completed retrieval practice, which occurred either individually or collaboratively (in dyads). Two days later, all learners completed a final individual test. Results from Experiments 1-2 showed a cost (with respect to efficiency) and no benefit (with respect to learning) of engaging in collaborative testing for key-term definitions. Experiment 3 evaluated a theoretical explanation for why collaborative benefits do not emerge under representative conditions. Collectively, outcomes indicate that collaborative testing versus individual testing is less effective and less efficient when learning key-term definitions under representative conditions.

  2. Preventing pressure ulcers in long-term care: a cost-effectiveness analysis.

    Science.gov (United States)

    Pham, Ba'; Stern, Anita; Chen, Wendong; Sander, Beate; John-Baptiste, Ava; Thein, Hla-Hla; Gomes, Tara; Wodchis, Walter P; Bayoumi, Ahmed; Machado, Márcio; Carcone, Steven; Krahn, Murray

    2011-11-14

    Pressure ulcers are common in many care settings, with adverse health outcomes and high treatment costs. We evaluated the cost-effectiveness of evidence-based strategies to improve current prevention practice in long-term care facilities. We used a validated Markov model to compare current prevention practice with the following 4 quality improvement strategies: (1) pressure redistribution mattresses for all residents, (2) oral nutritional supplements for high-risk residents with recent weight loss, (3) skin emollients for high-risk residents with dry skin, and (4) foam cleansing for high-risk residents requiring incontinence care. Primary outcomes included lifetime risk of stage 2 to 4 pressure ulcers, quality-adjusted life-years (QALYs), and lifetime costs, calculated according to a single health care payer's perspective and expressed in 2009 Canadian dollars (Can$1 = US$0.84). Strategies cost on average $11.66 per resident per week. They reduced lifetime risk; the associated number needed to treat was 45 (strategy 1), 63 (strategy 4), 158 (strategy 3), and 333 (strategy 2). Strategy 1 and 4 minimally improved QALYs and reduced the mean lifetime cost by $115 and $179 per resident, respectively. The cost per QALY gained was approximately $78 000 for strategy 3 and $7.8 million for strategy 2. If decision makers are willing to pay up to $50 000 for 1 QALY gained, the probability that improving prevention is cost-effective is 94% (strategy 4), 82% (strategy 1), 43% (strategy 3), and 1% (strategy 2). The clinical and economic evidence supports pressure redistribution mattresses for all long-term care residents. Improving prevention with perineal foam cleansers and dry skin emollients appears to be cost-effective, but firm conclusions are limited by the available clinical evidence.

  3. Long-term cost and life-expectancy consequences of hypertension.

    Science.gov (United States)

    Kiiskinen, U; Vartiainen, E; Puska, P; Aromaa, A

    1998-08-01

    To estimate hypertension's long-term cost and impact on life expectancy. A 19-year individual follow-up study. Subjects were categorized according to their baseline (1972) diastolic blood pressure (DBP) level into three groups: normotensive (DBP 104 mmHg). By using their social security identification numbers, we linked the subjects to a set of national registers covering hospital admissions, use of major drugs, absence due to sickness, disability pensions, and deaths. A random population sample of 10 284 men and women aged 25-59 years from the provinces of Kuopio and North Karelia in eastern Finland. The numbers of years of life and years of work lost, the cost of drugs and hospitalization, and the value of productivity lost due to disability and premature mortality. The difference in life expectancy between normotensive and severely hypertensive men was 2.7 years, of which 2.0 years was due to cardiovascular disease (CVD). Among women the corresponding differences were 2.0 and 1.5 years. Severely hypertensive men lost 2.6 years of work more than did normotensive men, of which 1.7 years was due to CVD. Among women the differences were 2.2 and 1.3 years. The mean undiscounted total costs (USA dollars at 1992 prices) were $132 500 among normotensive, $146 500 among mildly hypertensive, and $219 300 among severely hypertensive men, of which CVD accounted for 28, 39, and 43%, respectively. More than 90% of the total costs were indirect productivity losses. Among women the total costs were lower for all DBP categories, as were the shares of CVD-related costs. The proportional increase in costs on going from the lowest to the highest DBP category was, however, somewhat larger among women. On the population level, severe hypertension leads to considerable losses in terms of years of life lost, years of work lost, and costs. However, the overall impact of mild hypertension is much more limited.

  4. Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

    Directory of Open Access Journals (Sweden)

    Pattaraporn Khongboon

    2018-01-01

    Full Text Available Background. Rural-urban inequality in long-term care (LTC services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

  5. Geographical analyses of wood chips potentials, cost and supply for sustainable energy production in Denmark

    DEFF Research Database (Denmark)

    Möller, Bernd

    2004-01-01

    The paper presents a study which uses a practical application of rasterbased geographical information system to perform cost-supply analysis of wood chips resources for energy production.......The paper presents a study which uses a practical application of rasterbased geographical information system to perform cost-supply analysis of wood chips resources for energy production....

  6. Contingency Contractor Optimization Phase 3 Sustainment Cost by JCA Implementation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Durfee, Justin David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Frazier, Christopher Rawls [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arguello, Bryan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bandlow, Alisa [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gearhart, Jared Lee [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Katherine A [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    This document provides implementation guidance for implementing personnel group FTE costs by JCA Tier 1 or 2 categories in the Contingency Contractor Optimization Tool – Engineering Prototype (CCOT-P). CCOT-P currently only allows FTE costs by personnel group to differ by mission. Changes will need to be made to the user interface inputs pages and the database

  7. The Role of Corporate Sustainability in a Low-Cost Business Model

    DEFF Research Database (Denmark)

    Lueg, Rainer; Pedersen, Maria Medelby; Clemmensen, Søren Nørregaard

    2015-01-01

    ) improving leadership by motivating management and employees, and by directing their attention to critical issues. For companies, we offer the insight that corporate sustainability is a necessary complement to shareholder value, even if the relationship is not obvious at first sight. We also suggest...

  8. Sustainable Design: A Case of Environmental and Cost Life Cycle Assessment of a Kitchen Designed for Seniors and Disabled People

    Directory of Open Access Journals (Sweden)

    Anna Lewandowska

    2017-07-01

    Full Text Available Sustainable production and consumption patterns require a change in approach at the early conceptual stages, i.e., when planning and designing products and services. This article presents an example of sustainable kitchen design aimed at the needs of seniors and people with physical disabilities, which takes into account social, economic, and environmental aspects. The interdisciplinary project team used a variety of traditional design methods such as the identification of requirements using QFD (Quality Function Deployment and FMEA (Failure Mode Effects Analysis, the development and verification of the technical concepts of the designed objects and their use, the development of construction and technological documentation, assembly drawings of the product architecture and its parts, function cost analysis, virtual and real prototyping, and tools based on the concept of a life cycle such as environmental life cycle assessment (LCA and life cycle costing (LCC. The analysis of the design solutions from the point of view of several criteria and several life cycle stages shows the complexity of the decision-making process and the difficulties in selecting a clearly favourable solution. Environmentally preferred materials may be difficult for users to accept due to their costs. On the other hand, materials that have a high environmental impact at the production stage may show great potential for final disposal.

  9. Cost-benefit analysis of a sustainable safe road traffic system. Contribution to the conference `Traffic safety on two continents', Lisbon, Portugal, September 22-24, 1997.

    NARCIS (Netherlands)

    Poppe, F.

    1997-01-01

    In this report it is shown, using cost-benefit techniques, that for different variations of estimates, investments in a sustainable safe road traffic system are profitable from a societal point of view. (A)

  10. Energy Efficiency in Building as a Basic Prerequisite for a Long Term Energy Strategies Realization, Environmental Protection and Sustainability

    International Nuclear Information System (INIS)

    Miscevic, Lj.

    2006-01-01

    Energy efficiency in buildings at the low-energy and 'passive house' standard levels is presently the basic prerequisite for considering and formulating long term strategies, which with the task of meeting energy needs and system maintenance respond to requests of environmental protection and improvements in the context of sustainable development. Orientation to sustainable development is integrated in the development strategies of Croatia. The application of renewable energy sources, in particular solar energy in passive and active systems in the architecture is permanently confirmed by conducting energy monitoring and growing number of domestic studies, projects and realizations. The long-time research project of the European Union Cost Efficient Passive Houses as European Standards (CEPHEUS) with scientific monitoring corroborated energy and economic efficiency of such architectural designs in Germany, France, Austria, and Switzerland. Thus, the 'passive house' is proposed as a standard of residential architecture, but also of the construction of other functional types of architecture in general. The accomplished energy efficiency and verified favorable profitability of investment developed new forms of incentives to low-energy and passive architecture and relevant changes in concepts of long term energy strategies in the European Union member states. In Austria the 1000th passive house was built, and the city of Frankfurt/M brought decision regarding financing building construction through the city budget at the 'passive house' level. The new Technical Regulation on energy savings and thermal protection in Croatia, which is effectively in force as of 1 July, is a long-awaited step towards energy efficiency. Although, according to this Regulation the tolerance in energy use for space heating goes, in worst case calculation, up to 89 kWh/m2 a year, any other more favorable calculation with obligation to calculate the share of solar radiation for buildings, opens

  11. Cost-effectiveness of external cephalic version for term breech presentation.

    Science.gov (United States)

    Tan, Jonathan M; Macario, Alex; Carvalho, Brendan; Druzin, Maurice L; El-Sayed, Yasser Y

    2010-01-21

    External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse

  12. Cost-effectiveness of external cephalic version for term breech presentation

    Directory of Open Access Journals (Sweden)

    Carvalho Brendan

    2010-01-01

    Full Text Available Abstract Background External cephalic version (ECV is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc. was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery, utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion

  13. A retrospective cost-analysis of additional homeopathic treatment in Germany: Long-term economic outcomes

    Science.gov (United States)

    Ostermann, Julia K.; Witt, Claudia M.; Reinhold, Thomas

    2017-01-01

    Objectives This study aimed to provide a long-term cost comparison of patients using additional homeopathic treatment (homeopathy group) with patients using usual care (control group) over an observation period of 33 months. Methods Health claims data from a large statutory health insurance company were analysed from both the societal perspective (primary outcome) and from the statutory health insurance perspective (secondary outcome). To compare costs between patient groups, homeopathy and control patients were matched in a 1:1 ratio using propensity scores. Predictor variables for the propensity scores included health care costs and both medical and demographic variables. Health care costs were analysed using an analysis of covariance, adjusted for baseline costs, between groups both across diagnoses and for specific diagnoses over a period of 33 months. Specific diagnoses included depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache. Results Data from 21,939 patients in the homeopathy group (67.4% females) and 21,861 patients in the control group (67.2% females) were analysed. Health care costs over the 33 months were 12,414 EUR [95% CI 12,022–12,805] in the homeopathy group and 10,428 EUR [95% CI 10,036–10,820] in the control group (phomeopathy: EUR 6,289 [6,118–6,460]; control: EUR 5,498 [5,326–5,670], phomeopathy: EUR 1,794 [1,770–1,818]; control: EUR 1,438 [1,414–1,462], phomeopathy patients generated higher costs than control patients. Conclusion The analysis showed that even when following-up over 33 months, there were still cost differences between groups, with higher costs in the homeopathy group. PMID:28915242

  14. Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability.

    Science.gov (United States)

    Daviaud, Emmanuelle; Besada, Donnela; Leon, Natalie; Rohde, Sarah; Sanders, David; Oliphant, Nicholas; Doherty, Tanya

    2017-06-01

    economic cost of under US$ 1/capita/y represents a sound investment. Utilization remains low however, and strategies must be developed as a priority to improve demand. Continued donor support is required to sustain iCCM services and strengthen its integration within national health systems.

  15. Analysis of the thermal behaviour of a low cost, single-family, more sustainable house in Porto Alegre, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Grigoletti, Giane [Departamento de Arquitetura e Urbanismo, UFSM, Santa Maria, RS (Brazil); Nucleo Orientado para a Inovacao da Edificacao, UFRGS, Porto Alegre (Brazil); Sattler, Miguel A.; Morello, Alessandro [Nucleo Orientado para a Inovacao da Edificacao, UFRGS, Porto Alegre (Brazil)

    2008-07-01

    Efforts have been made in Brazil to improve the thermal performance of low-cost buildings. Since 1997 studies on low-cost housing have been developed by Nucleo Orientado para a Inovacao da Edificacao, the construction sector of the Engineering College of the Rio Grande do Sul University, Brazil. In 2000 a prototype of a low-cost house was built on the university campus. This prototype has undergone several evaluations in an attempt to assess its thermal and environmental performance, like: energy consumption, rainwater harvesting, use of sustainably managed wood for window frames and doors, besides a detailed accounting of overall costs. The thermal performance of the house was monitored, by recording outdoor and indoor air temperatures and relative humidity, over the period of whole year. A brief appraisal of such results, as well as the annual heating and cooling degree-hours are presented. Daily swings in outdoor are a common climatic event in Porto Alegre and the building response to daily temperature swings, greater than 10 K, and hot and cold spells are presented. The results show that the thermal performance of the prototype is fairly satisfactory, considering the limitations of a low-cost house, when artificial heating and cooling is not affordable. (author)

  16. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD.

    Science.gov (United States)

    Hoogendoorn, Martine; Feenstra, Talitha L; Hoogenveen, Rudolf T; Rutten-van Mölken, Maureen P M H

    2010-08-01

    The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). A systematic review was performed of randomised controlled trials on smoking cessation interventions in patients with COPD reporting 12-month biochemical validated abstinence rates. The different interventions were grouped into four categories: usual care, minimal counselling, intensive counselling and intensive counselling + pharmacotherapy ('pharmacotherapy'). For each category the average 12-month continuous abstinence rate and intervention costs were estimated. A dynamic population model for COPD was used to project the long-term (cost-) effectiveness (25 years) of 1-year implementation of the interventions for 50% of the patients with COPD who smoked compared with usual care. Uncertainty and one-way sensitivity analyses were performed for variations in the calculation of the abstinence rates, the type of projection, intervention costs and discount rates. Nine studies were selected. The average 12-month continuous abstinence rates were estimated to be 1.4% for usual care, 2.6% for minimal counselling, 6.0% for intensive counselling and 12.3% for pharmacotherapy. Compared with usual care, the costs per quality-adjusted life year (QALY) gained for minimal counselling, intensive counselling and pharmacotherapy were euro 16 900, euro 8200 and euro 2400, respectively. The results were most sensitive to variations in the estimation of the abstinence rates and discount rates. Compared with usual care, intensive counselling and pharmacotherapy resulted in low costs per QALY gained with ratios comparable to results for smoking cessation in the general population. Compared with intensive counselling, pharmacotherapy was cost saving and dominated the other interventions.

  17. Potential for the near-term use of the thorium cycle in a sustainable way

    International Nuclear Information System (INIS)

    Wider, H.; Tucek, K.; Carlsson, J.

    2007-01-01

    Nuclear sustainability is generally believed to be only reachable through the building of many fast breeder reactors. This paper shows that there is another possibility by using existing reactors that are either thermal breeders or have at least a high conversion ratio and considerably smaller critical masses than fast systems. Earlier it was believed that thermal molten salt breeders could eventually use the thorium / 233U cycle, which doesn't generate minor actinides and is therefore a cleaner fuel cycle. In the meantime, it has become rather clear that CANDU reactors that use heavy water cooling can also be self-breeders. The CANDU reactors could generate themselves 233U in thorium targets and could become selfsustaining after 12 years. However, additional 233U could also be generated in LWRs and fast reactors. It is shown that this generation of 233U will allow a faster large-term nuclear expansion than fast reactors alone. There could actually be a synergy between thermal and fast breeders if the latter are run with Pu/Minor Actinides/Th fuel, which burns the minor actinides and generates sizeable amounts of 233U. The main problem is still the necessary reprocessing on which India is working and intends to have in 10 years a large scale reprocessing facility available. However, there is at least an existing method for removing the 233U by the fluoride volatility method and to further use it in CANDUs. For the preparation of the use of 233U, we should attempt to run thorium subassemblies in CANDUs, LWRs, and fast reactors. Besides breeding 233U or at least having a high conversion ratio, CANDUs have the further advantage that they don't need a pressure vessel and therefore could be built in large numbers faster than LWRs. (author)

  18. Arctic plants are capable of sustained responses to long-term warming

    Directory of Open Access Journals (Sweden)

    Robert T. Barrett

    2016-05-01

    Full Text Available Previous studies have shown that Arctic plants typically respond to warming with increased growth and reproductive effort and accelerated phenology, and that the magnitude of these responses is likely to change over time. We investigated the effects of long-term experimental warming on plant growth (leaf length and reproduction (inflorescence height, reproductive phenology and reproductive effort using 17–19 years of measurements collected as part of the International Tundra Experiment (ITEX at sites near Barrow and Atqasuk, Alaska. During the study period, linear regressions indicated non-significant tendencies towards warming air temperatures at our study sites. Results of our meta-analyses on the effect size of experimental warming (calculated as Hedges’ d indicated species generally responded to warming by increasing inflorescence height, increasing leaf length and flowering earlier, while reproductive effort did not respond consistently. Using weighted least-squares regressions on effect sizes, we found a significant trend towards dampened response to experimental warming over time for reproductive phenology. This tendency was consistent, though non-significant, across all traits. A separate analysis revealed significant trends towards reduced responses to experimental warming during warmer summers for all traits. We therefore propose that tendencies towards dampened plant responses to experimental warming over time are the result of regional warming. These results show that Arctic plants are capable of sustained responses to warming over long periods of time but also suggest that, as the region continues to warm, factors such as nutrient availability, competition and herbivory will become more limiting to plant growth and reproduction than temperature.

  19. Scalable, sustainable cost-effective surgical care: a model for safety and quality in the developing world, part III: impact and sustainability.

    Science.gov (United States)

    Campbell, Alex; Restrepo, Carolina; Mackay, Don; Sherman, Randy; Varma, Ajit; Ayala, Ruben; Sarma, Hiteswar; Deshpande, Gaurav; Magee, William

    2014-09-01

    The Guwahati Comprehensive Cleft Care Center (GCCCC) utilizes a high-volume, subspecialized institution to provide safe, quality, and comprehensive and cost-effective surgical care to a highly vulnerable patient population. The GCCCC utilized a diagonal model of surgical care delivery, with vertical inputs of mission-based care transitioning to investments in infrastructure and human capital to create a sustainable, local care delivery system. Over the first 2.5 years of service (May 2011-November 2013), the GCCCC made significant advances in numerous areas. Progress was meticulously documented to evaluate performance and provide transparency to stakeholders including donors, government officials, medical oversight bodies, employees, and patients. During this time period, the GCCCC provided free operations to 7,034 patients, with improved safety, outcomes, and multidisciplinary services while dramatically decreasing costs and increasing investments in the local community. The center has become a regional referral cleft center, and governments of surrounding states have contracted the GCCCC to provide care for their citizens with cleft lip and cleft palate. Additional regional and global impact is anticipated through continued investments into education and training, comprehensive services, and research and outcomes. The success of this public private partnership demonstrates the value of this model of surgical care in the developing world, and offers a blueprint for reproduction. The GCCCC experience has been consistent with previous studies demonstrating a positive volume-outcomes relationship, and provides evidence for the value of the specialty hospital model for surgical delivery in the developing world.

  20. Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative.

    Science.gov (United States)

    Stolee, Paul; McAiney, Carrie A; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

    2009-01-01

    This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management support, particularly designation of time for PRP activities, development of PRP teams, and supportive learning strategies were significant factors affecting sustained knowledge transfer. Continuing education that is provided and evaluated on an ongoing basis, secures management commitment, is integrated within a broader system strategy, and provides on-the-job support has the greatest potential to affect care.

  1. A Cost Optimized Fully Sustainable Power System for Southeast Asia and the Pacific Rim

    Directory of Open Access Journals (Sweden)

    Ashish Gulagi

    2017-04-01

    Full Text Available In this paper, a cost optimal 100% renewable energy based system is obtained for Southeast Asia and the Pacific Rim region for the year 2030 on an hourly resolution for the whole year. For the optimization, the region was divided into 15 sub-regions and three different scenarios were set up based on the level of high voltage direct current grid connections. The results obtained for a total system levelized cost of electricity showed a decrease from 66.7 €/MWh in a decentralized scenario to 63.5 €/MWh for a centralized grid connected scenario. An integrated scenario was simulated to show the benefit of integrating additional demand of industrial gas and desalinated water which provided the system the required flexibility and increased the efficiency of the usage of storage technologies. This was reflected in the decrease of system cost by 9.5% and the total electricity generation by 5.1%. According to the results, grid integration on a larger scale decreases the total system cost and levelized cost of electricity by reducing the need for storage technologies due to seasonal variations in weather and demand profiles. The intermittency of renewable technologies can be effectively stabilized to satisfy hourly demand at a low cost level. A 100% renewable energy based system could be a reality economically and technically in Southeast Asia and the Pacific Rim with the cost assumptions used in this research and it may be more cost competitive than the nuclear and fossil carbon capture and storage (CCS alternatives.

  2. The impact of minimum pay implementation on small businesses operating cost and sustainability: A case of service business

    Directory of Open Access Journals (Sweden)

    Hanim Rusly Fariza

    2017-01-01

    Full Text Available The implementation of minimum wage requirement in Malaysia beginning mid 2016 seems to impact both employees and employers in different ways. While this implementation could increase household income and claimed to boost employees’ productivity, employers or business operators, on the other hand are experiencing stringent effect on their business operating cost. The effect is more significant for small business operators, including the childcare centers. Childcare industry operates in the service sector, which represents the main contributor of Malaysian SMEs. Unfortunately for the industry, there is an increasing numbers of childcare centers have to cease their operation due to inability to comply with the minimum pay requirement. In the absence of thorough understanding of the phenomena, the small businesses, particularly among institution-based childcare, is at the risk of losing their businesses. This exploratory study intends to assess how the implementation of minimum pay requirement affects the existing operating cost structure, and consequently business sustainability of Malaysian childcare industry.

  3. Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article

    Science.gov (United States)

    French, Dustin D.; Dixon, Brian E.; Perkins, Susan M.; Myers, Laura J.; Weiner, Michael; Zillich, Allan J.; Haggstrom, David A.

    2016-01-01

    Abstract The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans’ electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers. The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs. A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation. Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office. VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment. There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807–1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees. Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons. PMID:26765453

  4. Moving evidence into practice: cost analysis and assessment of macaques' sustained behavioral engagement with videogames and foraging devices.

    Science.gov (United States)

    Bennett, Allyson J; Perkins, Chaney M; Tenpas, Parker D; Reinebach, Alma L; Pierre, Peter J

    2016-12-01

    Environmental enrichment plans for captive nonhuman primates often include provision of foraging devices. The rationale for using foraging devices is to promote species-typical activity patterns that encourage physical engagement and provide multi-sensory stimulation. However, these devices have been shown to be ineffective at sustaining manipulation over long periods of time, and often produce minimal cognitive engagement. Here we use an evidence-based approach to directly compare the amount of object-directed behavior with a foraging device and a computer-based videogame system. We recorded 11 adult male rhesus monkeys' interactions with a foraging device and two tasks within a joystick videogame cognitive test battery. Both techniques successfully produced high levels of engagement during the initial 20 min of observation. After 1 hr the monkeys manipulated the foraging device significantly less than the joystick, F(2,10) = 43.93, P videogame play for the majority of a 5 hr period, provided that they received a 94 mg chow pellet upon successful completion of trials. Using a model approach, we developed previously as a basis for standardized cost:benefit analysis to inform facility decisions, we calculated the comprehensive cost of incorporating a videogame system as an enrichment strategy. The videogame system has a higher initial cost compared to widely-used foraging devices, however, the ongoing labor and supply costs are relatively low. Our findings add to two decades of empirical studies by a number of laboratories that have demonstrated the successful use of videogame-based systems to promote sustained non-social cognitive engagement for macaques. The broader significance of the work lies in the application of a systematic approach to compare and contrast enrichment strategies and encourage evidence-based decision making when choosing an enrichment strategy in a manner that promotes meaningful cognitive enrichment to the animals. © 2016 Wiley

  5. Moving Evidence into Practice: Cost Analysis and Assessment of Macaques’ Sustained Behavioral Engagement with Videogames and Foraging Devices

    Science.gov (United States)

    Bennett, Allyson J.; Perkins, Chaney M.; Tenpas, Parker D.; Reinebach, Alma L.; Pierre, Peter J.

    2017-01-01

    Environmental enrichment plans for captive nonhuman primates often include provision of foraging devices. The rationale for using foraging devices is to promote species-typical activity patterns that encourage physical engagement and provide multi-sensory stimulation. However, these devices have been shown to be ineffective at sustaining manipulation over long periods of time, and often produce minimal cognitive engagement. Here we use an evidence-based approach to directly compare the amount of object-directed behavior with a foraging device and a computer-based videogame system. We recorded 11adult male rhesus monkeys’ interactions with a foraging device and two tasks within a joystick videogame cognitive test battery. Both techniques successfully produced high levels of engagement during the initial 20-min of observation. After 1-hr the monkeys manipulated the foraging device significantly less than the joystick, F(2,10)= 43.93, p videogame play for the majority of a 5-hr period, provided that they received a 94mg chow pellet upon successful completion of trials. Using a model approach we developed previously as a basis for standardized cost:benefit analysis to inform facility decisions, we calculated the comprehensive cost of incorporating a videogame system as an enrichment strategy. The videogame system has a higher initial cost compared to widely-used foraging devices however, the ongoing labor and supply costs are relatively low. Our findings add to two decades of empirical studies by a number of laboratories that have demonstrated the successful use of videogame-based systems to promote sustained non-social cognitive engagement for macaques. The broader significance of the work lies in the application of a systematic approach to compare and contrast enrichment strategies and encourage evidence-based decision making when choosing an enrichment strategy in a manner that promotes meaningful cognitive enrichment to the animals. PMID:27404766

  6. Long-term socioeconomic consequences and health care costs of childhood and adolescent-onset epilepsy

    DEFF Research Database (Denmark)

    Jennum, Poul; Christensen, Jakob; Ibsen, Rikke

    2016-01-01

    . Income was lower from employment, which in part was compensated by social security, sick pay, disability pension and unemployment benefit, sick pay (public-funded), disability pension, and other public transfers. Predicted health care costs 30 years after epilepsy onset were significantly higher among......Objective: To estimate long-term socioeconomic consequences and health care costs of epilepsy with onset in childhood and adolescence. Methods: A historical prospective cohort study of Danish individuals with epilepsy, age up to 20 years at time of diagnosis between January 1981 and December 2012....... Information about marital status, parenthood, educational level, employment status, income, use of the health care system, and cost of medicine was obtained from nationwide administrative and health registers. Results: We identified 12,756 and 28,319 people with diagnosed with epilepsy, ages 0–5 and 6...

  7. Shifting the Paradigm for Long Term Monitoring at Legacy Sites to Improve Performance while Reducing Cost

    International Nuclear Information System (INIS)

    Eddy-Dilek, Carol A.; Looney, Brian B.; Seaman, John; Kmetz, Thomas

    2013-01-01

    A major issue facing many government and private industry sites that were previously contaminated with radioactive and chemical wastes is that often the sites cannot be cleaned up enough to permit unrestricted human access. These sites will require long-term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality in a cost effective manner. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site (SRS), the larger DOE complex, and many large federal and private sites. Currently, most monitoring strategies are focused on laboratory measurements of contaminants measured in groundwater samples collected from wells. This approach is expensive, and provides limited and lagging information about the effectiveness of cleanup activities and the behavior of the residual contamination. Over the last twenty years, DOE and other federal agencies have made significant investments in the development of various types of sensors and strategies that would allow for remote analysis of contaminants in groundwater, but these approaches do not promise significant reductions in risk or cost. Scientists at SRS have developed a new paradigm to simultaneously improve the performance of long term monitoring systems while lowering the overall cost of monitoring. This alternative approach incorporates traditional point measurements of contaminant concentration with measurements of controlling variables including boundary conditions, master variables, and traditional plume/contaminant variables. Boundary conditions are the overall driving forces that control plume movement and therefore provide leading indication to changes in plume stability. These variables include metrics associated with meteorology, hydrology, hydrogeology, and land use. Master variables are the key variables that control the chemistry of the

  8. A two-dimensional three-level sustainability framework for achieving short- and long-term gains: empirical evidence from the Chinese automotive sector

    OpenAIRE

    Wu, Lin

    2016-01-01

    A topic of academic research and business practice which has grown in importance recently is sustainability. Its main objective is to ensure the development of the current generation and protect the right of future generations to prosper. In the business context, sustainability should be reflected in firms’ efforts to simultaneously ensure short- and long-term gains. A time dimension is thus an important feature in the concept of sustainability. In the past two decades, sustainability res...

  9. Developing indigenous safeguards capabilities within the MPC ampersand A program: A transition from near-term upgrades to long-term sustainability

    International Nuclear Information System (INIS)

    Robinson, P.W.; Leutters, F.O.; Horton, R.D.; Soo Hoo, M.S.

    1997-01-01

    Approximately five years ago, the United States and countries of ampersand Former Soviet Union (FSU) started the Cooperative Threat Reduction program. The program's purpose was to accelerate reduction of the risk of nuclear proliferation, including such threats as theft, diversion, and unauthorized possession of nuclear materials. This goal would be accomplished through near-term upgrades to strengthen the nuclear material protection, control, and accounting systems within the FSU countries. In addition to this near-term goal, a long-term goal of the U.S. Department of Energy's (DOE) Material Protection, Control, and Accounting (MPC ampersand A) program is to promote a new safeguards culture and to support the establishment of a sustaining MPC ampersand A infrastructure in the FSU. This long-term goal is vital to assuring that the near-term upgrades remain effective for safeguarding nuclear material as these countries experience political and social changes. The MPC ampersand A program is managed by DOE's Russia/Newly Independent States (NIS) Nuclear Materials Security Task Force. A coordinated effort is underway to promote and to help establish a new safeguards culture and a sustaining infrastructure. Elements being implemented at both the national and site levels include system operational performance evaluations, development of MPC ampersand A training, operational procedures, national MPC ampersand A regulations, and adaptation of modern MPC ampersand A methodologies to suit the conditions in the FSU countries. This paper identifies current efforts in several countries that are undergoing transition from near-term upgrades to sustainable MPC ampersand A systems

  10. Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

    Science.gov (United States)

    Nuti, Sabina

    2017-01-01

    Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

  11. Long-term sustainability in the management of acid mine drainage ...

    African Journals Online (AJOL)

    2013-08-14

    Aug 14, 2013 ... It was shown, in what became known as the Rhodes BioSURE Process, that with ...... and social sustainability audit criteria has been summarised by .... HARTNADY CJH (2009) South Africa's gold production and reserves.

  12. Characterization of unsaturated fatty acid sustained-release microspheres for long-term algal inhibition.

    Science.gov (United States)

    Ni, Lixiao; Jie, Xiaoting; Wang, Peifang; Li, Shiyin; Hu, Shuzhen; Li, Yiping; Li, Yong; Acharya, Kumud

    2015-02-01

    The unsaturated fatty acid (linoleic acid) sustained-release microspheres were prepared with linoleic acid (LA) using alginate-chitosan microcapsule technology. These LA sustained-release microspheres had a high encapsulation efficiency (up to 62%) tested by high performance liquid chromatography with a photo diode array. The dry microspheres were characterized by a scanning electron microscope, X-ray diffraction measurement, dynamic thermogravimetric analysis and Fourier transform infrared spectral analysis. The results of characterization showed that the microspheres had good thermal stability (decomposition temperature of 236°C), stable and temperature independent release properties (release time of more than 40 d). Compared to direct dosing of LA, LA sustained-released microspheres could inhibit Microcystis aeruginosa growth to the non-growth state. The results of this study suggested that the LA sustained-release microspheres may be a potential candidate for algal inhibition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Cost of practice in a tertiary/quaternary referral center: is it sustainable?

    Science.gov (United States)

    Cologne, K G; Hwang, G S; Senagore, A J

    2014-11-01

    Third-party payers are moving toward a bundled care payment system. This means that there will need to be a warranty cost of care-where the cost of complexity and complication rates is built into the bundled payment. The theoretical benefit of this system is that providers with lower complication rates will be able to provide care with lower warranty costs and lower overall costs. This may also result in referring riskier patients to tertiary or quaternary referral centers. Unless the payment model truly covers the higher cost of managing such referred cases, the economic risk may be unsustainable for these centers. We took the last seven patients that were referred by other surgeons as "too high risk" for colectomy at other centers. A contribution margin was calculated using standard Medicare reimbursement rates at our institution and cost of care based on our administrative database. We then recalculated a contribution margin assuming a 3 % reduction in payment for a higher than average readmission rate, like that which will take effect in 2014. Finally, we took into account the cost of any readmissions. Seven patients with diagnosis related group (DRG) 330 were reviewed with an average age of 66.8 ± 16 years, American Society of Anesthesiologists score 2.3 ± 1.0, body mass index 31.6 ± 9.8 kg/m(2) (range 22-51 kg/m(2)). There was a 57 % readmission rate, 29 % reoperation rate, 10.8 ± 7.7 day average initial length of stay with 14 ± 8.6 day average readmission length of stay. Forty-two percent were discharged to a location other than home. Seventy-one percent of these patients had Medicare insurance. The case mix index was 2.45. Average reimbursement for DRG 330 was $17,084 (based on Medicare data) for our facility in 2012, with the national average being $12,520. The total contribution margin among all cases collectively was -$19,122 ± 13,285 (average per patient -$2,731, range -$21,905-$12,029). Assuming a 3 % reimbursement reduction made the overall

  14. Long-term health care utilisation and costs after spinal fusion in elderly patients

    DEFF Research Database (Denmark)

    Andersen, Thomas; Bünger, Cody; Søgaard, Rikke

    2012-01-01

    PURPOSE: Spinal fusion surgery rates in the elderly are increasing. Cost effectiveness analyses with relatively short-length follow-up have been performed. But the long-term effects in terms of health care use are largely unknown. The aim of the present study was to describe the long......-term consequences of spinal fusion surgery in elderly patients on health care use and costs using a health care system perspective. METHODS: 194 patients undergoing spinal fusion between 2001 and 2005 (70 men, 124 women) with a mean age of 70 years (range 59-88) at surgery were included. Average length of follow......-up was 6.2 years (range 0.3-9.0 years). Data on resource utilisation and costs were obtained from national registers providing complete coverage of all reimbursed contacts with primary- and secondary health care providers. Data were available from 3 years prior fusion surgery until the end of 2009. RESULTS...

  15. Is local participation always optimal for sustainable action? The costs of consensus-building in Local Agenda 21.

    Science.gov (United States)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-11-15

    Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits. Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable action in the future. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Assessing District-Heating Sustainability. Case Studies of CO{sub 2} Mitigation Strategies and Environmental Cost Accounting

    Energy Technology Data Exchange (ETDEWEB)

    Fahlen, Elsa

    2012-11-01

    District heating (DH) may play an important role in achieving the EU goal of a secure, competitive and sustainable energy supply. Integrated energy solutions based on technologies, such as biomass gasification for transport fuel, electricity and heat production and heat-driven absorption cooling, create new optimisation possibilities through the linkage between heat, power, cooling and transport fuel markets which may reduce the global warming contribution of the energy sector. With increasing focus on climate change impacts of greenhouse gas emissions, the environmental effects of other air pollutants should not be neglected. To achieve both a competitive and a sustainable energy supply, it is necessary to integrate environmental considerations into economic policies. Through accounting for external costs of air pollution in energy system modelling and analysis, sustainability aspects may be integrated into DH assessments. The aim of this thesis is to develop, apply and evaluate methodologies for assessing conventional and new technology solutions in a DH system; the assessments are made from a DH perspective with respect to two factors - cost-effectiveness and environmental impacts - which are either assessed separately or integrated through external cost accounting. Various CO{sub 2} mitigation strategies are evaluated with regard to the robustness of the DH system in meeting future developments of energy market prices and policies. The studies are performed using a systems approach by using the simulating DH supply model MARTES as applied to the DH system Sweden. This thesis concludes that the integration of biomass gasification technology and absorption cooling technology in DH systems has the potential for cost-effective CO{sub 2} emission reduction, in line with other EU goals to increase the share of renewable sources in energy use and to increase energy efficiency. Accounting for external costs of not only climate change but also other environmental

  17. A Cost Optimized Fully Sustainable Power System for Southeast Asia and the Pacific Rim

    OpenAIRE

    Ashish Gulagi; Dmitrii Bogdanov; Christian Breyer

    2017-01-01

    In this paper, a cost optimal 100% renewable energy based system is obtained for Southeast Asia and the Pacific Rim region for the year 2030 on an hourly resolution for the whole year. For the optimization, the region was divided into 15 sub-regions and three different scenarios were set up based on the level of high voltage direct current grid connections. The results obtained for a total system levelized cost of electricity showed a decrease from 66.7 €/MWh in a decentralized scenario to 63...

  18. REUSABLE PROPULSION ARCHITECTURE FOR SUSTAINABLE LOW-COST ACCESS TO SPACE

    Science.gov (United States)

    Bonometti, Joseph; Frame, Kyle L.; Dankanich, John W.

    2005-01-01

    Two transportation architecture changes are presented at either end of a conventional two-stage rocket flight: 1) Air launch using a large, conventional, pod hauler design (i.e., Crossbow)ans 2) Momentum exchange tether (i.e., an in-space asset like MXER). Air launch has ana analytically justified cost reduction of approx. 10%, but its intangible benefits suggest real-world operations cost reductions much higher: 1) Inherent launch safety; 2) Mission Risk Reduction; 3) Favorable payload/rocket limitations; and 4) Leveraging the aircraft for other uses (military transport, commercial cargo, public outreach activities, etc.)

  19. The nine-year sustained cost-containment impact of swiss pilot physicians-pharmacists quality circles.

    Science.gov (United States)

    Niquille, Anne; Ruggli, Martine; Buchmann, Michel; Jordan, Dominique; Bugnon, Olivier

    2010-04-01

    Six pioneer physicians-pharmacists quality circles (PPQCs) located in the Swiss canton of Fribourg (administratively corresponding to a state in the US) were under the responsibility of 6 trained community pharmacists moderating the prescribing process of 24 general practitioners (GPs). PPQCs are based on a multifaceted collaborative process mediated by community pharmacists for improving compliance with clinical guidelines within GPs' prescribing practices. To assess, over a 9-year period (1999-2007), the cost-containment impact of the PPQCs. The key elements of PPQCs are a structured continuous quality improvement and education process; local networking; feedback of comparative and detailed data regarding costs, drug choice, and frequency of prescribed drugs; and structured independent literature review for interdisciplinary continuing education. The data are issued from the community pharmacy invoices to the health insurance companies. The study analyzed the cost-containment impact of the PPQCs in comparison with GPs working in similar conditions of care without particular collaboration with pharmacists, the percentage of generic prescriptions for specific cardiovascular drug classes, and the percentage of drug costs or units prescribed for specific cardiovascular drugs. For the 9-year period, there was a 42% decrease in the drug costs in the PPQC group as compared to the control group, representing a $225,000 (USD) savings per GP only in 2007. These results are explained by better compliance with clinical and pharmacovigilance guidelines, larger distribution of generic drugs, a more balanced attitude toward marketing strategies, and interdisciplinary continuing education on the rational use of drugs. The PPQC work process has yielded sustainable results, such as significant cost savings, higher penetration of generics and reflection on patient safety, and the place of "new" drugs in therapy. The PPQCs may also constitute a solid basis for implementing more

  20. The system of protected areas in Bulgaria in terms of the implementation of the concepts of sustainable and alternative tourism

    Directory of Open Access Journals (Sweden)

    Georgiev Leonidov Georgi

    2010-01-01

    Full Text Available Protected areas hold a special position in terms of the sustainable socio-economic and tourism development of the planet. The International Union for Conservation of Nature has created a specific classifying system for cate­gorization of such areas depending on their nature-scientific and conservation value and significance. Except for preserving valuable biological species and their natural habitats, these areas could fulfill one more function. They can be integrated and contribute to the sustainable development of all spheres of socio-economic life of the com­munity. This paper sets the aim to determine to what extent and what categories of protected areas in Bulgaria could be integrated into the tourism sector of the country and to contribute that way to its sustainable development. Eco­tourism is considered as main tool to achieve this goal. Two concepts are laid upon its successful implementation. These are the concept for sustainable development and the one for development of alternative forms of tourism. The thesis that the concept for development of alternative forms of tourism is thought to compliment the one for development of sustainable tourism.

  1. Doctors commitment and long-term effectiveness for cost containment policies: lesson learned from biosimilar drugs.

    Science.gov (United States)

    Menditto, Enrica; Orlando, Valentina; Coretti, Silvia; Putignano, Daria; Fiorentino, Denise; Ruggeri, Matteo

    2015-01-01

    Agency is a pervasive feature of the health care market, with doctors acting as agents for both patients and the health care system. In a context of scarce resources, doctors are required to take opportunity cost into account when prescribing treatments, while cost containment policies cannot overlook their active role in determining health care resource allocation. This paper addresses this issue, investigating the effects of cost containment measures in the market of biosimilar drugs that represent a viable and cost-saving strategy for the reduction of health care expenditure. The analysis focuses on a particular region in Italy, where several timely policies to incentivize biosimilar prescribing were launched. Drugs were identified by the anatomical therapeutic chemical classification system. Information about biosimilar drugs and their originator biological products was extracted from the IMS Health regional database. Drug consumption was expressed in terms of counting units, while expenditure was evaluated in Euro (€). The market penetration of biosimilars was analyzed by year and quarterly. In the Campania region of Italy, the effects of cost containment policies, launched between 2009 and 2013, showed the prescription of biosimilars strongly increasing in 2010 until prescribing levels reached and exceeded the market share of the reference biological products in 2012. After a slight reduction, a plateau was observed at the beginning of 2013. At the same time, the use of the originator products had been decreasing until the first quarter of 2011. However, after a 1-year plateau, this trend was reversed, with a new increase in the consumption of the originators observed. Results show that the cost containment policies, applied to cut health expenditure "to cure and not to care", did not produce the cultural change necessary to make these policies effective in the long run. Therefore, top-down policies for cost containment are not successful; rather, a bottom

  2. The Impact of Maintenance Free Operating Period Approach to Acquisition Approaches, System Sustainment, and Costs

    Science.gov (United States)

    2013-01-07

    prediction and lineup , data recording, and ship monitoring), along with advanced techniques and algorithms for detection, track, and classification...the model translates into a sequential decision process driven by the value of the ratio:  information acquired by the test/test’s cost

  3. The Hidden Cost of Tourism: Detecting Long-term Effects of Tourism Using Behavioral Information

    Directory of Open Access Journals (Sweden)

    David Lusseau

    2004-06-01

    Full Text Available Increasingly, whales and dolphins are the focus of tourism activities in many coastal locations. Although these activities can affect individuals and populations of cetaceans, the biological significance and hence the cost of these impacts are as yet largely unknown. This study assessed the effects of boat interactions on the behavioral budget of two populations of bottlenose dolphins (Tersiops truncatus living in similar fjords but exposed to different levels of tourism activities. This comparison makes it possible to assess the costs of short-term avoidance strategies and the threshold at which those strategies are no longer effective. The effects of boat interactions were the same in both fjords. The resting state was the most sensitive to interactions; socializing was less sensitive. Short-term displacement was a typical response to boat exposure: dolphins were more likely to travel after an interaction with a vessel. Although the behavioral budgets of these populations were significantly altered during interactions with boats, their overall behavioral budgets were unchanged. Dolphins in Milford Sound actively avoided boat interactions, possibly to maintain their overall behavioral budget unchanged. This active avoidance led to avoidance of the area. Characteristics of dolphin-boat interactions in Milford Sound suggest that the advantages gained by short-term avoidance are lost if, on average, fewer than 68 min elapse between successive interactions with boats. If dolphin-boat interactions were more frequent than this, the dolphins switched to a longer-term response: area avoidance.

  4. Assessment of a novel alder biorefinery concept to meet demands of economic feasibility, energy production and long term environmental sustainability

    DEFF Research Database (Denmark)

    Thomsen, Tobias; Ahrenfeldt, Jesper; Thomsen, Sune Tjalfe

    2013-01-01

    A biorefinery concept based on alder tree plantations on degenerated soil is developed to comply with indicators of economic feasibility, fossil fuel depletion concerns, and long term sustainability issues. The potential performance of feedstock and biorefinery has been assessed through a literat......A biorefinery concept based on alder tree plantations on degenerated soil is developed to comply with indicators of economic feasibility, fossil fuel depletion concerns, and long term sustainability issues. The potential performance of feedstock and biorefinery has been assessed through...... degenerated soils. Integrating a biomass handling system, an LTCFB gasifier, a diarylheptanoids production chain, an anaerobic digestion facility, a slow pyrolysis unit, gas upgrading and various system integration units, the biorefinery could obtain the following production characteristics accounted...

  5. 48 CFR 1552.217-72 - Option to extend the term of the contract-cost-plus-award-fee contract.

    Science.gov (United States)

    2010-10-01

    ... of the contract-cost-plus-award-fee contract. 1552.217-72 Section 1552.217-72 Federal Acquisition...-award-fee contract. As prescribed in 1517.208(c), insert this contract clause in cost-plus-award-fee... Term of the Contract—Cost-Plus-Award-Fee Contract (APR 1984) (a) The Government has the option to...

  6. Assessment of the Impact of Business Activity in Sustainability Terms. Empirical Confirmation of Its Determination in Spanish Companies

    Directory of Open Access Journals (Sweden)

    María Luisa Pajuelo Moreno

    2013-05-01

    Full Text Available Because the issue of sustainability presents urgent problems crucial to the future of mankind, there has been serious discussion of the role accounting should play. In this context, a new line of research, still at a relatively unexplored, embryonic stage, has arisen, which tries to establish measurement of business sustainability and so compensate for the lack of information currently existing about the net impact of the company’s activity. Full Cost Accounting could allow sustainability to be translated into the language of business, together with analysis and comparison of its progress, so it might be the most appropriate vehicle for more participatory, democratic accounting, with greater dialogue, giving the accountant a much more active role, this being necessary in order to generalize the research, development and use. To analyze the current situation, a survey of 192 Spanish companies was carried out to obtain at first hand the perception of strategic positioning adopted with regard to Sustainable Development, measurement of the contribution of business activity to its achievement and the rendering of accounts carried out.

  7. Long-term benefit and cost-effectiveness analysis of screening for abdominal aortic aneurysms from a randomized controlled trial

    DEFF Research Database (Denmark)

    Lindholt, J S; Sørensen, J; Søgaard, Rikke

    2010-01-01

    The aim was to estimate long-term mortality benefits and cost-effectiveness of screening for abdominal aortic aneurysm (AAA) in men aged 64-73 years.......The aim was to estimate long-term mortality benefits and cost-effectiveness of screening for abdominal aortic aneurysm (AAA) in men aged 64-73 years....

  8. Employing asset management to control costs and sustain highway levels of service : volumes I and II.

    Science.gov (United States)

    2014-02-01

    This project investigated the impact of varying two elements of pavement, bridge, and mobility asset management on the long term networklevel : performance of those assets. The first element was the condition at which restorative treatments are tr...

  9. Gauging the Purported Costs of Public Data Archiving for Long-Term Population Studies.

    Science.gov (United States)

    Evans, Simon Robin

    2016-04-01

    It was recently proposed that long-term population studies be exempted from the expectation that authors publicly archive the primary data underlying published articles. Such studies are valuable to many areas of ecological and evolutionary biological research, and multiple risks to their viability were anticipated as a result of public data archiving (PDA), ultimately all stemming from independent reuse of archived data. However, empirical assessment was missing, making it difficult to determine whether such fears are realistic. I addressed this by surveying data packages from long-term population studies archived in the Dryad Digital Repository. I found no evidence that PDA results in reuse of data by independent parties, suggesting the purported costs of PDA for long-term population studies have been overstated.

  10. Cost-effectiveness of embryo transfer strategies: : A decision analytic model using long-term costs and consequences of singletons and multiples born as a consequence of IVF

    NARCIS (Netherlands)

    van Heesch, M. M. J.; van Asselt, A. D. I.; Evers, J. L. H.; van der Hoeven, M. A. H. B. M.; Dumoulin, J. C. M.; van Beijsterveldt, C. E. M.; Bonsel, G. J.; Dykgraaf, R. H. M.; van Goudoever, J. B.; Koopman-Esseboom, C.; Nelen, W. L. D. M.; Steiner, K.; Tamminga, P.; Tonch, N.; Torrance, H. L.; Dirksen, C. D.

    2016-01-01

    STUDY QUESTION: What is the cost-effectiveness of elective single embryo transfer (eSET) versus double embryo transfer (DET) strategies from a societal perspective, when applying a time horizon of 1, 5 and 18 years? SUMMARY ANSWER: From a short-term perspective (1 year) it is cost-effective to

  11. Use of pulmonary artery catheter in coronary artery bypass graft. Costs and long-term outcomes.

    Directory of Open Access Journals (Sweden)

    Fei Xu

    Full Text Available Pulmonary artery catheters (PAC are used widely to monitor hemodynamics in patients undergoing coronary bypass graft (CABG surgery. However, recent studies have raised concerns regarding both the effectiveness and safety of PAC. Therefore, our aim was to determine the effects of the use of PAC on the short- and long-term health and economic outcomes of patients undergoing CABG.1361 Chinese patients who consecutively underwent isolated, primary CABG at the Cardiovascular Institute of Fuwai Hospital from June 1, 2012 to December 31, 2012 were included in this study. Of all the patients, 453 received PAC during operation (PAC group and 908 received no PAC therapy (control group. Short-term and long-term mortality and major complications were analyzed with multivariate regression analysis and propensity score matched-pair analysis was used to yield two well-matched groups for further comparison.The patients who were managed with PAC more often received intraoperative vasoactive drugs dopamine (70.9% vs. 45.5%; P<0.001 and epinephrine (7.7% vs. 2.6%; P<0.001. In addition, costs for initial hospitalization were higher for PAC patients ($14,535 vs. $13,873, respectively, p = 0.004. PAC use was neither associated with the perioperative mortality or major complications, nor was it associated with long-term mortality and major adverse cardiac and cerebrovascular events. In addition, comparison between two well-matched groups showed no significant differences either in baseline characteristics or in short-term and long-term outcomes.There is no clear indication of any benefit or harm in managing CABG patients with PAC. However, use of PAC in CABG is more expensive. That is, PAC use increased costs without benefit and thus appears unjustified for routine use in CABG surgery.

  12. Strategies for achieving a sustainable, clean and cost-effective biomass resource

    International Nuclear Information System (INIS)

    Turnbull, J.

    1993-01-01

    Biomass produced in an economically and environmentally sustainable manner, could realistically be used to supply 50,000 MW (5 Quads) of electric capacity by the year 2010 and probably twice that amount by the year 2030. During the past year, the Electric Power Research Institute (EPRI) and the U.S. Department of Energy (DOE) have each been independently evaluating the potential for biomass to become a major renewable energy resource over the next four decades, able to offset some of the U.S. dependency on imported fossil fuels while also offering important environmental and economic benefits. This paper presents EPRI's conclusions, which are more conservative than those of DOE, and outlines possible strategies by which EPRI can advance acceptance of biomass as a preferred renewable resource

  13. Open Pit Mining & The Cost of Water Potential Opportunities Towards Sustainable Mining

    OpenAIRE

    Sébastien J.R. Fortin

    2015-01-01

    Mining operations require vast quantities of water to run ore processing facilities and thus have a responsibility to manage this critical resource. Operations are often located in areas of limited water supply, which may create a competitive climate for water consumption. Make-up water for mineral processing can represent a significant portion of production cost for mining companies. While necessary for mining, water in open pits is problematic for extraction activities and leads to increase...

  14. Sustainability Assessment of Large Irrigation Dams in Senegal: A Cost-Benefit Analysis for the Senegal River Valley

    Directory of Open Access Journals (Sweden)

    Stanislaw eManikowski

    2016-03-01

    Full Text Available Starting in the 1970s, the Senegalese Government invested in the development of irrigated schemes in the Senegalese part of the Senegal River Valley (S-SRV. From that time to 2012, the irrigated schemes increased from 10,000 ha to more than 110,000 ha. In the meantime, the economic viability of these schemes started to be questioned. It also appeared that the environmental health and social costs might outweigh the benefits of irrigation. Using a life cycle assessment approach and project cost-benefits modelling, this study (i quantified the costs and benefits of the S-SRV irrigated rice production, (ii evaluated the costs and benefits of its externalities and (iii discussed the irrigated rice support policy. The net financial revenues from the irrigated schemes were positive, but their economic equivalences. The economic return rate (EER was below the expected 12% and the net present value (NPV over 20 years of the project represented a loss of about US$-19.6 million. However, if we also include the project’s negative externalities, such as the reduced productivity of the valley ecosystems, protection cost of human health, environmental degradation and social impacts, then the NPV would be much worse, approximately US$-572.1 million. Therefore, the results show that to stop the economic loss and alleviate the human suffering, the S-SRV development policy should be revised using an integrated approach and the exploitation technology should aim at environmental sustainability. This paper may offer useful insights for reviewing the current Senegalese policies for the valley, as well as for assessing other similar cases or future projects worldwide, particularly in critical zones of developing countries.

  15. Sustained visual-spatial attention produces costs and benefits in response time and evoked neural activity.

    Science.gov (United States)

    Mangun, G R; Buck, L A

    1998-03-01

    This study investigated the simple reaction time (RT) and event-related potential (ERP) correlates of biasing attention towards a location in the visual field. RTs and ERPs were recorded to stimuli flashed randomly and with equal probability to the left and right visual hemifields in the three blocked, covert attention conditions: (i) attention divided equally to left and right hemifield locations; (ii) attention biased towards the left location; or (iii) attention biased towards the right location. Attention was biased towards left or right by instructions to the subjects, and responses were required to all stimuli. Relative to the divided attention condition, RTs were significantly faster for targets occurring where more attention was allocated (benefits), and slower to targets where less attention was allocated (costs). The early P1 (100-140 msec) component over the lateral occipital scalp regions showed attentional benefits. There were no amplitude modulations of the occipital N1 (125-180 msec) component with attention. Between 200 and 500 msec latency, a late positive deflection (LPD) showed both attentional costs and benefits. The behavioral findings show that when sufficiently induced to bias attention, human observers demonstrate RT benefits as well as costs. The corresponding P1 benefits suggest that the RT benefits of spatial attention may arise as the result of modulations of visual information processing in the extrastriate visual cortex.

  16. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre: a cost comparison study.

    Science.gov (United States)

    Eichler, Klaus; Hess, Sascha; Chmiel, Corinne; Bögli, Karin; Sidler, Patrick; Senn, Oliver; Rosemann, Thomas; Brügger, Urs

    2014-10-01

    Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. From the health-economic point of view, our new service model shows 'dominance' over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Benefit-cost aspects of long-term isolation of uranium mill tailings

    International Nuclear Information System (INIS)

    Van Dyke, J.

    1983-11-01

    The Uranium Mill Tailings Radiation Control Act of 1978 provides for regulations for control of radon diffusion from uranium mill tailings to protect the public welfare. In developing these regulations, the Office of Nuclear Material Safety and Safeguards of the Nuclear Regulatory Commission has sought to establish the benefits and costs for alternative regulatory criteria. This report provides a perspective on some economic issues associated with long-term radiation effects from disposal of uranium mill tailings. The general problem of developing an economic rationale for regulating this activity is complicated by the very long-term and widespread effects which could result from radon gas diffusion associated with tailings piles. The economic issues are also complex because of the trade-offs between costs of disposal and intangible social values. When intergenerational implications were considered the traditional basis for discounting in a benefit-cost framework was found to shift. The appropriate rate of discount was found to depend on ethical assumptions and expectations about the relative welfare of future generations. 30 references, 1 figure, 2 tables

  18. Benefit-cost aspects of long-term isolation of uranium mill tailings

    Energy Technology Data Exchange (ETDEWEB)

    Van Dyke, J.

    1983-11-01

    The Uranium Mill Tailings Radiation Control Act of 1978 provides for regulations for control of radon diffusion from uranium mill tailings to protect the public welfare. In developing these regulations, the Office of Nuclear Material Safety and Safeguards of the Nuclear Regulatory Commission has sought to establish the benefits and costs for alternative regulatory criteria. This report provides a perspective on some economic issues associated with long-term radiation effects from disposal of uranium mill tailings. The general problem of developing an economic rationale for regulating this activity is complicated by the very long-term and widespread effects which could result from radon gas diffusion associated with tailings piles. The economic issues are also complex because of the trade-offs between costs of disposal and intangible social values. When intergenerational implications were considered the traditional basis for discounting in a benefit-cost framework was found to shift. The appropriate rate of discount was found to depend on ethical assumptions and expectations about the relative welfare of future generations. 30 references, 1 figure, 2 tables.

  19. An Analysis of the Contribution of Japanese Business Terms to Corporate Sustainability: Learnings from the “Looking-Glass” of the East

    Directory of Open Access Journals (Sweden)

    Rodrigo Lozano

    2017-02-01

    Full Text Available During the last decade, there has been increasing research on Corporate Sustainability, whereby most of such research was undertaken in the Western world. This paper is aimed at analysing the contribution of Japanese Business terms to Corporate Sustainability. The paper analyses, using Grounded Theory, 28 Japanese business terms through a Corporate Sustainability framework based on the four dimensions of sustainability (economic, environmental, social, and time, the company system (operations and processes, strategy and management, organisational systems, procurement and marketing, and assessment and communication, and stakeholders (internal, interconnecting, and external. The underpinning principles of the Japanese business terms provide complementary approaches to Western views on corporate sustainability by offering a more holistic perspective by linking the company system and its stakeholders to the four dimensions of sustainability. The paper proposes that Corporate Sustainability can learn from Japanese business approaches through: (1 the interaction and alignment of the factory, the firm, and inter-firm network; (2 the relationships between management and employees; (3 the inter-linkages between the company system elements; and (4 how Japanese companies remained competitive, even under the stress of a long-term major economic crisis. However, the analysis indicates that the relationship with external stakeholders and communicating with them through assessment and reporting is lacking in Japanese business management practice. Japanese businesses and their management can also learn from the Corporate Sustainability of the West by: (1 considering the four dimensions of sustainability and how they interact; (2 taking a holistic and systemic approach to Corporate Sustainability; (3 engaging in more Corporate Sustainability research; and (4 making Corporate Sustainability part of a company’s culture and activities. Businesses in the East and

  20. Criteria for evaluation and guidelines for land use planning in terms of sustainable urban development

    Directory of Open Access Journals (Sweden)

    Irena Ostojić

    2014-10-01

    Full Text Available Sustainable spatial development is a generally accepted objective and principle in spatial planning. It is implemented mainly by regulations in the sectors for management of natural resources, but not comprehensively in implementing regulations for urban space management. One of the most important instruments of spatial planning at local level is land use, for which there is no comprehensive framework of implementing measures for achieving sustainable spatial objectives in urban areas. In accordance with the review and critical analysis of literature, there are four measures presented in the paper: protection of natural resources and reduction of environmental-climate risks, compact urban structure, mixed-use and accessibility of urban functions. The review and analysis have shown that the listed measures enable sustainable development of urban areas, but only if they are planned and implemented in accordance with supporting physical, social and economic elements of urban space. In the conclusion, indicators which can assess the level of sustainability in land use design are presented and guidelines for restructuring land use in existing settlement areas are described.

  1. 2010 World Expo and Urban Life Quality in Shanghai in Terms of Sustainable Development

    Institute of Scientific and Technical Information of China (English)

    Zhu Dajian; Peter P.Rogers

    2006-01-01

    Based on sustainable development theory and the UN's Human Development Index, this thesis puts forward what the quality of urban life implies,makes a study of the world Expo's potential influences on the urban life of Shanghai and advances the strategy and measures to strengthen the life-quality-facing urban management

  2. A framework and a measurement instrument for sustainability of work practices in long-term care

    NARCIS (Netherlands)

    S.S. Slaghuis (Sarah); M.M.H. Strating (Mathilde); R.A. Bal (Roland); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices

  3. A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

    DEFF Research Database (Denmark)

    Clark, J F; Mealing, S J; Scott, D A

    2016-01-01

    includes the long-term sequelae of impaired renal function and urinary tract infection (UTI). SETTING: Analysis based on a UK perspective. METHODS: A probabilistic Markov decision model was constructed, to compare lifetime costs and quality-adjusted life years, taking renal and UTI health states...... into consideration, as well as other catheter-related events. UTI event rates for the primary data set were based on data from hospital settings to ensure controlled and accurate reporting. A sensitivity analysis was applied to evaluate best- and worst-case scenarios. RESULTS: The model predicts that a 36-year......-old SCI patient with chronic urinary retention will live an additional 1.4 years if using HC catheters compared with UC catheters, at an incremental cost of £2100. Moreover, the lifetime number of UTI events will be reduced by 16%. All best- and worst-case estimates were within the UK threshold of being...

  4. A framework and a measurement instrument for sustainability of work practices in long-term care

    Directory of Open Access Journals (Sweden)

    Slaghuis Sarah S

    2011-11-01

    Full Text Available Abstract Background In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization. Methods The exploratory methodological design consisted of three phases: a framework development; b instrument development; and c field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual = 112. Data were collected not until at least one year had passed after implementation. Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrument are proposed. Results The χ2- difference test of the -2 Log Likelihood estimates demonstrated that the hierarchical two factor model with routinization and institutionalization as separate constructs showed a better fit than the one factor model (p Conclusions The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the subscales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects.

  5. Modular Laboratories—Cost-Effective and Sustainable Infrastructure for Resource-Limited Settings

    Science.gov (United States)

    Bridges, Daniel J.; Colborn, James; Chan, Adeline S. T.; Winters, Anna M.; Dengala, Dereje; Fornadel, Christen M.; Kosloff, Barry

    2014-01-01

    High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. PMID:25223943

  6. Doctors commitment and long-term effectiveness for cost containment policies: lesson learned from biosimilar drugs

    Directory of Open Access Journals (Sweden)

    Menditto E

    2015-11-01

    Full Text Available Enrica Menditto,1 Valentina Orlando,1 Silvia Coretti,2 Daria Putignano,1 Denise Fiorentino,1 Matteo Ruggeri2 1CIRFF, Center of Pharmacoeconomics, Federico II University of Naples, Naples, 2Postgraduate School of Health Economics and Management (ALTEMS, Università Cattolica del Sacro Cuore, School of Economics, Rome, Italy Background: Agency is a pervasive feature of the health care market, with doctors acting as agents for both patients and the health care system. In a context of scarce resources, doctors are required to take opportunity cost into account when prescribing treatments, while cost containment policies cannot overlook their active role in determining health care resource allocation. This paper addresses this issue, investigating the effects of cost containment measures in the market of biosimilar drugs that represent a viable and cost-saving strategy for the reduction of health care expenditure. The analysis focuses on a particular region in Italy, where several timely policies to incentivize biosimilar prescribing were launched. Methods: Drugs were identified by the anatomical therapeutic chemical classification system. Information about biosimilar drugs and their originator biological products was extracted from the IMS Health regional database. Drug consumption was expressed in terms of counting units, while expenditure was evaluated in Euro (€.The market penetration of biosimilars was analyzed by year and quarterly. Results: In the Campania region of Italy, the effects of cost containment policies, launched between 2009 and 2013, showed the prescription of biosimilars strongly increasing in 2010 until prescribing levels reached and exceeded the market share of the reference biological products in 2012. After a slight reduction, a plateau was observed at the beginning of 2013. At the same time, the use of the originator products had been decreasing until the first quarter of 2011. However, after a 1-year plateau, this trend

  7. Short-term costs and benefits of grooming in Japanese macaques.

    Science.gov (United States)

    Schino, Gabriele; Alessandrini, Alessandro

    2015-07-01

    This study investigated the short-term consequences of giving grooming in Japanese macaques (Macaca fuscata) in order to obtain information on its immediate costs and benefits. Giving grooming was associated with increased aggression received from groomees and decreased aggression received from third parties (but only as long as the groomer maintained proximity to the groomee). Grooming was also associated with decreased scratching rates. These results emphasize the unpredictable outcome of individual grooming interactions and the difficulties of social decision-making for monkeys living in despotic societies.

  8. Engineering IT-enabled sustainable electricity services the tale of two low-cost green Azores Islands

    CERN Document Server

    Xie, Le; Liu, Qixing

    2013-01-01

    Engineering IT-Enabled Electricity Services: The Tale of Two Low-Cost Green Azores Islands covers sustainable energy services to customers - a balanced choice and coordination of energy generated by traditional and alternative sources. The “Green Islands” project represents a decade of work by over a dozen researchers who have developed a model designed to utilize the potential of distributed clean resources. The key is the proper use of Information Technology (IT).  Sited on two islands in the Azores, the project developed the model of careful forecasting of demand and supply, down to the minute, coordinating the output of conventional power plants, wind energy, fly wheels, hydroelectricity, demand reduction, and even plug-in electric vehicles to take full advantage of the clean resources available. This contributed volume presents methods for predicting variable resources, such as wind power generation, and analyzes the achievable accuracy of these predictions. Throughout this book, contributors sho...

  9. Long-term health and medical cost impact of smoking prevention in adolescence.

    Science.gov (United States)

    Wang, Li Yan; Michael, Shannon L

    2015-02-01

    To estimate smoking progression probabilities from adolescence to young adulthood and to estimate long-term health and medical cost impacts of preventing smoking in today's adolescents. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we first estimated smoking progression probabilities from adolescence to young adulthood. Then, using the predicted probabilities, we estimated the number of adolescents who were prevented from becoming adult daily smokers as a result of a hypothetical 1 percentage point reduction in the prevalence of ever smoking in today's adolescents. We further estimated lifetime medical costs saved and quality-adjusted life years (QALYs) gained as a result of preventing adolescents from becoming adult daily smokers. All costs were in 2010 dollars. Compared with never smokers, those who had tried smoking at baseline had higher probabilities of becoming current or former daily smokers at follow-up regardless of baseline grade or sex. A hypothetical 1 percentage point reduction in the prevalence of ever smoking in 24.5 million students in 7th-12th grades today could prevent 35,962 individuals from becoming a former daily smoker and 44,318 individuals from becoming a current daily smoker at ages 24-32 years. As a result, lifetime medical care costs are estimated to decrease by $1.2 billion and lifetime QALYs is estimated to increase by 98,590. Effective smoking prevention programs for adolescents go beyond reducing smoking prevalence in adolescence; they also reduce daily smokers in young adulthood, increase QALYs, and reduce medical costs substantially in later life. This finding indicates the importance of continued investment in effective youth smoking prevention programs. Published by Elsevier Inc.

  10. Long-term medical costs and life expectancy of acute myeloid leukemia: a probabilistic decision model.

    Science.gov (United States)

    Wang, Han-I; Aas, Eline; Howell, Debra; Roman, Eve; Patmore, Russell; Jack, Andrew; Smith, Alexandra

    2014-03-01

    Acute myeloid leukemia (AML) can be diagnosed at any age and treatment, which can be given with supportive and/or curative intent, is considered expensive compared with that for other cancers. Despite this, no long-term predictive models have been developed for AML, mainly because of the complexities associated with this disease. The objective of the current study was to develop a model (based on a UK cohort) to predict cost and life expectancy at a population level. The model developed in this study combined a decision tree with several Markov models to reflect the complexity of the prognostic factors and treatments of AML. The model was simulated with a cycle length of 1 month for a time period of 5 years and further simulated until age 100 years or death. Results were compared for two age groups and five different initial treatment intents and responses. Transition probabilities, life expectancies, and costs were derived from a UK population-based specialist registry-the Haematological Malignancy Research Network (www.hmrn.org). Overall, expected 5-year medical costs and life expectancy ranged from £8,170 to £81,636 and 3.03 to 34.74 months, respectively. The economic and health outcomes varied with initial treatment intent, age at diagnosis, trial participation, and study time horizon. The model was validated by using face, internal, and external validation methods. The results show that the model captured more than 90% of the empirical costs, and it demonstrated good fit with the empirical overall survival. Costs and life expectancy of AML varied with patient characteristics and initial treatment intent. The robust AML model developed in this study could be used to evaluate new diagnostic tools/treatments, as well as enable policy makers to make informed decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  12. Biochar-based water treatment systems as a potential low-cost and sustainable technology for clean water provision.

    Science.gov (United States)

    Gwenzi, Willis; Chaukura, Nhamo; Noubactep, Chicgoua; Mukome, Fungai N D

    2017-07-15

    Approximately 600 million people lack access to safe drinking water, hence achieving Sustainable Development Goal 6 (Ensure availability and sustainable management of water and sanitation for all by 2030) calls for rapid translation of recent research into practical and frugal solutions within the remaining 13 years. Biochars, with excellent capacity to remove several contaminants from aqueous solutions, constitute an untapped technology for drinking water treatment. Biochar water treatment has several potential merits compared to existing low-cost methods (i.e., sand filtration, boiling, solar disinfection, chlorination): (1) biochar is a low-cost and renewable adsorbent made using readily available biomaterials and skills, making it appropriate for low-income communities; (2) existing methods predominantly remove pathogens, but biochars remove chemical, biological and physical contaminants; (3) biochars maintain organoleptic properties of water, while existing methods generate carcinogenic by-products (e.g., chlorination) and/or increase concentrations of chemical contaminants (e.g., boiling). Biochars have co-benefits including provision of clean energy for household heating and cooking, and soil application of spent biochar improves soil quality and crop yields. Integrating biochar into the water and sanitation system transforms linear material flows into looped material cycles, consistent with terra preta sanitation. Lack of design information on biochar water treatment, and environmental and public health risks constrain the biochar technology. Seven hypotheses for future research are highlighted under three themes: (1) design and optimization of biochar water treatment; (2) ecotoxicology and human health risks associated with contaminant transfer along the biochar-soil-food-human pathway, and (3) life cycle analyses of carbon and energy footprints of biochar water treatment systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Policy recommendations and cost implications for a more sustainable framework for European human biomonitoring surveys

    DEFF Research Database (Denmark)

    Joas, Anke; Knudsen, Lisbeth E.; Kolossa-Gehring, Marike

    2015-01-01

    The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004-2010 of th......, and EFSA. An economic frame with shared cost implications for national and European institutions is suggested benefitting from the capacity building set up by COPHES/DEMOCOPHES.......The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004...

  14. Low-cost engineering techniques in sustainable operation of a rural clean water plant in thailand

    International Nuclear Information System (INIS)

    Pengchai, P.; Keawkhun, K.; Suwapaet, N.

    2012-01-01

    Problems of water supply in many rural regions of Thailand result from the lack of awareness and financial limitations. Payanghang Clean Water Plant is an example of the rural water plant that has been suffering from the poor operation since 2003. The objective of this study was to modify the operation processes of this water plant to achieve cleaner water and better financial condition. Low-cost engineering techniques, such as the use of floating switches in filtration ponds, the use of water drip system for alum dosing and the addition of Tamarindus indica Linn seed solution was applied. As a result, 76% of turbidity removal efficiency was derived. Although, the difference was not statistically significant at 95% confidence level, higher removal efficiency in comparison with the one before modification (65%) suggested better operation. In the view of financial aspect, l07 dollars (1 baht = 0.0326 U.S. dollar) benefit was obtained from 7 month-operation period. (author)

  15. Modular laboratories--cost-effective and sustainable infrastructure for resource-limited settings.

    Science.gov (United States)

    Bridges, Daniel J; Colborn, James; Chan, Adeline S T; Winters, Anna M; Dengala, Dereje; Fornadel, Christen M; Kosloff, Barry

    2014-12-01

    High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. © The American Society of Tropical Medicine and Hygiene.

  16. Patient time and out-of-pocket costs for long-term prostate cancer survivors in Ontario, Canada.

    Science.gov (United States)

    de Oliveira, Claire; Bremner, Karen E; Ni, Andy; Alibhai, Shabbir M H; Laporte, Audrey; Krahn, Murray D

    2014-03-01

    Time and out-of-pocket (OOP) costs can represent a substantial burden for cancer patients but have not been described for long-term cancer survivors. We estimated these costs, their predictors, and their relationship to financial income, among a cohort of long-term prostate cancer (PC) survivors. A population-based, community-dwelling, geographically diverse sample of long-term (2-13 years) PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physicians. We obtained data on demographics, health care resource use, and OOP costs through mailed questionnaires and conducted chart reviews to obtain clinical data. We compared mean annual time and OOP costs (2006 Canadian dollars) across clinical and sociodemographic characteristics and examined the association between costs and four groups of predictors (patient, disease, system, symptom) using two-part regression models. Patients' (N = 585) mean age was 73 years; 77 % were retired, and 42 % reported total annual incomes less than $40,000. Overall, mean time costs were $838/year and mean OOP costs were $200/year. Although generally low, total costs represented approximately 10 % of income for lower income patients. No demographic variables were associated with costs. Radical prostatectomy, younger age, poor urinary function, current androgen deprivation therapy, and recent diagnosis were significantly associated with increased likelihood of incurring any costs, but only urinary function significantly affected total amount. Time and OOP costs are modest for most long-term PC survivors but can represent a substantial burden for lower income patients. Even several years after diagnosis, PC-specific treatments and treatment-related dysfunction are associated with increased costs. Time and out-of-pocket costs are generally manageable for long-term PC survivors but can be a significant burden mainly for lower income patients. The effects of PC

  17. Updating the content of home economics modules in terms of sustainability

    OpenAIRE

    Logar, Irena

    2017-01-01

    Home Economics is an obligatory subject in the fifth and sixth grades in nine-grade Slovenian elementary schools. Its objectives and contents are targeted at educational work that stimulates students to form positive viewpoints, knowledge and behaviour towards sustainable society development. The goal of the master’s thesis is to research curricula of the obligatory subject Home Economics and the elective subject Modern Food Preparation with regard to aims and contents that deal with sustaina...

  18. Operation analysis of AC traction motors in terms of electromagnetic torque capability on sustainable railway vehicles

    OpenAIRE

    Bulucea Cornelia A.; Nicola Doru A.; Rosen Marc A.; Mastorakis Nikos E.; Bulucea Carmen A.

    2016-01-01

    Sustainable operation of electric railway systems represents a significant purpose nowadays in the development of high power and high speed locomotives and trains. At present, high speed electric vehicles mostly work with three-phase induction motors or three-phase synchronous motors as traction motors. The two electric machine types have different efficiencies at different operation points, and experience differences with respect to safety, speed and power, energy use and exergy efficiency. ...

  19. Long-term sustainability of a worksite canteen intervention of serving more fruit and vegetables

    DEFF Research Database (Denmark)

    Thorsen, Anne Vibeke; Lassen, Anne Dahl; Tetens, Inge

    2010-01-01

    Objective: To analyse the 5-year sustainability of a worksite canteen intervention of serving more fruit and vegetables (F&V). Design: Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste. Data were collected by ...... where the participatory and empowering approach, self-monitoring, environmental change, dialogue with suppliers and networking among worksite canteens are applied....

  20. Modeling sustainable long-term electricity supply-demand in Africa

    International Nuclear Information System (INIS)

    Ouedraogo, Nadia S.

    2017-01-01

    Highlights: • This study is one of the first detailed and complete representation of the African power system. • It models, within LEAP, possible future paths for the regional power systems. • All the end-users and supply side activities and actors are considered. • Three scenarios are examined: the baseline, the renewable energy, and the energy efficiency. • The energy efficiency scenario has allowed to draw a sustainable pathway for electrification. - Abstract: This paper develops a scenario-based model to identify and provide an array of electricity demand in Africa, and to derive them from the African power system of development. A system-based approach is performed by applying the scenario methodology developed by Schwartz in the context of the energy-economic modeling platform ‘Long-range Energy Alternative Planning’. Four scenarios are investigated. The Business as Usual scenario (BAU) replicates the regional and national Master Plans. The renewable-promotion scenario increases the share of renewable energy in the electricity mix. The demand and supply side efficiency scenarios investigate the impact of energy efficiency measures on the power system. The results show an increase in electricity demand by 4% by 2040, supply shortages and high emissions of Greenhouse Gases. Contrary to expectations, the renewable energy scenario did not emerge as the best solution to a sustainable electrification of the region. The energy efficiency scenarios have allowed us to draw a sustainable pathway for electrification.

  1. Operation analysis of AC traction motors in terms of electromagnetic torque capability on sustainable railway vehicles

    Directory of Open Access Journals (Sweden)

    Bulucea Cornelia A.

    2016-01-01

    Full Text Available Sustainable operation of electric railway systems represents a significant purpose nowadays in the development of high power and high speed locomotives and trains. At present, high speed electric vehicles mostly work with three-phase induction motors or three-phase synchronous motors as traction motors. The two electric machine types have different efficiencies at different operation points, and experience differences with respect to safety, speed and power, energy use and exergy efficiency. An important issue that correlates these aspects is the electromagnetic torque developed by an electric traction motor. In order to provide an overview of the technical performance of the operation of sustainable railway systems, a detailed analysis is carried out of the electromagnetic torque capability of AC electric motors utilized as traction motors in modern locomotives of high power and/or high speed. The results of this work may help in enhancing the main criteria for optimising the safe and sustainable operation of electric railway traction systems.

  2. The Criteria and Principles of Sustainable Development in Terms of Changing the Quality of It

    Directory of Open Access Journals (Sweden)

    Modiga Georgeta

    2009-10-01

    Full Text Available Along with responsible addressing for future generations, efficient use of natural resources, energy, materials, informational andtechnologic presumes, in the same time, intensifying the activity of durable economy for satisfying today’s requests of human society. Sustainabledevelopment provides a framework trough which the communities can use the resources efficiently, create efficient infrastructures, protect andimprove the quality of life and new technologies, create new activities, which will strengthen their economy. It can help at creating of healthycommunities that can sustain both our new generation, and those that follow. The sustainable development was the innovative concept ofdevelopment, after that, from the general and theoretic plan of development, to be founded the solutions of particularization of it on activitydomains, concomitantly with the appropriate measures of practice realization the principles of the concept. Efficient use of natural, energetic,material and informational resources suppose both the responsible approach for the future generations and the intensifying of the sustainableeconomy working for the actual requirements satisfaction of the society. The work treats a unified and coherent set of criteria and principlesspecifics for the strategic and integrated management of sustainable development in relation with increasing the efficiency of using naturalresources, energetic, material and informational.

  3. Long-term care cost drivers and expenditure projection to 2036 in Hong Kong

    Directory of Open Access Journals (Sweden)

    Chan Wai

    2009-09-01

    Full Text Available Abstract Background Hong Kong's rapidly ageing population, characterised by one of the longest life expectancies and the lowest fertility rate in the world, is likely to drive long-term care (LTC expenditure higher. This study aims to identify key cost drivers and derive quantitative estimates of Hong Kong's LTC expenditure to 2036. Methods We parameterised a macro actuarial simulation with data from official demographic projections, Thematic Household Survey 2004, Hong Kong's Domestic Health Accounts and other routine data from relevant government departments, Hospital Authority and other LTC service providers. Base case results were tested against a wide range of sensitivity assumptions. Results Total projected LTC expenditure as a proportion of GDP reflected secular trends in the elderly dependency ratio, showing a shallow dip between 2004 and 2011, but thereafter yielding a monotonic rise to reach 3.0% by 2036. Demographic changes would have a larger impact than changes in unit costs on overall spending. Different sensitivity scenarios resulted in a wide range of spending estimates from 2.2% to 4.9% of GDP. The availability of informal care and the setting of formal care as well as associated unit costs were important drivers of expenditure. Conclusion The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning.

  4. Antimatter Requirements and Energy Costs for Near-Term Propulsion Applications

    Science.gov (United States)

    Schmidt, G. R.; Gerrish, H. P.; Martin, J. J.; Smith, G. A.; Meyer, K. J.

    1999-01-01

    The superior energy density of antimatter annihilation has often been pointed to as the ultimate source of energy for propulsion. However, the limited capacity and very low efficiency of present-day antiproton production methods suggest that antimatter may be too costly to consider for near-term propulsion applications. We address this issue by assessing the antimatter requirements for six different types of propulsion concepts, including two in which antiprotons are used to drive energy release from combined fission/fusion. These requirements are compared against the capacity of both the current antimatter production infrastructure and the improved capabilities that could exist within the early part of next century. Results show that although it may be impractical to consider systems that rely on antimatter as the sole source of propulsive energy, the requirements for propulsion based on antimatter-assisted fission/fusion do fall within projected near-term production capabilities. In fact, a new facility designed solely for antiproton production but based on existing technology could feasibly support interstellar precursor missions and omniplanetary spaceflight with antimatter costs ranging up to $6.4 million per mission.

  5. Locked into Copenhagen pledges - Implications of short-term emission targets for the cost and feasibility of long-term climate goals

    NARCIS (Netherlands)

    Riahi, Keywan; Kriegler, Elmar; Johnson, Nils; Bertram, Christoph; den Elzen, Michel; Eom, Jiyong; Schaeffer, Michiel; Edmonds, Jae; Isaac, Morna; Krey, Volker; Longden, Thomas; Luderer, Gunnar; Méjean, Aurélie; McCollum, David L.; Mima, Silvana; Turton, Hal; van Vuuren, Detlef P.; Wada, Kenichi; Bosetti, Valentina; Capros, Pantelis; Criqui, Patrick; Hamdi-Cherif, Meriem; Kainuma, Mikiko; Edenhofer, Ottmar

    2015-01-01

    This paper provides an overview of the AMPERE modeling comparison project with focus on the implications of near-term policies for the costs and attainability of long-term climate objectives. Nine modeling teams participated in the project to explore the consequences of global emissions following

  6. Light-cured polymer electrolytes for safe, low-cost and sustainable sodium-ion batteries

    Science.gov (United States)

    Colò, Francesca; Bella, Federico; Nair, Jijeesh R.; Gerbaldi, Claudio

    2017-10-01

    In this work we present a very simple preparation procedure of a poly(ethylene oxide) (PEO)-based crosslinked polymer electrolyte (XPE) for application in sodium-ion batteries (NIBs). The polymer electrolyte, containing NaClO4 as Na+ source, is prepared by rapid, energy saving, solvent-free photopolymerization technique, in a single step. Thermal, mechanical, morphological and electrochemical properties of the resulting XPE are thoroughly investigated. The highly ionic conducting (>1 mS cm-1 at 25 °C) polymer electrolyte is used in a lab-scale sodium cell with nanostructured TiO2 working electrode. The obtained results in terms of ambient temperature cycling behaviour (stable specific capacity of about 250 mAh g-1 at 0.1 mA cm-2 and overall remarkable stability, for a quasi-solid state Na polymer cell, upon very long term cycling exceeding 1000 reversible cycles at 0.5 mA cm-2 corresponding to > 5000 h of continuous operation) demonstrate the promising prospects of this novel XPE to be implemented in the next-generation NIBs conceived for large-scale energy storage systems, such as those connected to photovoltaic and wind factories.

  7. Cost-effectiveness of sustainable measures for water protection; Kosten-Wirksamkeitsanalyse von nachhaltigen Massnahmen im Gewaesserschutz

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, E.; Hillenbrand, T.; Liebert, J.; Schleich, J.; Walz, R.

    2001-08-01

    The study continues the project 'Environmental Action Plan for Sustainable Water Resources Management' (UBA-Texte 25/99). The methodological basis in high-priority fields of water protection is improved and the available knowledge with regard to costs and effectiveness of the measures is evaluated systematically. Especially for the fields urban waste water, agriculture and morphological water structures the cost-effectiveness of different measures could be assessed. The results may be an important item for priority setting among different measures on a national basis. On the other hand these methods and data may be helpful for action plans in river basin management as well. (orig.) [German] Das Vorhaben hatte zum Ziel, anknuepfend an das Projekt 'Massnahmenplan Nachhaltige Wasserwirtschaft' (UBA-Texte 25/99), fuer besonders wichtige Zielbereiche des Gewaesserschutzes die methodische Basis fuer die Abschaetzung kurz- bis mittelfristiger Wirkungen zu verbessern und fuer diese Bereiche die aktuellen Kenntnisse zu den Kosten und Wirkungen systematisch auszuwerten. Insbesondere fuer die Schwerpunkte Siedlungsentwaesserung, Landwirtschaft und Verbesserung der Gewaesserstruktur konnten damit Aussagen zur Kosten-Wirksamkeit unterschiedlicher Massnahmen zum Gewaesserschutz getroffen werden, die ein wesentliches Element der Priorisierung denkbarer Massnahmen sein koennen. Gegenstand der Untersuchung waren Massnahmen auf nationaler Ebene, jedoch koennen die erarbeiteten Methoden und Daten auch als Orientierung fuer das Erstellen von Massnahmenplaenen fuer einzelne Flusseinzugsgebiete dienen. (orig.)

  8. Sustainable Sanitation—A Cost-Effective Tool to Improve Plant Yields and the Environment

    Directory of Open Access Journals (Sweden)

    Päivi Karinen

    2010-01-01

    Full Text Available Human urine and faeces are products formed every day in every human society. The volume and fertilisation value of urine is higher than that of faeces. This paper reviews data that urine has been used successfully as a fertiliser for cereals and some vegetables. According to the literature, urine fertilised plants may have produced higher, similar or slightly lower yields than mineral fertilized plants but they invariably resulted in higher yields than non-fertilised plants. There have been no microbiological risks associated with any products. The taste and chemical quality of the products are similar to plants treated with mineral fertilisers. Separating toilets, where urine and faeces are separated already in the toilet, could be beneficial not only in poor but also in the industrialized countries. A separating toilet could be installed also in old buildings and it could allow individuals to live in coastal areas, mountainous or other sensitive environments. In poor areas, urine fertilisation could increase food production also in home plots and reduce hunger. It could also combat water contamination and help to reduce diseases caused by enteric micro-organisms. If urine were to be viewed as a resource rather than a waste product, more families could be encouraged to install low-cost toilets which would especially improve the wellbeing of women.

  9. Sustainable Pavement Management System in Urban Areas Considering the Vehicle Operating Costs

    Directory of Open Access Journals (Sweden)

    Giuseppe Loprencipe

    2017-03-01

    Full Text Available Urban roads constitute most of the existing roads and they are directly managed by small administrations. Normally, these small administrations do not have sufficient funds or sufficient qualified personnel to carry out this task. This paper deals with an easy-implementation Pavement Management System (PMS to develop strategies to maintain, preserve and rehabilitate urban roads. The proposed method includes the creation of the road network inventory, the visual surveys of the pavement and the evaluation of its condition by the Pavement Condition Index (PCI. The method intends to give a valid tool to road managers to compare alternative maintenance strategies and perform the priority analysis on the network. With this aim, the procedure assesses the Vehicle Operating Costs (VOC by a written regression between PCI and International Roughness Index (IRI. The proposed method has several advantages because it can be easily adapted to various situations and it does not require a large amount of time and money for its implementation.

  10. How can plant genetic engineering contribute to cost-effective fish vaccine development for promoting sustainable aquaculture?

    Science.gov (United States)

    Clarke, Jihong Liu; Waheed, Mohammad Tahir; Lössl, Andreas G; Martinussen, Inger; Daniell, Henry

    2013-09-01

    Aquaculture, the fastest growing food-producing sector, now accounts for nearly 50 % of the world's food fish (FAO in The state of world fisheries and aquaculture. FAO, Rome, 2010). The global aquaculture production of food fish reached 62.7 million tonnes in 2011 and is continuously increasing with an estimated production of food fish of 66.5 million tonnes in 2012 (a 9.4 % increase in 1 year, FAO, www.fao.org/fishery/topic/16140 ). Aquaculture is not only important for sustainable protein-based food fish production but also for the aquaculture industry and economy worldwide. Disease prevention is the key issue to maintain a sustainable development of aquaculture. Widespread use of antibiotics in aquaculture has led to the development of antibiotic-resistant bacteria and the accumulation of antibiotics in the environment, resulting in water and soil pollution. Thus, vaccination is the most effective and environmentally-friendly approach to combat diseases in aquaculture to manage fish health. Furthermore, when compared to >760 vaccines against human diseases, there are only about 30 fish vaccines commercially available, suggesting the urgent need for development and cost-effective production of fish vaccines for managing fish health, especially in the fast growing fish farming in Asia where profit is minimal and therefore given high priority. Plant genetic engineering has made significant contributions to production of biotech crops for food, feed, valuable recombinant proteins etc. in the past three decades. The use of plants for vaccine production offers several advantages such as low cost, safety and easy scaling up. To date a large number of plant-derived vaccines, antibodies and therapeutic proteins have been produced for human health, of which a few have been made commercially available. However, the development of animal vaccines in plants, especially fish vaccines by genetic engineering, has not yet been addressed. Therefore, there is a need to exploit

  11. Design and assessment of long-term sustainable transport system scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Nijkamp, P.; Rienstra, S.A.; Vleugel, J.M. [Systems and Control Group, Faculty of Mechanical and Marine Engineering, Delft University of Technology, Delft (Netherlands)

    1995-03-01

    Current trends in transport indicate that the system is moving away from a sustainable development because of a sky-rocketing mobility growth and a modal shift towards the most polluting modes. These trends are reinforced by several underlying factors, which may be found in the spatial, institutional, economic and social/psychological fields. It may be concluded that major changes in technology, public policy as well as in the behaviour of individuals are necessary to make the transport system more compatible with environmental sustainability. This provokes the need for assessing a set of future images for transport in relation to the environment. In this paper expert scenarios are constructed on the basis of the recently developed `spider model`. Based on a set of distinct characteristics of a transport system, represented by eight axes in the above mentioned fields, an evaluation framework is constructed, which visualizes the main discussed driving forces. Scenarios can be constructed by connecting points on the successive axes, which may lead to entirely different transport systems. An expected and desired scenario are constructed next, by means of opinions of Dutch transport experts, which have been investigated by means of a nation-wide survey. The expected scenario indicates that many current trends will continue, while the transport system is largely the same as the current one. The desired scenario on the other hand, gives a more collective system, in which also many new modes are operating. The conclusion is that expected trends may not lead to a sustainable transport system, but that the desired road will be very hard to follow. 5 figs., 2 tabs., 27 refs.

  12. STRATEGIES FOR ORGANIZING JOBS IN TERMS OF SUSTAINABLE DEVELOPMENT OF ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    OPREA MIHAELA CIOPI

    2014-05-01

    Full Text Available In the production process, the objectives of sustainable development are: the protecting human health and the environment, the technological restructuring and maintaining the risks under control, waste management, reducing losses. On this line, an important role have the strategies of management that aimed at better organizing of jobs, for assuring labor safety and ergonomics conditions, indicating priorities, understanding the performance indicators, better visibility of workflow and support, using the standards and increasing the visual control, providing feedback. To achieve these objectives can be successfully implemented a number of strategies such as: Kaizen, 5S and Maintenance autonomous, which will be developed in this paper

  13. Clay Nanoparticles Elicit Long-Term Immune Responses by Forming Biodegradable Depots for Sustained Antigen Stimulation.

    Science.gov (United States)

    Chen, Weiyu; Zuo, Huali; Li, Bei; Duan, Chengcheng; Rolfe, Barbara; Zhang, Bing; Mahony, Timothy J; Xu, Zhi Ping

    2018-05-01

    Nanomaterials have been widely tested as new generation vaccine adjuvants, but few evoke efficient immunoreactions. Clay nanoparticles, for example, layered double hydroxide (LDH) and hectorite (HEC) nanoparticles, have shown their potent adjuvanticity in generating effective and durable immune responses. However, the mechanism by which clay nanoadjuvants stimulate the immune system is not well understood. Here, it is demonstrated that LDH and HEC-antigen complexes form loose agglomerates in culture medium/serum. They also form nodules with loose structures in tissue after subcutaneous injection, where they act as a depot for up to 35 d. More importantly, clay nanoparticles actively and continuously recruit immune cells into the depot for up to one month, and stimulate stronger immune responses than FDA-approved adjuvants, Alum and QuilA. Sustained antigen release is also observed in clay nanoparticle depots, with 50-60% antigen released after 35 d. In contrast, Alum-antigen complexes show minimal antigen release from the depot. Importantly, LDH and HEC are more effective than QuilA and Alum in promoting memory T-cell proliferation. These findings suggest that both clay nanoadjuvants can serve as active vaccine platforms for sustained and potent immune responses. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Long-term socioeconomic consequences and health care costs of childhood and adolescent-onset epilepsy.

    Science.gov (United States)

    Jennum, Poul; Christensen, Jakob; Ibsen, Rikke; Kjellberg, Jakob

    2016-07-01

    To estimate long-term socioeconomic consequences and health care costs of epilepsy with onset in childhood and adolescence. A historical prospective cohort study of Danish individuals with epilepsy, age up to 20 years at time of diagnosis between January 1981 and December 2012. Information about marital status, parenthood, educational level, employment status, income, use of the health care system, and cost of medicine was obtained from nationwide administrative and health registers. We identified 12,756 and 28,319 people with diagnosed with epilepsy, ages 0-5 and 6-20 years at onset, respectively. Using follow-up data for a maximum of 30 years, 1,394 of those ages 0-5 years at onset were compared with 2,897 controls persons without epilepsy, and 10,195 of those ages 6-20 years at onset were compared with 20,678 controls without epilepsy. Compared with people without the epilepsy, those with epilepsy tended to have a lower level of education, to be less likely to be married, to be more likely to live alone, and to have higher divorce and unemployment rates, lower employment rates, and people with epilepsy were more likely to receive disability pension and social security. Income was lower from employment, which in part was compensated by social security, sick pay, disability pension and unemployment benefit, sick pay (public-funded), disability pension, and other public transfers. Predicted health care costs 30 years after epilepsy onset were significantly higher among persons with epilepsy onset at 0-5 and 6-20 years, including costs for outpatient and inpatient services (hospital services), emergency room use, primary health care sector (general practice), and use of medication. The long-term negative effects on all aspects of health care and social domains, including marital status, parental socioeconomic status, educational level, employment status, and use of welfare benefits compared with controls without epilepsy calls for increased awareness on

  15. Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term

    NARCIS (Netherlands)

    van Baaren, Gert-Jan; Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Bloemenkamp, Kitty W. M.; van der Post, Joris A.; Porath, Martina; Ponjee, Gabrielle A. E.; Tamsma, Jouke T.; Mol, Ben Willem J.; Opmeer, Brent C.; de Groot, Christianne J. M.

    2014-01-01

    Objectives: To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term. Study design: Two separate Markov models evaluated the cost-effectiveness analysis of

  16. The Cost Analysis of Corrosion Protection Solutions for Steel Components in Terms of the Object Life Cycle Cost

    Directory of Open Access Journals (Sweden)

    Kowalski Dariusz

    2017-09-01

    Full Text Available Steel materials, due to their numerous advantages - high availability, easiness of processing and possibility of almost any shaping are commonly applied in construction for carrying out basic carrier systems and auxiliary structures. However, the major disadvantage of this material is its high corrosion susceptibility, which depends strictly on the local conditions of the facility and the applied type of corrosion protection system. The paper presents an analysis of life cycle costs of structures installed on bridges used in the road lane conditions. Three anti-corrosion protection systems were considered, analyzing their essential cost components. The possibility of reducing significantly the costs associated with anti-corrosion protection at the stage of steel barriers maintenance over a period of 30 years has been indicated. The possibility of using a new approach based on the life cycle cost estimation in the anti-corrosion protection of steel elements is presented. The relationship between the method of steel barrier protection, the scope of repair, renewal work and costs is shown. The article proposes an optimal solution which, while reducing the cost of maintenance of road infrastructure components in the area of corrosion protection, allows to maintain certain safety standards for steel barriers that are installed on the bridge.

  17. The Cost Analysis of Corrosion Protection Solutions for Steel Components in Terms of the Object Life Cycle Cost

    Science.gov (United States)

    Kowalski, Dariusz; Grzyl, Beata; Kristowski, Adam

    2017-09-01

    Steel materials, due to their numerous advantages - high availability, easiness of processing and possibility of almost any shaping are commonly applied in construction for carrying out basic carrier systems and auxiliary structures. However, the major disadvantage of this material is its high corrosion susceptibility, which depends strictly on the local conditions of the facility and the applied type of corrosion protection system. The paper presents an analysis of life cycle costs of structures installed on bridges used in the road lane conditions. Three anti-corrosion protection systems were considered, analyzing their essential cost components. The possibility of reducing significantly the costs associated with anti-corrosion protection at the stage of steel barriers maintenance over a period of 30 years has been indicated. The possibility of using a new approach based on the life cycle cost estimation in the anti-corrosion protection of steel elements is presented. The relationship between the method of steel barrier protection, the scope of repair, renewal work and costs is shown. The article proposes an optimal solution which, while reducing the cost of maintenance of road infrastructure components in the area of corrosion protection, allows to maintain certain safety standards for steel barriers that are installed on the bridge.

  18. SCOPEOUT: sustainability and spread of quality improvement activities in long-term care- a mixed methods approach.

    Science.gov (United States)

    Cranley, Lisa A; Hoben, Matthias; Yeung, Jasper; Estabrooks, Carole A; Norton, Peter G; Wagg, Adrian

    2018-03-12

    Interventions to improve quality of care for residents of long-term care facilities, and to examine the sustainability and spread of such initiatives, remain a top research priority. The purpose of this exploratory study was to assess the extent to which activities initiated in a quality improvement (QI) collaborative study using care aide led teams were sustained or spread following cessation of the initial project and to identify factors that led to its success. This study used an exploratory mixed methods study design and was conducted in seven residential long-term care facilities in two Canadian provinces. Sustainability and spread of QI activities were assessed by a questionnaire over five time points for 18 months following the collaborative study with staff from both intervention with non-intervention units. Semi-structured interviews were conducted with care managers at six and 12 months. QI team success in applying the QI model was ranked as high, medium, or low using criteria developed by the research team. Descriptive statistics, bivariate analyses, and General Estimating Equations were used to analyze the data. Interview data were analyzed using thematic analysis. In total, 683 surveys were received over the five time periods from 476 unique individuals on a facility unit. Seven managers were interviewed. A total of 533 surveys were analyzed. While both intervention and non-intervention units experienced a decline over time in all outcome measures, this decline was significantly less pronounced on intervention units. Facilities with medium and high success ranking had significantly higher scores in all four outcomes than facilities with a low success ranking. Care aides reported significantly less involvement of others in QI activities, less empowerment and less satisfaction with the quality of their work life than regulated care providers. Manager interviews provided evidence of sustainability of QI activities on the intervention units in four of

  19. Costs of Adopting a Common European Currency. Analysis in Terms of the Optimum Currency Areas Theory

    Directory of Open Access Journals (Sweden)

    Aura Gabriela SOCOL

    2011-02-01

    Full Text Available This analysis presents a theoretical approach of the possible costs related to a national economy which desires to be part of a monetary union. The analysis is made in terms of the classical optimum currency areas theory, which represents the basis of the monetary union process. The objective of this theory was to make a monetary union possible. This theory shows that the countries can obtain net benefits as a result of having a common currency, thus being able to avoid the possible adjustment problems. As a matter of fact, its great merit is that it identified certain properties of the countries being part of a monetary union, these properties representing real alternative tools for losing the independence of the monetary policy

  20. Sustainable winegrowing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mariani A

    2015-05-01

    Full Text Available Angela Mariani,1 Antonella Vastola2 1Department of Economic and Legal Studies, University Parthenope, Naples, 2School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy Abstract: The winegrowing sector worldwide is strongly committed to improving environmental and social sustainability. The aim of this work, based on a literature review, is to highlight current sustainability perspectives and the related main issues. There is a broad consensus that the challenge to achieve a greater spread of sustainable practices is to enhance environmental and social sustainability while maintaining economic viability. From the producers' point of view, the priority is to bridge the still substantial knowledge gaps in terms of perceived environmental benefits, economic benefits, and costs. Thus, an increased research effort focusing on the costs and benefits of different winegrowing practices and technical assistance with implementation might support their diffusion. Moreover, targeted marketing strategies are needed to: enhance consumers' involvement and their attitude toward sustainable wine; improve understanding and use of sustainable labels and claims; and raise awareness of some environmental credentials of wine packaging, mainly with reference to lightweight glass bottles. Keywords: winegrower, sustainability, wine, consumer, marketing strategies

  1. Factory '82 - 30% reduction of operation cost at short term. Fabrik '82. Kurzzeitig 30% der Betriebskosten beeinflussen

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    The present-day situation of many companies is characterized by a decreasing production volume. Consequences and effects of this phenomenon on production and ancillary branches are presented and analysed under aspects of cost, measures are described for influencing operation cost in an effective and continuing way at short term: cost of energy and disposal, heat insulation and heat recovery, cost reduction by computer application, cost reduction with material flow, operational cost analyses with detection of weak spots. Replanning factories and subsections which frequently have shown to be necessary - new planning projects have become more or less rare these days - is accounted for by the range of problem-related topics. Next to issues of CAD in factory planning, another approach is demonstrated which is still underutilized when designing and using factory buildings in keeping with cost: value-analysis factory planning.

  2. Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction.

    Directory of Open Access Journals (Sweden)

    Anton Emmanuel

    Full Text Available People suffering from neurogenic bowel dysfunction (NBD and an ineffective bowel regimen often suffer from fecal incontinence (FI and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI has been shown to reduce these symptoms and improve quality of life.To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC.A deterministic Markov decision model was developed to project the lifetime health economic outcomes, including quality-adjusted life years (QALYs, episodes of FI, urinary tract infections (UTIs, and stoma surgery when initiating TAI relative to continuing SBC. A data set consisting of 227 patients with NBD due to spinal cord injury (SCI, multiple sclerosis, spina bifida and cauda equina syndrome was used in the analysis. In the model a 30-year old individual with SCI was used as a base-case. A probabilistic sensitivity analysis was applied to evaluate the robustness of the model.The model predicts that a 30-year old SCI patient with a life expectancy of 37 years initiating TAI will experience a 36% reduction in FI episodes, a 29% reduction in UTIs, a 35% reduction in likelihood of stoma surgery and a 0.4 improvement in QALYs, compared with patients continuing SBC. A lifetime cost-saving of £21,768 per patient was estimated for TAI versus continuing SBC alone.TAI is a cost-saving treatment strategy reducing risk of stoma surgery, UTIs, episodes of FI and improving QALYs for NBD patients who have failed SBC.

  3. Long term health care consumption and cost expenditure in systolic heart failure.

    Science.gov (United States)

    Mejhert, Märit; Lindgren, Peter; Schill, Owe; Edner, Magnus; Persson, Hans; Kahan, Thomas

    2013-04-01

    The prevalence, health care consumption, and mortality increase in elderly patients with heart failure. This study aimed to analyse long term cost expenditure and predictors of health care consumption in these patients. We included 208 patients aged 60 years or older and hospitalised with heart failure (NYHA class II-IV and left ventricular systolic dysfunction); 58% were men, mean age 76 years, and mean ejection fraction 0.34. Data on all hospital admissions, discharge diagnoses, lengths of stay, and outpatient visits were collected from the National Board of Health and Welfare. We obtained data of all health care consumption for each individual. After 8-12 years of prospective follow up 72% were dead (median survival 4.6 years). Main drivers of health care expenditure were non-cardiac (40%) and cardiac (29%) hospitalizations, and visits to primary care centres (16%), and hospital outpatient clinics (15%). On average, health care expenditures were € 36,447 per patient during follow up. The average yearly cost per patient was about 5,700€, in contrast to the estimated consumption of primary and hospital care in the general population: € 1,956 in 65-74 year olds and € 2,701 in 75-84 year olds. Poor quality of life (Nottingham Health Profile) was the strongest independent predictor of total health care consumption and costs (pheart failure are at least two-fold higher than in the general population. Quality of life is a strong independent predictor of health care consumption. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Models of Disease Vector Control: When Can Aggressive Initial Intervention Lower Long-Term Cost?

    Science.gov (United States)

    Oduro, Bismark; Grijalva, Mario J; Just, Winfried

    2018-04-01

    Insecticide spraying of housing units is an important control measure for vector-borne infections such as Chagas disease. As vectors may invade both from other infested houses and sylvatic areas and as the effectiveness of insecticide wears off over time, the dynamics of (re)infestations can be approximated by [Formula: see text]-type models with a reservoir, where housing units are treated as hosts, and insecticide spraying corresponds to removal of hosts. Here, we investigate three ODE-based models of this type. We describe a dual-rate effect where an initially very high spraying rate can push the system into a region of the state space with low endemic levels of infestation that can be maintained in the long run at relatively moderate cost, while in the absence of an aggressive initial intervention the same average cost would only allow a much less significant reduction in long-term infestation levels. We determine some sufficient and some necessary conditions under which this effect occurs and show that it is robust in models that incorporate some heterogeneity in the relevant properties of housing units.

  5. Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

    Directory of Open Access Journals (Sweden)

    Thomas Hadjistavropoulos

    2016-01-01

    Full Text Available Background. Although feasible protocols for pain assessment and management in long-term care (LTC have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

  6. [Silymarin/galega administration in term and preterm mothers to sustain breast feeding: an observational study].

    Science.gov (United States)

    Castoldi, F; Pivetti, V; Moiraghi, L; Marangione, P; Lista, G

    2014-10-01

    Breastfeeding is considered the most important source of nutrition both in the first year of life for term and preterm infants, because of its well-known positive effects on short and long-term outcome. Unfortunately not all the mothers can begin or maintain an adequate milk secretion. Premature delivery and prolonged length of stay in the hospital can influence maternal milk production due to maternal anxiety and/ or neonatal pathologies related to prematurity. A variety of herbal and pharmaceutical products have been recommended as galactogogues, substances that promote lactation. In this observational study, the authors compared the effect on breast milk production of an oral maternal supplementation of two galactogogues (sylimarine and galega-Lutein latte®) in a term and preterm mothers group (preterm infants recovered in neonatal intensive care unit-NICU). The breast milk production significantly reduced at start in preterm mothers (N.=16) versus term mothers (N.=16) (P<0.08), after sylimarine and galega supplementation was the same in both groups within two months of life (P=NS). This galactogogues supplementation could be recommended to maintain an adequate lactation in premature mothers, especially when their infants are still recovered in the NICU.

  7. Long-term risks of inadequate management practices on the sustainability of agricultural soils

    NARCIS (Netherlands)

    Vries, de W.; Groenenberg, J.E.; Murányi, A.; Curlík, J.; Sefcík, P.; Römkens, P.F.A.M.; Reinds, G.J.; Bril, J.; Modin, A.K.; Sverdrup, H.U.; Alloway, B.J.

    2003-01-01

    This report describes the major result of a research project funded by the INCO-Copernicus programma of European Commission under Contract number ERB-IC15-CT98-0133. The study focused on the long-term environmental risk of soil acidification on: (i) mobilisation and leaching and (ii) plant uptake of

  8. DEVELOPMENT OF THE UNDERGROUND SPACE OF CITIES IN TERMS OF THEIR SUSTAINABLE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Belyaev Valeriy L’vovich

    2014-02-01

    Full Text Available The article shows that the negative trends in the cities development, especially their territorial "sprawling" contributes to the onset of the global environmental crisis. This call requires setting the city planners mind on noosphere thinking and establishing an adequate system of spatial development of the cities. The formation of compact city models "new urbanism", "smart development" can be considered a progressive response and a world trend. It fully meets the course of integrated urban development of the underground space.In order to overcome the significant gap on this issue between Russia and many foreign countries the urban policy needs to be updated (disclosure of the fundamental principle of sustainable development, methodologies and tools of developing underground urbanity should be developed. The authors propose such a change of the underground space as an integrated spatial and geoenergy resource with the commitment to the strategic evaluation of its development during the entire life cycle of underground construction projects.The co-authors take into account the environmental effects of the proposed development under the direction of modern paradigms of the biosphere compatible, viable and growing cities, as well as the capacity to organize their own groups. As a base model, we take a city as a complex system of natural and man-caused, containing a fiber space where underground space and underground structures is one of the layers. The instrument for this approach implementation may be a biotechnospherical humanitarian balance of the city, including the parameters of underground layers. In addition, the calculations of the information flow (Entropy between the layers is of great importance. The sustainable development of the city is dominated by a stream of negative entropy.On this basis, for the conditions of Moscow the device tools "physical planning" should be used in respect of the characteristics of underground space

  9. Are citizens not accurately informed about long-term societal costs of unsustainable travel or do they not care?

    NARCIS (Netherlands)

    Gärling, Tommy; Ettema, Dick; Friman, Margareta

    2015-01-01

    We argue that people think more about the short-term individual benefits of personal motorized travel than the long-term societal costs. One explanation is that people are more concerned about their own wellbeing and the wellbeing of their close relatives than the well-being of unknown others.

  10. 26 CFR 1.79-3 - Determination of amount equal to cost of group-term life insurance.

    Science.gov (United States)

    2010-04-01

    ... section prescribes the rules for determining the amount equal to the cost of group-term life insurance on an employee's life which is to be included in his gross income pursuant to the rule of inclusion set..., of group-term life insurance on such employee's life to which the rule of inclusion set forth in...

  11. Long-term outcomes and cost effectiveness of high-dose dexamethasone for cardiac surgery : A randomised trial

    NARCIS (Netherlands)

    Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.

    Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,

  12. Long-term outcomes and cost effectiveness of high-dose dexamethasone for cardiac surgery: a randomised trial

    NARCIS (Netherlands)

    Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.

    2017-01-01

    Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,

  13. Long-term heavy marijuana users make costly decisions on a gambling task.

    Science.gov (United States)

    Whitlow, Christopher T; Liguori, Anthony; Livengood, L Brooke; Hart, Stephanie L; Mussat-Whitlow, Becky J; Lamborn, Corey M; Laurienti, Paul J; Porrino, Linda J

    2004-10-05

    Chronic marijuana use has been associated with impairments of learning, memory, and executive functions. Little is known, however, about the effects of marijuana use on other cognitive domains, such as decision-making, which are thought to play an important role in addiction and drug abuse. The purpose of the present study was to determine if long-term heavy marijuana users employ different decision-making strategies than individuals with minimal marijuana exposure. Volunteers were assigned to a cannabis (n = 10) or control group (n = 10) based upon history of prior marijuana use. Demographic and neuropsychological variables were evaluated, and a decision-making task--the gambling task (GT) was administered. Although few demographic and neuropsychological differences were noted between groups, marijuana users made more decisions that led to larger immediate gains despite more costly losses than controls. These data suggest that long-term heavy marijuana users may have specific deficits in the ability to balance rewards and punishments that may contribute to continued drug-taking behavior. It is unknown, however, whether the basis for such deficits might be attributed directly to marijuana exposure or pre-existing genetic or behavioral differences.

  14. Leisure-time physical activity and direct cost of short-term sickness absence among Finnish municipal employees.

    Science.gov (United States)

    Tolonen, Anu; Rahkonen, Ossi; Lahti, Jouni

    2017-03-04

    We aimed to examine the direct costs of short-term (1-14 days) sickness absence and the effect of employees' physical activity on the costs. The Finnish Helsinki Health Study survey (2007) was used in the analysis (n = 3,935). Physical activity was classified into inactive, moderately active, and vigorously active. Sickness absence (3 years follow-up) and salary data were derived from the employer's registers. On average, an employee was absent 6 days a year due to short-term sickness absence, with a production loss of 2,350 EUR during the 3 years. The vigorously active had less sickness absence than those less active. The direct cost of sickness absence of a vigorously active employee was 404 EUR less than that of an inactive employee. Promoting physical activity among employees may decrease direct cost of short-term sickness absence.

  15. Beyond cost-effectiveness, analysis. Value-based pricing and result-oriented financing as a pathway to sustainability for the national health system in Spain

    Directory of Open Access Journals (Sweden)

    Alvaro Hidalgo-Vega

    2017-01-01

    Full Text Available Beyond cost-effectiveness, analysis. Value-based pricing and result-oriented financing as a pathway to sustainability for the national health system in SpainThe editorial addresses the current use of economic evaluation in the assessment and potential funding and reimbursement of health technologies. Cost-effectiveness ratio and the acceptability thresholds are analyzed, pointing out the limitations that the current approach has for capturing the value of new technologies. A potential shift from National Health Systems to value-based prices is discussed, with a focus on health economics outcomes where multi-criteria analyses can be a complementary tool to traditional cost-effectiveness approaches.

  16. [Effect of long-term application of NPK fertilizer on maize yield and yellow soil nutrients sustainability in Guizhou, China].

    Science.gov (United States)

    Liu, Yan Ling; Li, Yu; Zhang, Ya Rong; Huang, Xing Cheng; Zhang, Wen An; Jiang, Tai Ming

    2017-11-01

    A long-term fertilization field experiment was conducted to investigate the effect of nitrogen (N), phosphorus (P), and potassium (K) fertilizer on maize relative yield, yield-increasing effect and the changes of nutrients in yellow soil in Guizhou Province. Five fertilizer combinations were evaluated, including balanced fertilization (NPK) and nutrient deficiency treatments (N, NK, NP, and PK). The maize relative yield, contribution efficiency of N, P, K fertilizer application, sustainability index of soil N, P, K nutrients, and other indicators were measured. The results revealed that the balanced fertilization (NPK) significantly increased maize yield, and the average yield under each treatment ranked as: NPK>NP>NK>PK>CK. The contribution efficiency and agronomic efficiency of N, P, K fertilizer application was N>P>K. The fertilization dependence was ranked as: combined application of N, P and K>N>P>K. But in the lack of P treatment (NK), the maize relative yield significantly decreased at a speed of 1.4% per year, with the contribution efficiency and fertilization dependence of applied P significantly increasing at a speed of 2.3% per year and 1.4% per year, respectively. Over time, the effect of P fertilizer on maize yield gradually became equal to that of N fertilizer. The pH and soil organic matter content were the lowest in the P-lack treatment (NK), while they were higher in the N-lack treatment (PK). The application of chemical P significantly improved the sustainability index of soil P, but the application of chemical N and K did not significantly change the sustainability index of soil N and K nutrients compared to the N- and K-lack treatments, respectively. In summary, the use of balanced fertilizer application is critical for achieving high maize yield in typical yellow soil regions in Guizhou Province. P and N fertilizers are equally important for improving maize yield, and long-term application of unbalanced chemical fertilizer, especially the lack

  17. Long-term outlook for Alberta's primary petrochemical industry : panel discussion : sustainability, feedstocks, infrastructure, transportation

    International Nuclear Information System (INIS)

    Lauzon, D.

    1997-01-01

    The long-term outlook for Dow Chemical's involvement in Alberta's petrochemical industry was discussed. Dow Chemical Canada is a company with annual sales of more than $20 billion that manufactures and supplies chemicals, plastics, energy, agricultural products, consumer goods and environmental services in 157 countries in the world. Alberta is the centre of growth and development for the Canadian petrochemical industry because of the proximity to feedstocks. Alberta is seen as a good, long-term source of ethane. Dow Chemical intends to continue being a major player in the further development of the industry in Alberta. As proof of that confidence, there are 11 capital projects in progress at Dow's Western Canada Operation, totaling $600 million. An important ingredient of the continuing success of the petrochemical industry in Alberta will be the willingness and ability of the federal and provincial governments to work in partnership with industry to develop support infrastructure and policies

  18. Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization.

    Science.gov (United States)

    Rudoler, David; de Oliveira, Claire; Jacob, Binu; Hopkins, Melonie; Kurdyak, Paul

    2018-01-01

    The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

  19. Sustained Cortical and Subcortical Measures of Auditory and Visual Plasticity following Short-Term Perceptual Learning.

    Science.gov (United States)

    Lau, Bonnie K; Ruggles, Dorea R; Katyal, Sucharit; Engel, Stephen A; Oxenham, Andrew J

    2017-01-01

    Short-term training can lead to improvements in behavioral discrimination of auditory and visual stimuli, as well as enhanced EEG responses to those stimuli. In the auditory domain, fluency with tonal languages and musical training has been associated with long-term cortical and subcortical plasticity, but less is known about the effects of shorter-term training. This study combined electroencephalography (EEG) and behavioral measures to investigate short-term learning and neural plasticity in both auditory and visual domains. Forty adult participants were divided into four groups. Three groups trained on one of three tasks, involving discrimination of auditory fundamental frequency (F0), auditory amplitude modulation rate (AM), or visual orientation (VIS). The fourth (control) group received no training. Pre- and post-training tests, as well as retention tests 30 days after training, involved behavioral discrimination thresholds, steady-state visually evoked potentials (SSVEP) to the flicker frequencies of visual stimuli, and auditory envelope-following responses simultaneously evoked and measured in response to rapid stimulus F0 (EFR), thought to reflect subcortical generators, and slow amplitude modulation (ASSR), thought to reflect cortical generators. Enhancement of the ASSR was observed in both auditory-trained groups, not specific to the AM-trained group, whereas enhancement of the SSVEP was found only in the visually-trained group. No evidence was found for changes in the EFR. The results suggest that some aspects of neural plasticity can develop rapidly and may generalize across tasks but not across modalities. Behaviorally, the pattern of learning was complex, with significant cross-task and cross-modal learning effects.

  20. Astrocytes sustain long-term productive HIV-1 infection without establishment of reactivable viral latency.

    Science.gov (United States)

    Barat, Corinne; Proust, Alizé; Deshiere, Alexandre; Leboeuf, Mathieu; Drouin, Jean; Tremblay, Michel J

    2018-02-21

    The "shock and kill" HIV-1 cure strategy proposes eradication of stable cellular reservoirs by clinical treatment with latency-reversing agents (LRAs). Although resting CD4 + T cells latently infected with HIV-1 constitute the main reservoir that is targeted by these approaches, their consequences on other reservoirs such as the central nervous system are still unknown and should be taken into consideration. We performed experiments aimed at defining the possible role of astrocytes in HIV-1 persistence in the brain and the effect of LRA treatments on this viral sanctuary. We first demonstrate that the diminished HIV-1 production in a proliferating astrocyte culture is due to a reduced proliferative capacity of virus-infected cells compared with uninfected astrocytes. In contrast, infection of non-proliferating astrocytes led to a robust HIV-1 infection that was sustained for over 60 days. To identify astrocytes latently infected with HIV-1, we designed a new dual-color reporter virus called NL4.3 eGFP-IRES-Crimson that is fully infectious and encodes for all viral proteins. Although we detected a small fraction of astrocytes carrying silent HIV-1 proviruses, we did not observe any reactivation using various LRAs and even strong inducers such as tumor necrosis factor, thus suggesting that these proviruses were either not transcriptionally competent or in a state of deep latency. Our findings imply that astrocytes might not constitute a latent reservoir per se but that relentless virus production by this brain cell population could contribute to the neurological disorders seen in HIV-1-infected persons subjected to combination antiretroviral therapy. © 2018 Wiley Periodicals, Inc.

  1. A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study.

    Science.gov (United States)

    Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

    2016-01-01

    Best practice guidelines are a tool for narrowing research-to-practice gaps and improving care outcomes. There is some empirical understanding of guideline implementation in nursing settings, yet there has been almost no consideration of the longer-term sustainability of guideline-based practice improvements. Many healthcare innovations are not sustained, underscoring the need for knowledge about how to promote their survival. To understand how a nursing best practice guidelines program was sustained on acute healthcare center nursing units. We undertook a qualitative descriptive case study of an organization-wide nursing best practice guidelines program with four embedded nursing unit subcases. The setting was a large, tertiary/quaternary urban health center in Canada. The nursing department initiated a program to enhance patient safety through the implementation of three guidelines: falls prevention, pressure ulcer prevention, and pain management. We selected four inpatient unit subcases that had differing levels of program sustainability at an average of almost seven years post initial program implementation. Data sources included 39 key informant interviews with nursing leaders/administrators and frontline nurses; site visits; and program-related documents. Data collection and content analysis were guided by a framework for the sustainability of healthcare innovations. Program sustainability was characterized by three elements: benefits, routinization, and development. Seven key factors most accounted for the differences in the level of program sustainability between subcases. These factors were: perceptions of advantages, collaboration, accountability, staffing, linked levels of leadership, attributes of formal unit leadership, and leaders' use of sustainability activities. Some prominent relationships between characteristics and factors explained long-term program sustainability. Of primary importance was the extent to which unit leaders used sustainability

  2. Straw-to-soil or straw-to-energy? An optimal trade off in a long term sustainability perspective

    International Nuclear Information System (INIS)

    Monteleone, Massimo; Cammerino, Anna Rita Bernadette; Garofalo, Pasquale; Delivand, Mitra Kami

    2015-01-01

    Highlights: • Energy balance and GHG savings of a straw-to-electricity value chain were determined. • An “expanded” LCA was performed, from farm field to electricity delivery. • Both direct and indirect factors of land use change have been considered in the analysis. • No-tillage and crop rotation significantly improved the system performance. • A win–win, sustainable solution for the energy use of straw has been identified. - Abstract: This study examined some management strategies of wheat cultivation system and its sustainability in using straw as an energy feedstock. According to the EU regulatory framework on biofuels, no GHG emissions should be assigned to straws when they are used for energy. Given this relevance in the current energy policy, it is advisable to include all possible marginal effects related to land use, resource utilization and management changes in the comparison of different biomass options. Coherently, an expanded life cycle assessment (LCA) was applied to include the upstream cultivation phase and to make a comparison between “straw to soil” and “straw to energy”. Different crop management conditions in Southern Italy were simulated, by using the CropSyst model, to estimate the long-term soil organic carbon and annual N 2 O soil emissions. Three wheat cropping systems were considered: the conventional single wheat system without straw removal (W0) and with partial straw removal (W1), together with a no-tillage “wheat-wheat-herbage” rotation system with partial straw removal (W2). The results of the simulations were integrated in the LCA to compare fossil energy consumption and greenhouse gas (GHG) emissions of straw-to-electricity with respect to the fossil-based electricity system. The “improved” rotational wheat cropping system (W2) gave the best performance in terms both of GHG savings and fossil displacement, thus stressing that straw use for energy generation in parallel with the optimization of the

  3. The cost of long-term follow-up of high-risk infants for research studies.

    Science.gov (United States)

    Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

    2015-10-01

    Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Long-term climatic change and sustainable ground water resources management

    International Nuclear Information System (INIS)

    Loaiciga, Hugo A

    2009-01-01

    Atmospheric concentrations of greenhouse gases (GHGs), prominently carbon dioxide (CO 2 ), methane (CH 4 ), nitrous oxide (N 2 O), and halocarbons, have risen from fossil-fuel combustion, deforestation, agriculture, and industry. There is currently heated national and international debate about the consequences of such increasing concentrations of GHGs on the Earth's climate, and, ultimately, on life and society in the world as we know it. This paper reviews (i) long-term patterns of climate change, secular climatic variability, and predicted population growth and their relation to water resources management, and, specifically, to ground water resources management, (ii) means available for mitigating and adapting to trends of climatic change and climatic variability and their impacts on ground water resources. Long-term (that is, over hundreds of millions of years), global-scale, climatic fluctuations are compared with more recent (in the Holocene) patterns of the global and regional climates to shed light on the meaning of rising mean surface temperature over the last century or so, especially in regions whose historical hydroclimatic records exhibit large inter-annual variability. One example of regional ground water resources response to global warming and population growth is presented.

  5. Downscaling of Short-Term Precipitation from Regional Climate Models for Sustainable Urban Planning

    Directory of Open Access Journals (Sweden)

    Holger Hoppe

    2012-05-01

    Full Text Available A framework for downscaling precipitation from RCM projections to the high resolutions in time and space required in the urban hydrological climate change impact assessment is outlined and demonstrated. The basic approach is that of Delta Change, developed for both continuous and event-based applications. In both cases, Delta Change Factors (DCFs are calculated which represent the expected future change of some key precipitation statistics. In the continuous case, short-term precipitation from climate projections are analysed in order to estimate DCFs associated with different percentiles in the frequency distribution of non-zero intensities. The DCFs may then be applied to an observed time series, producing a realisation of a future time series. The event-based case involves downscaling of Intensity-Duration-Frequency (IDF curves based on extreme value analysis of annual maxima using the Gumbel distribution. The resulting DCFs are expressed as a function of duration and frequency (i.e., return period and may be used to estimate future design storms. The applications are demonstrated in case studies focusing on the expected changes in short-term precipitation statistics until 2100 in the cities of Linz (Austria and Wuppertal (Germany. The downscaling framework is implemented in the climate service developed within the EU-project SUDPLAN.

  6. Improvement of Renal Function by Long-Term Sustained Eculizumab Treatment in a Patient with Paroxysmal Nocturnal Hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Haruhiko Ninomiya

    2015-01-01

    Full Text Available Chronic kidney disease (CKD is one of the major manifestations of paroxysmal nocturnal hemoglobinuria (PNH. CKD in PNH is induced mainly by intravascular hemolysis of PNH-affected red blood cells (RBC missing the glycosylphosphatidylinositol-anchored proteins with complement-regulatory activities, CD55 and CD59. CKD develops by heme absorption in the proximal tubules resulting in the interstitial deposition of iron in the kidneys. We administered eculizumab to a patient with PNH, who was one of 29 patients enrolled in the AEGIS clinical trial, an open-label study of eculizumab in Japan. The patient was complicated by stage 3 CKD with impaired estimated glomerular filtration rate (eGFR, at grade G3b, and had obvious proteinuria (2-3+, 1-2 g/day. In a two-year extension to the 12-week AEGIS study, eGFR improved significantly, and the eGFR has since been maintained at grade G2 without proteinuria by sustained eculizumab treatment (>6 years. Renal function improved and maintained by long-term sustained eculizumab treatment, presumably by clearance of iron from the kidney as well as inhibition of the production of anaphylatoxin C5a, even in advanced stages of CKD, is one of the benefits of eculizumab treatment in PNH.

  7. Geochemical constraints on sustainable development: Can an advanced global economy achieve long-term stability?

    Science.gov (United States)

    Pickard, William F.

    2008-04-01

    The eighty-one stable chemical elements are examined individually with respect to (i) recent annual demand and (ii) worst case long-term availability in a distant future in which they must be extracted from the background sources of air, seawater, and ordinary rock. It is shown that, if a conventional use scenario is envisioned, the supplies of ruthenium, rhodium, palladium, tellurium, rhenium, osmium, iridium, platinum, gold, and especially phosphorus will be questionable while the supplies of copper, zinc, molybdenum, silver, cadmium, tin, antimony, tungsten, mercury, lead, and bismuth will be inadequate. It is therefore concluded that, in the long run, only the promotion of massive recycling and substitution technologies will suffice to maintain the global industrial society now developing.

  8. The sustainability of communicative packaging concepts in the food supply chain. A case study: part 2. Life cycle costing and sustainability assessment

    NARCIS (Netherlands)

    Dobon, A.; Cordero, P.; Pereira da Silva, F.I.D.G.; Ostergaard, S.R.; Antvorskov, H.; Robertsson, M.; Smolander, M.; Hortal, M.

    2011-01-01

    This paper is the second part of a two-paper series dealing with the sustainability evaluation of a new communicative packaging concept. The communicative packaging concept includes a device that allows changing the expiry date of the product as function of temperature during transport and storage:

  9. Sustained long-term benefit of patent foramen ovale closure on migraine.

    Science.gov (United States)

    Trabattoni, Daniela; Fabbiocchi, Franco; Montorsi, Piero; Galli, Stefano; Teruzzi, Giovanni; Grancini, Luca; Gatto, Pamela; Bartorelli, Antonio L

    2011-03-01

    This single-center, observational, prospective study evaluated the impact of patent foramen ovale (PFO) closure on migraine attacks over time. PFO closure may reduce the frequency and severity of migraine headaches in patients with significant right-to-left shunts. Between May 2000 and September 2009, 305 consecutive patients (mean age, 43 ± 12 years; 54.5% women) with a prior embolic cerebrovascular event underwent PFO closure with the Amplatzer PFO occluder for recurrence prevention. All patients had right-to-left shunts; the shunts were associated with migraine symptoms in 77 (25%), either alone (n = 64, 83%) or with aura (n = 13, 17%). Septal aneurysm was present in 15 (19.5%) migraine patients, and 43 (56%) had a previous transient brain ischemic attack. All migraine patients had a computed tomography scan or magnetic resonance imaging, indicating a previous brain ischemic lesion. All 305 patients underwent transthoracic echocardiography with clinical follow-up at 24 hr, at 3, 6, and 12 months, and then yearly. An acute migraine attack occurred 24-48 hr after PFO closure in 28 (36.4%) of 77 patients. There was a significant reduction (>50%) in the number and intensity of attacks in 46 (60.5%) of 77 patients at the 3-month follow-up. At the 12-month follow-up, migraine had ceased in 23 (46%) patients, and 20 (40%) had a reduction in the migraine recurrence rate and disabling symptoms. These results were maintained at follow-up (mean, 28 ± 27 months). There was overall improvement in migraine in 89% of the treated patients. Percutaneous PFO closure in migraineurs may provide beneficial mid-term and long-term results, with significant reduction in the intensity and frequency of headache symptoms. Copyright © 2010 Wiley-Liss, Inc.

  10. Long-Term Protection of Genetically Ablated Rabbit Retinal Degeneration by Sustained Transscleral Unoprostone Delivery.

    Science.gov (United States)

    Nagai, Nobuhiro; Koyanagi, Eri; Izumida, Yasuko; Liu, Junjun; Katsuyama, Aya; Kaji, Hirokazu; Nishizawa, Matsuhiko; Osumi, Noriko; Kondo, Mineo; Terasaki, Hiroko; Mashima, Yukihiko; Nakazawa, Toru; Abe, Toshiaki

    2016-12-01

    To evaluate the long-term protective effects of transscleral unoprostone (UNO) against retinal degeneration in transgenic (Tg) rabbits (Pro347Leu rhodopsin mutation). The UNO release devices (URDs) were implanted into the sclerae of Tg rabbits and ERG, optical coherence tomography (OCT), and ophthalmic examinations were conducted for 40 weeks. Unoprostone metabolites in retina, choroid/RPE, aqueous humor, and plasma from wild-type (Wt) rabbits were measured using liquid chromatography-tandem mass spectrometry. In situ hybridization and immunohistochemistry evaluated the retinal distribution of big potassium (BK) channels, and RT-PCR evaluated the expressions of BK channels and m-opsin at 1 week after URD treatment. The URD released UNO at a rate of 10.2 ±1.0 μg/d, and the release rate and amount of UNO decreased during 32 weeks. Higher ERG amplitudes were observed in the URD-treated Tg rabbits compared with the placebo-URD, or nontreated controls. At 24 weeks after implantation into the URD-treated Tg rabbits, OCT images showed preservation of retinal thickness, and histologic examinations (44 weeks) showed greater thickness of outer nuclear layers. Unoprostone was detected in the retina, choroid, and plasma of Wt rabbits. Retina/plasma ratio of UNO levels were 38.0 vs. 0.68 ng UNO*hour/mL in the URD-treated group versus control (topical UNO), respectively. Big potassium channels were observed in cone, cone ON-bipolar, and rod bipolar cells. Reverse-transcriptase PCR demonstrated BK channels and m-opsins increased in URD-treated eyes. In Tg rabbits, URD use slowed the decline of retinal function for more than 32 weeks, and therefore provides a promising tool for long-term treatment of RP.

  11. Comparison of low cost measurement techniques for long-term monitoring of atmospheric ammonia.

    Science.gov (United States)

    Sutton, M A; Miners, B; Tang, Y S; Milford, C; Wyers, G P; Duyzer, J H; Fowler, D

    2001-10-01

    An inter-comparison of techniques for long-term sampling of atmospheric ammonia (NH3) was conducted with a view to establishing a national network with > 50 sites. Key requirements were for: a low cost system, simplicity and durability to enable a postal exchange with local site operators, a precision of sampling at expected NH3 concentrations of 1-2 micrograms m-3, a detection limit sufficient to resolve the small NH3 concentrations (sampling methods were compared: A, a commercially available membrane diffusion tube (exposed in triplicate), with membranes removed immediately after sampling; B, the above method, with the membranes left in place until analysis; C, open-ended diffusion tubes (exposed with 4 replicates); D, a new active sampling diffusion denuder system; and E, an active sampling bubbler system. Method D consisted of two 0.1 m acid coated glass denuders in series with sampling at approximately 0.3 l min-1. These methods were deployed at 6 locations in the UK and the Netherlands and compared against reference estimates. Method D was the most precise and sensitive of the techniques compared, with a detection limit of 3 micrograms m-3), but were less precise and overestimated NH3 at smaller concentrations. Of the passive methods, A was the most precise and C the least precise. On the basis of the results, method D has been implemented in the national network, together with application of method A to explore spatial variability in regions with expected high NH3 concentrations.

  12. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

    Science.gov (United States)

    Fruh, Sharon M

    2017-10-01

    The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

  13. INTEGRATED MARKETING COMMUNICATION, INTRUMENT OF MODERN ORGANIZATIONS DEVELOPMENT IN TERMS OF SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Mihaela DIACONU

    2016-08-01

    Full Text Available This paper aims to provide, on the one hand, a conceptual framework of the importance that integrated marketing communication has acquired today and, on the other hand to outline an overview of the main communication tools used in Social Media.. The methodology used was the literrature review. The main conclusions of this study show that marketing communication environment has changed greatly. Technology and the Internet have fundamentally changed the way people and businesses communicate and interact. Integrated marketing communication is the means by which companies inform, persuade and remind consumers, directly or indirectly, on the products and / or services they market. Consequently, integrated marketing communication has become a fundamental aspect, a business vision and an essential factor in the success of marketing activity. Most of today's businesses are achieved through digital networks that are designed to connect people and companies. The online environment has fundamentally changed consumer notions about comfort, speed, price, product and services information. The result is a new way to create value for customers and build long-term and profitable relationships with them

  14. OLTENIA NORTHERN MEDICAL TOURISM AND DEVELOPMENT IN TERMS OF THE POSSIBILITY OF REGIONAL SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Constanta Enea

    2013-06-01

    Full Text Available Health tourism in Romania is at the beginning - it exists, develops in some areas, shy, we do not boast of many tourists who come to us for such services, however, the data provided by NATA, now a year or two there were over 60,000 people who came to our country for health tourism. Of course, data are incomplete because not all tourists coming to say. But it seems that 250 million would have entered this area. Potential exists, and curiosity and demand for Romania there. But there is enough interest for the development of such tourism. Medical tourism (also called medical travel, health tourism or global healthcare is a term initially coined by travel agencies and the media to rapidly growing phenomenon of crossing international borders to obtain health care services. The paper tries to highlight the chances for Romania, more specifically, Northern Oltenia become a specific area of medical tourism or medical tourism practiced in other countries, to local patient survival chance.

  15. Long Term Fuel Sustainable Fission Energy Perspective Relevant for Combating Climate Change

    International Nuclear Information System (INIS)

    Knapp, V.; Matijevic, M.; Pevec, D.; Crnobrnja, B.; Lale, D.

    2016-01-01

    In recent research we outlined climate relevant and immediately available proven light water nuclear strategy with a potential to contribute essentially and timely to reduction of carbon dioxide emission to the year 2065. We consider in this paper what is the perspective of fission energy after that year should its contribution be needed. Singling out two technologies with long term perspective which need no or small amounts of uranium, fast breeders and molten salt thorium reactors, we consider their main technical and safety characteristics. In both of these technologies it is essential to have starter nuclides as neither U238 nor Th232 are fissile. We investigated whether plutonium from spent fuel of light water reactors generated to the year 2065 would be present in quantities sufficient to continue operation on the same or similar level in both technologies. However in operational safety, proliferation risks, waste production, in our judgement we must give preference to thorium technology, if it would be ready in second half of the century.(author).

  16. Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.

    Science.gov (United States)

    Geri, Guillaume; Fahrenbruch, Carol; Meischke, Hendrika; Painter, Ian; White, Lindsay; Rea, Thomas D; Weaver, Marcia R

    2017-06-01

    Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA. Utstein-style information was obtained from the EMS registry, including 5-year survival. Costs from the OHCA hospitalization were obtained from the Washington State Comprehensive Hospital Abstract Reporting System. Cost effectiveness was based on hospital costs divided by quality-adjusted life years (QALYs) for a 5-year follow-up window. Of the 4448 eligible patients, 18.5% (n=824) were discharged alive from hospital and 12.1% (n=539) were alive at 5 years. Five-year survival was higher in patients who received bystander CPR (14.3% vs. 8.7%, pbystander CPR. The average (SD) total cost of the initial acute care hospitalization was USD 19,961 (40,498) for all admitted patients and USD 75,175 (52,276) for patients alive at year 5. The incremental cost-effectiveness ratio associated with bystander CPR was USD 48,044 per QALY. Based on this population-based investigation, bystander CPR was positively associated with long-term survival and appears cost-effective. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Comparison of Long-term Care in Nursing Homes Versus Home Health: Costs and Outcomes in Alabama.

    Science.gov (United States)

    Blackburn, Justin; Locher, Julie L; Kilgore, Meredith L

    2016-04-01

    To compare acute care outcomes and costs among nursing home residents with community-dwelling home health recipients. A matched retrospective cohort study of Alabamians aged more than or equal to 65 years admitted to a nursing home or home health between March 31, 2007 and December 31, 2008 (N = 1,291 pairs). Medicare claims were compared up to one year after admission into either setting. Death, emergency department and inpatient visits, inpatient length of stay, and acute care costs were compared using t tests. Medicaid long-term care costs were compared for a subset of matched beneficiaries. After one year, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries (p Home health beneficiaries averaged 0.2 hospital visits and 0.1 emergency department visits more than nursing home beneficiaries, differences that were statistically significant. Overall acute care costs were not statistically different; home health beneficiaries' costs averaged $31,423, nursing home beneficiaries' $32,239 (p = .5032). Among 426 dual-eligible pairs, Medicaid long-term care costs averaged $4,582 greater for nursing home residents (p nursing home or home health care. Additional research controlling for exogenous factors relating to long-term care decisions is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. A Novel Short-Term Maintenance Strategy for Power Transmission and Transformation Equipment Based on Risk-Cost-Analysis

    Directory of Open Access Journals (Sweden)

    Hang Yang

    2017-11-01

    Full Text Available Current studies on preventive condition-based maintenance of power transmission and transformation equipment mainly focus on mid-term or long-term maintenance, and cannot meet the requirements of short-term especially temporary maintenance. In order to solve the defects of the present preventive maintenance strategies, according to the engineering application and based on risk-cost analysis, a short-term maintenance strategy is proposed in this manuscript. For the equipment working in bad health condition, its active maintenance costs and operation risk costs are evaluated, respectively. Then the latest maintenance time is calculated in accordance with the principle that its operation risk costs are no higher than active maintenance costs. Utilizing the latest maintenance time, the best maintenance time is calculated by setting the maximum relative earnings of postponing maintenance as the target, which provides the operation staffs with comprehensive maintenance-decision support. In the end, different cases on the IEEE 24-bus system are simulated. The effectiveness and advantages of the proposed strategy are demonstrated by the simulation results.

  19. Risk-adjusted impact of administrative costs on the distribution of terminal wealth for long-term investment.

    Science.gov (United States)

    Guillén, Montserrat; Jarner, Søren Fiig; Nielsen, Jens Perch; Pérez-Marín, Ana M

    2014-01-01

    The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.

  20. Long-term Correction in Sleep Disturbance Is Sustained After Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Horneff, John G; Tjoumakaris, Fotios; Wowkanech, Charles; Pepe, Matthew; Tucker, Bradford; Austin, Luke

    2017-06-01

    Sleep disturbance is a major complaint of patients with rotator cuff disease that often leads them to seek treatment. The authors previously reported a prospective analysis of patients who underwent rotator cuff repair and found that sleep disturbance significantly improved at 3 months after surgery. That improvement in sleep was maintained at 6 months. In the current study, the authors sought to gain medium-term data on this same population at greater than 2 years. The hypotheses were that improvement in sleep disturbance after arthroscopic rotator cuff repair is maintained at 2-year follow-up and that the continued use of narcotic pain medication has a negative effect on sleep quality at 2-year follow-up. Case series; Level of evidence, 4. The original cohort of patients was contacted at a minimum of 24 months after their surgery. Thirty-seven of the 56 patients (66%) involved in the original study were available. Patient outcomes were scored using the Pittsburgh Sleep Quality Index (PSQI), Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Single Assessment Numeric Evaluation (SANE). The newly obtained scores were compared with prior scores, which ranged from preoperatively to 6 months postoperatively. The statistically significant improvement of the PSQI score demonstrated in our prior analysis at 6 months postoperatively was maintained, with a mean PSQI score of 5.5 for the 37 patients followed beyond 24 months. Of those patients, 41% still had a PSQI score >5, indicative of sleep disturbance. However, even those patients in our study with a PSQI score >5, indicative of sleep disturbance, had an improved mean score of 9.3 at greater than 24 months compared with those patients with a PSQI score >5 at 6 months, who had a mean PSQI score of 11.5 ( P = .13). Both the SST and VAS scores displayed continued improvement at greater than 24 months, with both displaying moderate strength correlation to the PSQI score (VAS: Spearman rho = 0.479, P < .001

  1. The future of Alberta's oil and gas: Long-term strategies necessary to sustain markets

    International Nuclear Information System (INIS)

    Anon

    2002-01-01

    The Canadian Association of Petroleum Producers predicts that based on current combustion and depending on world oil prices, Canadian oil sands can supply North American demand for 40 years and Canadian natural gas can meet North American requirements for 20 years. Natural gas production in the U.S. is greater in total energy output than oil production of the world's largest oil producer, Saudi Arabia. At the same time the U.S. gas industry is confronting a unique and profound combination of events, namely it is facing the first true shortage of deliverable reserves in its history. This may be harsh news for the consumer, however, for Alberta's oil and gas industry, the new world energy order has the potential to be a huge blessing. With relatively large, unexploited oil and gas reserves and a next door neighbour with the world's most voracious appetite for fossil fuels, it is inevitable that much of this shortage is going to be satisfied by oil and gas from Canadian sources. Nevertheless, there are some barriers to be overcome. The greatest barriers to an assured U. S. market for Canadian oil and gas is competition from Venezuelan heavy crude and synthetic crude and light sour crude from the Gulf of Mexico. To assure a ready market for Canadian heavy crude in the U. S. Midwest, Canadian producers need to be pro-active in working with U. S. refiners to develop new conversion capacity, or develop upgrading in Canada. Mexico and Venezuela have been successfully participating in major U. S. expansions in coker projects to allow projects to run heavy crude. This will eventually result in an additional 600,000 barrels per day of heavy crude available on the U. S. market, putting further pressure on Canadian markets. The challenge is for Albertan producers to undertake similar strategies with U. S. Midwest refiners for heavy and synthetic crude. Long-term supply arrangements appear to be the only way to induce American Midwest refiners to make more investment to process

  2. Saturation of auditory short-term memory causes a plateau in the sustained anterior negativity event-related potential.

    Science.gov (United States)

    Alunni-Menichini, Kristelle; Guimond, Synthia; Bermudez, Patrick; Nolden, Sophie; Lefebvre, Christine; Jolicoeur, Pierre

    2014-12-10

    The maintenance of information in auditory short-term memory (ASTM) is accompanied by a sustained anterior negativity (SAN) in the event-related potential measured during the retention interval of simple auditory memory tasks. Previous work on ASTM showed that the amplitude of the SAN increased in negativity as the number of maintained items increases. The aim of the current study was to measure the SAN and observe its behavior beyond the point of saturation of auditory short-term memory. We used atonal pure tones in sequences of 2, 4, 6, or 8t. Our results showed that the amplitude of SAN increased in negativity from 2 to 4 items and then levelled off from 4 to 8 items. Behavioral results suggested that the average span in the task was slightly below 3, which was consistent with the observed plateau in the electrophysiological results. Furthermore, the amplitude of the SAN predicted individual differences in auditory memory capacity. The results support the hypothesis that the SAN is an electrophysiological index of brain activity specifically related to the maintenance of auditory information in ASTM. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Long-term nutrient fertilization and the carbon balance of permanent grassland: any evidence for sustainable intensification?

    Science.gov (United States)

    Fornara, Dario A.; Wasson, Elizabeth-Anne; Christie, Peter; Watson, Catherine J.

    2016-09-01

    Sustainable grassland intensification aims to increase plant yields while maintaining the ability of soil to act as a sink rather than sources of atmospheric CO2. High biomass yields from managed grasslands, however, can be only maintained through long-term nutrient fertilization, which can significantly affect soil carbon (C) storage and cycling. Key questions remain about (1) how long-term inorganic vs. organic fertilization influences soil C stocks, and (2) how soil C gains (or losses) contribute to the long-term C balance of managed grasslands. Using 43 years of data from a permanent grassland experiment, we show that soils not only act as significant C sinks but have not yet reached C saturation. Even unfertilized control soils showed C sequestration rates of 0.35 Mg C ha-1 yr-1 (i.e. 35 g C m-2 yr-1; 0-15 cm depth) between 1970 and 2013. High application rates of liquid manure (i.e. cattle slurry) further increased soil C sequestration to 0.86 Mg C ha-1 yr-1 (i.e. 86 g C m-2 yr-1) and a key cause of this C accrual was greater C inputs from cattle slurry. However, average coefficients of slurry-C retention in soils suggest that 85 % of C added yearly through liquid manure is lost possibly via CO2 fluxes and organic C leaching. Inorganically fertilized soils (i.e. NPK) had the lowest C-gain efficiency (i.e. unit of C gained per unit of N added) and lowest C sequestration (similar to control soils). Soils receiving cattle slurry showed higher C-gain and N-retention efficiencies compared to soils receiving NPK or pig slurry. We estimate that net rates of CO2-sequestration in the top 15 cm of the soil can offset 9-25 % of GHG (greenhouse gas) emissions from intensive management. However, because of multiple GHG sources associated with livestock farming, the net C balance of these grasslands remains positive (9-12 Mg CO2-equivalent ha-1 yr-1), thus contributing to climate change. Further C-gain efficiencies (e.g. reduced enteric fermentation and use of feed

  4. Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study

    Directory of Open Access Journals (Sweden)

    Beecham Jennifer

    2011-10-01

    Full Text Available Abstract Background Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder. Methods A decision-analytic Markov model compares two scenarios: 1 a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2 the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted. Results Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices. Conclusions Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.

  5. Aggregated effects of combining daily milk consumption and aerobic exercise on short-term memory and sustained attention among female students.

    Science.gov (United States)

    Leong, In-Tyng; Moghadam, Sedigheh; Hashim, Hairul A

    2015-02-01

    Regular aerobic exercise and milk consumption have been found to have positive effects on certain cognitive functions such as short-term memory and sustained attention. However, aggregated effects of combining these modalities have not been explored. This study examined the combined effects of milk supplementation and aerobic exercise on the short-term memory and sustained attention of female students aged 16 yr. (N = 81). The intervention involved serving of 250 ml of regular milk during school days and/or a 1-hr. aerobic exercise period twice per week for 6 weeks. The Digit Span Test and Digit Vigilance Test were used to measure short-term memory and sustained attention, respectively. The combination group (milk and exercise) and exercise group performed significantly better than did the milk and control groups in terms of short-term memory. No significant interaction or group differences were found for sustained attention. The results suggest benefits of regular exercise for students' short-term memory.

  6. Influence of transportation cost on long-term retention in clinic for HIV patients in rural Haiti.

    Science.gov (United States)

    Sowah, Leonard A; Turenne, Franck V; Buchwald, Ulrike K; Delva, Guesly; Mesidor, Romaine N; Dessaigne, Camille G; Previl, Harold; Patel, Devang; Edozien, Anthony; Redfield, Robert R; Amoroso, Anthony

    2014-12-01

    With improved access to antiretroviral therapy in resource-constrained settings, long-term retention in HIV clinics has become an important means of reducing costs and improving outcomes. Published data on retention in HIV clinics beyond 24 months are, however, limited. In our clinic in rural Haiti, we hypothesized that individuals residing in locations with higher transportation costs to clinic would have poorer retention than those who had lower costs. We used a retrospective cohort design to evaluate potential predictors of HIV clinic retention. Patient information was abstracted from the electronic medical records. Cox proportional hazards regression was used to identify independent predictors of 4-year clinic retention. There were 410 patients in our cohort, 266 (64.9%) females and 144 (35.1%) males. Forty-five (11%) patients lived in locations with transportation costs >$2. Males were 1.5 times more likely to live in municipalities with transportation costs to clinic of >$2. Multivariate analysis suggested that age transportation cost were independent predictors of loss to follow-up (LTFU): risk ratio of 2.98, 95% confidence interval (CI): 1.73 to 4.96, P transportation costs greater than $2 were 1.9 times more likely to be lost to care compared with those who paid less for transportation. HIV treatment programs in resource-constrained settings may need to pay closer attention to issues related to transportation cost to improve patient retention.

  7. Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

    Science.gov (United States)

    van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert

    2012-11-01

    Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.

  8. Centralising and optimising decentralised stroke care systems : A simulation study on short-term costs and effects

    NARCIS (Netherlands)

    Lahr, Maarten M. H.; van der Zee, Durk-Jouke; Luijckx, Gert-Jan; Vroomen, Patrick C. A. J.; Buskens, Erik

    2017-01-01

    Background: Centralisation of thrombolysis may offer substantial benefits. The aim of this study was to assess short term costs and effects of centralisation of thrombolysis and optimised care in a decentralised system. Methods: Using simulation modelling, three scenarios to improve decentralised

  9. Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument.

    Science.gov (United States)

    Urquhart, J; Kennie, D C; Murdoch, P S; Smith, R G; Lennox, I

    1999-03-01

    to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. National Health Service continuing-care wards in 50 Scottish hospitals. 2783 long-stay patients aged 65 years and over. inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care.

  10. Prioritization of perspectives for a sustainable concrete chain. Cost curve on the basis of a quick scan of 16 sustainability options; Prioritering handelingsperspectieven verduurzaming betonketen. Kostencurve opgesteld op basis van quickscan van 16 door het MVO-netwerk beton geselecteerde verduurzamingsopties

    Energy Technology Data Exchange (ETDEWEB)

    Van Lieshout, M.; Warringa, G.E.A.; Bergsma, G.C.

    2013-11-15

    The goal of the project is make a rough estimate of the cost curve for 16 options for the medium term to improve the sustainability of the chain in the cement industry. In Chapter 2, the selection process of the sustainability options is described. Appendix A holds the list of options for the medium term. Next, the selected sustainability options are described of which CO2 emission reduction costs and CO2 emission reduction potentials are investigated. In Appendix B, the following aspects are described: ( a) the working principle of the measure (how does this measure contribute to the reduction of CO2 emission in the concrete chain?), (b) the reduction costs (how much are the costs for the reduction of 1 tonne CO2?, (c) the reduction potential (the amount of CO2 emissions that can be avoided on an annual basis, with the production in 2010 as the reference base)? In Chapter 3, the cost curve is presented: What are the reduction costs, What is the reduction potential, How sensitive are the data presented for variations in parameters? In Chapter 4 conclusions and recommendations are presented [Dutch] Het doel van het project is om een ruwe inschatting van de kostencurve op te stellen voor 16 opties voor de middellange termijn om de betonketen te verduurzamen. In Hoofdstuk 2 is het selectieproces van de verduurzamingopties beschreven. In Bijlage A staat de lijst met opties voor de middellange termijn waarmee de begeleidingsgroep begonnen is. Vervolgens beschrijven we welke verduurzamingsopties geselecteerd zijn waarvan de CO2-emissiereductiekosten en het CO2-emissiereductiepotentieel onderzocht zijn. In Bijlage B zijn de volgende aspecten beschreven: (a) het werkingsprincipe van de maatregel (hoe draagt deze maatregel bij aan CO2-emissiereductie in de betonketen?); (b) de reductiekosten (hoeveel kost het om op deze manier een ton CO2 te besparen?); (c) het reductiepotentieel (hoeveel CO2-emissie kan er op deze manier voorkomen worden per jaar, uitgaande van de

  11. Strategic framework for sustainable development in the period of transition towards market economy: Critical overview of the strategy of long-term development of Serbia

    Directory of Open Access Journals (Sweden)

    Hadžić Miroljub

    2005-01-01

    Full Text Available This paper offers a critical analysis of the strategic framework for long-term economic development of Serbia, of the role of strategic development in the success of the transition process, and the consequences of the lack of a development strategy. The strategy of long-term economic development of Serbia, as a programme intended to designate the economic and development policy of the state, is analyzed with the aim of finding an acceptable formulation of development strategy. The authors consider various approaches and propose a strategy for Serbia in the period of transition towards market economy. They also point out that, in the period of transition from a government-planned towards a market economy, strategy should be given greater importance than in periods that do not represent turning points, because of the greater possibility of incorrect policy making, potential conflicts of interest groups, reaching sustainable development, and maximizing prosperity. The authors take into account the advantages and disadvantages of the radical and of the gradualist approach to transition and propose formulating a development strategy that would contain combined elements of plan and market mechanisms. They believe that the process of transition lacks a clear development strategy, and that the quality of the existing development strategy of Serbia until 2010 is such that it cannot be understood as a serious approach to the transition issue. The authors stress the consequences of undergoing transition without a development strategy, that include inappropriate dynamic and sequence of reforms; a lack of coordination between development policy, macroeconomic policy, market reforms, and spatial planning policy; higher costs of transition, insufficient rate of economic growth, etc. They offer proposals for a comprehensive development framework (CDF and for strategic planning of territorial industrial development.

  12. Long-term impact of war on healthcare costs: an eight-country study

    NARCIS (Netherlands)

    Sabes-Figuera, R.; McCrone, P.; Bogic, M.; Ajdukovic, D.; Franciskovic, T.; Colombini, N.; Kucukalic, A.; Lecic-Tosevski, D.; Morina, N.; Popovski, M.; Schützwohl, M.; Priebe, S.

    2012-01-01

    Objective Exposure to war can negatively affect health and may impact on healthcare costs. Estimating these costs and identifying their predictors is important for appropriate service planning. We aimed to measure use of health services in an adult population who had experienced war in the

  13. Long-term cost-effectiveness of ticagrelor versus clopidogrel in acute coronary syndrome in Spain

    Directory of Open Access Journals (Sweden)

    E. Molina-Cuadrado

    2014-07-01

    Full Text Available Objective: To assess the cost-effectiveness relationship of Ticagrelor versus Clopidogrel for the management of acute coronary syndrome in Spain. Methods: The data from the PLATO study were used for the calculation of the events rate and health-related quality of life for Ticagrelor and Clopidogrel for the first 12 months, whereas the costs were obtained from Spanish sources. Quality of lifeadjusted survival and costs were estimated according to the fact that the patients did not suffer any thrombotic event (myocardial infarction or ictus or this one was not fatal. The lifetime cots, life years gained, and the quality of life-adjusted survival were estimated for both treatment arms. Incremental costeffectiveness ratios were assessed through the perspective of the Spanish healthcare system for 2013, by using a macro-costs strategy based on published literature and the survival tables for the Spanish population. Results: Treatment with Ticagrelor was associated to an incremental cost of 1,228 per year, an increase in 0.1652 life years gained, and 0.1365 years adjusted by quality of life, as compared to Clopidogrel. The cost for one quality of life-adjusted life year was 8,997 and the cost per one gained life year of 7,435 . The sensitivity analysis showed consistent results. Conclusions: Treatment of acute coronary syndrome for 12 months with Ticagrelor was associated with a cost per 1 life year of quality of life-adjusted cost below the cost-effectiveness limits generally accepted in Spain.

  14. Sustainable livelihood cost-benefit model to enhance the understanding of the dynamics between low income housing and location

    CSIR Research Space (South Africa)

    Biermann, SM

    2006-12-01

    Full Text Available and the three most locality-influenced aspects of sustainable livelihoods – physical, social and natural capital. 2. RESEARCH FRAMEWORK 2.1 Sustainable livelihoods framework Moser (1998) uses the idea of “asset portfolios”, which are sets of physical... or enhance its capabilities and assets both now and in the future, while not undermining the natural resource base” (Department for International Development, 2000). Whereas Moser originally only covered three kinds of capital, i.e: • investments (in...

  15. Minimum long-term cost solution for remote telecommunication stations on the basis of photovoltaic-based hybrid power systems

    International Nuclear Information System (INIS)

    Kaldellis, J.K.; Ninou, I.; Zafirakis, D.

    2011-01-01

    In the case of the telecommunication (T/C) services' expansion to rural and remote areas, the market generally responds with the minimum investments required. Considering the existing situation, cost-effective operation of the T/C infrastructure installed in these regions (i.e. remote T/C stations) becomes critical. However, since in most cases grid-connection is not feasible, the up-to-now electrification solution for remote T/C stations is based on the operation of costly, oil consuming and heavy polluting diesel engines. Instead, the use of photovoltaic (PV)-based hybrid power stations is currently examined, using as a case study a representative remote T/C station of the Greek territory. In this context, the present study is concentrated on the detailed cost-benefit analysis of the proposed solution. More precisely, the main part of the analysis is devoted to develop a complete electricity production cost model, accordingly applied for numerous oil consumption and service period scenarios. Note that in all cases examined, zero load rejections is a prerequisite while minimum long-term cost solutions designated are favorably compared with the diesel-only solution. Finally, a sensitivity analysis, demonstrating the impact of the main economic parameters on the energy production cost of optimum sized PV-diesel hybrid power stations, is also provided. - Research highlights: → Expansion of telecommunication (T/C) in remote areas is vital for their development. → Off-grid T/C stations employed in such areas operate on diesel engines. → The use of PV-diesel-battery hybrid power stations is currently examined. → A detailed long-term electricity production cost model is developed. → Cost-effectiveness of the proposed system is reflected for numerous configurations.

  16. Evaluation of the long-term cost-effectiveness of liraglutide therapy for patients with type 2 diabetes in France.

    Science.gov (United States)

    Roussel, Ronan; Martinez, Luc; Vandebrouck, Tom; Douik, Habiba; Emiel, Patrick; Guery, Matthieu; Hunt, Barnaby; Valentine, William J

    2016-01-01

    The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France. Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France. Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.

  17. Cost of presumptive source term Remedial Actions Laboratory for energy-related health research, University of California, Davis

    International Nuclear Information System (INIS)

    Last, G.V.; Bagaasen, L.M.; Josephson, G.B.; Lanigan, D.C.; Liikala, T.L.; Newcomer, D.R.; Pearson, A.W.; Teel, S.S.

    1995-12-01

    A Remedial Investigation/Feasibility Study (RI/FS) is in progress at the Laboratory for Energy Related Health Research (LEHR) at the University of California, Davis. The purpose of the RI/FS is to gather sufficient information to support an informed risk management decision regarding the most appropriate remedial actions for impacted areas of the facility. In an effort to expedite remediation of the LEHR facility, the remedial project managers requested a more detailed evaluation of a selected set of remedial actions. In particular, they requested information on both characterization and remedial action costs. The US Department of Energy -- Oakland Office requested the assistance of the Pacific Northwest National Laboratory to prepare order-of-magnitude cost estimates for presumptive remedial actions being considered for the five source term operable units. The cost estimates presented in this report include characterization costs, capital costs, and annual operation and maintenance (O ampersand M) costs. These cost estimates are intended to aid planning and direction of future environmental remediation efforts

  18. Improved Housing Accessibility for Older People in Sweden and Germany: Short Term Costs and Long-Term Gains.

    Science.gov (United States)

    Slaug, Björn; Chiatti, Carlos; Oswald, Frank; Kaspar, Roman; Schmidt, Steven M

    2017-08-26

    The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.

  19. Long-term impact of war on healthcare costs: an eight-country study.

    Directory of Open Access Journals (Sweden)

    Ramon Sabes-Figuera

    Full Text Available Exposure to war can negatively affect health and may impact on healthcare costs. Estimating these costs and identifying their predictors is important for appropriate service planning. We aimed to measure use of health services in an adult population who had experienced war in the former-Yugoslavia on average 8 years previously, and to identify characteristics associated with the use and costs of healthcare.War-affected community samples in Bosnia-Herzegovina, Croatia, Kosovo, FYR Macedonia, and Serbia were recruited through a random walk technique. Refugees in Germany, Italy and the UK were contacted through registers, organisations and networking. Current service use was measured for the previous three months and combined with unit costs for each country for the year 2006/7. A two-part approach was used, to identify predictors of service use with a multiple logistic regression model and predictors of cost with a generalised linear regression model.3,313 participants were interviewed in Balkan countries and 854 refugees in Western European countries. In the Balkan countries, traumatic events and mental health status were related to greater service use while in Western countries these associations were not found. Participants in Balkan countries with post traumatic stress disorder (PTSD had costs that were 63% higher (p = 0.005 than those without PTSD. Distress experienced during the most traumatic war event was associated with higher costs (p = 0.013. In Western European countries costs were 76% higher if non-PTSD anxiety disorders were present (0.027 and 63% higher for mood disorders (p = 0.006.War experiences and their effects on mental health are associated with increased health care costs even many years later, especially for those who stayed in the area of conflict. Focussing on the mental health impact of war is important for many reasons including those of an economic nature.

  20. An analysis of the energetic cost of the branchial and cardiac pumps during sustained swimming in trout

    DEFF Research Database (Denmark)

    FARRELL, AP; STEFFENSEN, JF

    1987-01-01

    Experimental data are available for the oxygen cost of the branchial and cardiac pumps in fish. These data were used to theoretically analyze the relative oxygen cost of these pumps during rest and swimming in rainbow troutSalmo gairdneri. Efficiency of the heart increases with activity and so...... the relative oxygen cost of the cardiac pumps decreased from 4.6% at rest to 1.9% at the critical swimming speed. The relative oxygen cost of the branchial pump is significant in the resting and slowly swimming fish, being 10 to 15% of total oxygen uptake. However, when swimming trout switch to a ram mode...... of ventilation, a considerable saving in oxygen cost is accrued by switching the cost of ventilation from the branchial to the tail musculature. Thus, the relative oxygen cost of the branchial and cardiac pumps actually decreases at critical swimming speed compared to rest and therefore is unlikely to be a major...

  1. Boundary Organizations: Creating a Unique Model for Sustained Dialog Among Scientists and Decison Makers About Long-term Change

    Science.gov (United States)

    Duncan, B.; Carter, H.; Knight, E.; Meyer, R.

    2015-12-01

    California Ocean Science Trust is a boundary organization formed by the state of California. We work across traditional boundaries between government, science, and communities to build trust and understanding in ocean and coastal science. We work closely with decision makers to understand their priority needs and identify opportunities for science to have a meaningful impact, and we engage scientists and other experts to compile and translate information into innovative products that help to meet those needs. This often sparks new collaborations that live well beyond the products themselves. Through this unique model, we are deepening relationships and facilitating an ongoing dialogue between scientists, decision-makers, and communities. The West Coast of the United States is already experiencing climate-driven changes in marine conditions at both large and small spatial scales. Decision makers are increasingly concerned with the potential threats that these changes pose to coastal communities, industries, ecosystems, and species. Detecting and understanding these multi-stressor changes requires consideration across scientific disciplines and management jurisdictions. Research and monitoring programs must reflect this new reality: they should be designed to connect with the decision makers who may use their results. In this presentation, I will share how we are drawing from the West Coast Ocean Acidification and Hypoxia Science Panel - an interdisciplinary team of scientists convened by Ocean Science Trust from California, Oregon, Washington, and British Columbia - to develop actionable guidance for long-term monitoring for long-term change. Building on our experiences working with the Panel, I will discuss the unique model that boundary organizations provide for sustained dialog across traditionally siloed disciplines and management regimes, and share best practices and lessons learned in working across those boundaries.

  2. Health Care Cost Growth and Demographic Trends Drive the Long-Term Fiscal Challenge

    National Research Council Canada - National Science Library

    2008-01-01

    ... health care costs and known demographic trends. In fact, the oldest members of the baby boom generation are now eligible for Social Security retirement benefits and will be eligible for Medicare benefits in less than 3 years...

  3. Cost estimates for near-term depolyment of advanced traffic management systems. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, S.S.; Chin, S.M.

    1993-02-15

    The objective of this study is to provide cost est engineering, design, installation, operation and maintenance of Advanced Traffic Management Systems (ATMS) in the largest 75 metropolitan areas in the United States. This report gives estimates for deployment costs for ATMS in the next five years, subject to the qualifications and caveats set out in following paragraphs. The report considers infrastructure components required to realize fully a functional ATMS over each of two highway networks (as discussed in the Section describing our general assumptions) under each of the four architectures identified in the MITRE Intelligent Vehicle Highway Systems (IVHS) Architecture studies. The architectures are summarized in this report in Table 2. Estimates are given for eight combinations of highway networks and architectures. We estimate that it will cost between $8.5 Billion (minimal network) and $26 Billion (augmented network) to proceed immediately with deployment of ATMS in the largest 75 metropolitan areas. Costs are given in 1992 dollars, and are not adjusted for future inflation. Our estimates are based partially on completed project costs, which have been adjusted to 1992 dollars. We assume that a particular architecture will be chosen; projected costs are broken by architecture.

  4. Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program

    Directory of Open Access Journals (Sweden)

    van Holland Berry J

    2012-11-01

    Full Text Available Abstract Background Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment was developed to evaluate a comprehensive workers’ health promotion program on its effectiveness, cost-benefit, and process of the intervention. Methods The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability. The main goals of the POSE program are 1 providing employee’s insight into their current employability and health status, 2 offering opportunities to improve employability and decrease health risks and 3 improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers’ perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. Discussion This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit

  5. Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program.

    Science.gov (United States)

    van Holland, Berry J; de Boer, Michiel R; Brouwer, Sandra; Soer, Remko; Reneman, Michiel F

    2012-11-20

    Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment) was developed to evaluate a comprehensive workers' health promotion program on its effectiveness, cost-benefit, and process of the intervention. The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability). The main goals of the POSE program are 1) providing employee's insight into their current employability and health status, 2) offering opportunities to improve employability and decrease health risks and 3) improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers' perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit from healthier employees, reduced sick leave (costs) and

  6. Field-scale monitoring of the long-term impact and sustainability of drainage water reuse on the west side of California’s San Joaquin Valley

    Science.gov (United States)

    Diminishing freshwater resources have brought attention to the reuse of degraded water as a potential water resource rather than as a disposal problem. Drainage water from tile-drained, irrigated agricultural land is degraded water that is often in large supply, but the long-term impact and sustain...

  7. Field-scale monitoring of the long-term impact and sustainability of drainage water reuse using ECa-directed soil sampling

    Science.gov (United States)

    Diminishing freshwater resources have brought attention to the reuse of degraded water as a water resource rather than a disposal problem. Drainage water from tile-drained, irrigated agricultural land is degraded water that is often in large supply, but the long-term impact and sustainability of it...

  8. Long term developments in irradiated natural uranium processing costs. Optimal size and siting of plants

    International Nuclear Information System (INIS)

    Thiriet, L.

    1964-01-01

    The aim of this paper is to help solve the problem of the selection of optimal sizes and sites for spent nuclear fuel processing plants associated with power capacity programmes already installed. Firstly, the structure of capital and running costs of irradiated natural uranium processing plants is studied, as well as the influence of plant sizes on these costs and structures. Shipping costs from the production site to the plant must also be added to processing costs. An attempt to reach a minimum cost for the production of a country or a group of countries must therefore take into account both the size and the location of the plants. The foreseeable shipping costs and their structure (freight, insurance, container cost and depreciation), for spent natural uranium are indicated. Secondly, for various annual spent fuel reprocessing programmes, the optimal sizes and locations of the plants are determined. The sensitivity of the results to the basic assumptions relative to processing costs, shipping costs, the starting up year of the plant programme and the length of period considered, is also tested. - this rather complex problem, of a combinative nature, is solved through dynamic programming methods. - It is shown that these methods can also be applied to the problem of selecting the optimal sizes and locations of processing plants for MTR type fuel elements, related to research reactor programmes, as well as to future plutonium element processing plants related to breeder reactors. Thirdly, the case where yearly extraction of the plutonium contained in the irradiated natural uranium is not compulsory is examined; some stockpiling of the fuel is then allowed some years, entailing delayed processing. The load factor of such plants is thus greatly improved with respect to that of plants where the annual plutonium demand is strictly satisfied. By including spent natural uranium stockpiling costs an optimal rhythm of introduction and optimal sizes for spent fuel

  9. Audit in radiation therapy: long-term survival and cost of treatment

    International Nuclear Information System (INIS)

    Stevens, G.; Firth, I.

    1997-01-01

    In order to determine the cost of radiation treatment and the survival rate of a cohort of patients treated in a 6 month period in 1988, estimates of the capital and recurrent costs of this service were made for the calendar year 1988, expressed as $A(1988). Data collected prospectively included workload statistics (including number of attendances), field treated and complexity of treatment. Patient and tumour-related data included tumour site, intent of treatment and survival. The survival rate of patients during this period was determined in June 1995. The cost per field in 1988 was estimated at $A44.32. The 1988 costs of courses of definitive, adjuvant and palliative radiation therapy were estimated at $A2545, $A2482 and $A929, respectively. The major contributor to the cost of salaries and consumables within the Radiation Oncology Department (81.6%), with capital costs accounting for 13.5%, overheads accounting for 4.5% of the costs and planned admissions accounting for 0.2%. The median survival time of 580 patients with malignant disease treated during this period in 1988 was 12.4 months. The overall 5 year survival rate was 27%. For 105 patients treated definitively with radiation therapy, the median and 5 year survival rate figures were 26.0 months and 40%. For 149 patients treated with adjuvant radiation therapy, the 5 year survival rate was 62% (median survival rate not reached). For 279 patients treated palliatively, median and 5 year survival rate figures were 5.2 months and 3%. The cost per month of survival for all patients with malignancy was $A67; the figures for definitive , adjuvant and palliative treatments being $A74, $A48 and $A105, respectively. A sensitivity analysis indicated that these figures were robust. The cost of radiation treatment per field was comparable to reports for other centres and emphasizes the utility of radiation therapy as a cost-effective cancer treatment modality. 7 refs., 6 tabs., 2 figs

  10. Long-Term Cost-Effectiveness of Insulin Glargine Versus Neutral Protamine Hagedorn Insulin for Type 2 Diabetes in Thailand.

    Science.gov (United States)

    Permsuwan, Unchalee; Chaiyakunapruk, Nathorn; Dilokthornsakul, Piyameth; Thavorn, Kednapa; Saokaew, Surasak

    2016-06-01

    Even though Insulin glargine (IGlar) has been available and used in other countries for more than a decade, it has not been adopted into Thai national formulary. This study aimed to evaluate the long-term cost effectiveness of IGlar versus neutral protamine Hagedorn (NPH) insulin in type 2 diabetes from the perspective of Thai Health Care System. A validated computer simulation model (the IMS CORE Diabetes Model) was used to estimate the long-term projection of costs and clinical outcomes. The model was populated with published characteristics of Thai patients with type 2 diabetes. Baseline risk factors were obtained from Thai cohort studies, while relative risk reduction was derived from a meta-analysis study conducted by the Canadian Agency for Drugs and Technology in Health. Only direct costs were taken into account. Costs of diabetes management and complications were obtained from hospital databases in Thailand. Both costs and outcomes were discounted at 3 % per annum and presented in US dollars in terms of 2014 dollar value. Incremental cost-effectiveness ratio (ICER) was calculated. One-way and probabilistic sensitivity analyses were also performed. IGlar is associated with a slight gain in quality-adjusted life years (0.488 QALYs), an additional life expectancy (0.677 life years), and an incremental cost of THB119,543 (US$3522.19) compared with NPH insulin. The ICERs were THB244,915/QALY (US$7216.12/QALY) and THB176,525/life-year gained (LYG) (US$5201.09/LYG). The ICER was sensitive to discount rates and IGlar cost. At the acceptable willingness to pay of THB160,000/QALY (US$4714.20/QALY), the probability that IGlar was cost effective was less than 20 %. Compared to treatment with NPH insulin, treatment with IGlar in type 2 diabetes patients who had uncontrolled blood glucose with oral anti-diabetic drugs did not represent good value for money at the acceptable threshold in Thailand.

  11. Cost-effectiveness of embryo transfer strategies: a decision analytic model using long-term costs and consequences of singletons and multiples born as a consequence of IVF.

    Science.gov (United States)

    van Heesch, M M J; van Asselt, A D I; Evers, J L H; van der Hoeven, M A H B M; Dumoulin, J C M; van Beijsterveldt, C E M; Bonsel, G J; Dykgraaf, R H M; van Goudoever, J B; Koopman-Esseboom, C; Nelen, W L D M; Steiner, K; Tamminga, P; Tonch, N; Torrance, H L; Dirksen, C D

    2016-11-01

    What is the cost-effectiveness of elective single embryo transfer (eSET) versus double embryo transfer (DET) strategies from a societal perspective, when applying a time horizon of 1, 5 and 18 years? From a short-term perspective (1 year) it is cost-effective to replace DET with single embryo transfer; however when intermediate- (5 years) and long-term (18 years) costs and consequences are incorporated, DET becomes the most cost-effective strategy, given a ceiling ratio of €20 000 per quality-adjusted life years (QALY) gained. According to previous cost-effectiveness research into embryo transfer strategies, DET is considered cost-effective if society is willing to pay around €20 000 for an extra live birth. However, interpretation of those studies is complicated, as those studies fail to incorporate long-term costs and outcomes and used live birth as a measure of effectiveness instead of QALYs. With this outcome, both multiple and singletons were valued as one live birth, whereas costs of all children of a multiple were incorporated. A Markov model (cycle length: 1 year; time horizon: 1, 5 and 18 years) was developed comparing a maximum of: (i) three cycles of eSET in all patients; (ii) four cycles of eSET in all patients; (iii) five cycles of eSET in all patients; (iv) three cycles of standard treatment policy (STP), i.e. eSET in women costs were estimated for all comparators. Input parameters were derived from a retrospective cohort study, in which hospital resource data were collected (n=580) and a parental questionnaire was sent out (431 respondents). Probabilistic sensitivity analysis (5000 iterations) was performed. With a time horizon of 18 years, DETx3 is most effective (0.54 live births, 10.2 LYs and 9.8 QALYs) and expensive (€37 871) per couple starting IVF. Three cycles of eSET are least effective (0.43 live births, 7.1 LYs and 6.8 QALYs) and expensive (€25 563). We assumed that society is willing to pay €20 000 per QALY gained. With a time

  12. Short-term global warming mitigation costs of fischer-tropsch diesel production and policy scenarios in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Bright, Ryan M.; Stroemman, Anders Hammer

    2010-07-01

    Full text: Increasing the supply of advanced biofuels like synthetic diesel produced from woody biomass require attractive investment environments so that novel technologies are deployed and technological learning can lead to reduced production costs and accelerated market diffusion. Technology-specific biofuel policy designed to minimize perceived risk may encourage shortterm investment into those biofuels offering superior environmental benefits - particularly climate mitigation benefits - thereby leading to steeper learning curves and deeper greenhouse gas (GHG) emission cuts over the medium- and long-term horizon. We perform both a Life Cycle Assessment (LCA) and an economic analysis of Fischer-Tropsch diesel (FTD) produced from Norwegian forest biomass at an 'nth' commercial plant (a plant with the same technologies that have been employed in previous commercial plants). This is followed with a cost growth analysis in order to derive production costs likely to be borne by pioneer commercial plants in Norway in the short-term (2016). LCA results are used to calculate shortterm GHG mitigation costs. We then assess, through scenarios, how various policy measures and financial support mechanisms would reduce production costs for incentivizing short-term investment and expediting commercial deployment in Norway. Because 'top-down' or 'market pull' biofuel support policy like excise tax exemptions or carbon taxes do not directly encourage investment into specific biofuel technologies like wood-FTD in the short term, we choose to analyze three 'bottom-up' or 'market push' policy scenarios to assess their effects on reducing levelized unit production costs. These include a Capital Grant, a low-interest Loan Guarantee, a Corporate Tax Credit, and a Feedstock Credit scenario. Under the Capital Grant scenario, we assess the change in levelized production and thus GHG abatement costs when a 50% capital grant (TCI) is

  13. Long-term costs of introducing HPV-DNA post-treatment surveillance to national cervical cancer screening in Ireland.

    Science.gov (United States)

    Agapova, Maria; Duignan, Andrea; Smith, Alan; O'Neill, Ciaran; Basu, Anirban

    2015-01-01

    Co-testing (cytology plus human papillomavirus DNA testing) as part of cervical cancer surveillance in Ireland increases one-time testing costs. Of interest to policy makers was the long-term impact of these costs accompanied by decreases in intensity of recalls for women with no detected abnormalities. A cost analysis of cytology-only and co-testing strategy was implemented using decision analytic modeling, aggregating testing utilization and costs for each of the two strategies over 12 years. Aggregated incremental costs of the co-testing strategy were positive for the first 3 years but became negative thereafter, generating a cost savings of roughly €20 million in favor of the cytology-only strategy over a 12-year period. Results were robust over a range of sensitivity analyses with respect to discount and attrition rates. This analysis provided valuable information to policy makers contributing to the introduction of co-testing for post-treatment surveillance (PTS) in Ireland.

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

    Directory of Open Access Journals (Sweden)

    John Stover

    Full Text Available BACKGROUND: By the end of 2011 Global Fund investments will be supporting 3.5 million people on antiretroviral therapy (ART in 104 low- and middle-income countries. We estimated the cost and health impact of continuing treatment for these patients through 2020. METHODS AND FINDINGS: Survival on first-line and second-line ART regimens is estimated based on annual retention rates reported by national AIDS programs. Costs per patient-year were calculated from country-reported ARV procurement prices, and expenditures on laboratory tests, health care utilization and end-of-life care from in-depth costing studies. Of the 3.5 million ART patients in 2011, 2.3 million will still need treatment in 2020. The annual cost of maintaining ART falls from $1.9 billion in 2011 to $1.7 billion in 2020, as a result of a declining number of surviving patients partially offset by increasing costs as more patients migrate to second-line therapy. The Global Fund is expected to continue being a major contributor to meeting this financial need, alongside other international funders and domestic resources. Costs would be $150 million less in 2020 with an annual 5% decline in first-line ARV prices and $150-370 million less with a 5%-12% annual decline in second-line prices, but $200 million higher in 2020 with phase out of stavudine (d4T, or $200 million higher with increased migration to second-line regimens expected if all countries routinely adopted viral load monitoring. Deaths postponed by ART correspond to 830,000 life-years saved in 2011, increasing to around 2.3 million life-years every year between 2015 and 2020. CONCLUSIONS: Annual patient-level direct costs of supporting a patient cohort remain fairly stable over 2011-2020, if current antiretroviral prices and delivery costs are maintained. Second-line antiretroviral prices are a major cost driver, underscoring the importance of investing in treatment quality to improve retention on first-line regimens.

  15. Interdependences between sustainable development and sustainable economy

    OpenAIRE

    Emilia Mioara CÂMPEANU; Carmen Valentina RĂDULESCU

    2014-01-01

    Sustainable development and sustainable economy are mostly used concepts. Understanding clearly their meaning allows their use in an appropriate context and, therefore, their boundaries in terms of theoretical and practical approaches on which occasion it can be given their interdependencies. The paper aim is to analyze the interdependences between sustainable development and sustainable economy.

  16. The Formation of Learners' Motivation to Study Physics in Terms of Sustainable Development of Education in Ukraine

    Science.gov (United States)

    Korsun, Igor

    2017-01-01

    This study is aimed at creating a general technique for the formation of learners' interest in physics in the context of sustainable development of education. The active means of training and active learning methods are the components of this technique. The sequence of interest formation for physics in the context of sustainable development of…

  17. Evaluating C-RAN Fronthaul Functional Splits in Terms of Network Level Energy and Cost Savings

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Popovska Avramova, Andrijana; Berger, Michael Stübert

    2016-01-01

    The placement of the complete baseband processing in a centralized pool results in high data rate requirement and inflexibility of the fronthaul network, which challenges the energy and cost effectiveness of the cloud radio access network (C-RAN). Recently, redesign of the C-RAN through functional...... split in the baseband processing chain has been proposed to overcome these challenges. This paper evaluates, by mathematical and simulation methods, different splits with respect to network level energy and cost efficiency having in the mind the expected quality of service.The proposed mathematical...... model quantifies the multiplexing gains and the trade-offs between centralization and decentralization concerning the cost of the pool, fronthaul network capacity and resource utilization. The event-based simulation captures the influence of the traffic load dynamics and traffic type variation...

  18. Short-term costs of preeclampsia to the United States health care system.

    Science.gov (United States)

    Stevens, Warren; Shih, Tiffany; Incerti, Devin; Ton, Thanh G N; Lee, Henry C; Peneva, Desi; Macones, George A; Sibai, Baha M; Jena, Anupam B

    2017-09-01

    Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States. This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012. We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population-based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set. Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P preeclampsia during the first 12 months after birth was $1.03 billion for mothers and $1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from $150,000 at 26 weeks gestational age to $1311 at 36 weeks gestational age. In 2012, the cost of preeclampsia within the first 12 months of delivery was $2.18 billion in the United States ($1.03 billion for mothers and $1.15 billion for infants), and was disproportionately borne by births of low gestational age. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The Long-Term Effectiveness and Cost Effectiveness of Organized versus Opportunistic Screening for Breast Cancer in Austria.

    Science.gov (United States)

    Schiller-Fruehwirth, Irmgard; Jahn, Beate; Einzinger, Patrick; Zauner, Günther; Urach, Christoph; Siebert, Uwe

    2017-09-01

    In 2014, Austrian health authorities implemented an organized breast cancer screening program. Until then, there has been a long-standing tradition of opportunistic screening. To evaluate the cost-effectiveness of organized screening compared with opportunistic screening, as well as to identify factors influencing the clinical and economic outcomes. We developed and validated an individual-level state-transition model and assessed the health outcomes and costs of organized and opportunistic screening for 40-year-old asymptomatic women. The base-case analysis compared a scenario involving organized biennial screening with a scenario reflecting opportunistic screening practice for an average-risk woman aged 45 to 69 years. We applied an annual discount rate of 3% and estimated the incremental cost-effectiveness ratio in terms of the cost (2012 euros) per life-year gained (LYG) from a health care perspective. Deterministic and probabilistic sensitivity analyses were performed to assess uncertainty. Compared with opportunistic screening, an organized program yielded on average additional 0.0118 undiscounted life-years (i.e., 4.3 days) and cost savings of €41 per woman. In the base-case analysis, the incremental cost-effectiveness ratio of organized screening was approximately €20,000 per LYG compared with no screening. Assuming a willingness-to-pay threshold of €50,000 per LYG, there was a 70% probability that organized screening would be considered cost-effective. The attendance rate, but not the test accuracy of mammography, was an influential factor for the cost-effectiveness. The decision to adopt organized screening is likely an efficient use of limited health care resources in Austria. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. A retrospective investigation of energy efficiency standards: policies may have accelerated long term declines in appliance costs

    International Nuclear Information System (INIS)

    Van Buskirk, R D; Kantner, C L S; Gerke, B F; Chu, S

    2014-01-01

    We perform a retrospective investigation of multi-decade trends in price and life-cycle cost (LCC) for home appliances in periods with and without energy efficiency (EE) standards and labeling polices. In contrast to the classical picture of the impact of efficiency standards, the introduction and updating of appliance standards is not associated with a long-term increase in purchase price; rather, quality-adjusted prices undergo a continued or accelerated long-term decline. In addition, long term trends in appliance LCCs—which include operating costs—consistently show an accelerated long term decline with EE policies. We also show that the incremental price of efficiency improvements has declined faster than the baseline product price for selected products. These observations are inconsistent with a view of EE standards that supposes a perfectly competitive market with static supply costs. These results suggest that EE policies may be associated with other forces at play, such as innovation and learning-by-doing in appliance production and design, that can affect long term trends in quality-adjusted prices and LCCs. (letter)

  1. Developing an Onboard Traffic-Aware Flight Optimization Capability for Near-Term Low-Cost Implementation

    Science.gov (United States)

    Wing, David J.; Ballin, Mark G.; Koczo, Stefan, Jr.; Vivona, Robert A.; Henderson, Jeffrey M.

    2013-01-01

    The concept of Traffic Aware Strategic Aircrew Requests (TASAR) combines Automatic Dependent Surveillance Broadcast (ADS-B) IN and airborne automation to enable user-optimal in-flight trajectory replanning and to increase the likelihood of Air Traffic Control (ATC) approval for the resulting trajectory change request. TASAR is designed as a near-term application to improve flight efficiency or other user-desired attributes of the flight while not impacting and potentially benefiting ATC. Previous work has indicated the potential for significant benefits for each TASAR-equipped aircraft. This paper will discuss the approach to minimizing TASAR's cost for implementation and accelerating readiness for near-term implementation.

  2. Shifting the Paradigm for Long Term Monitoring at Legacy Sites to Improve Performance while Reducing Costs - 13422

    International Nuclear Information System (INIS)

    Eddy-Dilek, Carol A; Looney, Brian B.; Gaughan, Thomas; Kmetz, Thomas; Seaman, John

    2013-01-01

    A major issue facing many government and private industry sites that were previously contaminated with radioactive and chemical wastes is that often the sites cannot be cleaned up enough to permit unrestricted human access. These sites will require long-term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality in a cost effective manner. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site (SRS), the larger DOE complex, and many large federal and private sites. Currently, most monitoring strategies are focused on laboratory measurements of contaminants measured in groundwater samples collected from wells. This approach is expensive, and provides limited and lagging information about the effectiveness of cleanup activities and the behavior of the residual contamination. Over the last twenty years, DOE and other federal agencies have made significant investments in the development of various types of sensors and strategies that would allow for remote analysis of contaminants in groundwater, but these approaches do not promise significant reductions in risk or cost. Scientists at SRS have developed a new paradigm to simultaneously improve the performance of long term monitoring systems while lowering the overall cost of monitoring. This alternative approach incorporates traditional point measurements of contaminant concentration with measurements of controlling variables including boundary conditions, master variables, and traditional plume/contaminant variables. Boundary conditions are the overall driving forces that control plume movement and therefore provide leading indication to changes in plume stability. These variables include metrics associated with meteorology, hydrology, hydrogeology, and land use. Master variables are the key variables that control the chemistry of the

  3. Project evaluation, sustainability and accountability : combining cost-benefit analysis (CBA) and multi-criteria analysis (MCA)

    NARCIS (Netherlands)

    Sijtsma, F.J.

    2006-01-01

    General abstract Decision-makers in governments and businesses must choose among different project alternatives which, in varying degrees, contribute to sustainability. Decision-makers also have to account for their choices to a large audience or a broad range of stakeholders. This thesis is about

  4. Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term.

    Science.gov (United States)

    van Baaren, Gert-Jan; Hermes, Wietske; Franx, Arie; van Pampus, Maria G; Bloemenkamp, Kitty W M; van der Post, Joris A; Porath, Martina; Ponjee, Gabrielle A E; Tamsma, Jouke T; Mol, Ben Willem J; Opmeer, Brent C; de Groot, Christianne J M

    2014-10-01

    To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term. Two separate Markov models evaluated the cost-effectiveness analysis of hypertension (HT) screening and screening on metabolic syndrome (MetS), respectively, as compared to current practice in women with a history of term hypertensive pregnancy disorders. Analyses were performed from the Dutch health care perspective, using a lifetime horizon. One-way sensitivity analyses and Monte Carlo simulation evaluated the robustness of the results. Both screening on HT and MetS in women with a history of gestational hypertension or pre-eclampsia resulted in increase in life expectancy (HT screening 0.23year (95% CI -0.06 to 0.54); MetS screening 0.14years (95% CI -0.16 to 0.45)). The gain in QALYs was limited, with HT screening and MetS screening generating 0.04 QALYs (95% CI -0.12 to 0.20) and 0.03 QALYs (95% CI -0.14 to 0.19), resulting in costs to gain one QALY of €4228 and €28,148, respectively. Analyses for uncertainty showed a chance of 74% and 75%, respectively, that post-partum screening is cost-effective at a threshold of €60,000/QALY. According to the available knowledge post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term is likely to be cost-effective. Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  5. Afterschool Sustainability

    Directory of Open Access Journals (Sweden)

    Hilary D. Joyce

    2014-12-01

    Full Text Available Youth participation in quality extended learning opportunities (ELOs results in positive academic, physical, mental health, and social/emotional outcomes. Funding is essential to implementing and sustaining quality ELOs; however multiple funding barriers and challenges exist. Understanding the types of funds available for ELOs and the factors that influence sustainability is critical. Through surveys and telephone interviews of ELO providers, this descriptive study identified and examined ELO funding streams, the ways ELO providers use these funding streams, and the barriers and challenges to sustainability. ELO programs often relied on one major funding stream coupled with nutrition supports as well as in-kind resources. Barriers to sustainability included year-to-year funding, transportation costs, reducing community partnerships, and difficulty in diversifying funds. Recommendations to enhance ELO sustainability are offered, particularly in relation to overcoming the challenges to diversification of funding resources and establishing mutually supportive partnerships and collaboration.

  6. Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Maddix Jason

    2010-07-01

    Full Text Available Abstract Background Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. Methods We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007. Results Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Conclusion Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals

  7. Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan.

    Science.gov (United States)

    Waning, Brenda; Maddix, Jason; Soucy, Lyne

    2010-07-13

    Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative

  8. Implications of the international reduction pledges on long-term energy system changes and costs in China and India

    International Nuclear Information System (INIS)

    Lucas, Paul L.; Shukla, P.R.; Chen, Wenying; Ruijven, Bas J. van; Dhar, Subash; Elzen, Michel G.J. den; Vuuren, Detlef P. van

    2013-01-01

    This paper analyses the impact of postponing global mitigation action on abatement costs and energy systems changes in China and India. It compares energy-system changes and mitigation costs from a global and two national energy-system models under two global emission pathways with medium likelihood of meeting the 2 °C target: a least-cost pathway and a pathway that postpones ambitious mitigation action, starting from the Copenhagen Accord pledges. Both pathways have similar 2010–2050 cumulative greenhouse gas emissions. The analysis shows that postponing mitigation action increases the lock-in in less energy efficient technologies and results in much higher cumulative mitigation costs. The models agree that carbon capture and storage (CCS) and nuclear energy are important mitigation technologies, while the shares of biofuels and other renewables vary largely over the models. Differences between India and China with respect to the timing of emission reductions and the choice of mitigation measures relate to differences in projections of rapid economic change, capital stock turnover and technological development. Furthermore, depending on the way it is implemented, climate policy could increase indoor air pollution, but it is likely to provide synergies for energy security. These relations should be taken into account when designing national climate policies. - highlights: • We analyze long-term impacts of the international pledges for China and India. • We compare a least-cost pathway with a pathway starting from the Copenhagen pledges. • Postponing mitigation action implies much higher cumulative mitigation costs. • Postponing increases fossil fuel dependence and requires deeper long-term reductions. • Countries differ mainly due to different periods of rapid economic change

  9. Thesis: the ''evolutions of the long term European gas market - organisation and costs''

    International Nuclear Information System (INIS)

    Ouvry, V.

    1998-01-01

    This paper presents the main conclusions of the thesis defended by the author on January 30, 1998: recalls of some characteristics of the European gas market, the stakes of the gas market liberation, the regulatory aspects, the tariffs problem, the competition in the gas marketing segment, and different possible modeling of the gas market evolution (contracts, costs, competition). (J.S.)

  10. Assessment of Low-Cost Elevators for Near Term Application in Transit Stations

    Science.gov (United States)

    1982-09-01

    This study of low-cost elevators for use in existing transit stations was commissioned by the Transportation Systems Center and included a four-day site study of screw column elevators manufactured by the Ebel Company of Brussels, Belgium. The site s...

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. Long Term Potentials and Costs of RES - Part II: The Role of International Biomass Trade

    NARCIS (Netherlands)

    Hoefnagels, E.T.A.; Junginger, H.M.; Resch, G.; Panzer, C.

    2011-01-01

    This report investigated the impact of international transport on the total cost and greenhouse gas balance of solid woody biomass. For this purpose, a geospatial intermodal biomass transport model was developed in the ArcGIS 10.0 Network Analyst extension. This model has been complemented with data

  13. The effect of oxygen content during an initial sustained inflation on heart rate in asphyxiated near-term lambs.

    Science.gov (United States)

    Sobotka, K S; Ong, T; Polglase, G R; Crossley, K J; Moss, T J M; Hooper, S B

    2015-07-01

    At birth, an initial sustained inflation (SI) uniformly aerates the lungs, increases arterial oxygenation and rapidly improves circulatory recovery in asphyxiated newborns. We hypothesised that lung aeration, in the absence of an increase in arterial oxygenation, can increase heart rate (HR) in asphyxiated near-term lambs. Lambs were delivered and instrumented at 139±2 days of gestation. Asphyxia was induced by umbilical cord clamping and then delaying the onset of ventilation until mean carotid arterial pressures (CAPs) had decreased <20 mm Hg. Lambs then received a single 30-s SI using nitrogen (N2; n=6), 5% oxygen (O2; n=6), 21% O2 (n=6) or 100% O2 (n=6) followed by ventilation in air for 30 min. HR, CAP and pulmonary blood flow (PBF) were continuously recorded. HR and PBF increased more quickly in lambs resuscitated with 100% and 21% O2 than with 5% O2 or N2. HR and PBF recovery in the 5% O2 group was delayed relative to all other oxygen SI groups. HR in 5%, 21% and 100% O2 groups reached 100 bpm before the SI was complete. HR and PBF in the N2 group did not increase until 10 s after the SI was completed and ventilation was initiated with air. CAP tended to increase quicker in all O2 groups than in N2 group. Oxygen content during an SI is important for circulatory recovery in asphyxiated lambs. This increase in HR is likely driven by the increase in PBF and venous return to the heart. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Short- and longer-term health-care resource utilization and costs associated with acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Johnson BH

    2016-02-01

    .Conclusion: In addition to the substantial costs of the initial hospitalization of an AIS, these costs double within the year following this event. Given the high cost associated with AIS, new interventions reducing either the acute or longer-term burden of AIS are needed. Keywords: acute ischemic stroke, health-care resource utilization, health-care costs, readmissions

  15. Analysis of near-term spent fuel transportation hardware requirements and transportation costs

    International Nuclear Information System (INIS)

    Daling, P.M.; Engel, R.L.

    1983-01-01

    A computer model was developed to quantify the transportation hardware requirements and transportation costs associated with shipping spent fuel in the commercial nucler fuel cycle in the near future. Results from this study indicate that alternative spent fuel shipping systems (consolidated or disassembled fuel elements and new casks designed for older fuel) will significantly reduce the transportation hardware requirements and costs for shipping spent fuel in the commercial nuclear fuel cycle, if there is no significant change in their operating/handling characteristics. It was also found that a more modest cost reduction results from increasing the fraction of spent fuel shipped by truck from 25% to 50%. Larger transportation cost reductions could be realized with further increases in the truck shipping fraction. Using the given set of assumptions, it was found that the existing spent fuel cask fleet size is generally adequate to perform the needed transportation services until a fuel reprocessing plant (FRP) begins to receive fuel (assumed in 1987). Once the FRP opens, up to 7 additional truck systems and 16 additional rail systems are required at the reference truck shipping fraction of 25%. For the 50% truck shipping fraction, 17 additional truck systems and 9 additional rail systems are required. If consolidated fuel only is shipped (25% by truck), 5 additional rail casks are required and the current truck cask fleet is more than adequate until at least 1995. Changes in assumptions could affect the results. Transportation costs for a federal interim storage program could total about $25M if the FRP begins receiving fuel in 1987 or about $95M if the FRP is delayed until 1989. This is due to an increased utilization of federal interim storage facility from 350 MTU for the reference scenario to about 750 MTU if reprocessing is delayed by two years

  16. Sustentabilidade empresarial e o impacto no custo de capital próprio das empresas de capital aberto Sustainable development and consequences for equity costs in public companies

    Directory of Open Access Journals (Sweden)

    Lílian Simone Aguiar da Silva

    2006-12-01

    Full Text Available Este trabalho apresenta o impacto no custo de capital próprio para as empresas brasileiras de capital aberto face à adoção dos princípios de sustentabilidade. O conceito de desenvolvimento sustentável tem se aprimorado num processo contínuo de reavaliação da relação existente entre: crescimento econômico, a sociedade civil e o meio ambiente. O triple-bottom-line das dimensões econômica, ambiental e social da sustentabilidade tem emergido como um modelo de interpretação pelas empresas, embora cada uma dessas dimensões represente um grande desafio. O segmento corporativo vem atendendo às demandas cada vez maiores da sociedade frente a essas questões, ficando a dúvida quanto à legitimidade dessas ações e o questionamento relativo ao papel das empresas na economia e na sociedade. Para avaliar o impacto no custo de capital próprio, foi implementado um modelo de decomposição do beta em medidas contábeis de risco, incluindo uma variável referente à sustentabilidade. O resultado confirma a expectativa de que ao aderir aos padrões de sustentabilidade a empresa reduz o risco corporativo medido pelo risco sistemático, determinando a redução do custo de capital e aumento do valor econômico.This article provides an analysis of equity costs in Brazilian public companies regarding the adoption of sustainability principles. The concept of sustainable development has evolved considering the relation among economic growth, the society and the environment. The triple-bottom-line of economic, environmental, and social dimensions has emerged as an interpretation model by companies, although each of these dimensions may present a challenge. The corporate sector has faced an increasing demand from society regarding these sustainability concepts, though the actions and the role to be played by companies within this context are still being questioned. Equity costs were analyzed by a multivariate regression of beta on accounting measures

  17. Optimizing inspection intervals—Reliability and availability in terms of a cost model: A case study on railway carriers

    International Nuclear Information System (INIS)

    Wolde, Mike ten; Ghobbar, Adel A.

    2013-01-01

    This paper states the problem that railway carriers have with inspections and maintenance in its most cost optimal way. Often there is external pressure to improve reliability and availability and to reduce costs significantly. To overcome this problem this paper suggests a model that tries to find the optimal inspection interval. Not all maintenance companies have their inspection intervals that match with the actual reliability of a system anymore and the inspection intervals are not necessarily at a cost optimum. This research retrieves the actual failure and repair data and combines this together with the availability of a system to find the optimum inspection interval in terms of costs. The application of the optimization approach to a railway carrier maintenance company in the Netherlands is also presented. -- Highlights: ► New optimization technique for reliability and availability by minimizing costs. ► Adaptable to multiple types of repairs. ► Usable as a practical model. ► Applicable to the FMECA, RCM and ISO31000 risk management methods

  18. Conceptual costing study for the long-term management of the Port Hope area low-level radioactive wastes

    International Nuclear Information System (INIS)

    1989-12-01

    Comparative conceptual cost estimates for several possible options for the long-term management of the Port Hope area low-level radioactive wastes have been developed. Five potentially applicable concepts were considered in the study: shallow land burial, using either unlined trenches, lined trenches or concrete canisters; engineered storage mounds; above-ground concrete vaults; below-ground concrete vaults; and intermediate-depth caverns using either open stopes or shrinkage mining. The objective was to develop comparative estimates. The differences in costs between concepts reflect the differences in handling methodology or costs of additional engineered barriers around the stored waste. An in situ waste volume of 805 000 m 3 , relatively favorable site conditions, a four-year disposal schedule and a consistent costing basis were assumed for each concept. Limited effort was made to optimize specific facility designs or disposal operations. The projected disposal costs vary from $68/m 3 of waste for shallow land burial in unlined trenches, to $312/m 3 of waste disposal in concrete canisters in trenches. The results of this study are reasonably consistent with previous estimates prepared for the low-level Radioactive Waste Management Office

  19. A Critical Comparison of Alternative Distribution Configurations in Omni-Channel Retailing in Terms of Cost and Greenhouse Gas Emissions

    Directory of Open Access Journals (Sweden)

    Marco Melacini

    2018-01-01

    Full Text Available New opportunities and challenges forced by the ever-increasing importance of the online channel have arisen for retailers. The retailing industry is moving to a new phase, in which the distinctions between traditional and online channels disappear, namely omni-channel (OC retailing. At the same time, the awareness of environmentally sustainable processes has been enhanced around the world and the environmental impact that results from the online order fulfilment process is becoming a key issue for logistics managers. The new challenge is to understand how multiple channels can be synergistically managed to provide a seamless customer experience, taking an economic and environmental perspective simultaneously. Retailers need to define the distribution configuration for serving the online demand, making decisions on the integration level between online and traditional channels. In this paper, we developed an assessment model of the operational costs and greenhouse gas emissions for three distribution configurations in OC retailing. The model was also applied to a real case operating in the consumer electronics industry. Results highlighted that the search for synergies between online and traditional flows in both warehouse and transport activities is a key factor for the economic and environmental sustainability of OC systems.

  20. The price for biofuels sustainability

    International Nuclear Information System (INIS)

    Pacini, Henrique; Assunção, Lucas; Dam, Jinke van; Toneto, Rudinei

    2013-01-01

    The production and usage of biofuels has increased worldwide, seeking goals of energy security, low-carbon energy and rural development. As biofuels trade increased, the European Union introduced sustainability regulations in an attempt to reduce the risks associated with biofuels. Producers were then confronted with costs of sustainability certification, in order to access the EU market. Hopes were that sustainably-produced biofuels would be rewarded with higher prices in the EU. Based on a review of recent literature, interviews with traders and price data from Platts, this paper explores whether sustainability premiums emerged and if so, did they represent an attracting feature in the market for sustainable biofuels. This article finds that premiums for ethanol and biodiesel evolved differently between 2011 and 2012, but have been in general very small or inexistent, with certified fuels becoming the new norm in the market. For different reasons, there has been an apparent convergence between biofuel policies in the EU and the US. As market operators perceive a long-term trend for full certification in the biofuels market, producers in developing countries are likely to face additional challenges in terms of finance and capacity to cope with the sustainability requirements. - Highlights: • EU biofuel sustainability rules were once thought to reward compliant producers with price-premiums. • Premiums for certified biofuels, however, have been small for biodiesel and almost non-existent for ethanol. • As sustainable biofuels became the new norm, premiums disappeared almost completely in 2012. • Early stages of supply chains concentrate the highest compliance costs, affecting specially developing country producers. • Producers are now in a market where sustainable biofuels have become the new norm

  1. The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury.

    Directory of Open Access Journals (Sweden)

    Gilles Clermont

    Full Text Available The pulmonary artery catheter (PAC remains widely used in acute lung injury (ALI despite known complications and little evidence of improved short-term mortality. Concurrent with NHLBI ARDS Clinical Trials Network Fluid and Catheters Treatment Trial (FACTT, we conducted a prospectively-defined comparison of healthcare costs and long-term outcomes for care with a PAC vs. central venous catheter (CVC. We explored if use of the PAC in ALI is justified by a beneficial cost-effectiveness profile.We obtained detailed bills for the initial hospitalization. We interviewed survivors using the Health Utilities Index Mark 2 questionnaire at 2, 6, 9 and 12 m to determine quality of life (QOL and post-discharge resource use. Outcomes beyond 12 m were estimated from federal databases. Incremental costs and outcomes were generated using MonteCarlo simulation.Of 1001 subjects enrolled in FACTT, 774 (86% were eligible for long-term follow-up and 655 (85% consented. Hospital costs were similar for the PAC and CVC groups ($96.8k vs. $89.2k, p = 0.38. Post-discharge to 12 m costs were higher for PAC subjects ($61.1k vs. 45.4k, p = 0.03. One-year mortality and QOL among survivors were similar in PAC and CVC groups (mortality: 35.6% vs. 31.9%, p = 0.33; QOL [scale: 0-1]: 0.61 vs. 0.66, p = 0.49. MonteCarlo simulation showed PAC use had a 75.2% probability of being more expensive and less effective (mean cost increase of $14.4k and mean loss of 0.3 quality-adjusted life years (QALYs and a 94.2% probability of being higher than the $100k/QALY willingness-to-pay threshold.PAC use increased costs with no patient benefit and thus appears unjustified for routine use in ALI.www.clinicaltrials.gov NCT00234767.

  2. TASKA-M - a low cost, near term tandem mirror device for fusion technology testing

    International Nuclear Information System (INIS)

    Badger, B.; Corradini, M.L.; El-Guebaly, L.; Emmert, G.A.; Kulcinski, G.L.; Larsen, E.M.; Maynard, C.W.; Perkins, L.J.; Peterson, R.R.; Plute, K.E.; Santarius, J.F.; Sawan, M.E.; Scharer, J.E.; Sviatoslavsky, I.N.; Sze, D.K.; Vogelsang, W.F.; Wittenberg, L.J.; Leppelmeier, G.W.; Grover, J.M.; Opperman, E.K.; Vogel, M.A.; Borie, E.; Taczanowski, S.; Arendt, F.; Dittrich, H.G.; Fett, T.; Haferkamp, B.; Heinz, W.; Hoelzchen, E.; Kleefeldt, K.; Klingelhoefer, R.; Komarek, P.; Kuntze, M.; Leiste, H.G.; Link, W.; Malang, S.; Manes, B.M.; Maurer, W.; Michael, I.; Mueller, R.A.; Neffe, G.; Schramm, K.; Suppan, A.; Weinberg, D.

    1984-04-01

    TASKA-M (Modifizierte Tandem Spiegelmaschine Karlsruhe) is a study of a dedicated fusion technology device based on the mirror principle, in continuation of the 1981/82 TASKA study. The main objective is to minimize cost while retaining key requirements of neutron flux and fluence for blanket and material development and for component testing in a nuclear environment. Direct costs are reduced to about 400 M$ by dropping reactor-relevant aspects not essential to technology testing: No thermal barrier and electrostatic plugging of the plasma; fusion power of 7 MW at an injected power of 44 MW; tritium supply from external sources. All technologies for operating the machine are expected to be available by 1990; the plasma physics relies on microstabilization in a sloshing ion population. (orig.) [de

  3. Changes in Cleanup Strategies and Long-Term Monitoring Costs for DOE FUSRAP Sites-17241

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, Darina [U.S. Department of Energy, Office of Legacy Management; Carpenter, Cliff [U.S. Department of Energy, Office of Legacy Management; Roberts, Rebecca [Navarro Research and Engineering, Inc.; Young, Carl [Navarro Research and Engineering, Inc.

    2017-03-05

    LM is preparing for the transfer of 11 new FUSRAP sites within the next 10 years from USACE, many of which will have substantially greater LTSM requirements than the current Completed sites. LM is analyzing the estimates for the level of effort required to monitor the new sites in order to make more customized and accurate predictions of future life cycle costs and environmental liabilities of these sites.

  4. ''No smoking''. CO2-low power generation in a sustainable German energy system. A comparison of CO2 abatement costs of renewable energy sources and carbon capture and storage

    International Nuclear Information System (INIS)

    Trittin, Tom

    2012-05-01

    Significant reduction of CO 2 -emissions is essential in order to prevent a worsening of ongoing climate change. This thesis analyses two different pathways for the mitigation of CO 2 -emissions in electricity generation. It focuses on the calculation of CO 2 -mitigation costs of renewable energy sources (RES) as well as of power plants with carbon capture and storage (CCS). Under the frame of long-term CO 2 reductions targets for the German electricity sector future CO 2 -mitigation costs are calculated on a system-based and a technology-based approach. The calculations show that RES have lower system-based mitigation costs in all scenarios compared to a system based on CCS. If the retrofit of power plants is taken into consideration, the results are even more clearly in favour of RES. Further, the thesis investigates whether CCS can serve as a bridge towards a sustainable energy system based on RES. Findings of different scientific disciplines suggest that CCS is not the optimal choice. These findings lead to the conclusion that CCS cannot support an easier integration of RES. CCS rather has the potential to further strengthen the fossil pathway and delaying the large-scale integration of RES. Hence, CCS is rather unsuited as a bridging technology towards a system mainly based on RES.

  5. Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

    Science.gov (United States)

    Forster, Anne; Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

    2015-08-01

    We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. © 2015 Bradford Teaching Hospitals NHS Foundation Trust.

  6. Cost-benefit analysis of sustainable energy development using life-cycle co-benefits assessment and the system dynamics approach

    International Nuclear Information System (INIS)

    Shih, Yi-Hsuan; Tseng, Chao-Heng

    2014-01-01

    Highlights: • The energy policy was assessed using the system dynamics approach. • A life table approach was presented to estimate averted loss of life expectancy. • The mortality benefits estimated by VSL and VSLY are found to be similar. • Economic feasibility of the energy policy for climate change mitigation was presented. - Abstract: A novel Air Resource Co-benefits model was developed to estimate the social benefits of a Sustainable Energy Policy, involving both renewable energy (RE) and energy efficiency improvements (EEI). The costs and benefits of the policy during 2010–2030 were quantified. A system dynamics model was constructed to simulate the amount of energy saving under the scenario of promoting both RE and EEI. The life-cycle co-reductions of five criteria pollutants (PM 10 , SO 2 , NOx, CO, and ozone) and greenhouse gas are estimated by assuming coal fired as marginal electricity suppliers. Moreover, a concise life table approach was developed to estimate averted years of life lost (YOLL). The results showed that YOLL totaling 0.11–0.21 years (41–78 days) per capita, or premature deaths totaling 126,507–251,169, is expected to be averted during 2010–2030 under the RE plus EEI scenario. Specifically, because of the higher investment cost, the benefit-cost ratio of 1.9–2.1 under the EEI scenario is lower than the 7.2–7.9 under the RE scenario. This difference reveals that RE is more socially beneficial than EEI. The net benefit of the RE and EEI scenarios during 2010–2030 totaled approximately US$ 5,972–6,893 per person or US$ 170–190 per MW h. To summarize, this study presents a new approach to estimate averted YOLL, and finds that the health benefits can justify the compliance costs associated with the Sustainable Energy Policy

  7. What Are the Long-Term Economic Costs of Psychological Problems during Childhood? Fact Sheet

    Science.gov (United States)

    Steinberg, Paul

    2010-01-01

    Recent research has established evidence of a strong link between poor physical health during childhood (and even in utero) and health and economic outcomes much later in adulthood. But much less is known about the long-term economic consequences of psychological conditions experienced during childhood, although childhood psychological…

  8. Cost Analysis and Long Term Planning Over the Lifecycle of an Enterprise Storage Solution

    Directory of Open Access Journals (Sweden)

    Christopher J. McKnight

    2006-12-01

    Full Text Available This document will cover the basics of Storage Area Networks (SAN, IP-Based Storage Networks such as NAS, and the basics of choosing a technology for an Enterprise Storage infrastructure. This document will focus on SAS (Serial Attached Storage and SATA (Serial ATA disk drive technologies. The primary focus for this document will be to aid a manager in making a purchasing decision for the selection of storage technologies. I will cover purchase options such as buy, lease, and lease-to-buy. This document will cover the basic costs associated with maintenance and upgrades over the lifetime of different storage technologies.

  9. Mid-term cost-effectiveness analysis of open and endovascular repair for ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Rollins, K E; Shak, J; Ambler, G K; Tang, T Y; Hayes, P D; Boyle, J R

    2014-02-01

    Emergency endovascular repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) may have lower operative mortality rates than open surgical repair. Concerns remain that the early survival benefit after EVAR for rAAA may be offset by late reinterventions. The aim of this study was to compare reintervention rates and cost-effectiveness of EVAR and open repair for rAAA. A retrospective analysis was undertaken of patients with rAAA undergoing EVAR or open repair over 6 years. A health economic model developed for the cost-effectiveness of elective EVAR was used in the emergency setting. Sixty-two patients (mean age 77·9 years) underwent EVAR and 85 (mean age 75·9 years) had open repair of rAAA. Median follow-up was 42 and 39 months respectively. There was no significant difference in 30-day mortality rates after EVAR and open repair (18 and 26 per cent respectively; P = 0·243). Reintervention rates were also similar (32 and 31 per cent; P = 0·701). The mean cost per patient was €26,725 for EVAR and €30,297 for open repair, and the cost per life-year gained was €7906 and €9933 respectively (P = 0·561). Open repair had greater initial costs: longer procedural times (217 versus 178·5 min; P < 0·001) and intensive care stay (5·0 versus 1·0 days; P = 0·015). Conversely, EVAR had greater reintervention (€156,939 versus €35,335; P = 0·001) and surveillance (P < 0·001) costs. There was no significant difference in reintervention rates after EVAR or open repair for rAAA. EVAR was as cost-effective at mid-term follow-up. The increased procedural costs of open repair are not outweighed by greater surveillance and reintervention costs after EVAR. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  10. ''Beauty of Wholeness and Beauty of Partiality.'' New Terms Defining the Concept of Beauty in Architecture in Terms of Sustainability and Computer Aided Design

    Science.gov (United States)

    Farid, Ayman A.; Zaghloul, Weaam M.; Dewidar, Khaled M.

    2014-01-01

    The great shift in sustainability and computer aided design in the field of architecture caused a remarkable change in the architecture philosophy, new aspects of beauty and aesthetic values are being introduced, and traditional definitions for beauty cannot fully cover this aspects, which causes a gap between; new architecture works criticism and…

  11. JNK1 ablation in mice confers long-term metabolic protection from diet-induced obesity at the cost of moderate skin oxidative damage.

    Science.gov (United States)

    Becattini, Barbara; Zani, Fabio; Breasson, Ludovic; Sardi, Claudia; D'Agostino, Vito Giuseppe; Choo, Min-Kyung; Provenzani, Alessandro; Park, Jin Mo; Solinas, Giovanni

    2016-09-01

    Obesity and insulin resistance are associated with oxidative stress, which may be implicated in the progression of obesity-related diseases. The kinase JNK1 has emerged as a promising drug target for the treatment of obesity and type 2 diabetes. JNK1 is also a key mediator of the oxidative stress response, which can promote cell death or survival, depending on the magnitude and context of its activation. In this article, we describe a study in which the long-term effects of JNK1 inactivation on glucose homeostasis and oxidative stress in obese mice were investigated for the first time. Mice lacking JNK1 (JNK1(-/-)) were fed an obesogenic high-fat diet (HFD) for a long period. JNK1(-/-) mice fed an HFD for the long term had reduced expression of antioxidant genes in their skin, more skin oxidative damage, and increased epidermal thickness and inflammation compared with the effects in control wild-type mice. However, we also observed that the protection from obesity, adipose tissue inflammation, steatosis, and insulin resistance, conferred by JNK1 ablation, was sustained over a long period and was paralleled by decreased oxidative damage in fat and liver. We conclude that compounds targeting JNK1 activity in brain and adipose tissue, which do not accumulate in the skin, may be safer and most effective.-Becattini, B., Zani, F., Breasson, L., Sardi, C., D'Agostino, V. G., Choo, M.-K., Provenzani, A., Park, J. M., Solinas, G. JNK1 ablation in mice confers long-term metabolic protection from diet-induced obesity at the cost of moderate skin oxidative damage. © FASEB.

  12. The Cost-Effectiveness of Investments to Meet the Guiding Principles for High-Performance Sustainable Buildings on the PNNL Campus

    Energy Technology Data Exchange (ETDEWEB)

    Cort, Katherine A.; Judd, Kathleen S.

    2014-08-29

    As part its campus sustainability efforts, Pacific Northwest National Laboratory (PNNL) has invested in eight new and existing buildings to ensure they meet the U.S. Department of Energy’s requirements for high performance sustainable buildings (HPSB) at DOE sites. These investments are expected to benefit PNNL by reducing the total life-cycle cost of facilities, improving energy efficiency and water conservation, and making buildings safer and healthier for the occupants. This study examines the cost-effectiveness of the implementing measures that meet the criteria for HPSBs in 3 different types of buildings on the PNNL campus: offices, scientific laboratories, and data centers. In each of the three case studies examined the investments made to achieve HPSB status demonstrated a high return on the HPSB investments that have taken place in these varied environments. Simple paybacks for total investments in the three case study buildings ranged from just 2 to 5 years; savings-to-investment ratios all exceeded the desirable threshold of 1; and the net present values associated with these investments were all positive.

  13. Exploiting the Medium Term Biomass Energy Potentials in Austria. A Comparison of Costs and Macroeconomic Impact

    International Nuclear Information System (INIS)

    Steininger, K.W.; Voraberger, H.

    2003-01-01

    The transition to an implicitly solar-based energy system can make use of various specific biomass energy systems. This paper provides economic and environmental indicators for evaluating alternative options. The paper proceeds in three empirical steps. First, an expert survey supplies the primary biomass potentials available for non-food use in Austria and their respective costs. Second, an inquiry into investment, operating and financing costs of 30 different biomass energy use systems allows a standardized comparison among them and their relationship to fossil reference technologies. Third, a computable general equilibrium model of the Austrian economy is employed to quantify the impacts of fostering the use of distinct biomass energy technologies. The results allow us to distinguish between those technologies that tend to lead to an increase in both GDP and employment (e.g., combined heat and power production from sewage sludge biogas), to an increase only in employment, while GDP tends to diminish (e.g., district heating based on agricultural pellets) or to a decline in both (e.g., co-firing based on wood-chips, bark or industrial pellets). Individual technologies could account for up to one third of Austria's Kyoto obligation, while combinations of technologies, triggered by a combined CO2 tax and biomass energy subsidy for example, could almost fully lead to Austrian Kyoto-compliance

  14. A medium term bulk production cost model based on decomposition techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, A.; Munoz, L. [Univ. Pontificia Comillas, Madrid (Spain). Inst. de Investigacion Tecnologica; Martinez-Corcoles, F.; Martin-Corrochano, V. [IBERDROLA, Madrid (Spain)

    1995-11-01

    This model provides the minimum variable cost subject to operating constraints (generation, transmission and fuel constraints). Generation constraints include power reserve margin with respect to the system peak load, first Kirchhoff`s law at each node, hydro energy scheduling, maintenance scheduling, and generation limitations. Transmission constraints cover the second Kirchhoff`s law and transmission limitations. The generation and transmission economic dispatch is approximated by the linearized (also called DC) load flow. Network losses are included as a non linear approximation. Fuel constraints include minimum consumption quotas and fuel scheduling for domestic coal thermal plants. This production costing problem is formulated as a large-scale non linear optimization problem solved by generalized Benders decomposition method. Master problem determines the inter-period decisions, i.e., maintenance, fuel and hydro scheduling, and each subproblem solves the intra-period decisions, i.e., generation and transmission economic dispatch for one period. The model has been implemented in GAMS, a mathematical programming language. An application to the large-scale Spanish electric power system is presented. 11 refs

  15. Techno-economic analysis of concentrated solar power plants in terms of levelized cost of electricity

    Science.gov (United States)

    Musi, Richard; Grange, Benjamin; Sgouridis, Sgouris; Guedez, Rafael; Armstrong, Peter; Slocum, Alexander; Calvet, Nicolas

    2017-06-01

    Levelized Cost of Electricity (LCOE) is an important metric which provides one way to compare the economic competitiveness of different electricity generation systems, calculated simply by dividing lifetime costs by lifetime production. Hidden behind the simplicity of this formula are various assumptions which may significantly alter results. Different LCOE studies exist in the literature, although their assumptions are rarely explicitly stated. This analysis gives all formulas and assumptions which allow for inter-study comparisons. The results of this analysis indicate that CSP LCOE is reducing markedly over time and that given the right location and market conditions, the SunShot 6¢/kWh 2020 target can be reached. Increased industrial cooperation is needed to advance the CSP market and continue to drive down LCOE. The results also indicate that there exist a country and technology level learning effect, either when installing an existing CSP technology in a new country or when using a new technology in an existing CSP country, which seems to impact market progress.

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

    Directory of Open Access Journals (Sweden)

    Nevzat Onat

    2017-01-01

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

  17. The impact of federalism on the healthcare system in terms of efficiency, equity, and cost containment: the case of Switzerland.

    Science.gov (United States)

    Crivelli, Luca; Salari, Paola

    2014-01-01

    According to the economic theory of federalism (Oates 1999), a decentralized decision to collectively fund and supply the quantity and quality of public services will increase economic welfare as long as three conditions are fulfilled: preferences and production costs of the different local constituencies are heterogeneous; local governments are better informed than the central agency because of their proximity to the citizens; and the competition between local governments exerts a significant impact on the performance of the local administration and on the ability of public agencies to implement policy innovation. Federalism also presents some negative aspects, including the opportunity costs of decentralization, which materialize in terms of unexploited economies of scale; the emergence of spillover effects among jurisdictions; and the risk of cost-shifting exercises from one layer of the government to the other. Finally, competition between fiscal regimes can affect the level of equity. The literature considers fiscal federalism as a mechanism for controlling the size of the public sector and for constraining the development of redistributive measures. The present paper reviews the impact that federalism has on the efficiency, equity, and cost containment of the healthcare system in Switzerland, a country with a strongly decentralized political system that is based on federalism and the institutions of direct democracy, a liberal economic culture, and a well-developed tradition of mutualism and social security (generous social expenditure and welfare system). By analyzing the empirical evidence available for Switzerland, we expect to draw some general policy lessons that might also be useful for other countries.

  18. Long term strategy for electricity generation in Peninsular Malaysia – Analysis of cost and carbon footprint using MESSAGE

    International Nuclear Information System (INIS)

    Fairuz, S.M.C.; Sulaiman, M.Y.; Lim, C.H.; Mat, S.; Ali, B.; Saadatian, O.; Ruslan, M.H.; Salleh, E.; Sopian, K.

    2013-01-01

    Malaysia envisages becoming a developed nation by 2020. To sustain industrial expansion and attract investments Malaysia must introduce new energy strategies. These strategies should also moderate carbon footprint. The new energy strategies introduced by the government are (i) installation of nuclear power plant by 2021, (ii) import of Sarawak hydropower from 2015 and (iii) enhancement of use of renewable energy from 2015. In this paper we analyze the cost and resulting carbon footprint of energy expansion for 12 energy scenes (inclusive of new strategies) to produce electricity for Peninsular Malaysia for the period 2009–2030. We use a computer model MESSAGE to provide optimization. The best strategy is for the following accumulated percentage of energy resource in the fuel mix: 49.3% (natural gas), 28.4% (coal), 4.06% (nuclear), 2.98% (hydropower), 4.45% (renewable), 10.82% (import hydropower). The minimum cost of expanding this strategy from 2009 until 2030 is USD6.090B. The CO 2 emission index of this strategy is 0.329 t/MWh. The accumulated carbon dioxide emission for this period is 1825.96 Mton CO 2 eq. -- Highlights: •We analyzed the cost of energy expansion and resulting carbon emission using software MESSAGE. •We studied the energy situation for the next 20 years beginning 2009 for Peninsular Malaysia. •We maintained the present energy resources of natural gas, coal and internal hydropower. •We included nuclear, hydropower import and renewable energy as new strategies

  19. Long-term congestion management by investment in gas-turbine generators : a cost-benefit analysis

    International Nuclear Information System (INIS)

    Tuan, L.A.; Bhattacharya, K.

    2007-01-01

    Load management is one of the most important tasks in the operation of an electric power system. Transmission congestion occurs whenever the grid has one or more violations of the physical, operation, or policy constraints under which it normally operates. In a deregulated electricity market, the independent system operator (ISO) must ensure that contracted power transactions are carried out reliably. Several schemes of congestion management run the risk of increasing electricity prices due to the market power of local generators in congested areas. An alternative is to manage congestion through the installation of reserve gas turbine generators which can be brought online to the system within a short time. The use of gas turbines at different buses in the system can enhance the system in ways of transmission relief during emergency events. This paper proposed a framework for the evaluation of long-term investment by the ISO on gas-turbine generators as a tool for providing transmission congestion relief in the dispatch stage based on cost-benefit analysis. The objective of the framework is to optimally decide the locations and sizes of the generators at different buses in the network in order to minimize the total cost of investment of gas turbines and to minimize total system congestion. A bus-wise cost-benefit analysis was carried out by solving the DC optimal power flow (dc-OPF) model. The CIGRE 32-Bus system was used for the case study. It was shown that network overloading can be significantly reduced with the support of gas turbines at selected buses. The long-term decision of the investment on gas-turbine would depend on the opportunity cost of the gas-turbine with respect to the congestion problem. The gas turbines could also reduce the amount of unserved energy during peak load conditions. 11 refs., 4 tabs., 3 figs

  20. Irritable bowel symptoms, use of healthcare, costs, sickness and disability pension benefits: A long-term population-based study.

    Science.gov (United States)

    Poulsen, Chalotte H; Eplov, Lene F; Hjorthøj, Carsten; Hastrup, Lene H; Eliasen, Marie; Dantoft, Thomas M; Schröder, Andreas; Jørgensen, Torben

    2018-05-01

    Irritable bowel syndrome (IBS) is associated with increased healthcare use and work absenteeism. We aimed to investigate long-term use of healthcare services and social benefits across IBS symptom groups. Additionally, we estimated excess healthcare costs. A longitudinal population-based study comprising two 5-year follow-up studies: The Danish part of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (Dan-MONICA) 1 (1982-1987) and Inter99 (1999-2004) recruited from the western part of Copenhagen County. The total study population ( n = 7278) was divided into symptom groups according to degree of IBS definition fulfillment at baseline and/or 5-year follow-up and was followed until 31 December 2013 in Danish central registries. Poisson regression was used for the analyses adjusting for age, sex, length of education, comorbidity, cohort membership and mental vulnerability. IBS symptom groups compared to no IBS symptoms were associated with an increased number of contacts with primary and secondary healthcare, as well as weeks on sickness and disability benefits. Accounting for mental vulnerability decreased the estimates and all but two associations between IBS symptom groups and outcomes remained statistically significant. The two associations that became insignificant were contacts with psychiatric hospitals and weeks on disability pension. The excess unadjusted healthcare costs for IBS were 680 Euros per year and the overall association between symptom groups and total healthcare costs were statistically significant. IBS symptoms influence the long-term use and costs of healthcare, as well as the use of social benefits in the general population. Mental vulnerability explained some, but not all, of the use of healthcare and social benefits.

  1. Sustained long-term immune responses after in situ gene therapy combined with radiotherapy and hormonal therapy in prostate cancer patients

    International Nuclear Information System (INIS)

    Fujita, Tetsuo; Teh, Bin S.; Timme, Terry L.; Mai, W.-Y.; Satoh, Takefumi; Kusaka, Nobuyuki; Naruishi, Koji; Fattah, Elmoataz Abdel; Aguilar-Cordova, Estuardo; Butler, E. Brian; Thompson, Timothy C.

    2006-01-01

    Purpose: To explore long-term immune responses after combined radio-gene-hormonal therapy. Methods and Materials: Thirty-three patients with prostate specific antigen 10 or higher or Gleason score of 7 or higher or clinical stage T2b to T3 were treated with gene therapy that consisted of 3 separate intraprostatic injections of AdHSV-tk on Days 0, 56, and 70. Each injection was followed by 2 weeks of valacyclovir. Intensity-modulated radiation therapy was delivered 2 days after the second AdHSV-tk injection for 7 weeks. Hormonal therapy was initiated on Day 0 and continued for 4 months or 2.3 years. Blood samples were taken before, during, and after treatment. Lymphocytes were analyzed by fluorescent antibody cell sorting (FACS). Results: Median follow-up was 26 months (range, 4-48 months). The mean percentages of DR + CD8 + T cells were increased at all timepoints up to 8 months. The mean percentages of DR + CD4 + T cells were increased later and sustained longer until 12 months. Long-term (2.3 years) use of hormonal therapy did not affect the percentage of any lymphocyte population. Conclusions: Sustained long-term (up to 8 to 12 months) systemic T-cell responses were noted after combined radio-gene-hormonal therapy for prostate cancer. Prolonged use of hormonal therapy does not suppress this response. These results suggest the potential for sustained activation of cell-mediated immune responses against cancer

  2. Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

    Science.gov (United States)

    Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

    2015-12-01

    In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

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

    International Nuclear Information System (INIS)

    Yon, Guillaume

    2014-01-01

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

  4. Centralising and optimising decentralised stroke care systems: a simulation study on short-term costs and effects

    Directory of Open Access Journals (Sweden)

    Maarten M. H. Lahr

    2017-01-01

    Full Text Available Abstract Background Centralisation of thrombolysis may offer substantial benefits. The aim of this study was to assess short term costs and effects of centralisation of thrombolysis and optimised care in a decentralised system. Methods Using simulation modelling, three scenarios to improve decentralised settings in the North of Netherlands were compared from the perspective of the policy maker and compared to current decentralised care: (1 improving stroke care at nine separate hospitals, (2 centralising and improving thrombolysis treatment to four, and (3 two hospitals. Outcomes were annual mean and incremental costs per patient up to the treatment with thrombolysis, incremental cost-effectiveness ratio (iCER per 1% increase in thrombolysis rate, and the proportion treated with thrombolysis. Results Compared to current decentralised care, improving stroke care at individual community hospitals led to mean annual costs per patient of $US 1,834 (95% CI, 1,823–1,843 whereas centralising to four and two hospitals led to $US 1,462 (95% CI, 1,451–1,473 and $US 1,317 (95% CI, 1,306–1,328, respectively (P < 0.001. The iCER of improving community hospitals was $US 113 (95% CI, 91–150 and $US 71 (95% CI, 59–94, $US 56 (95% CI, 44–74 when centralising to four and two hospitals, respectively. Thrombolysis rates decreased from 22.4 to 21.8% and 21.2% (P = 0.120 and P = 0.001 in case of increasing centralisation. Conclusions Centralising thrombolysis substantially lowers mean annual costs per patient compared to raising stroke care at community hospitals simultaneously. Small, but negative effects on thrombolysis rates may be expected.

  5. Urban Sustainability through Public Architecture

    Directory of Open Access Journals (Sweden)

    Soomi Kim

    2018-04-01

    Full Text Available As the sustainability of contemporary cities has gained emphasis, interest in architecture has increased, due to its social and public responsibility. Since sustainability is linked to public values, research on sustainable public spaces is an important way to secure sustainability in cities. Based on this, we analyzed the sustainability of European cities by examining the design methods of public architecture according to the region. The aim of the study is to derive architectural methodology corresponding to local characteristics, and to suggest issues to consider in public architecture design to promote urban sustainability based on this. First, regarding the environmental aspect, it can be observed that there is an effort to secure sustainability. Second, in terms of social sustainability, historical value remains as a trace of architectural place, so that it continues in people’s memory. In addition, public architecture provides public places where citizens can gather and enjoy programs, while the architectural methods showed differences influenced by cultural conditions. Third, in economic sustainability, it was shown that energy saving was achieved through cost reduction through recycling of materials, facilities, or environmental factors. In conclusion, the issues to be considered in public architectural design are the voiding of urban space through architectural devices in the construction method. In other words, the intention is to form “ground” that attempts to be part of the city, and thereby create better places. Since skin and material have a deep relationship with the environment, they should have the durability and an outer skin that are suitable for the regional environment. Finally, sustainability is to be utilized through the influx of programs that meet local and environmental characteristics. Design research into public architecture that is oriented towards urban sustainability will be a task to be carried out by the

  6. Shifting the Paradigm for Long Term Monitoring at Legacy Sites to Improve Performance while Reducing Costs - 13422

    Energy Technology Data Exchange (ETDEWEB)

    Eddy-Dilek, Carol A; Looney, Brian B. [Savannah River National Laboratory (United States); Gaughan, Thomas; Kmetz, Thomas [Savannah River Nuclear Solutions, LLC (United States); Seaman, John [Savannah River Ecology Laboratory (United States)

    2013-07-01

    A major issue facing many government and private industry sites that were previously contaminated with radioactive and chemical wastes is that often the sites cannot be cleaned up enough to permit unrestricted human access. These sites will require long-term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality in a cost effective manner. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site (SRS), the larger DOE complex, and many large federal and private sites. Currently, most monitoring strategies are focused on laboratory measurements of contaminants measured in groundwater samples collected from wells. This approach is expensive, and provides limited and lagging information about the effectiveness of cleanup activities and the behavior of the residual contamination. Over the last twenty years, DOE and other federal agencies have made significant investments in the development of various types of sensors and strategies that would allow for remote analysis of contaminants in groundwater, but these approaches do not promise significant reductions in risk or cost. Scientists at SRS have developed a new paradigm to simultaneously improve the performance of long term monitoring systems while lowering the overall cost of monitoring. This alternative approach incorporates traditional point measurements of contaminant concentration with measurements of controlling variables including boundary conditions, master variables, and traditional plume/contaminant variables. Boundary conditions are the overall driving forces that control plume movement and therefore provide leading indication to changes in plume stability. These variables include metrics associated with meteorology, hydrology, hydrogeology, and land use. Master variables are the key variables that control the chemistry of the

  7. Cost tradeoffs in consequence management at nuclear power plants: A risk based approach to setting optimal long-term interdiction limits for regulatory analyses

    International Nuclear Information System (INIS)

    Mubayi, V.

    1995-05-01

    The consequences of severe accidents at nuclear power plants can be limited by various protective actions, including emergency responses and long-term measures, to reduce exposures of affected populations. Each of these protective actions involve costs to society. The costs of the long-term protective actions depend on the criterion adopted for the allowable level of long-term exposure. This criterion, called the ''long term interdiction limit,'' is expressed in terms of the projected dose to an individual over a certain time period from the long-term exposure pathways. The two measures of offsite consequences, latent cancers and costs, are inversely related and the choice of an interdiction limit is, in effect, a trade-off between these two measures. By monetizing the health effects (through ascribing a monetary value to life lost), the costs of the two consequence measures vary with the interdiction limit, the health effect costs increasing as the limit is relaxed and the protective action costs decreasing. The minimum of the total cost curve can be used to calculate an optimal long term interdiction limit. The calculation of such an optimal limit is presented for each of five US nuclear power plants which were analyzed for severe accident risk in the NUREG-1150 program by the Nuclear Regulatory Commission

  8. Sustainable apple breedings needs sustainable marketing and management

    OpenAIRE

    Weber, M.

    2008-01-01

    Apple breeding programmes are currently in the middle of transition in terms of ownership and management. Until now most of them were funded by the public. Breeding took place by traditional methods since decades in a very sustainable way to develop better apple varieties. Today, increasing loss of national boundaries and globalisation, less interest by national bodies and institutions and rising cost levels for high tech breeding methods entire programmes are nowadays urged to...

  9. The impact of minimum pay implementation on small businesses operating cost and sustainability: A case of service business

    OpenAIRE

    Hanim Rusly Fariza; Yakimin Abdul Talib Yurita; Salleh Danilah

    2017-01-01

    The implementation of minimum wage requirement in Malaysia beginning mid 2016 seems to impact both employees and employers in different ways. While this implementation could increase household income and claimed to boost employees’ productivity, employers or business operators, on the other hand are experiencing stringent effect on their business operating cost. The effect is more significant for small business operators, including the childcare centers. Childcare industry operates in the ser...

  10. Possibilities for Near-term Bioenergy Production and GHG-Mitigation through Sustainable Intensification of Agriculture and Forestry in Denmark

    DEFF Research Database (Denmark)

    Larsen, Søren; Bentsen, Niclas S; Dalgaard, Tommy

    2017-01-01

    To mitigate climate change it is necessary to further increase the deployment of renewable energy, including bioenergy. This analysis shows how this can be achieved in Danish agriculture and forestry before 2020. The key is a sustainable intensification and we show through three scenarios how...

  11. Long-term socio-economic consequences and health care costs of poliomyelitis

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte

    2016-01-01

    ) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio...... survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31–40, 41–50 and 51–60 years were similar to controls....... Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29–2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23–1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups...

  12. Short-term strategies for Dutch wind power producers to reduce imbalance costs

    International Nuclear Information System (INIS)

    Chaves-Ávila, José Pablo; Hakvoort, Rudi A.; Ramos, Andrés

    2013-01-01

    The paper assesses bidding strategies for a wind power producer in the Netherlands. To this end, a three-stage stochastic optimization framework is used, maximizing wind power producer's profit using the day-ahead and cross-border intraday market, taking into account available interconnection capacity. Results show that the wind power producer can increase its profits by trading on the intraday market and – under certain imbalance prices – by intentionally creating imbalances. It has been considered uncertainties about prices, power forecast and interconnection capacity at the day-ahead and intraday timeframes. - Highlights: ► A cross-border bidding strategy model for wind power producers has been developed. ► The model was applied to a real case study of a Dutch offshore wind power producer. ► Under certain imbalance prices, it is not profitable to deliver all possible power. ► Intraday markets give the possibility to reduce imbalance costs. ► Integration of intraday markets will increase liquidity.

  13. Effect of continuous positive airway pressure treatment on short-term memory performance over 24 h of sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome.

    Science.gov (United States)

    Grenèche, Jérôme; Krieger, Jean; Bertrand, Frédéric; Erhardt, Christine; Maumy, Myriam; Tassi, Patricia

    2013-10-01

    Few studies have examined the impact of continuous positive airway pressure (CPAP) therapy on short-term memory (STM) over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We have investigated if impaired STM can be reversed by CPAP treatment in a 24-h sustained wakefulness paradigm. Our follow-up study was conducted with repeated-memory tasks within 12 OSAHS patients and 10 healthy controls who underwent three 32-h sessions, one before CPAP (T0) and the second (T3) and the third (T6), after 3 and 6 months of treatment, respectively, for OSAHS patients. Each session included one night of sleep followed by 24h of sustained wakefulness, during which both groups performed STM tasks including both digit span (DS) and Sternberg tasks. Untreated OSAHS patients had no deficit in the forward DS task measuring immediate memory but were impaired in STM, especially working memory assessed by the complex Sternberg task and the backward DS. However, only performance in the latter was improved after 6 months of CPAP treatment. Because the high level of memory scanning required high speed in information processing, persistent impairment on the complex Sternberg task may be attributable to working memory slowing, possibly enhanced by sustained wakefulness. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  14. Securing the long-term financing of decommissioning and radioactive waste management - From cost estimates to a comprehensive financing system

    International Nuclear Information System (INIS)

    Aebersold, Michael

    2003-01-01

    One of the most important issues in the area of waste disposal concerns the long-term securing of the necessary financing. Large amounts of money will have to be invested, managed and subsequently spent at the appropriate time, over an extended period of 100 years or more. In an electricity market that is opening up across Europe and is characterised by complicated legal structures, a focus on a handful of major groups and cost pressure due to increased competition, it will be necessary to create the corresponding background conditions. The anticipated costs for decommissioning and disposal will have to be calculated or estimated on the basis of available know-how and criteria. The required funds will then have to be collected and invested on the domestic and international money markets, which given the current situation on the stock markets will by no means be an easy task. But the assurance that enough money will be available is essential for public confidence. Using Switzerland as an example, the author wishes to demonstrate which steps are necessary in order to calculate the potential decommissioning and waste disposal costs based on a defined disposal concept and programme, determine the annual contributions to be paid in by operators, and establish a suitable system for securing the necessary funding. This paper deals with the following issues: 1. Political background and legislative framework in Switzerland; 2. Swiss radioactive waste management policy and programmes; 3. Calculating the decommissioning and waste management costs; 4. Calculating the contributions to the Funds; 5. Financing system

  15. When renewable energy met sustainable growth. Regulation, cost reduction, and the rise of renewable energy in the United States

    International Nuclear Information System (INIS)

    Stephens, Samantha

    2016-01-01

    Historically and famously fossil-fuel dependent, the U.S. energy and electricity mixes are evolving quickly as costs fall for renewables, regulations mandate their implementation, and fiscal policy incentivizes their installation. The investment and production tax credits (ITC and PTC) as well as power purchase agreements (PPAs) are well-known for their contributions to the development of solar and wind capacity, and the recent extensions of these credits has led to a positive outlook for continued growth in installations and generation. In addition, the green power market is experiencing record participation, as tracking the positive environmental externalities of renewable power has become important to meet renewable portfolio standards, which mandate implementation of renewable energy by state. Cost reduction is further taking place globally due to technological advances and economies of scale, which serves as another key driver for development. Of course, challenges are still present, particularly due to a plentiful and inexpensive domestic fossil fuel supply, uneven application of regulation and incentives state-by-state, and the uncertainty of continued political support. Even so, a progressive lowering of traditional barriers is leading to the potential for widespread deployment of renewables across the American landscape. (author)

  16. Analysis of costs to dispense prescriptions in independently owned, closed-door long-term care pharmacies.

    Science.gov (United States)

    Carroll, Norman V; Rupp, Michael T; Holdford, David A

    2014-03-01

    The need for accurate calculation of long-term care (LTC) pharmacies' costs to dispense (CTD) has become more important as payers have moved toward reimbursement models based on pharmacies' actual acquisition cost for drug products and the Centers for Medicare Medicaid Services (CMS) has implemented requirements that LTC pharmacies must dispense prescriptions for certain branded drugs in 14-day-or-less quantities. To (a) calculate the average cost that the typical independently owned, closed-door LTC pharmacy currently incurs to dispense and deliver a prescription to the resident of a client LTC facility and (b) estimate how CMS-mandated changes to a 14-day-or-less dispensing cycle would affect the typical LTC pharmacy's average CTD. The data requirements and measurement model were developed by academic researchers in consultation with an industry advisory committee of independent LTC pharmacy owners. A survey instrument was constructed to collect financial and operating data required to calculate the CTD. Surveys were distributed via 3 dissemination channels to approximately 1,000 independently owned, closed-door LTC pharmacies. The National Community Pharmacists Association mailed surveys to their LTC members; 3 major national wholesalers distributed surveys to their LTC customers through their newsletters; and 3 LTC group purchasing organizations distributed the surveys to their members through emails, newsletters, mailings, and/or regional meetings. Each pharmacy's CTD was calculated by dividing total LTC dispensing-related 
costs by the total number of prescriptions dispensed. Dispensing-related costs included costs incurred to physically dispense and deliver prescriptions (e.g., dispensing pharmacists' and technicians' salaries and costs of medication containers) and costs incurred to support the dispensing function (e.g., salaries of delivery and medical records personnel). A model based on dispensing-related fixed, variable, and semivariable costs was

  17. A comprehensive overview of the frequency and the severity of injuries sustained by car occupants and subsequent implications in terms of injury prevention.

    Science.gov (United States)

    Page, Yves; Cuny, Sophie; Hermitte, Thierry; Labrousse, Maxime

    2012-01-01

    The objective of the paper is to give an overview of the road injuries issues in France in the 2010's by determining the frequency and the severity of injuries sustained by car occupants, and to infer the implications in terms of vehicule safety. Three types of analysis are conducted. First, we present a time series analysis at a macro statistical level showing a dramatic decrease of injured and fatally injured occupants in passenger cars compared to other modes of road transport. Secondly, we propose a descriptive statistical analysis of the injuries (frequency and severity) sustained by car occupants, by body regions, using the AIS. Finally we propose some insights into the effectiveness of some safety features. French National crash census (BAAC) is used for a general overview of injury frequencies and raw severity scores (fatal, hospitalized, slighty injured) in car crashes. In-depth crash investigations data are used to specify the body regions and the severity of the injuries sustained by car occupants. Data show that car occupants mortality and morbidity decreased more over the last decade than other road modes: -58 % fatalities and -64 % hospitalized (compared to -39% and -55% for pedestrians, and -21% and -44% for motorcyclists for example). In crashes for which at least one person has been injured, 19 % of occupants are uninjured, 49 % of occupants sustain MAIS 1 injuries, 15 % MAIS2, 8% MAIS 3, and 9 % MAIS 4+. Regardless of seat belt use, the body regions most often injured are head, upper and lower extremities and thorax. However, at least two third up to 92% of involved persons sustain no injury at each of these body regions. The frequency of severe injuries is low, often less than 10 % and concern head and thorax mainly. Finally, the frequency and severity of injuries decrease for belted occupants in newer cars compared to older cars, whatever body regions. The frequency of severe injuries decreased by almost 50 % in these newer cars.

  18. [Cost-effectiveness research in elderly residents in long-term care: prevention is better than cure, but not always cheaper].

    Science.gov (United States)

    Achterberg, Wilco P; Gussekloo, Jacobijn; van den Hout, Wilbert B

    2015-01-01

    Cost-effectiveness research in elderly residents in long-term care facilities is based on general principals of cost-effectiveness research; these have been developed primarily from the perspective of relatively healthy adults in curative medicine. These principals are, however, inadequate when evaluating interventions for the fragile elderly in long-term care, both in terms of the value attached to the health of patients and to the specific decision-making context of the institution. Here we discuss the pitfalls of cost-effectiveness research in long-term care facilities, illustrated by two prevention interventions for prevalent conditions in nursing homes: pressure ulcers and urinary tract infections. These turned out to be effective, but not cost-effective.

  19. A sustainable use of low-cost raw substrates for biodiesel production by the oleaginous yeast Wickerhamomyces anomalus.

    Science.gov (United States)

    Arous, Fatma; Atitallah, Imen Ben; Nasri, Moncef; Mechichi, Tahar

    2017-08-01

    Over the past decade, the increasing demand of vegetable oils for biodiesel production has highlighted the need for alternative oil feedstocks that do not compete with food production. In this context, the combined use of agro-industrial wastes and oleaginous microorganisms could be a promising strategy for sustainable biodiesel production. The present investigation involves the performance of the oleaginous yeast Wickerhamomyces anomalus strain EC28 to produce lipids from different agro-industrial wastewaters (i.e., deproteinized cheese whey, olive mill wastewater, and wastewaters from confectionary industries) and waste frying oils (i.e., waste oil from frying fish, waste oil from frying potato and waste oil from frying meat). Results indicated that this strain can adequately grow on agro-industrial wastewater-based media and produce substantial amounts of lipids [up to 24%, wt/wt in deproteinized cheese whey-based medium and olive mill wastewater-based medium (75%, v/v in water)] of similar fatty acid composition to that of the most commonly used vegetable oils in the biodiesel industry. However, the addition of frying oils to the culture media resulted in a significant decrease in total lipid content, probably due to excess of available nitrogen released from meat, fish, and potato into the frying oil. The estimated properties of the resulting biodiesels, such as SV (190.69-203.13), IV (61.77-88.32), CN (53.45-59.32), and CFPP (-0.54 to 10.4), are reported, for the first time, for W. anomalus and correlate well with specified standards. In conclusion, W. anomalus strain EC28, for which there is very limited amount of available information, might be regarded as a promising candidate for biodiesel production and additional efforts for process improvement should be envisaged.

  20. 48 CFR 9903.302 - Definitions, explanations, and illustrations of the terms, “cost accounting practice” and “change...

    Science.gov (United States)

    2010-10-01

    ... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.302 Definitions, explanations, and... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Definitions, explanations, and illustrations of the terms, âcost accounting practiceâ and âchange to a cost accounting practice.â...

  1. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    Science.gov (United States)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  2. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    total cost of ownership (TCO. Moreover the activity based analyses reveals the opportunities for rationalizing the supply related activities and containing costs and it enables the effective involvement of the supplier in the process of target costing when he provides activity based information on the costs sustained to produce the product/service: the purchaser can evaluate the impact, in terms of cost, of the activities requested of the supplier and, as a result, he has the chance to rationalize these activities by reducing their number or intensity and enables the effective involvement of the supplier in the process of target costing. The paper gives a contribution in the advancement of costing methodologies applicable to the target costing, proposing the use of a flexible model that supports the decision process according to different time horizons so that effectively supports target costing. The model is suitable for production characterized by high complexity in terms of number and intensity of activities

  3. Repetitive transcranial magnetic stimulation once a week induces sustainable long-term relief of central poststroke pain.

    Science.gov (United States)

    Kobayashi, Masahito; Fujimaki, Takamitsu; Mihara, Ban; Ohira, Takayuki

    2015-06-01

    Central poststroke pain is a serious problem for some patients after stroke. Repetitive transcranial magnetic stimulation (rTMS) has been reported to relieve poststroke pain but its efficacy is still controversial. We tested the possibility that rTMS, when applied once a week, would induce sustainable relief of poststroke pain. Eighteen patients with central poststroke pain were included in this study. rTMS (10 trains of 10-sec 5 Hz-rTMS) was delivered over the primary motor cortex on the affected side. The rTMS session was repeated once a week for 12 weeks, and for six patients the intervention was continued for one year. The degree of the pain was assessed before each weekly rTMS session to evaluate sustainable effects. The effects of the rTMS reached a plateau at the eighth week. At the 12th week, the rTMS was effective in 61.1% of the patients; 5 of the 18 patients showed more than 70% reduction based on a visual analog scale, 6 patients showed 40-69% reduction, and 7 remained at a pain reduction level of less than 40%. When patients were divided into two groups with or without severe dysesthesia, it was found that eight patients with severe dysesthesia showed less pain relief than those without. In the six patients who continued rTMS for one year, the pain relief effects also were sustained. Although this was an open-label study without a control group, our findings suggest that rTMS of the primary motor cortex, when maintained once a week, could help to relieve poststroke pain. © 2015 International Neuromodulation Society.

  4. Short-term separation from groups by male Japanese macaques: costs and benefits in feeding behavior and social interaction.

    Science.gov (United States)

    Otani, Yosuke; Sawada, Akiko; Hanya, Goro

    2014-04-01

    To expand our understanding of fission-fusion behavior and determine its variability among primates, studies of both individual-based and group-based fission-fusion are necessary. We conducted a parallel tracking study of male and female Japanese macaques (Macaca fuscata yakui) during the non-mating season to clarify the general features of separate ranging by males of this species, an example of fission-fusion behavior, and to reveal its associated costs and benefits. Males frequently engaged in short-term separate ranging, leaving the company of females and ranging on their own for periods averaging 68 min in duration. However, the males did not venture outside the group's home range. When ranging separately from the group, males spent more time feeding, particularly on fruit, stayed longer in each feeding tree, and fed at a lower rate than when ranging with the group. These behavioral changes suggest that males can avoid within-group feeding competition by ranging alone. However, this behavior was also associated with higher traveling costs, and these separated males were more vulnerable to intergroup competition and had fewer opportunities for social interaction. The frequency of separate ranging was lower when highly clumped food plant species were the main food source. Lower-ranked males, who received more aggression when ranging with the group, exhibited a higher frequency of separate ranging. This behavioral flexibility with respect to group cohesion may allow males to reduce the costs of group living without completely losing the benefits. Specifically, by ranging alone, males may acquire sufficient feeding time without being disturbed by other group members. Conversely, when ranging with the group, males can access grooming partners and advantages in intergroup competition. © 2013 Wiley Periodicals, Inc.

  5. ESTIMATION OF LONG-TERM INVESTMENT PROJECTS WITH ENERGY-EFFICIENT SOLUTIONS BASED ON LIFE CYCLE COSTS INDICATOR

    Directory of Open Access Journals (Sweden)

    Bazhenov Viktor Ivanovich

    2015-09-01

    Full Text Available The starting stage of the tender procedures in Russia with the participation of foreign suppliers dictates the feasibility of the developments for economical methods directed to comparison of technical solutions on the construction field. The article describes the example of practical Life Cycle Cost (LCC evaluations under respect of Present Value (PV determination. These create a possibility for investor to estimate long-term projects (indicated as 25 years as commercially profitable, taking into account inflation rate, interest rate, real discount rate (indicated as 5 %. For economic analysis air-blower station of WWTP was selected as a significant energy consumer. Technical variants for the comparison of blower types are: 1 - multistage without control, 2 - multistage with VFD control, 3 - single stage double vane control. The result of LCC estimation shows the last variant as most attractive or cost-effective for investments with economy of 17,2 % (variant 1 and 21,0 % (variant 2 under adopted duty conditions and evaluations of capital costs (Cic + Cin with annual expenditure related (Ce+Co+Cm. The adopted duty conditions include daily and seasonal fluctuations of air flow. This was the reason for the adopted energy consumption as, kW∙h: 2158 (variant 1,1743...2201 (variant 2, 1058...1951 (variant 3. The article refers to Europump guide tables in order to simplify sophisticated factors search (Cp /Cn, df, which can be useful for economical analyses in Russia. Example of evaluations connected with energy-efficient solutions is given, but this reference involves the use of materials for the cases with resource savings, such as all types of fuel. In conclusion follows the assent to use LCC indicator jointly with the method of determining discounted cash flows, that will satisfy the investor’s need for interest source due to technical and economical comparisons.

  6. Business Management in Sustainable Buildings: Ankara-Turkey Case

    Science.gov (United States)

    Kutay Karaca, Neşet; Burcu Gültekin, Arzuhan

    2017-10-01

    The concept of the sustainability is described as efficiently and effectively consuming of exhaustible and recyclable sources of the world. A sustainable building implements sustainability criteria in its life cycle, and business management is the process by which an organization uses its resources in the most efficient way to reach its goal. From the beginning, sustainable building proves their differences from the conventional buildings. Sustainable buildings are resource-efficient and environmentally responsible structures in terms of energy consumption, construction principles, siting, renovation and maintenance throughout its life cycle while conventional buildings are more traditional in these matters. The differences are observable especially in costs and expenditures. It is possible and feasible to compare and contrast the design, construction and management costs of both types of structures. Thence, contributions of sustainable buildings are priced favourably in terms of ecological and sociological aspects. In this context, a prospective projection can be made considering the extra costs of sustainable structures, as well as the consumption profits due to the use of less energy than conventional construction. Considering this, it is possible to project consumption savings in long term. By calculating a forward-looking net cash flow projection, it can be forecasted how much time it will take to cover the extra cost. When making decisions, investors always contemplate maximum profitability. Within the scope of this study, costs of sustainable and conventional buildings will be compared and contrasted through precedence of a sustainable building certificated and non-certificated building. It will be analysed in which time period the initial cost difference between them will be compensated totally and partially. Furthermore, an efficiency analyses will be done in the scope of the necessities and expenses of these businesses.

  7. New environment-friendly and cost-saving fertiliser recommendation system for supporting sustainable agriculture in Hungary and beyond

    Directory of Open Access Journals (Sweden)

    Nándor FODOR

    2011-07-01

    Full Text Available In the current economic situation the former, intensive fertiliser recommendation system is unfit to help Hungarian farmers in their fertilising practice. The aim of the new system has been to apply the lowest possible NPK rates required to achieve safe and high yields as well as allowing minimal agricultural NP losses to surface and subsurface waters. The new system was developed by using the correlations revealed by analyzing the results of long-term fertilisation experiments set up in Hungary between 1960 and 2000. Several field experiments as well as comparative analyses confirmed the correctness of the basic principles as well as of the methods of calculating fertiliser rates of the new system. An estimated amount of 3,200,000 € was saved for the Hungarian farmers in 2007 alone by giving recommendations for more than 160,000 ha arable land applying the new system.

  8. Comment 2 on workshop in economics - issues in benefit-cost analysis: Amplification channels and discounting long-term environmental damages

    International Nuclear Information System (INIS)

    Hanson, D.A.

    1992-01-01

    Many environmental problems have long-term effects. Acid rain has long-term effects on soils, forests, and exposed materials. Global climate change has even longer-term effects. This difference in timing - between the near-term cost of environmental protection and the long-term environmental effects - makes it difficult to conduct a cost-benefit analysis of any program designed to abate environmental damages. The rate at which to discount long-term environmental damages becomes a key question in comparisons of benefits and costs. This comment points out an important facet of the discounting issue. The discount rate for calculating the present value of future environmental benefits may be much lower than the rate of return on investment. Cost-benefit analysis is a framework in which to evaluate policies and decisions. Because global climate change is a complex problem, extensions of cost-benefit theory can be expected to add additional insights, particularly in the following areas: distinguishing distributional effects among nations, over time, and among generations; determining the rate of discount that is appropriate for long-term environmental damages and separating risk aspects from the rate of discount; and assessing amplification effects when policies involve large expenditures relative to the economy or when affected sectors are significant sectors of the economy

  9. Impact of growing costs on the profitability of crop production in Poland in the mid-term perspective

    Directory of Open Access Journals (Sweden)

    Aldona SKARŻYŃSKA

    2016-02-01

    Full Text Available Main aim of this paper was to demonstrate the impact of cultivation intensity on economic of selected activities of crop production in Poland. The projection of income of these activities in mid-term perspective, i.e. in 2016, has also been developed. Studies have shown that for cultivation technology of low intensity, as compared to high, the economic results of examined activities were more favourable. The profitability of production, expressed as a ratio of the value of production to economic costs, was higher by 10.0 to 52.7%. According to the projection results, in the highly intensive cultivation, high costs and dynamics of growth, stronger than growth of income, had a negative impact on the level of income. It is expected, even with an exceptionally high yield, income level will be lower than in the cultivation of low intensity. The results show that the use of technological progress can reduce a negative impact of chemicals on the environment while maintaining the high economic efficiency of production.

  10. HPS: A space fission power system suitable for near-term, low-cost lunar and planetary bases

    International Nuclear Information System (INIS)

    Houts, M.G.; Poston, D.I.; Ranken, W.A.

    1996-01-01

    Near-term, low-cost space fission power systems can enhance the feasibility and utility of lunar and planetary bases. One such system, the Heatpipe Power System (HPS), is described in this paper. The HPS draws on 40 yr of United States and international experience to enable a system that can be developed in <5 yr at a cost of <$100M. Total HPS mass is <600 kg at 5 kWe and <2000 kg at 50 kWe, assuming that thermoelectric power conversion is used. More advanced power conversion systems could reduce system mass significantly. System mass for planetary surface systems also may be reduced (1) if indigenous material is used for radiation shielding and (2) because of the positive effect of the gravitational field on heatpipe operation. The HPS is virtually non-radioactive at launch and is passively subcritical during all credible launch accidents. Full-system electrically heated testing is possible, and a ground nuclear power test is not needed for flight qualification. Fuel burnup limits are not reached for several decades, thus giving the system long-life potential

  11. Sustainable construction - the standard for all public building?

    Energy Technology Data Exchange (ETDEWEB)

    Handyside, R. [Richard Handyside Construction Resources (United Kingdom)

    2002-01-01

    This article argues for the need for foresight and planning to achieve sustainable development in the construction of public buildings. Reasons why sustainable development fails are highlighted, and the key factors that go to make a development sustainable are listed and involve the choice and layout of the site, site services, the fitting of spaces to the required purpose, the arrangement of rooms to achieve maximum use of natural light, heat and air, and the choice of construction materials and finishes. The balancing of short and long-term costs, and the use of life-cycle costs in every project are discussed.

  12. Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia - a pilot evaluation.

    Science.gov (United States)

    Lenoir-Wijnkoop, Irene; van der Beek, Eline M; Garssen, Johan; Nuijten, Mark J C; Uauy, Ricardo D

    2015-01-01

    Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g., macrosomia), body adiposity, and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life. Provide insight in the short-term health-economic impact of maternal overweight, GDM, and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences. Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop diabetes emphasizes the urgent need to collect more country

  13. Potential long-term effects of a mind-body intervention for women with major depressive disorder: sustained mental health improvements with a pilot yoga intervention.

    Science.gov (United States)

    Kinser, Patricia Anne; Elswick, R K; Kornstein, Susan

    2014-12-01

    Despite pharmacologic and psychotherapeutic advances over the past decades, many individuals with major depressive disorder (MDD) experience recurrent depressive episodes and persistent depressive symptoms despite treatment with the usual care. Yoga is a mind-body therapeutic modality that has received attention in both the lay and research literature as a possible adjunctive therapy for depression. Although promising, recent findings about the positive mental health effects of yoga are limited because few studies have used standardized outcome measures and none of them have involved long-term follow-up beyond a few months after the intervention period. The goal of our research study was to evaluate the feasibility, acceptability, and effects of a yoga intervention for women with MDD using standardized outcome measures and a long follow-up period (1year after the intervention). The key finding is that previous yoga practice has long-term positive effects, as revealed in both qualitative reports of participants' experiences and in the quantitative data about depression and rumination scores over time. Although generalizability of the study findings is limited because of a very small sample size at the 1-year follow-up assessment, the trends in the data suggest that exposure to yoga may convey a sustained positive effect on depression, ruminations, stress, anxiety, and health-related quality of life. Whether an individual continues with yoga practice, simple exposure to a yoga intervention appears to provide sustained benefits to the individual. This is important because it is rare that any intervention, pharmacologic or non-pharmacologic, for depression conveys such sustained effects for individuals with MDD, particularly after the treatment is discontinued. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Relative association of processing speed, short-term memory and sustained attention with task on gait speed: a study of community-dwelling people 50 years and older.

    Science.gov (United States)

    Killane, Isabelle; Donoghue, Orna A; Savva, George M; Cronin, Hilary; Kenny, Rose Anne; Reilly, Richard B

    2014-11-01

    For single gait tasks, associations have been reported between gait speed and cognitive domains. However, few studies have evaluated if this association is altered in dual gait tasks given gait speed changes with complexity and nature of task. We evaluated relative contributions of specific elements of cognitive function (including sustained attention and processing speed) to dual task gait speed in a nationally representative population of community-dwelling adults over 50 years. Gait speed was obtained using the GaitRite walkway during three gait tasks: single, cognitive (alternate letters), and motor (carrying a filled glass). Linear regression models, adjusted for covariates, were constructed to predict the relative contributions of seven neuropsychological tests to gait speed differences and to investigate gait task effects. The mean age and gait speed of the population (n = 4,431, 55% women) was 62.4 years (SD = 8.2) and 135.85 cm/s (SD = 20.20, single task), respectively. Poorer processing speed, short-term memory, and sustained attention were major cognitive contributors to slower gait speed for all gait tasks. Both dual gait tasks were robust to covariate adjustment and had a significant additional executive function element not found for the single gait task. For community-dwelling older adults processing speed, short-term memory and sustained attention were independently associated with gait speed for all gait tasks. Dual gait tasks were found to highlight specific executive function elements. This result forms a baseline value for dual task gait speed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Firewood harvest from forests of the Murray-Darling Basin, Australia. Part 1: Long-term, sustainable supply available from native forests

    International Nuclear Information System (INIS)

    West, P.W.; Cawsey, E.M.; Stol, J.; Freudenberger, D.

    2008-01-01

    The Murray-Darling Basin is a 1 million km 2 agricultural region of south-eastern Australia, although 29% of it retains native forests. Some are mallee eucalypt types, whilst the 'principal' types are dominated mainly by other eucalypt species. One-third of the 6-7 million oven-dry tonne of firewood burnt annually in Australia is obtained from these forests, principally through collection of coarse woody debris. There are fears that removal of this debris may prejudice the floral and faunal biodiversity of the Basin. The present work considers what silvicultural management practices will allow the long-term maintenance of the native forests of the Basin and their continued contribution to its biodiversity. It then estimates that the maximum, long-term, annual, sustainable yield of firewood which could be harvested, by collection of coarse woody debris, from principal forest types of the Basin would be 10 million oven-dry tonne yr -1 . An alternative, harvest of firewood from live trees by thinning the principal forests and clear-felling mallee forests, would be able to supply 2.3 million tonne yr -1 sustainably. Whilst coarse woody debris harvests could supply far more than the present demand for firewood from the Basin, they would lead to substantial reductions of the debris remaining in the forests; this may be detrimental to biodiversity maintenance. Live tree harvest does not lead to this problem, but would barely be able to supply existing firewood demand

  16. Influence of Silica Fume Addition in the Long-Term Performance of Sustainable Cement Grouts for Micropiles Exposed to a Sulphate Aggressive Medium

    Directory of Open Access Journals (Sweden)

    José Marcos Ortega

    2017-08-01

    Full Text Available At present, sustainability is of major importance in the cement industry, and the use of additions such as silica fume as clinker replacement contributes towards that goal. Special foundations, and particularly micropiles, are one of the most suitable areas for the use of sustainable cements. The aim of this research is to analyse the effects in the very long-term (for 600 days produced by sulphate attack in the microstructure of grouts for micropiles in which OPC (ordinary Portland cement has been replaced by 5% and 10% silica fume. This line of study is building on a previous work, where these effects were studied in slag and fly ash grouts. Grouts made using a commercial sulphate-resisting Portland cement were also studied. The non-destructive impedance spectroscopy technique, mercury intrusion porosimetry, and Wenner resistivity testing were used. Mass variation and the compressive strength have also been analysed. Apparently, impedance spectroscopy is the most suitable technique for studying sulphate attack development. According to the results obtained, grouts for micropiles with a content of silica fume up to 10% and exposed to an aggressive sulphate medium, have a similar or even better behaviour in the very long-term, compared to grouts prepared using sulphate-resisting Portland cement.

  17. Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.

    Science.gov (United States)

    Laviana, Aaron A; Ilg, Annette M; Veruttipong, Darlene; Tan, Hung-Jui; Burke, Michael A; Niedzwiecki, Douglas R; Kupelian, Patrick A; King, Chris R; Steinberg, Michael L; Kundavaram, Chandan R; Kamrava, Mitchell; Kaplan, Alan L; Moriarity, Andrew K; Hsu, William; Margolis, Daniel J A; Hu, Jim C; Saigal, Christopher S

    2016-02-01

    Given the costs of delivering care for men with prostate cancer remain poorly described, this article reports the results of time-driven activity-based costing (TDABC) for competing treatments of low-risk prostate cancer. Process maps were developed for each phase of care from the initial urologic visit through 12 years of follow-up for robotic-assisted laparoscopic prostatectomy (RALP), cryotherapy, high-dose rate (HDR) and low-dose rate (LDR) brachytherapy, intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and active surveillance (AS). The last modality incorporated both traditional transrectal ultrasound (TRUS) biopsy and multiparametric-MRI/TRUS fusion biopsy. The costs of materials, equipment, personnel, and space were calculated per unit of time and based on the relative proportion of capacity used. TDABC for each treatment was defined as the sum of its resources. Substantial cost variation was observed at 5 years, with costs ranging from $7,298 for AS to $23,565 for IMRT, and they remained consistent through 12 years of follow-up. LDR brachytherapy ($8,978) was notably cheaper than HDR brachytherapy ($11,448), and SBRT ($11,665) was notably cheaper than IMRT, with the cost savings attributable to shorter procedure times and fewer visits required for treatment. Both equipment costs and an inpatient stay ($2,306) contributed to the high cost of RALP ($16,946). Cryotherapy ($11,215) was more costly than LDR brachytherapy, largely because of increased single-use equipment costs ($6,292 vs $1,921). AS reached cost equivalence with LDR brachytherapy after 7 years of follow-up. The use of TDABC is feasible for analyzing cancer services and provides insights into cost-reduction tactics in an era focused on emphasizing value. By detailing all steps from diagnosis and treatment through 12 years of follow-up for low-risk prostate cancer, this study has demonstrated significant cost variation between competing treatments. © 2015

  18. Developing a long-term global tourism transport model using a behavioural approach: implications for sustainable tourism policy making.

    NARCIS (Netherlands)

    Peeters, P.M.

    2013-01-01

    This paper explores the creation and use of a long-term global tourism transport model for private and public sector tourism policy makers. Given that technology is unlikely to reduce tourism transport's impact on climate change sufficiently to avoid serious dangers, behavioural change is necessary.

  19. Sustainability and Substitution of Exhaustible Natural Resources : How Resource Prices Affect Long-Term R&D Investments

    NARCIS (Netherlands)

    Bretschger, L.; Smulders, J.A.

    2003-01-01

    Traditional resource economics has been criticised for assuming too high elasticities of substitution, not observing material balance principles and relying too much on planner solutions to obtain long-term growth.By analysing a multi-sector R&D based endogenous growth model with exhaustible natural

  20. The dual sustainability of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Welch, Jonathan B.; Venkateswaran, Anand [413 Hayden Hall, College of Business, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 (United States)

    2009-06-15

    Academics, practitioners, and policy makers continue to debate the benefits and costs of alternative sources of energy. Environmental and economic concerns have yet to be fully reconciled. One view is that decisions that incorporate both society's concern with the environment and investors' desire for shareholder value maximization are more likely to be truly sustainable. We coin the term dual sustainability to mean the achievement of environmental and financial sustainability simultaneously. Many experts believe that wind energy can help to meet society's needs without harming future generations. It is clean and renewable. Because the fuel is free it provides the ultimate in energy independence. Wind energy has emerged as a leading prospect, in part, because it is considered by many to be environmentally sustainable. However, a key question that remains is whether wind energy is financially sustainable without the extensive government support that has helped to create and nurture this growth industry. Using reliable, proprietary data from field research, our analysis employs a capital budgeting framework to evaluate the financial economics of investments in wind energy. We find that because of the convergence of improved technology, greater efficiency, and with the increasing cost of traditional, competing sources such as oil and natural gas, wind energy is close to becoming self-sustaining financially without the extensive federal government support that exists today. Wind energy can provide the best of both worlds. It is sustainable from an environmental perspective and it is becoming sustainable financially. In short, those companies investing in wind energy will be able to do well by doing good. Perhaps the achievement of dual sustainability is true sustainability. Our research findings and dual sustainability have several interesting and important implications for public policy towards wind energy. All imply that public policy can now be

  1. Cost-effectiveness of a mild compared with a standard strategy for IVF: a randomized comparison using cumulative term live birth as the primary endpoint.

    Science.gov (United States)

    Polinder, S; Heijnen, E M E W; Macklon, N S; Habbema, J D F; Fauser, B J C M; Eijkemans, M J C

    2008-02-01

    BACKGROUND Conventional ovarian stimulation and the transfer of two embryos in IVF exhibits an inherent high probability of multiple pregnancies, resulting in high costs. We evaluated the cost-effectiveness of a mild compared with a conventional strategy for IVF. METHODS Four hundred and four patients were randomly assigned to undergo either mild ovarian stimulation/GnRH antagonist co-treatment combined with single embryo transfer, or standard stimulation/GnRH agonist long protocol and the transfer of two embryos. The main outcome measures are total costs of treatment within a 12 months period after randomization, and the relationship between total costs and proportion of cumulative pregnancies resulting in term live birth within 1 year of randomization. RESULTS Despite a significantly increased average number of IVF cycles (2.3 versus 1.7; P costs over a 12-month period (8333 versus euro10 745; P = 0.006) were observed using the mild strategy. This was mainly due to higher costs of the obstetric and post-natal period for the standard strategy, related to multiple pregnancies. The costs per pregnancy leading to term live birth were euro19 156 in the mild strategy and euro24 038 in the standard. The incremental cost-effectiveness ratio of the standard strategy compared with the mild strategy was euro185 000 per extra pregnancy leading to term live birth. CONCLUSIONS Despite an increased mean number of IVF cycles within 1 year, from an economic perspective, the mild treatment strategy is more advantageous per term live birth. It is unlikely, over a wide range of society's willingness-to-pay, that the standard treatment strategy is cost-effective, compared with the mild strategy.

  2. Antifouling coating with controllable and sustained silver release for long-term inhibition of infection and encrustation in urinary catheters.

    Science.gov (United States)

    Wang, Rong; Neoh, Koon Gee; Kang, En-Tang; Tambyah, Paul Anantharajah; Chiong, Edmund

    2015-04-01

    Urinary tract infections constitute a large proportion of nosocomial infections, and the urinary catheter is the most important predisposing factor. Encrustation induced by urease-producing uropathogens like Proteus mirabilis causes further complications. In the present work, a strategy for controllable and sustained release of silver over several weeks has been developed for combating bacterial infection and encrustation in urinary devices. Silver nanoparticles (AgNPs) were first immobilized on polydopamine (PDA) pre-treated silicone catheter surface and this was followed by another PDA coating. The number of AgNP-PDA bilayers could be manipulated to control the amount of silver loaded and its subsequent release. Poly(sulfobetaine methacrylate-co-acrylamide) was then grafted to provide an antifouling outer layer, and to ensure free diffusion of Ag from the surface. The micron-scale combination of an antifouling coating with AgNP-PDA bilayers reduced colonization of the urinary catheter by uropathogens by approximately two orders of magnitude. With one and two AgNP-PDA bilayers, the coated catheter could resist encrustation for 12 and 45 days, respectively, compared with approximately 6 days with the Dover™ silver-coated catheter. Such anti-infective and anti-encrustation catheters can potentially have a large impact on reducing patient morbidity and healthcare expenditure. © 2014 Wiley Periodicals, Inc.

  3. Human-in-the-Loop simulation in support of long-term sustainability of light water reactors

    International Nuclear Information System (INIS)

    Hallbert, Bruce P.

    2014-01-01

    Reliable instrumentation, information, and control systems technologies are essential to ensuring safe and efficient operation of the U.S. light water reactor (LWR) fleet. These technologies affect every aspect of nuclear power plant (NPP) and balance-of-plant operations. In 1997, the National Research Council conducted a study concerning the challenges involved in modernization of digital instrumentation and control systems in NPPs. Their findings identified the need for new II and C technology integration. The NPP owners and operators realize that the traditional analog technology represents a significant challenge to sustaining the operation of the current fleet of NPPs. Beyond control systems, new technologies are needed to monitor and characterize the effects of aging and degradation in critical areas of key structures, systems, and components. The objective of the efforts sponsored by the U.S. Department of Energy is to develop, demonstrate, and deploy new digital technologies for II and C architectures and provide monitoring capabilities to ensure the continued safe, reliable, and economic operation of the nation's NPPs. (author)

  4. Heatwave and elderly mortality: An evaluation of death burden and health costs considering short-term mortality displacement.

    Science.gov (United States)

    Cheng, Jian; Xu, Zhiwei; Bambrick, Hilary; Su, Hong; Tong, Shilu; Hu, Wenbiao

    2018-06-01

    A heatwave can be a devastating natural disaster to human health, and elderly people are particularly vulnerable. With the continuing rise in earth's surface temperature alongside the world's aging population, research on the mortality burden of heatwave for the older population remains relatively sparse. The potential magnitude of benefits of averting such deaths may be considerable. This paper examined the short-term mortality displacement (or "harvesting") of heatwave, characterized the heatwave-mortality relationship, and estimated death burden and health costs attributable to heatwave among the elderly in Australia. We collected daily data on the temperature and deaths of people aged ≥75 years in the five largest cities of Australia (Sydney, Melbourne, Brisbane, Perth and Adelaide), totaling 368,767 deaths in different periods between 1988 and 2011. A total of 15-tiered heatwave definitions, based on intensity (95th to 99th percentiles of temperature distribution) and duration (two or more consecutive days), were used to quantify heatwave effects, using time-series regression and random-effects meta-analysis. We calculated attributable deaths for each city and by different types of heatwave. Potential economic benefits in monetary terms were also estimated, considering that heat-related deaths are avoidable. Among the Australian elderly population, we found significant associations between heatwave and deaths, with raised mortality immediately in the first few days followed by lower-than-expected mortality. In general, heatwave was associated with an average death increase of 28% (95% confidence interval: 15% to 42%), and greater increases were mostly observed for more intense heatwaves across multiple megacities. During the study period, there were dozens to hundreds of deaths attributable to heatwave for each city, equating to an economic loss of several million Australian dollars every year. Although the estimated attributable deaths varied by heatwave

  5. Estimating Total Program Cost of a Long-Term, High-Technology, High-Risk Project with Task Durations and Costs That May Increase Over Time

    National Research Council Canada - National Science Library

    Brown, Gerald G; Grose, Roger T; Koyak, Robert A

    2006-01-01

    .... Each task suffers some risk of delay and changed cost. Ignoring budget constraints, we use Monte Carlo simulation of the duration of each task in the project to infer the probability distribution of the project completion time...

  6. Systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care.

    Science.gov (United States)

    Fluke, John D; Goldman, Philip S; Shriberg, Janet; Hillis, Susan D; Yun, Katherine; Allison, Susannah; Light, Enid

    2012-10-01

    This article reviews the available evidence regarding the efficacy, effectiveness, ethics, and sustainability of approaches to strengthen systems to care for and protect children living outside family care in low- and middle-income countries. For trafficked children, children of and on the street, children of conflict/disaster, and institutionalized children, a systems framework approach was used to organize the topic of sustainable approaches in low- and middle-income countries and addresses the following: legislation, policies, and regulations; system structures and functions (formal and informal); and continuum of care and services. The article draws on the findings of a focal group convened by the U.S. Government Evidence Summit: Protecting Children Outside of Family Care (December 12-13, 2011, Washington, DC), tasked with reviewing the literature on systems, strategies, and interventions for sustainable long-term care and protection of children with a history of living outside of family care in low- and middle-income country contexts. The specific methodology for the review is described in the commentary paper (Higgs, Zlidar, & Balster, 2012) that accompanies these papers. For the most part, the evidence base in support of sustainable long-term care for the populations of interest is relatively weak, with some stronger but unreplicated studies. Some populations have been studied more thoroughly than others, and there are many gaps. Most of the existing studies identify population characteristics, needs, and consequences of a lack of systemic services to promote family-like care. There is some evidence of the effectiveness of laws and policies, as well as some evidence of service effectiveness, in improving outcomes for children outside of family care. Despite the weaknesses and gaps of the existing research, there is a foundation of research for going forward, which should focus on developing and implementing systems for these most vulnerable children. The

  7. Sustainable Change Sequence: a framework for developing behavior change interventions for patients with long-term conditions

    OpenAIRE

    Elwyn, Glyn; Marrin, Katy; Frosch, Dominick; White, James

    2014-01-01

    Objective\\ud \\ud Interactive interventions are increasingly advocated to support behavior change for patients who have long-term conditions. Such interventions are most likely to achieve behavior change when they are based on appropriate theoretical frameworks. Developers of interventions are faced with a diverse set of behavioral theories that do not specifically address intervention development. The aim of our work was to develop a framework to guide the developers of interactive healthcare...

  8. Assessment of cooperation mechanism options: Cost-efficient and sustainable deployment of renewable energy sources towards the 20% target by 2020, and beyond. D3.2

    Energy Technology Data Exchange (ETDEWEB)

    Pade Hansen, L.-L.; Klinge Jacobsen, H.; Skovsgaard Nielsen, L.

    2012-12-15

    The RES Directive 2009/28/EC (European Commission 2009) set legally binding targets for EU Member States on energy consumption from renewable sources - the 2020 RES targets. A part of this can be achieved through the use of cooperation mechanisms: statistical transfer, joint project and joint support schemes. The intention of the cooperation mechanisms is to provide the flexibility needed to achieve Europe's renewable energy targets in a more cost-efficient way. In Task 3 of the RES4Less project we analyse the benefits and challenges of using the two cooperation mechanisms: joint project and joint support schemes. This report is the outcome of the work in Task 3.2 where we analyse how the barriers can be overcome and how different design options can be used under varying conditions and time horizons. Cooperation mechanisms have the potential to reduce the compliance costs of reaching the 2020 RES targets for EU member states. The largest benefits can be achieved under full harmonisation and one joints support scheme. However, the different national objectives along with uneven distribution of benefits and costs make this unrealistic in the near future. Cooperation between pairs or groups of countries with large net benefits that can be relatively easy estimated and shared is attractive and realisable in a shorter time horizon. Joint project cooperation is the most flexible instrument to use as it preserves the national legislation and support schemes (national objectives) and can be easily scaled in size. The drawback is the high transaction costs and some uncertainty regarding which party should carry the project implementation risk and guaranty the support for the projects for the entire lifetime. The joint projects can be realised in a short term horizon and as such pave the way for further cooperation. Large projects has a considerable advantage in the reduced transaction cost relative to project size and governments can be expected to be more willing to

  9. Development of a long term macro econometric model for strategic analysis and cost assessments in nuclear R and D fields

    International Nuclear Information System (INIS)

    Mankin, Shuichi; Yamazaki, Shigeki.

    1985-11-01

    A Long Term Macro Econometric Model (LTMEMO) has been developed for the purpose of generating economic scenarios for strategic analysis and for cost assessments of technologies in the field of nuclear research and development. The program system of the model is composed of such sub-programs as related social and economic statistic data base and its treatment program, identification and estimation programs of various econometric functions, simulation programs for future projections, and a reference econometric model program. The reference econometric model in the program system would be improved and modified easily by using data base and other sub-programs as the purpose of data retrieval, application of economic hypothesis, and scenario generation. The reference model belongs to a category of such standard types as macro-econometric, deterministic, and descriptive one, however, it was deviated based on the combination of Keynesian theories and Neo-classical theories and was modified by system engineering aspects. The model obtained good performances in such various econometric tests as statistical examinations in parameter estimation of each functions and so called partial tests, total tests, and final tests. Macro economic scenarios α and β, long term projections through 2030 of macro economy in our country were evaluated appropriately by this model. This report describes the process in the development of the model from needs of econometric model in nuclear fields to examples of economic scenarios generated by this model. Some consideration are taken into descriptions on the deviation of each functions and on the application of economic theories for practical use of this program system at the time of modification and improvements of the reference model. (author)

  10. Long-term temporal trajectories to enhance restoration efficiency and sustainability on large rivers: an interdisciplinary study

    Science.gov (United States)

    Eschbach, David; Schmitt, Laurent; Imfeld, Gwenaël; May, Jan-Hendrik; Payraudeau, Sylvain; Preusser, Frank; Trauerstein, Mareike; Skupinski, Grzegorz

    2018-05-01

    While the history of a fluvial hydrosystem can provide essential knowledge on present functioning, historical context remains rarely considered in river restoration. Here we show the relevance of an interdisciplinary study for improving restoration within the framework of a European LIFE+ project on the French side of the Upper Rhine (Rohrschollen Island). Investigating the planimetric evolution combined with historical high-flow data enabled us to reconstruct pre-disturbance hydromorphological functioning and major changes that occurred on the reach. A deposition frequency assessment combining vertical evolution of the Rhine thalweg, chronology of deposits in the floodplain, and a hydrological model revealed that the period of incision in the main channel corresponded to high rates of narrowing and lateral channel filling. Analysis of filling processes using Passega diagrams and IRSL dating highlights that periods of engineering works were closely related to fine sediment deposition, which also presents concomitant heavy metal accumulation. In fact, current fluvial forms, processes and sediment chemistry around Rohrschollen Island directly reflect the disturbances that occurred during past correction works, and up to today. Our results underscore the advantage of combining functional restoration with detailed knowledge of the past trajectory to (i) understand the functioning of the hydrosystem prior to anthropogenic disturbances, (ii) characterize the human-driven morphodynamic adjustments during the last 2 centuries, (iii) characterize physico-chemical sediment properties to trace anthropogenic activities and evaluate the potential impact of the restoration on pollutant remobilization, (iv) deduce the post-restoration evolution tendency and (v) evaluate the efficiency and sustainability of the restoration effects. We anticipate our approach will expand the toolbox of decision-makers and help orientate functional restoration actions in the future.

  11. Long-Term Urban Growth and Land Use Efficiency in Southern Europe: Implications for Sustainable Land Management

    Directory of Open Access Journals (Sweden)

    Marco Zitti

    2015-03-01

    Full Text Available The present study illustrates a multidimensional analysis of an indicator of urban land use efficiency (per-capita built-up area, LUE in mainland Attica, a Mediterranean urban region, along different expansion waves (1960–2010: compaction and densification in the 1960s, dispersed growth along the coasts and on Athens’ fringe in the 1970s, fringe consolidation in the 1980s, moderate re-polarization and discontinuous expansion in the 1990s and sprawl in remote areas in the 2000s. The non-linear trend in LUE (a continuous increase up to the 1980s and a moderate decrease in 1990 and 2000 preceding the rise observed over the last decade reflects Athens’ expansion waves. A total of 23 indicators were collected by decade for each municipality of the study area with the aim of identifying the drivers of land use efficiency. In 1960, municipalities with low efficiency in the use of land were concentrated on both coastal areas and Athens’ fringe, while in 2010, the lowest efficiency rate was observed in the most remote, rural areas. Typical urban functions (e.g., mixed land uses, multiple-use buildings, vertical profile are the variables most associated with high efficiency in the use of land. Policies for sustainable land management should consider local and regional factors shaping land use efficiency promoting self-contained expansion and more tightly protecting rural and remote land from dispersed urbanization. LUE is a promising indicator reflecting the increased complexity of growth patterns and may anticipate future urban trends.

  12. Long-term temporal trajectories to enhance restoration efficiency and sustainability on large rivers: an interdisciplinary study

    Directory of Open Access Journals (Sweden)

    D. Eschbach

    2018-05-01

    Full Text Available While the history of a fluvial hydrosystem can provide essential knowledge on present functioning, historical context remains rarely considered in river restoration. Here we show the relevance of an interdisciplinary study for improving restoration within the framework of a European LIFE+ project on the French side of the Upper Rhine (Rohrschollen Island. Investigating the planimetric evolution combined with historical high-flow data enabled us to reconstruct pre-disturbance hydromorphological functioning and major changes that occurred on the reach. A deposition frequency assessment combining vertical evolution of the Rhine thalweg, chronology of deposits in the floodplain, and a hydrological model revealed that the period of incision in the main channel corresponded to high rates of narrowing and lateral channel filling. Analysis of filling processes using Passega diagrams and IRSL dating highlights that periods of engineering works were closely related to fine sediment deposition, which also presents concomitant heavy metal accumulation. In fact, current fluvial forms, processes and sediment chemistry around Rohrschollen Island directly reflect the disturbances that occurred during past correction works, and up to today. Our results underscore the advantage of combining functional restoration with detailed knowledge of the past trajectory to (i understand the functioning of the hydrosystem prior to anthropogenic disturbances, (ii characterize the human-driven morphodynamic adjustments during the last 2 centuries, (iii characterize physico-chemical sediment properties to trace anthropogenic activities and evaluate the potential impact of the restoration on pollutant remobilization, (iv deduce the post-restoration evolution tendency and (v evaluate the efficiency and sustainability of the restoration effects. We anticipate our approach will expand the toolbox of decision-makers and help orientate functional restoration actions in the

  13. Sustainability of the Catalytic Activity of a Silica-Titania Composite (STC) for Long-Term Indoor Air Quality Control

    Science.gov (United States)

    Coutts, Janelle L.; Levine, Lanfang H.; Richards, Jeffrey T.

    2011-01-01

    TiO2-assisted photocatalytic oxidation (PCO) is an emerging technology for indoor air quality control and is also being evaluated as an alternative trace contaminant control technology for crew habitats in space exploration. Though there exists a vast range of literature on the development of photocatalysts and associated reactor systems, including catalyst performance and performance-influencing factors, the critical question of whether photocatalysts can sustain their initial catalytic activity over an extended period of operation has not been adequately addressed. For a catalyst to effectively serve as a