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Sample records for united states costs

  1. The societal cost of heroin use disorder in the United States.

    Directory of Open Access Journals (Sweden)

    Ruixuan Jiang

    Full Text Available Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars.An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose.Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user. One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users.The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder.

  2. Finding and development costs in the United States

    International Nuclear Information System (INIS)

    Espenshade, S.A.

    1996-01-01

    The finding and development costs, or reserve replacement costs have become important statistics for benchmarking independent oil and gas companies against one another. However, no standard definition for finding costs exists. Every company reports their costs differently because of different accounting practices. The time period a company uses to calculate its finding costs is also important. Since exploring for a field and developing new properties involves a long lead time, costs should be calculated on an annual basis. Reserve replacement costs should include: acquisition costs, developments costs, exploration costs, geological and geophysical costs, general and administrative costs, drilling costs and improved recovery costs. The importance of independent oil and gas companies was emphasized. They drill 85% of all the wells in the United States and produce 64% of the natural gas and 37% of the crude oil. In the lower 48 states alone, they produce 49% of the crude oil. Lightening of regulatory and legislative burdens, opening up access to more public lands, improving the tax situation, and to obtain royalty relief, were considered essential to providing for the energy needs of Americans in the years to come. 12 figs

  3. 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.

  4. Is scorpion antivenom cost-effective as marketed in the United States?

    Science.gov (United States)

    Armstrong, Edward P; Bakall, Maja; Skrepnek, Grant H; Boyer, Leslie V

    2013-12-15

    The purpose of this study was to analyze the cost-effectiveness of scorpion antivenom compared to no antivenom, in the United States, using a decision analysis framework. A decision analytic model was created to assess patient course with and without antivenom. Costs were determined from the perspective of a health care payer. Cost data used in the model were extracted from Arizona Medicaid. The probability of clinical events occurring with and without antivenom was obtained from the published literature, medical claims obtained from Arizona Medicaid, and results of recent clinical trials. Patients that became so ill that mechanical ventilator support was necessary were considered treatment failures. A Monte Carlo simulation was run 1000 times and sampled simultaneously across all variable distributions in the model. The mean success rate was 99.87% (95% CI 99.64%-99.98%) with scorpion antivenom and 94.31% (95% CI 91.10%-96.61%) without scorpion antivenom. The mean cost using scorpion antivenom was $10,708 (95% CI $10,556 - $11,010) and the mean cost without scorpion antivenom was $3178 (95% CI $1627 - $5184). Since the 95% CIs do not overlap for either the success or cost, use of the scorpion antivenom was significantly more effective and significantly more expensive than no antivenom. Cost-effectiveness analysis found that the scorpion antivenom was not cost-effective at its current price as marketed in the United States. The scorpion antivenom marketed in the United States is extremely effective, but too costly to justify its use in most clinical situations. Formulary committees should restrict the use of this antivenom to only the most severe scorpion envenomations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Cost-effectiveness of human papillomavirus vaccination in the United States.

    Science.gov (United States)

    Chesson, Harrell W; Ekwueme, Donatus U; Saraiya, Mona; Markowitz, Lauri E

    2008-02-01

    We describe a simplified model, based on the current economic and health effects of human papillomavirus (HPV), to estimate the cost-effectiveness of HPV vaccination of 12-year-old girls in the United States. Under base-case parameter values, the estimated cost per quality-adjusted life year gained by vaccination in the context of current cervical cancer screening practices in the United States ranged from $3,906 to $14,723 (2005 US dollars), depending on factors such as whether herd immunity effects were assumed; the types of HPV targeted by the vaccine; and whether the benefits of preventing anal, vaginal, vulvar, and oropharyngeal cancers were included. The results of our simplified model were consistent with published studies based on more complex models when key assumptions were similar. This consistency is reassuring because models of varying complexity will be essential tools for policy makers in the development of optimal HPV vaccination strategies.

  6. Cryptococcal Meningitis Treatment Strategies Affected by the Explosive Cost of Flucytosine in the United States: A Cost-effectiveness Analysis.

    Science.gov (United States)

    Merry, Matthew; Boulware, David R

    2016-06-15

    In the United States, cryptococcal meningitis causes approximately 3400 hospitalizations and approximately 330 deaths annually. The US guidelines recommend treatment with amphotericin B plus flucytosine for at least 2 weeks, followed by fluconazole for a minimum of 8 weeks. Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22. Cost-effectiveness analysis was performed to determine the value of flucytosine relative to alternative regimens. We estimated the incremental cost-effectiveness ratio (ICER) of 3 cryptococcal induction regimens: (1) amphotericin B deoxycholate for 4 weeks; (2) amphotericin and flucytosine (100 mg/kg/day) for 2 weeks; and (3) amphotericin and fluconazole (800 mg/day) for 2 weeks. Costs of care were calculated using 2015 US prices and the medication costs. Survival estimates were derived from a randomized trial and scaled relative to published US survival data. Cost estimates were $83 227 for amphotericin monotherapy, $75 121 for amphotericin plus flucytosine, and $44 605 for amphotericin plus fluconazole. The ICER of amphotericin plus flucytosine was $23 842 per quality-adjusted life-year. Flucytosine is currently cost-effective in the United States despite a dramatic increase in price in recent years. Combination therapy with amphotericin and flucytosine is the most attractive treatment strategy for cryptococcal meningitis, though the rising price may be creating access issues that will exacerbate if the trend of profiteering continues. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  7. The Economic Cost of Methamphetamine Use in the United States, 2005

    Science.gov (United States)

    Nicosia, Nancy; Pacula, Rosalie Liccardo; Kilmer, Beau; Lundberg, Russell; Chiesa, James

    2009-01-01

    This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of…

  8. Nuclear power generation costs in the United States of America

    International Nuclear Information System (INIS)

    Willis, W.F.

    1983-01-01

    Increasing world energy prices and shortages of fuel resources make the utilization of nuclear power extremely important. The United States nuclear power industry represents the largest body of nuclear power experience in the world. Analysis of the recent United States experience of substantial increases in the cost of nuclear power generation provides good insight into the interdependence of technological, financial, and institutional influences and their combined impact on the economic viability of nuclear power generation. The various factors influencing ultimate generation costs, including construction cost, fuel cost, regulatory reviews, and siting considerations are discussed, and their relative impacts are explored, including discussion of design complexity and related regulatory response. A closer look into the recent relatively high escalation of nuclear plant construction costs shows how differing economic conditions can affect the relative cost effectiveness of various methods of power generation. The vulnerability of capital-intensive, long-lead-time projects to changes in economic conditions and uncertainty in future power demands is discussed. Likewise, the pitfalls of new designs and increased sophistication are contrasted to the advantages which result from proven designs, reliable engineering, and shorter lead times. The value of reliable architect-engineers experienced in the design and construction of the plant is discussed. A discussion is presented of additional regulatory requirements stemming from public safety aspects of nuclear power. These include recognition of requirements for the very large effort for quality assurance of materials and workmanship during plant construction and operation. Likewise, a discussion is included of the demanding nature of operations, maintenance, and modification of plants during the operational phase because of the need for highly qualified operations and maintenance personnel and strict quality assurance

  9. Health Utilization and Cost Impact of Childhood Constipation in the United States

    NARCIS (Netherlands)

    Liem, Olivia; Harman, Jeffrey; Benninga, Marc; Kelleher, Kelly; Mousa, Hayat; Di Lorenzo, Carlo

    2009-01-01

    Objective To estimate the total health care utilization and costs for children with constipation in the United States. Study design We analyzed data from 2 consecutive years (2003 and 2004) of the Medical Expenditure Panel Survey (MEPS), a nationally representative household survey. We identified

  10. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    Science.gov (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  11. Break-Even Cost for Residential Solar Water Heating in the United States: Key Drivers and Sensitivities

    Energy Technology Data Exchange (ETDEWEB)

    Cassard, H.; Denholm, P.; Ong, S.

    2011-02-01

    This paper examines the break-even cost for residential rooftop solar water heating (SWH) technology, defined as the point where the cost of the energy saved with a SWH system equals the cost of a conventional heating fuel purchased from the grid (either electricity or natural gas). We examine the break-even cost for the largest 1,000 electric and natural gas utilities serving residential customers in the United States as of 2008. Currently, the break-even cost of SWH in the United States varies by more than a factor of five for both electricity and natural gas, despite a much smaller variation in the amount of energy saved by the systems (a factor of approximately one and a half). The break-even price for natural gas is lower than that for electricity due to a lower fuel cost. We also consider the relationship between SWH price and solar fraction and examine the key drivers behind break-even costs. Overall, the key drivers of the break-even cost of SWH are a combination of fuel price, local incentives, and technical factors including the solar resource location, system size, and hot water draw.

  12. Tracking the Sun III; The Installed Cost of Photovoltaics in the United States from 1998-2009

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Darghouth, Naim; Wiser, Ryan

    2010-12-13

    Installations of solar photovoltaic (PV) systems have been growing at a rapid pace in recent years. In 2009, approximately 7,500 megawatts (MW) of PV were installed globally, up from approximately 6,000 MW in 2008, consisting primarily of grid-connected applications. With 335 MW of grid-connected PV capacity added in 2009, the United States was the world's fourth largest PV market in 2009, behind Germany, Italy, and Japan. The market for PV in the United States is driven by national, state, and local government incentives, including up-front cash rebates, production-based incentives, requirements that electricity suppliers purchase a certain amount of solar energy, and federal and state tax benefits. These programs are, in part, motivated by the popular appeal of solar energy, and by the positive attributes of PV - modest environmental impacts, avoidance of fuel price risks, coincidence with peak electrical demand, and the possible deployment of PV at the point of use. Given the relatively high cost of PV, however, a key goal of these policies is to encourage cost reductions over time. Therefore, as policy incentives have become more significant and as PV deployment has accelerated, so too has the desire to track the installed cost of PV systems over time, by system characteristics, by system location, and by component. Despite the significant year-on-year growth, however, the share of global and U.S. electricity supply met with PV remains small, and annual PV additions are currently modest in the context of the overall electric system. To address this need, Lawrence Berkeley National Laboratory initiated a report series focused on describing trends in the installed cost of grid-connected PV systems in the United States. The present report, the third in the series, describes installed cost trends from 1998 through 2009, and provides preliminary cost data for systems installed in 2010. The analysis is based on project-level cost data from approximately 78

  13. United States cost of military force projection in the Persian Gulf, 1976-2007

    Energy Technology Data Exchange (ETDEWEB)

    Stern, Roger J. [Oil, Energy and the Middle East Program, Department of Near Eastern Studies and Princeton Environmental Institute, Guyot Hall, Princeton University, Princeton, NJ 08544 (United States)

    2010-06-15

    This paper presents the first estimate of United States military cost for Persian Gulf force (C{sub PGfp}) derived entirely by a quantitative method. An activity-based cost (ABC) model uses geographic distribution of aircraft carriers as a proxy allocator of Department of Defense (DoD) baseline cost to regional operations. Allocation follows simply from DoD data that since 1990 no less than one aircraft carrier has been continuously on-station in the Persian Gulf; that eight are required to keep one on-station there; that the Navy has had eleven-fifteen carriers since 1990; and that Army and Air Force units are virtually never deployed to combat operations without Navy units. For 1976-2007 C{sub PGfp} is estimated to be $6.8 x 10{sup 12} and for 2007 $0.5 x 10{sup 12} (2008$). This substantial military investment is not a remedy for the market failure at the heart of regional security problem, which is oil market power. When C{sub PGfp} is added to economic losses attributed to market power in another recent study, the severity of this market failure becomes more apparent. (author)

  14. United States cost of military force projection in the Persian Gulf, 1976-2007

    International Nuclear Information System (INIS)

    Stern, Roger J.

    2010-01-01

    This paper presents the first estimate of United States military cost for Persian Gulf force (C PGfp ) derived entirely by a quantitative method. An activity-based cost (ABC) model uses geographic distribution of aircraft carriers as a proxy allocator of Department of Defense (DoD) baseline cost to regional operations. Allocation follows simply from DoD data that since 1990 no less than one aircraft carrier has been continuously on-station in the Persian Gulf; that eight are required to keep one on-station there; that the Navy has had eleven-fifteen carriers since 1990; and that Army and Air Force units are virtually never deployed to combat operations without Navy units. For 1976-2007 C PGfp is estimated to be $6.8 x 10 12 and for 2007 $0.5 x 10 12 (2008$). This substantial military investment is not a remedy for the market failure at the heart of regional security problem, which is oil market power. When C PGfp is added to economic losses attributed to market power in another recent study, the severity of this market failure becomes more apparent. (author)

  15. Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States.

    Science.gov (United States)

    Bonafede, Machaon; Sapra, Sandhya; Shah, Neel; Tepper, Stewart; Cappell, Katherine; Desai, Pooja

    2018-05-01

    The goal of this analysis was to provide a contemporary estimate of the burden of migraine, incorporating both direct and indirect costs, by comparing the costs of migraine patients to a matched group of patients without migraine in a large, nationally representative sample of commercially insured patients in the United States. Previous studies have shown that the economic burden of migraine in the United States is substantial for payers, patients, and employers. Despite the availability of multiple acute and preventive pharmacological treatment options and a relatively stable migraine prevalence in the United States, there has been a documented increase in migraine-related healthcare resource and pharmacy use. Given the frequently disabling nature of migraine and its high prevalence, especially during peak productive years, and the lack of recent estimates of the burden of migraine, there is a need to update the existing literature with more current data. This retrospective, observational cohort study identified migraine patients in the Truven Health Market Scan Research Databases between January 2008 and June 2013. Adult patients had 12 months of continuous enrollment before (baseline period) and after (follow-up period) the day they received migraine diagnoses and/or medications (index) and no diagnosis of HIV or malignancy during the study period. The patients with migraine were matched 1:1 to a group of patients without migraine on demographic variables and index date. Direct healthcare utilization and costs and indirect (absenteeism, short-term disability, and long-term disability) costs were assessed during the 12-month follow-up period and differences between patients with vs without migraine were assessed. Two additional multivariable logistic regression analyses were conducted. First, an analysis was conducted comparing the odds of having a short-term disability claim between patients with and without migraine after controlling for patient demographic and

  16. Nuclear power in the United States

    International Nuclear Information System (INIS)

    Johnston, J.B.

    1985-01-01

    All over the world except in the United States, nuclear energy is a low cost, secure, environmentally acceptable form of energy. In the United States, civilian nuclear power is dead. 112 nuclear power plants have been abandoned or cancelled in the last decade, and there has been no new order for nuclear plants since 1978. It will be fortunate to have 125 operating nuclear plants in the United States in the year 2000. There are almost 90 completed nuclear power plants and about 45 under construction in the United States, but several of those under construction will eventually be abandoned. About 20 % of the electricity in the United States will be generated by nuclear plants in 2000 as compared with 13 % supplied in the last year. Under the present regulatory and institutional arrangement, American electric utilities would not consider to order a new nuclear power plant. Post-TMI nuclear plants became very expensive, and there is also ideological opposition to nuclear power. Coal-firing plants are also in the similar situation. The uncertainty about electric power demand, the cost of money, the inflation of construction cost and regulation caused the situation. (Kako, I.)

  17. State-level medical and absenteeism cost of asthma in the United States.

    Science.gov (United States)

    Nurmagambetov, Tursynbek; Khavjou, Olga; Murphy, Louise; Orenstein, Diane

    2017-05-01

    For medically treated asthma, we estimated prevalence, medical and absenteeism costs, and projected medical costs from 2015 to 2020 for the entire population and separately for children in the 50 US states and District of Columbia (DC) using the most recently available data. We used multiple data sources, including the Medical Expenditure Panel Survey, U.S. Census Bureau, Kaiser Family Foundation, Medical Statistical Information System, and Current Population Survey. We used a two-part regression model to estimate annual medical costs of asthma and a negative binomial model to estimate annual school and work days missed due to asthma. Per capita medical costs of asthma ranged from $1,860 (Mississippi) to $2,514 (Michigan). Total medical costs of asthma ranged from $60.7 million (Wyoming) to $3.4 billion (California). Medicaid costs ranged from $4.1 million (Wyoming) to $566.8 million (California), Medicare from $5.9 million (DC) to $446.6 million (California), and costs paid by private insurers ranged from $27.2 million (DC) to $1.4 billion (California). Total annual school and work days lost due to asthma ranged from 22.4 thousand (Wyoming) to 1.5 million days (California) and absenteeism costs ranged from $4.4 million (Wyoming) to $345 million (California). Projected increase in medical costs from 2015 to 2020 ranged from 9% (DC) to 34% (Arizona). Medical and absenteeism costs of asthma represent a significant economic burden for states and these costs are expected to rise. Our study results emphasize the urgency for strategies to strengthen state level efforts to prevent and control asthma attacks.

  18. United States advanced technologies

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1985-01-01

    In the United States, the advanced technologies have been applied to uranium enrichment as a means by which it can be assured that nuclear fuel cost will remain competitive in the future. The United States is strongly committed to the development of advanced enrichment technology, and has brought both advanced gas centrifuge (AGC) and atomic vapor laser isotope separation (AVLIS) programs to a point of significant technical refinement. The ability to deploy advanced technologies is the basis for the confidence in competitive future price. Unfortunately, the development of advanced technologies is capital intensive. The year 1985 is the key year for advanced technology development in the United States, since the decision on the primary enrichment technology for the future, AGC or AVLIS, will be made shortly. The background on the technology selection process, the highlights of AGC and AVLIS programs and the way to proceed after the process selection are described. The key objective is to maximize the sales volume and minimize the operating cost. This will help the utilities in other countries supply low cost energy on a reliable, long term basis. (Kako, I.)

  19. Synthesis on construction unit cost development : technical report.

    Science.gov (United States)

    2009-01-01

    Availability of historical unit cost data is an important factor in developing accurate project cost estimates. : State highway agencies (SHAs) collect data on historical bids and/or production rates, crew sizes and mixes, : material costs, and equip...

  20. Feasibility Study and Cost Benefit Analysis of Thin-Client Computer System Implementation Onboard United States Navy Ships

    National Research Council Canada - National Science Library

    Arbulu, Timothy D; Vosberg, Brian J

    2007-01-01

    The purpose of this MBA project was to conduct a feasibility study and a cost benefit analysis of using thin-client computer systems instead of traditional networks onboard United States Navy ships...

  1. Benefit/cost analysis of plutonium recycle options in the United States of America

    International Nuclear Information System (INIS)

    Lowenberg, H.; Burnham, J.B.; Fisher, F.D.; Ray, W.H.

    1977-01-01

    Beginning in 1973, the USAEC started the analysis of the benefit/cost balance of Pu recycling in light-water reactors and the US Nuclear Regulatory Commission has continued this effort to the present time. A study of the United States nuclear industry from 1975 until 2000 was summarized in a final environmental statement called GESMO - Generic Environmental Statement on Mixed Oxide, NUREG-0002. Cumulative environmental and economic effects for several industry growth patterns were determined. Five alternatives were evaluated, covering the basic options of recycling uranium and plutonium; recycling uranium; and no recycling. The NRC findings, excluding consideration of proliferation and safeguards questions, are: the safety of reactors and fuel-cycle facilities are not significantly affected by recycle; excluding consideration of radiological effects, the environmental effects of recycle are slightly less than those from a non-recycle system; plutonium recycling extends uranium resources and reduces environmental impacts at the same time requiring reprocessing and Pu-handling facilities; despite uncertainties, recycling has probable economic advantages over other fuel concepts; differences in health effects attributable to recycling provide no basis for selecting a particular fuel-cycle option; no waste-management considerations appear that could be a basis for the selection of any particular option. The NRC studies on health, safety and environmental considerations of Pu recycling in the United States of America show that the differences in benefits/costs between the alternative fuel cycles are small and hence do not provide a clear basis for a decision on Pu recycle at this time. Safeguards and international proliferation implications appear to be the controlling factors in reaching a decision. President Carter's statement indefinitely deferring reprocessing and Pu recycle in the United States of America has resulted in a re-evaluation by NRC of its programme to

  2. A Cost-Benefit Analysis of Low-Dose Aspirin Prophylaxis for the Prevention of Preeclampsia in the United States.

    Science.gov (United States)

    Werner, Erika F; Hauspurg, Alisse K; Rouse, Dwight J

    2015-12-01

    To develop a decision model to evaluate the risks, benefits, and costs of different approaches to aspirin prophylaxis for the approximately 4 million pregnant women in the United States annually. We created a decision model to evaluate four approaches to aspirin prophylaxis in the United States: no prophylaxis, prophylaxis per American College of Obstetricians and Gynecologists (the College) recommendations, prophylaxis per U.S. Preventive Services Task Force recommendations, and universal prophylaxis. We included the costs associated with aspirin, preeclampsia, preterm birth, and potential aspirin-associated adverse effects. TreeAge Pro 2011 was used to perform the analysis. The estimated rate of preeclampsia would be 4.18% without prophylaxis compared with 4.17% with the College approach in which 0.35% (n=14,000) of women receive aspirin, 3.83% with the U.S. Preventive Services Task Force approach in which 23.5% (n=940,800) receive aspirin, and 3.81% with universal prophylaxis. Compared with no prophylaxis, the U.S. Preventive Services Task Force approach would save $377.4 million in direct medical care costs annually, and universal prophylaxis would save $365 million assuming 4 million births each year. The U.S. Preventive Services Task Force approach is the most cost-beneficial in 79% of probabilistic simulations. Assuming a willingness to pay of $100,000 per neonatal quality-adjusted life-year gained, the universal approach is the most cost-effective in more than 99% of simulations. Both the U.S. Preventive Services Task Force approach and universal prophylaxis would reduce morbidity, save lives, and lower health care costs in the United States to a much greater degree than the approach currently recommended by the College.

  3. The cost of karst subsidence and sinkhole collapse in the United States compared with other natural hazards

    Science.gov (United States)

    Weary, David J.

    2015-01-01

    Rocks with potential for karst formation are found in all 50 states. Damage due to karst subsidence and sinkhole collapse is a natural hazard of national scope. Repair of damage to buildings, highways, and other infrastructure represents a significant national cost. Sparse and incomplete data show that the average cost of karst-related damages in the United States over the last 15 years is estimated to be at least $300,000,000 per year and the actual total is probably much higher. This estimate is lower than the estimated annual costs for other natural hazards; flooding, hurricanes and cyclonic storms, tornadoes, landslides, earthquakes, or wildfires, all of which average over $1 billion per year. Very few state organizations track karst subsidence and sinkhole damage mitigation costs; none occurs at the Federal level. Many states discuss the karst hazard in their State hazard mitigation plans, but seldom include detailed reports of subsidence incidents or their mitigation costs. Most State highway departments do not differentiate karst subsidence or sinkhole collapse from other road repair costs. Amassing of these data would raise the estimated annual cost considerably. Information from insurance organizations about sinkhole damage claims and payouts is also not readily available. Currently there is no agency with a mandate for developing such data. If a more realistic estimate could be made, it would illuminate the national scope of this hazard and make comparison with costs of other natural hazards more realistic.

  4. Tracking the Sun IV: An Historical Summary of the Installed Cost of Photovoltaics in the United States from 1998 to 2010

    Energy Technology Data Exchange (ETDEWEB)

    Darghouth, Naim; Wiser, Ryan

    2011-09-07

    The present report describes installed cost trends for grid-connected PV projects installed from 1998 through 2010 (with some limited and preliminary results presented for projects installed in the first six months of 2011). The analysis is based on project-level cost data from approximately 116,500 residential, non-residential, and utility-sector PV systems in the United States. The inclusion of utility-sector PV is a new element in this year’s report. The combined capacity of all systems in the data sample totals 1,685 MW, equal to 79% of all grid-connected PV capacity installed in the United States through 2010 and representing one of the most comprehensive sources of installed PV cost data for the U.S. Based on this dataset, the report describes historical installed cost trends over time, and by location, market segment, technology type, and component. The report also briefly compares recent PV installed costs in the United States to those in Germany and Japan, and describes trends in customer incentives for PV installations and net installed costs after receipt of such incentives. The analysis presented here focuses on descriptive trends in the underlying data, serving primarily to summarize the data in tabular and graphical form.

  5. Unit labour costs, productivity and international competitiveness

    NARCIS (Netherlands)

    Ark, Bart van; Stuivenwold, Edwin; Ypma, Gerard

    2005-01-01

    This paper provides international comparisons of relative levels of unit labour costs (ULC) for several OECD countries relative to the United States. The estimates are based on the Total Economy Database and the 60-Industry Database of the Groningen Growth and Development Centre (GGDC), and are also

  6. The cost-effectiveness of male HPV vaccination in the United States.

    Science.gov (United States)

    Chesson, Harrell W; Ekwueme, Donatus U; Saraiya, Mona; Dunne, Eileen F; Markowitz, Lauri E

    2011-10-26

    The objective of this study was to estimate the cost-effectiveness of adding human papillomavirus (HPV) vaccination of 12-year-old males to a female-only vaccination program for ages 12-26 years in the United States. We used a simplified model of HPV transmission to estimate the reduction in the health and economic burden of HPV-associated diseases in males and females as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes were based on the literature. The HPV-associated outcomes included were: cervical intraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrent respiratory papillomatosis (RRP); and cervical, vaginal, vulvar, anal, oropharyngeal, and penile cancers. The cost-effectiveness of male vaccination depended on vaccine coverage of females. When including all HPV-associated outcomes in the analysis, the incremental cost per quality-adjusted life year (QALY) gained by adding male vaccination to a female-only vaccination program was $23,600 in the lower female coverage scenario (20% coverage at age 12 years) and $184,300 in the higher female coverage scenario (75% coverage at age 12 years). The cost-effectiveness of male vaccination appeared less favorable when compared to a strategy of increased female vaccination coverage. For example, we found that increasing coverage of 12-year-old girls would be more cost-effective than adding male vaccination even if the increased female vaccination strategy incurred program costs of $350 per additional girl vaccinated. HPV vaccination of 12-year-old males might potentially be cost-effective, particularly if female HPV vaccination coverage is low and if all potential health benefits of HPV vaccination are included in the analysis. However, increasing female coverage could be a more efficient strategy than male vaccination for reducing the overall health burden of HPV in the population. Published by Elsevier Ltd.

  7. Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

    Science.gov (United States)

    Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

    2014-11-13

    The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-01

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

  9. Structural interventions to prevent HIV/sexually transmitted disease: are they cost-effective for women in the southern United States?

    Science.gov (United States)

    Cohen, Deborah A; Wu, Shin-Yi; Farley, Thomas A

    2006-07-01

    Structural interventions are theoretically promising for populations with a low prevalence of HIV, because they can reach large numbers of people to influence their social norms and collective risky behaviors for a relatively low cost per person. Because HIV transmission is continuing to increase among women in the southern United States, interventions to stem this epidemic are particularly warranted. This study explores whether structural interventions may be a cost-effective way to prevent HIV in this population. We used the cost-effectiveness estimator, "Maximizing the Benefit" to determine the relative cost-effectiveness of 6 structural HIV prevention interventions. "Maximizing the Benefit" is a spreadsheet tool using mathematical models to estimate the cost per HIV infection prevented taking into account the epidemiologic contexts, behavioral change as a result of an intervention, and the costs of intervention. We applied estimates of HIV prevalence related to blacks in the southern United States. All the structural interventions were cost-effective compared with average lifetime treatment costs of HIV, but mass media, condom availability, and alcohol taxes theoretically prevented the largest numbers of HIV infections. Although the assumptions used in cost-effectiveness estimates have many limitations, they do allow for a relative comparison of different interventions and help to inform policy decisions related to the allocation of HIV prevention resources. Structural interventions hold the greatest promise in reducing HIV transmission among low-prevalence populations.

  10. 45 CFR 212.7 - Repayment to the United States.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Repayment to the United States. 212.7 Section 212... UNITED STATES CITIZENS RETURNED FROM FOREIGN COUNTRIES § 212.7 Repayment to the United States. (a) An..., any or all of the cost of such assistance to the United States, except insofar as it is determined...

  11. Economic benefits, external costs and the regulation of unconventional gas in the United States

    International Nuclear Information System (INIS)

    Cronshaw, Ian; Grafton, R. Quentin

    2016-01-01

    We review the economic benefits and external costs of unconventional gas production (UCG) in the United States from a policy perspective. Based on an overview of state regulation in Pennsylvania, a state that has witnessed very rapid growth of gas production over the past 5 years, and global experiences we present 10 key principles that are proposed to reduce the risks and to increase the net rewards of UCG. Application of these principles has the potential to reduce the risks of UCG, especially at a local level, while maximizing the benefits of gas developments. - Highlights: • SWOT summary of unconventional gas developments. • Risks and returns of unconventional gas highlighted. • 10 principles given to reduce risks and increase rewards of gas extraction.

  12. Energy Savings and Breakeven Costs for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, Jeff [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burch, Jay [National Renewable Energy Lab. (NREL), Golden, CO (United States); Merrigan, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ong, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-07-01

    Heat pump water heaters (HPWHs) have recently re-emerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, NREL performed simulations of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern United States. When replacing an electric water heater, the HPWH is likely to break even in California, the southern United States, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  13. 76 FR 38700 - United States, et al.

    Science.gov (United States)

    2011-07-01

    ... prices in advertisements, in-store displays, and online. Consumer World believes these rules should be... has ruled on that motion. I. Procedural History The United States and seven Plaintiff States filed the... Restraints result in higher merchant costs, and merchants generally pass costs on to consumers, retail prices...

  14. Replacement energy costs for nuclear electricity-generating units in the United States: 1997--2001. Volume 4

    International Nuclear Information System (INIS)

    VanKuiken, J.C.; Guziel, K.A.; Tompkins, M.M.; Buehring, W.A.

    1997-09-01

    This report updates previous estimates of replacement energy costs for potential short-term shutdowns of 109 US nuclear electricity-generating units. This information was developed to assist the US Nuclear Regulatory Commission (NRC) in its regulatory impact analyses, specifically those that examine the impacts of proposed regulations requiring retrofitting of or safety modifications to nuclear reactors. Such actions might necessitate shutdowns of nuclear power plants while these changes are being implemented. The change in energy cost represents one factor that the NRC must consider when deciding to require a particular modification. Cost estimates were derived from probabilistic production cost simulations of pooled utility system operations. Factors affecting replacement energy costs, such as random unit failures, maintenance and refueling requirements, and load variations, are treated in the analysis. This report describes an abbreviated analytical approach as it was adopted to update the cost estimates published in NUREG/CR-4012, Vol. 3. The updates were made to extend the time frame of cost estimates and to account for recent changes in utility system conditions, such as change in fuel prices, construction and retirement schedules, and system demand projects

  15. Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.

    Science.gov (United States)

    Chen, Han-Yang; Chauhan, Suneet P; Blackwell, Sean C

    2018-05-03

     The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.  Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.  The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Unit Cost Compendium Calculations

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Unit Cost Compendium (UCC) Calculations raw data set was designed to provide for greater accuracy and consistency in the use of unit costs across the USEPA...

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

    Directory of Open Access Journals (Sweden)

    Dominique M. Bain

    2018-02-01

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

  18. Benefit/cost analysis of plutonium recycle options in the United States

    International Nuclear Information System (INIS)

    Lowenberg, H.; Burnham, J.B.; Fisher, F.; Ray, W.H.

    1977-01-01

    Predictable effects of the recycle of plutonium and uranium recovered from spent LWR fuels were assessed in a final environmental statement (GESMO). Five alternative dispositions of LWR-produced plutonium ranging from prompt recycle of recovered plutonium and uranium to no recovery and no recycle are compared. The assessments consider cumulative effects for the period 1975 through 2000, and are centered on a conservative low growth rate resulting in about 500 LWR's in the U.S. in 2000. A more optimistic growth projection resulting in about 800 LWR's in 2000 is also analyzed in order to assess the effects of industry size upon the impacts. Demands for fuel cycle services were calculated with an ERDA program, NUFUEL, which was modified to include penalties for 236 U and 242 Pu. Unit cost data, including a simulation of market place reaction to supply-demand functions for uranium costs, were combined with the NUFUEL demand data in an economics code, NUCOST. Environmental impacts were also based upon NUFUEL demand data and were developed using a model plant industry concept. Using the most likely unit costs with a 10% discount rate, present worth incentives for prompt recycle over no recycle of $3.2 billion for the lower growth and about $6 billion for the higher growth were indicated. Present worth costs of delays in recycle of up to 5 years were less than $1 billion. Sensitivity of the economic assessments to unit cost variations and discount rates were also evaluated. Environmental impacts other than radiological were lowest for prompt Pu recycle and highest for no recycle. Radiological impacts for the total world wide total body exposure from U.S. industry for the 26 year period were estimated to be: - No recycle-8.2 million person-rem; U only recycle-9.5 million person-rem; Pu and U recycle-8.8 million person-rem. Comparison of the decreased radiological impact of the no recycle option with its increased costs relative to prompt plutonium recycle resulted in a

  19. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis.

    Science.gov (United States)

    Bartick, Melissa; Reinhold, Arnold

    2010-05-01

    A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality. Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars. If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.

  20. Cost of wind energy: comparing distant wind resources to local resources in the midwestern United States.

    Science.gov (United States)

    Hoppock, David C; Patiño-Echeverri, Dalia

    2010-11-15

    The best wind sites in the United States are often located far from electricity demand centers and lack transmission access. Local sites that have lower quality wind resources but do not require as much power transmission capacity are an alternative to distant wind resources. In this paper, we explore the trade-offs between developing new wind generation at local sites and installing wind farms at remote sites. We first examine the general relationship between the high capital costs required for local wind development and the relatively lower capital costs required to install a wind farm capable of generating the same electrical output at a remote site,with the results representing the maximum amount an investor should be willing to pay for transmission access. We suggest that this analysis can be used as a first step in comparing potential wind resources to meet a state renewable portfolio standard (RPS). To illustrate, we compare the cost of local wind (∼50 km from the load) to the cost of distant wind requiring new transmission (∼550-750 km from the load) to meet the Illinois RPS. We find that local, lower capacity factor wind sites are the lowest cost option for meeting the Illinois RPS if new long distance transmission is required to access distant, higher capacity factor wind resources. If higher capacity wind sites can be connected to the existing grid at minimal cost, in many cases they will have lower costs.

  1. State-Level Estimates of Cancer-Related Absenteeism Costs

    Science.gov (United States)

    Tangka, Florence K.; Trogdon, Justin G.; Nwaise, Isaac; Ekwueme, Donatus U.; Guy, Gery P.; Orenstein, Diane

    2016-01-01

    Background Cancer is one of the top five most costly diseases in the United States and leads to substantial work loss. Nevertheless, limited state-level estimates of cancer absenteeism costs have been published. Methods In analyses of data from the 2004–2008 Medical Expenditure Panel Survey, the 2004 National Nursing Home Survey, the U.S. Census Bureau for 2008, and the 2009 Current Population Survey, we used regression modeling to estimate annual state-level absenteeism costs attributable to cancer from 2004 to 2008. Results We estimated that the state-level median number of days of absenteeism per year among employed cancer patients was 6.1 days and that annual state-level cancer absenteeism costs ranged from $14.9 million to $915.9 million (median = $115.9 million) across states in 2010 dollars. Absenteeism costs are approximately 6.5% of the costs of premature cancer mortality. Conclusions The results from this study suggest that lost productivity attributable to cancer is a substantial cost to employees and employers and contributes to estimates of the overall impact of cancer in a state population. PMID:23969498

  2. A cross-sectional study of emergency care utilization and associated costs of violent-related (assault) injuries in the United States.

    Science.gov (United States)

    Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K

    2017-11-01

    Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.

  3. Enhancing Groundwater Cost Estimation with the Interpolation of Water Tables across the United States

    Science.gov (United States)

    Rosli, A. U. M.; Lall, U.; Josset, L.; Rising, J. A.; Russo, T. A.; Eisenhart, T.

    2017-12-01

    Analyzing the trends in water use and supply across the United States is fundamental to efforts in ensuring water sustainability. As part of this, estimating the costs of producing or obtaining water (water extraction) and the correlation with water use is an important aspect in understanding the underlying trends. This study estimates groundwater costs by interpolating the depth to water level across the US in each county. We use Ordinary and Universal Kriging, accounting for the differences between aquifers. Kriging generates a best linear unbiased estimate at each location and has been widely used to map ground-water surfaces (Alley, 1993).The spatial covariates included in the universal Kriging were land-surface elevation as well as aquifer information. The average water table is computed for each county using block kriging to obtain a national map of groundwater cost, which we compare with survey estimates of depth to the water table performed by the USDA. Groundwater extraction costs were then assumed to be proportional to water table depth. Beyond estimating the water cost, the approach can provide an indication of groundwater-stress by exploring the historical evolution of depth to the water table using time series information between 1960 and 2015. Despite data limitations, we hope to enable a more compelling and meaningful national-level analysis through the quantification of cost and stress for more economically efficient water management.

  4. Decommissioning cost recovery in the United States: lessons learned from Connecticut Yankee NPP

    International Nuclear Information System (INIS)

    Joosten, J.

    1999-01-01

    The international audience at ICONE-7 is already familiar with the roles of the owner and the NRC in ensuring the technical and safety performance goals of nuclear plant decommissioning. This paper addresses the role of the economic regulator since the pursuit of technical and safety goals must necessarily carry with them -a price tag- and owners must be concerned with the recovery of those costs. Answers to questions about how to pay and who should pay for decommissioning can very often influence nuclear power plant owner's decision-making. In the United States, most nuclear power plants are privately owned. Nevertheless, their owners are not totally free to determine the plant's economics or profitability. Instead, plant owners must sell their electricity to consumers in a regulated market wherein the price of electricity and terms of sale are controlled by the government. Under this regulatory regime, utilities are generally allowed to recover their investment costs -including decommissioning costs- provided that such costs are prudently, incurred. However, when an owner retires the plant prematurely, the prudence of his actions -up to and including the shutdown- are likely to be challenged. In 1997, for example, the owners of the Connecticut Yankee reactor faced a stiff challenge to the recovery of decommissioning costs when they shut down the plant ten years before license expiration. The Connecticut Yankee case thus provides valuable insights into the role of economic regulation on a nuclear plant's decommissioning strategy. (author)

  5. Utility-Scale Solar 2014. An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-09-01

    Other than the nine Solar Energy Generation Systems (“SEGS”) parabolic trough projects built in the 1980s, virtually no large-scale or “utility-scale” solar projects – defined here to include any groundmounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar thermal power (“CSP”) project larger than 5 MWAC – existed in the United States prior to 2007. By 2012 – just five years later – utility-scale had become the largest sector of the overall PV market in the United States, a distinction that was repeated in both 2013 and 2014 and that is expected to continue for at least the next few years. Over this same short period, CSP also experienced a bit of a renaissance in the United States, with a number of large new parabolic trough and power tower systems – some including thermal storage – achieving commercial operation. With this critical mass of new utility-scale projects now online and in some cases having operated for a number of years (generating not only electricity, but also empirical data that can be mined), the rapidly growing utility-scale sector is ripe for analysis. This report, the third edition in an ongoing annual series, meets this need through in-depth, annually updated, data-driven analysis of not just installed project costs or prices – i.e., the traditional realm of solar economics analyses – but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects in the United States. Given its current dominance in the market, utility-scale PV also dominates much of this report, though data from CPV and CSP projects are presented where appropriate.

  6. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States.

    Science.gov (United States)

    Chhatwal, Jagpreet; Kanwal, Fasiha; Roberts, Mark S; Dunn, Michael A

    2015-03-17

    Sofosbuvir and ledipasvir, which have recently been approved for treatment of chronic hepatitis C virus (HCV) infection, are more efficacious and safer than the old standard of care (oSOC) but are substantially more expensive. Whether and in which patients their improved efficacy justifies their increased cost is unclear. To evaluate the cost-effectiveness and budget impact of sofosbuvir and ledipasvir. Microsimulation model of the natural history of HCV infection. Published literature. Treatment-naive and treatment-experienced HCV population defined on the basis of HCV genotype, age, and fibrosis distribution in the United States. Lifetime. Third-party payer. Simulation of sofosbuvir-ledipasvir compared with the oSOC (interferon-based therapies). Quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and 5-year spending on antiviral drugs. Sofosbuvir-based therapies added 0.56 QALY relative to the oSOC at an ICER of $55 400 per additional QALY. The ICERs ranged from $9700 to $284 300 per QALY depending on the patient's status with respect to treatment history, HCV genotype, and presence of cirrhosis. At a willingness-to-pay threshold of $100 000 per QALY, sofosbuvir-based therapies were cost-effective in 83% of treatment-naive and 81% of treatment-experienced patients. Compared with the oSOC, treating eligible HCV-infected persons in the United States with the new drugs would cost an additional $65 billion in the next 5 years, whereas the resulting cost offsets would be $16 billion. Results were sensitive to drug price, drug efficacy, and quality of life after successful treatment. Data on real-world effectiveness of new antivirals are lacking. Treatment of HCV is cost-effective in most patients, but additional resources and value-based patient prioritization are needed to manage patients with HCV. National Institutes of Health.

  7. 31 CFR 515.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

  8. 31 CFR 500.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 500.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including U.S. trust territories...

  9. 31 CFR 535.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

  10. Cost estimating for CERCLA remedial alternatives a unit cost methodology

    International Nuclear Information System (INIS)

    Brettin, R.W.; Carr, D.J.; Janke, R.J.

    1995-06-01

    The United States Environmental Protection Agency (EPA) Guidance for Conducting Remedial Investigations and Feasibility Studies Under CERCLA, Interim Final, dated October 1988 (EPA 1988) requires a detailed analysis be conducted of the most promising remedial alternatives against several evaluation criteria, including cost. To complete the detailed analysis, order-of-magnitude cost estimates (having an accuracy of +50 percent to -30 percent) must be developed for each remedial alternative. This paper presents a methodology for developing cost estimates of remedial alternatives comprised of various technology and process options with a wide range of estimated contaminated media quantities. In addition, the cost estimating methodology provides flexibility for incorporating revisions to remedial alternatives and achieves the desired range of accuracy. It is important to note that the cost estimating methodology presented here was developed as a concurrent path to the development of contaminated media quantity estimates. This methodology can be initiated before contaminated media quantities are estimated. As a result, this methodology is useful in developing cost estimates for use in screening and evaluating remedial technologies and process options. However, remedial alternative cost estimates cannot be prepared without the contaminated media quantity estimates. In the conduct of the feasibility study for Operable Unit 5 at the Fernald Environmental Management Project (FEMP), fourteen remedial alternatives were retained for detailed analysis. Each remedial alternative was composed of combinations of remedial technologies and processes which were earlier determined to be best suited for addressing the media-specific contaminants found at the FEMP site, and achieving desired remedial action objectives

  11. Internalizing social costs in power plant siting: some examples for coal and nuclear plants in the United States

    International Nuclear Information System (INIS)

    Peelle, E.

    1976-01-01

    Selected aspects of the United States experience in one particular type of energy development project, the siting of nuclear and fossil fueled power generating facilities, are examined in terms of how well community-level impacts are internalized. New institutional arrangements being devised and new requirements being made at local, state, regional, and federal levels in response to these dissociations of cost and benefits from large energy development projects are discussed. Selected examples of these new institutional responses are analyzed for adequacy and significance

  12. Expanding the usefulness of unit supply cost

    International Nuclear Information System (INIS)

    McKenzie, M.B.; Petr, K.

    1992-01-01

    Unit supply cost is a widely used tool in the energy business for providing a one number-unit cost description. For example, controllable costs such as finding costs, development costs and operating costs have traditionally been described in an average cost per unit of reserves format for the oil and gas industry, however using this approach on more specific applications is not always informative. Projects with widely varying controllable parameters can still yield the same unit cost, making comparisons difficult. The application of unit supply cost can be readily expanded by adding a new unit cost component termed cost of capital. This element introduces the impacts of timing and return on investment into the supply cost determination through discounting annual costs. The cost of capital component adds the ability to represent a project's unique characteristics, particularly reserves' depletion rate and the timing or phasing of development. Introducing the cost of capital element into the supply cost analysis provides additional information and improves the likelihood of drawing correct conclusions when comparing and ranking projects. 4 figs., 6 tabs

  13. Reforming Cardiovascular Care in the United States towards High-Quality Care at Lower Cost with Examples from Model Programs in the State of Michigan.

    Science.gov (United States)

    Alyeshmerni, Daniel; Froehlich, James B; Lewin, Jack; Eagle, Kim A

    2014-07-01

    Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA), and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act.

  14. Reforming Cardiovascular Care in the United States towards High-Quality Care at Lower Cost with Examples from Model Programs in the State of Michigan

    Directory of Open Access Journals (Sweden)

    Daniel Alyeshmerni

    2014-07-01

    Full Text Available Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA, and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act.

  15. Comparative costs of coal and nuclear-generated electricity in the united states

    International Nuclear Information System (INIS)

    Brandfon, W.W.

    1987-01-01

    This paper compares the future first-year operating costs and lifetime levelized costs of producing baseload coal- and nuclear-generated electricity under schedules shorter than those recently experienced at U.S. plants. Nuclear appears to have a clear economic advantage. Coal is favorable only when it is assumed that the units will operate at very low capacity factors and/or when the capital cost differential between nuclear and coal is increased far above the recent historical level. Nuclear is therefore a cost-competitive electric energy option for utilities and should be considered as an alternative to coal when large baseload capacity is required. (author)

  16. Rapanos v. United States & Carabell v. United States

    Science.gov (United States)

    Documents associated with guidance for implementing the definition of waters of the United States under the Clean Water Act following the Rapanos v. United States, and Carabell v. United States Supreme Court decision.

  17. Cancer insurance policies in Japan and the United States.

    Science.gov (United States)

    Bennett, C L; Weinberg, P D; Lieberman, J J

    1998-01-01

    Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

  18. Cost of managing an episode of relapse in multiple sclerosis in the United States

    Directory of Open Access Journals (Sweden)

    Ward Alexandra J

    2003-09-01

    Full Text Available Abstract Background The purpose of this study was to determine the direct medical US cost of managing multiple sclerosis relapses. Methods Direct data analysis and cost modeling were employed to derive typical resource use profiles and costs in 2002 US dollars, from the perspective of a third-party payer responsible for comprehensive health-care. The location and scope of health care services provided over a 90-day period were used to define three levels of relapse management. Hospitalization and resulting subsequent care was defined as high intensity management. A medium level of intervention was defined as either use of the emergency room, an observational unit, or administration of acute treatments, such as intravenous methylprednisolone in an outpatient or home setting. The lowest intensity of care comprised physician office visits and symptom-related medications. Data were obtained from many sources including all payer inpatient, ambulatory and emergency room databases from several states, fee schedules, government reports, and literature. All charges were adjusted using cost-to-charge ratios. Results Average cost per person for high management level was $12,870, based on analysis of 4,634 hospital cases (mean age 48 years, 73% female. Hospital care comprised 71% of that cost. At discharge, 36% required inpatient sub-acute care, rehabilitation or home care. The typical cost per moderate episode was $1,847 and mild episode $243. Conclusions Management strategies leading to a reduction in the frequency and severity of a relapse, less reliance on inpatient care, or increased access to steroid infusions in the home, would have a substantial impact on the economic consequences of managing relapses.

  19. Taxation of United States general aviation

    Science.gov (United States)

    Sobieralski, Joseph Bernard

    General aviation in the United States has been an important part of the economy and American life. General aviation is defined as all flying excluding military and scheduled airline operations, and is utilized in many areas of our society. The majority of aircraft operations and airports in the United States are categorized as general aviation, and general aviation contributes more than one percent to the United States gross domestic product each year. Despite the many benefits of general aviation, the lead emissions from aviation gasoline consumption are of great concern. General aviation emits over half the lead emissions in the United States or over 630 tons in 2005. The other significant negative externality attributed to general aviation usage is aircraft accidents. General aviation accidents have caused over 8000 fatalities over the period 1994-2006. A recent Federal Aviation Administration proposed increase in the aviation gasoline tax from 19.4 to 70.1 cents per gallon has renewed interest in better understanding the implications of such a tax increase as well as the possible optimal rate of taxation. Few studies have examined aviation fuel elasticities and all have failed to study general aviation fuel elasticities. Chapter one fills that gap and examines the elasticity of aviation gasoline consumption in United States general aviation. Utilizing aggregate time series and dynamic panel data, the price and income elasticities of demand are estimated. The price elasticity of demand for aviation gasoline is estimated to range from -0.093 to -0.185 in the short-run and from -0.132 to -0.303 in the long-run. These results prove to be similar in magnitude to automobile gasoline elasticities and therefore tax policies could more closely mirror those of automobile tax policies. The second chapter examines the costs associated with general aviation accidents. Given the large number of general aviation operations as well as the large number of fatalities and

  20. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, Jason S. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Grace, Robert C. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Rickerson, Wilson H. [Meister Consultants Group, Inc., Boston, MA (United States)

    2011-05-01

    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  1. Decommissioning Unit Cost Data

    International Nuclear Information System (INIS)

    Sanford, P. C.; Stevens, J. L.; Brandt, R.

    2002-01-01

    The Rocky Flats Closure Site (Site) is in the process of stabilizing residual nuclear materials, decommissioning nuclear facilities, and remediating environmental media. A number of contaminated facilities have been decommissioned, including one building, Building 779, that contained gloveboxes used for plutonium process development but did little actual plutonium processing. The actual costs incurred to decommission this facility formed much of the basis or standards used to estimate the decommissioning of the remaining plutonium-processing buildings. Recent decommissioning activities in the first actual production facility, Building 771, implemented a number of process and procedural improvements. These include methods for handling plutonium contaminated equipment, including size reduction, decontamination, and waste packaging, as well as management improvements to streamline planning and work control. These improvements resulted in a safer working environment and reduced project cost, as demonstrated in the overall project efficiency. The topic of this paper is the analysis of how this improved efficiency is reflected in recent unit costs for activities specific to the decommissioning of plutonium facilities. This analysis will allow the Site to quantify the impacts on future Rocky Flats decommissioning activities, and to develop data for planning and cost estimating the decommissioning of future facilities. The paper discusses the methods used to collect and arrange the project data from the individual work areas within Building 771. Regression and data correlation techniques were used to quantify values for different types of decommissioning activities. The discussion includes the approach to identify and allocate overall project support, waste management, and Site support costs based on the overall Site and project costs to provide a ''burdened'' unit cost. The paper ultimately provides a unit cost basis that can be used to support cost estimates for

  2. PV Project Finance in the United States, 2016

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, David; Lowder, Travis; Schwabe, Paul

    2016-09-01

    This brief is a compilation of data points and market insights that reflect the state of the project finance market for solar photovoltaic (PV) assets in the United States as of the third quarter of 2016. This information can generally be used as a simplified benchmark of the costs associated with securing financing for solar PV as well as the cost of the financing itself (i.e., the cost of capital). Three sources of capital are considered -- tax equity, sponsor equity, and debt -- across three segments of the PV marketplace.

  3. New York State interim waste management cost evaluation

    International Nuclear Information System (INIS)

    Ma, M.S.; Watts, R.J.; Jorgensen, J.R.; Rochester Gas and Electric Corp., NY)

    1985-01-01

    The purpose of this study is to investigate and quantify the comparative costs associated with including or excluding Class A utility wastes at a centralized interim waste management facility in New York State. The objective of the study is to assess the unit costs and total statewide costs associated with two distinct scenarios: (1) the case where non-utility Class A LLRW is received, incinerated and stored at the centralized interim facility, and utility Class A wastes are held without incineration at respective nuclear power plant interim onsite facilities without incineration; and (2) the alternative case where both utility and non-utility Class A wastes are accepted, incinerated and stored at the centralized facility. Unit costs to waste generators are estimated for each of the two cases described. This is followed by an estimation of the statewide cost impact to the public. The cost impact represents the cost differential resulting from the exclusion of utility Class A waste from the centralized NYS interim waste management facility. The principal factors comprising the cost differential include (1) higher unit disposal fees charged to non-utility waste generators, which are passed along in the costs of products and services; and (2) costs to utilities due to construction of additional onsite storage capacity, which in turn are charged to electric rate payers

  4. Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

    Science.gov (United States)

    Korbel, Lindsey; Spencer, John David

    2015-03-01

    The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Fusion reactor design studies: standard unit costs and cost scaling rules

    International Nuclear Information System (INIS)

    Schulte, S.C.; Bickford, W.E.; Willingham, C.E.; Ghose, S.K.; Walker, M.G.

    1979-09-01

    This report establishes standard unit costs and scaling rules for estimating costs of material, equipment, land, and labor components used in magnetic confinement fusion reactor plant construction and operation. Use of the standard unit costs and scaling rules will add uniformity to cost estimates, and thus allow valid comparison of the economic characteristics of various reactor concepts

  6. The Cost of Distribution System Upgrades to Accommodate Increasing Penetrations of Distributed Photovoltaic Systems on Real Feeders in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Ding, Fei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mather, Barry A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Palmintier, Bryan S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-05

    The increasing deployment of distributed photovoltaic systems (DPV) can impact operations at the distribution level and the transmission level of the electric grid. It is important to develop and implement forward-looking approaches for calculating distribution upgrade costs that can be used to inform system planning, market and tariff design, cost allocation, and other policymaking as penetration levels of DPV increase. Using a bottom-up approach that involves iterative hosting capacity analysis, this report calculates distribution upgrade costs as a function of DPV penetration on three real feeders - two in California and one in the Northeastern United States.

  7. Residential, Commercial, and Utility-Scale Photovoltaic (PV) System Prices in the United States: Current Drivers and Cost-Reduction Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Goodrich, A.; James, T.; Woodhouse, M.

    2012-02-01

    The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has dropped precipitously in recent years, led by substantial reductions in global PV module prices. However, system cost reductions are not necessarily realized or realized in a timely manner by many customers. Many reasons exist for the apparent disconnects between installation costs, component prices, and system prices; most notable is the impact of fair market value considerations on system prices. To guide policy and research and development strategy decisions, it is necessary to develop a granular perspective on the factors that underlie PV system prices and to eliminate subjective pricing parameters. This report's analysis of the overnight capital costs (cash purchase) paid for PV systems attempts to establish an objective methodology that most closely approximates the book value of PV system assets.

  8. The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

    Directory of Open Access Journals (Sweden)

    Katherine E Baird

    2016-01-01

    Full Text Available Background: This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income. Method: The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries. Results: The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold. Conclusion: Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have.

  9. Cost and Operational Effectiveness Analysis of Aiternative Force Structures for Fulfillment of the United States Marine Corps Operational Support Airlift and Search and Rescue Missions

    National Research Council Canada - National Science Library

    Chase, Eric

    2000-01-01

    This thesis provides a preliminary cost and operational effectiveness analysis of alternative force structures for the United States Marine Corps operational support airlift and search and rescue missions...

  10. Commerical electric power cost studies. Capital cost addendum multi-unit coal and nuclear stations

    International Nuclear Information System (INIS)

    1977-09-01

    This report is the culmination of a study performed to develop designs and associated capital cost estimates for multi-unit nuclear and coal commercial electric power stations, and to determine the distribution of these costs among the individual units. This report addresses six different types of 2400 MWe (nominal) multi-unit stations as follows: Two Unit PWR Station-1139 MWe Each, Two Unit BWR Station-1190 MWe Each, Two Unit High Sulfur Coal-Fired Station-1232 MWe Each, Two Unit Low Sulfur Coal-Fired Station-1243 MWe Each, Three Unit High Sulfur Coal-Fired Station-794 MWe Each, Three Unit Low Sulfur Coal-Fired Station-801 MWe Each. Recent capital cost studies performed for ERDA/NRC of single unit nuclear and coal stations are used as the basis for developing the designs and costs of the multi-unit stations. This report includes the major study groundrules, a summary of single and multi-unit stations total base cost estimates, details of cost estimates at the three digit account level and plot plan drawings for each multi-unit station identified

  11. United States rejoin ITER

    International Nuclear Information System (INIS)

    Roberts, M.

    2003-01-01

    Upon pressure from the United States Congress, the US Department of Energy had to withdraw from further American participation in the ITER Engineering Design Activities after the end of its commitment to the EDA in July 1998. In the years since that time, changes have taken place in both the ITER activity and the US fusion community's position on burning plasma physics. Reflecting the interest in the United States in pursuing burning plasma physics, the DOE's Office of Science commissioned three studies as part of its examination of the option of entering the Negotiations on the Agreement on the Establishment of the International Fusion Energy Organization for the Joint Implementation of the ITER Project. These were a National Academy Review Panel Report supporting the burning plasma mission; a Fusion Energy Sciences Advisory Committee (FESAC) report confirming the role of ITER in achieving fusion power production, and The Lehman Review of the ITER project costing and project management processes (for the latter one, see ITER CTA Newsletter, no. 15, December 2002). All three studies have endorsed the US return to the ITER activities. This historical decision was announced by DOE Secretary Abraham during his remarks to employees of the Department's Princeton Plasma Physics Laboratory. The United States will be working with the other Participants in the ITER Negotiations on the Agreement and is preparing to participate in the ITA

  12. Health and cost impact of air pollution from biomass burning over the United States

    Science.gov (United States)

    Eslami, E.; Sadeghi, B.; Choi, Y.

    2017-12-01

    Effective assessment of health and cost effects of air pollution associated with wildfire events is critical for supporting sustainable management and policy analysis to reduce environmental damages. Since biomass burning events result in higher ozone, PM2.5, and NOx concentration values in urban regions due to long-range transport, preliminary results indicated that wildfire events cause a considerable increase in incident estimates and costs. This study aims to evaluate the health and cost impact of biomass burning events over the continental United States using combined air quality and health impact modeling. To meet this goal, a comprehensive air quality modeling scenarios containing biomass burning emissions were conducted using the Community Multiscale Air Quality (CMAQ) modeling system from 2011 to 2014 with a spatial resolution of 12 km. The modeling period includes fire seasons between April and October over the course of four years. By using modeled pollutants concentrations, the USEPA's GIS-based computer program Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) provides an inclusive figure of health and cost impact caused by changing gaseous and particulate air pollution due to fire events. The basis of BenMAP-CE is the use of a damage-function approach to estimate the health impact of an applied change in air quality by comparing a biomass burning scenario (the one that includes wildfire events) with a baseline scenario (without biomass emissions). This approach considers several factors containing population, exposure to the pollutants, adverse health effects of a particular pollutant, and economic costs. Hence, this study made it capable of showing how biomass burning across U.S. influences people's health in different months, seasons, and regions. Besides, the cost impact of the wildfire events during study periods has also been estimated at both national and regional levels. The results of this study demonstrate the

  13. An analysis of residential PV system price differences between the United States and Germany

    International Nuclear Information System (INIS)

    Seel, Joachim; Barbose, Galen L.; Wiser, Ryan H.

    2014-01-01

    Residential photovoltaic (PV) systems were twice as expensive in the United States as in Germany (median of $5.29/W vs. $2.59/W) in 2012. This price discrepancy stems primarily from differences in non-hardware or “soft” costs between the two countries, which can only in part be explained by differences in cumulative market size and associated learning. A survey of German PV installers was deployed to collect granular data on PV soft costs in Germany, and the results are compared to those of a similar survey of U.S. PV installers. Non-module hardware costs and all analyzed soft costs are lower in Germany, especially for customer acquisition, installation labor, and profit/overhead costs, but also for expenses related to permitting, interconnection, and inspection procedures. Additional costs occur in the United States due to state and local sales taxes, smaller average system sizes, and longer project-development times. To reduce the identified additional costs of residential PV systems, the United States could introduce policies that enable a robust and lasting market while minimizing market fragmentation. Regularly declining incentives offering a transparent and certain value proposition—combined with simple interconnection, permitting, and inspection requirements—might help accelerate PV cost reductions in the United States. - Highlights: • Residential PV system prices are twice as high in the USA than in Germany in 2012. • Different cumulative national PV market sizes explain only 35% of price gap. • Installer surveys show that price differences stem from non-module and soft costs. • Largest cost differences stem from customer acquisition and installation labor. • Incentives in the US are less effective in driving and following cost reductions

  14. Present state of electric power business in United States and Europe

    International Nuclear Information System (INIS)

    Onishi, Kenichi

    2011-01-01

    This article reported present state of nuclear power and electric power business in United States and Europe after Fukushima Daiichi Accident. As for the trend of demand and supply of electric power and policy, the accident forced Germany possibly to proceed with phase-out of nuclear power, but France and United States to sustain nuclear power with no great change of energy policy at this moment. As for the trend of electric power market, there was not state in United States with liberalized retail market of electric power after rolling blackouts occurred in California State in the early 2000s. In Germany proceeding with renewable energy introduction, renewable electricity fed into the grid was paid for by the network operators at fixed tariffs and the costs passed on to electricity consumers were increasing. Renewable Portfolio Standards (RPS) in United States forced the state to introduction of renewable energy to some ratio, and Feed-in Tariff (FIT) introduced in EU in 1990s lead to introduction of a large amount of renewable electricity targeted in 2020. Huge amount of wind power introduction brought about several problems to solve such that excess electric power above domestic demand had bad effects on grids in neighboring region. Enforcement of power transmission lines was also needed with increase of maximum electric power as well as introduction of a large amount of renewable electricity. (T. Tanaka)

  15. Cost analysis of LEED certified United States navy buildings

    OpenAIRE

    Kirar, Carl V.

    2011-01-01

    CIVINS (Civilian Institutions) Thesis document A study was completed at UW-Madison in 2010 that reviewed the energy consumption of US Navy buildings which earned Leadership in Energy and Environmental Design (LEED) certification by the United States Green Building Council (USGBC). The research compared LEED certified buildings to a commercial counterpart within the US Navy inventory against Executive Order (EO) 13423. The EO mandated that all federal agencies meet a 30 percent reduction of...

  16. Cost-effectiveness of programs to eliminate disparities in elderly vaccination rates in the United States.

    Science.gov (United States)

    Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Smith, Kenneth J

    2014-07-15

    There are disparities in influenza and pneumococcal vaccination rates among elderly minority groups and little guidance as to which intervention or combination of interventions to eliminate these disparities is likely to be most cost-effective. Here, we evaluate the cost-effectiveness of four hypothetical vaccination programs designed to eliminate disparities in elderly vaccination rates and differing in the number of interventions. We developed a Markov model in which we assumed a healthcare system perspective, 10-year vaccination program and lifetime time horizon. The cohort was the combined African-American and Hispanic 65 year-old birth cohort in the United States in 2009. We evaluated five different vaccination strategies: no vaccination program and four vaccination programs that varied from "low intensity" to "very high intensity" based on the number of interventions deployed in each program, their cumulative cost and their cumulative impact on elderly minority influenza and pneumococcal vaccination rates. The very high intensity vaccination program ($24,479/quality-adjusted life year; QALY) was preferred at willingness-to-pay-thresholds of $50,000 and $100,000/QALY and prevented 37,178 influenza cases, 342 influenza deaths, 1,158 invasive pneumococcal disease (IPD) cases and 174 IPD deaths over the birth cohort's lifetime. In one-way sensitivity analyses, the very high intensity program only became cost-prohibitive (>$100,000/QALY) at less likely values for the influenza vaccination rates achieved in year 10 of the high intensity (>73.5%) or very high intensity (eliminate disparities in elderly minority vaccination rates and including four interventions would be cost-effective.

  17. Low-cost inertial measurement unit.

    Energy Technology Data Exchange (ETDEWEB)

    Deyle, Travis Jay

    2005-03-01

    Sandia National Laboratories performs many expensive tests using inertial measurement units (IMUs)--systems that use accelerometers, gyroscopes, and other sensors to measure flight dynamics in three dimensions. For the purpose of this report, the metrics used to evaluate an IMU are cost, size, performance, resolution, upgradeability and testing. The cost of a precision IMU is very high and can cost hundreds of thousands of dollars. Thus the goals and results of this project are as follows: (1) Examine the data flow in an IMU and determine a generic IMU design. (2) Discuss a high cost IMU implementation and its theoretically achievable results. (3) Discuss design modifications that would save money for suited applications. (4) Design and implement a low cost IMU and discuss its theoretically achievable results. (5) Test the low cost IMU and compare theoretical results with empirical results. (6) Construct a more streamlined printed circuit board design reducing noise, increasing capabilities, and constructing a self-contained unit. Using these results, we can compare a high cost IMU versus a low cost IMU using the metrics from above. Further, we can examine and suggest situations where a low cost IMU could be used instead of a high cost IMU for saving cost, size, or both.

  18. Further Validation of the Psychosocial Costs of Racism to Whites Scale on a Sample of University Students in the Southeastern United States

    Science.gov (United States)

    Sifford, Amy; Ng, Kok-Mun; Wang, Chuang

    2009-01-01

    We examined the factor structure of the Psychosocial Costs of Racism to Whites Scale (PCRW; Spanierman & Heppner, 2004) on 766 White American university students from the southeastern United States. Results from confirmatory factor analyses supported the 3-factor model proposed by Spanierman and Heppner (2004). The construct validity of the…

  19. United Kingdom and United States Tourism Demand for Malaysia:A Cointegration Analysis

    OpenAIRE

    Habibi, Fateh; Abdul Rahim, Khalid; Chin, Lee

    2008-01-01

    Tourism industry has been an important contributor to the Malaysia economy. In this paper we inspect variations in the long run demand for tourism from United Kingdom and United States to Malaysia. The demand for tourism has been explained by macroeconomic variables, including income in origin countries, tourism prices in Malaysia, and travel cost between the two countries. Annual data from 1972 to 2006 are used for the analysis. Augmented Dickey-Fuller and Johansen’s maximum likelihood tests...

  20. United States experience in environmental cost-benefit analysis for nuclear power plants with implications for developing countries

    International Nuclear Information System (INIS)

    Spangler, M.B.

    1980-08-01

    Environmental cost-benefit analysis in the United States involves a comparison of diverse societal impacts of the proposed developments and its alternatives. Regarding nuclear power plant licensing actions, such analyses include the need for base-load electrical generating capacity versus the no-action alternative; alternative sources of energy; alternative sites for the proposed nuclear plants; and alternative technologies for mitigating environmental impacts. Many U.S. experiences and environmental assessment practices and comparative resource requirements presented in this report will not provide a wholly reliable reflection of the precise situation of each country. Nevertheless, the procedural and substantive issues encountered by the United States in nuclear power plant licensing may exhibit a number of important, if rough, parallelisms for other countries. Procedural issues dealt with include: the scoping of alternatives and impact issues; the problem of balancing incommensurable impacts; and treating uncertainty in measuring or forecasting certain kinds of environmental impacts. Although substantive environmental impact issues will vary appreciably among nations, it is to be expected that many of the substantive impact issues such as impacts on biota, community-related effects, and aesthetic impacts will also have some measure of universal interest to other countries

  1. Energy Savings and Breakeven Cost for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, J.; Burch, J.; Merrigan, T.; Ong, S.

    2013-07-01

    Heat pump water heaters (HPWHs) have recently reemerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, simulations were performed of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern US. When replacing an electric water heater, the HPWH is likely to break even in California, the southern US, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  2. Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States

    Directory of Open Access Journals (Sweden)

    Chandran A

    2013-04-01

    a significant proportion of total costs in all countries. Conclusion: The significant HRU and costs associated with FM in the US, France, and Germany documented in this study highlight the substantial global economic burden of FM. Indirect costs represented a significant proportion of the total costs, particularly in Europe. Comparisons between the three countries show differences in HRU, with significantly higher direct costs in the US compared with France and Germany. Keywords: fibromyalgia, cost, burden of illness, United States, France, Germany

  3. Basic Research about Calculation of the Decommissioning Unit Cost based on The KRR-2 Decommissioning Project

    Energy Technology Data Exchange (ETDEWEB)

    Song, Chan-Ho; Park, Hee-Seong; Ha, Jea-Hyun; Jin, Hyung-Gon; Park, Seung-Kook [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    The KAERI be used to calculate the decommissioning cost and manage the data of decommissioning activity experience through systems such as the decommissioning information management system (DECOMMIS), Decommissioning Facility Characterization DB System (DEFACS), decommissioning work-unit productivity calculation system (DEWOCS). Some country such as Japan and The United States have the information for decommissioning experience of the NPP and publish reports on decommissioning cost analysis. These reports as valuable data be used to compare with the decommissioning unit cost. In particular, need a method to estimate the decommissioning cost of the NPP because there is no decommissioning experience of NPP in case of Korea. makes possible to predict the more precise prediction about the decommissioning unit cost. But still, there are many differences on calculation for the decommissioning unit cost in domestic and foreign country. Typically, it is difficult to compare with data because published not detailed reports. Therefore, field of estimation for decommissioning cost have to use a unified framework in order to the decommissioning cost be provided to exact of the decommissioning cost.

  4. Basic Research about Calculation of the Decommissioning Unit Cost based on The KRR-2 Decommissioning Project

    International Nuclear Information System (INIS)

    Song, Chan-Ho; Park, Hee-Seong; Ha, Jea-Hyun; Jin, Hyung-Gon; Park, Seung-Kook

    2015-01-01

    The KAERI be used to calculate the decommissioning cost and manage the data of decommissioning activity experience through systems such as the decommissioning information management system (DECOMMIS), Decommissioning Facility Characterization DB System (DEFACS), decommissioning work-unit productivity calculation system (DEWOCS). Some country such as Japan and The United States have the information for decommissioning experience of the NPP and publish reports on decommissioning cost analysis. These reports as valuable data be used to compare with the decommissioning unit cost. In particular, need a method to estimate the decommissioning cost of the NPP because there is no decommissioning experience of NPP in case of Korea. makes possible to predict the more precise prediction about the decommissioning unit cost. But still, there are many differences on calculation for the decommissioning unit cost in domestic and foreign country. Typically, it is difficult to compare with data because published not detailed reports. Therefore, field of estimation for decommissioning cost have to use a unified framework in order to the decommissioning cost be provided to exact of the decommissioning cost

  5. Analisis Unit Cost Sectio Caesaria dengan Metode Activity Based Costing di Rumah Sakit Bhayangkara Yogyakarta

    Directory of Open Access Journals (Sweden)

    Tsalisah Damayanti

    2017-01-01

    Full Text Available This study aims to analyze the unit cost of sectio Caesaria by ABC method, second to analyze the differences between the unit cost calculation of Sectio Caesaria by ABC method with applied cost. Unit cost analysis was conducted at Sectio Caesaria procedure without comorbidities or complications. Data that used in the form of primary data interviews with specialists Obgyn and secondary data financial data and hospitals profiles. The result of the calculation of unit cost of Sectio Caesaria service through Activity Based Costing approach is still lower than INA CBG’s tariff.

  6. Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

    Science.gov (United States)

    Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

    1996-06-01

    Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

  7. Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States.

    Science.gov (United States)

    Peterson, Cora; Grosse, Scott D; Li, Rui; Sharma, Andrea J; Razzaghi, Hilda; Herman, William H; Gilboa, Suzanne M

    2015-01-01

    Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. We aimed to estimate the preconception care (PCC)-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus (PGDM) in the United States. Among women of reproductive age (15-44 years), we estimated age- and race/ethnicity-specific prevalence of diagnosed and undiagnosed diabetes. We applied age and race/ethnicity-specific pregnancy rates, estimates of the risk reduction from PCC for 3 adverse birth outcomes (preterm birth, major birth defects, and perinatal mortality), and lifetime medical and lost productivity costs for children with those outcomes. Using a probabilistic model, we estimated the reduction in adverse birth outcomes and costs associated with universal PCC compared with no PCC among women with PGDM. We did not assess maternal outcomes and associated costs. We estimated 2.2% of US births are to women with PGDM. Among women with diagnosed diabetes, universal PCC might avert 8397 (90% prediction interval [PI], 5252-11,449) preterm deliveries, 3725 (90% PI, 3259-4126) birth defects, and 1872 (90% PI, 1239-2415) perinatal deaths annually. Associated discounted lifetime costs averted for the affected cohort of children could be as high as $4.3 billion (90% PI, 3.4-5.1 billion) (2012 US dollars). PCC among women with undiagnosed diabetes could yield an additional $1.2 billion (90% PI, 951 million-1.4 billion) in averted cost. Results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care. Published by Elsevier Inc.

  8. The economic costs and benefits of potassium iodide prophylaxis for a reference LWR facility in the United States

    International Nuclear Information System (INIS)

    Behling, U.H.; Behling, K.

    1995-01-01

    Policy decisions relating to radiation protection are commonly based on an evaluation in which the benefits of exposure reduction are compared to the economic costs of the protective measure. A generic difficulty countered in cost-benefit analyses, however, is the quantification of major elements that define the costs and the benefits in commensurate units. In this study, the costs of making KI (potassium iodine) available for public use and the avoidance of thyroidal health effects (i.e., the benefit) in the event of nuclear emergency are defined in the commensurate units of dollars. (Authors). 11 refs., 15 tabs

  9. 76 FR 14637 - State Medicaid Fraud Control Units; Data Mining

    Science.gov (United States)

    2011-03-17

    ...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... and analyzing State Medicaid claims data, known as data mining. To support and modernize MFCU efforts... (FFP) in the costs of defined data mining activities under specified conditions. In addition, we...

  10. IEA Wind Task 26. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007–2012

    Energy Technology Data Exchange (ETDEWEB)

    Vitina, Aisma [Ea Energy Analyses, Copenhagen (Denmark); Lüers, Silke [Deutsche WindGuard, Varel (Germany); Wallasch, Anna-Kathrin [Deutsche WindGuard, Varel (Germany); Berkhout, Volker [Fraunhofer IWES, Kassel (Germany); Duffy, Aidan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Cleary, Brendan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Husabø, Lief I. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Weir, David E. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Lacal-Arántegui, Roberto [European Commission, Ispra (Italy). Joint Research Centre; Hand, Maureen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Belyeu, Kathy [Belyeu Consulting, Takoma Park, MD (United States); Wiser, Ryan H [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-01

    The International Energy Agency Implementing Agreement for cooperation in Research, Development, and Deployment of Wind Energy Systems (IEA Wind) Task 26—The Cost of Wind Energy represents an international collaboration dedicated to exploring past, present and future cost of wind energy. This report provides an overview of recent trends in wind plant technology, cost, and performance in those countries that are currently represented by participating organizations in IEA Wind Task 26: Denmark, Germany, Ireland, Norway, and the United States as well as the European Union.

  11. 7 CFR 1220.615 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.615 Section 1220.615... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.615 State and United States. State and United States include the 50 States of the United States of America, the District of Columbia...

  12. 7 CFR 1220.129 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.129 Section 1220.129... CONSUMER INFORMATION Soybean Promotion and Research Order Definitions § 1220.129 State and United States. The terms State and United States include the 50 States of the United States of America, the District...

  13. Green electricity policies in the United States: case study

    International Nuclear Information System (INIS)

    Menz, Fredric C.

    2005-01-01

    While there has been interest in promoting the use of renewable energy in electricity production for a number of years in the United States, the market share of non-hydro renewable energy sources in electricity production has remained at about 2 percent over the past decade. The paper reviews the principal energy resources used for electricity production, considers the changing regulatory environment for the electricity industry, and describes government policies that have been used to promote green electricity in the United States, with an emphasis on measures adopted by state governments. Factors influencing the development of green power markets are also discussed, including underlying economic issues, public policy measures, the regulatory environment, external costs, and subsidies. Without significant increases in fossil fuel prices, much more stringent environmental regulations, or significant changes in electricity customer preferences, green electricity markets are likely to develop slowly in the United States

  14. An Analysis of Unit Costs at a Consolidated Supply Depot

    Science.gov (United States)

    1990-12-01

    Not-For-Profit Setting,"The Accounting Review,July 1990. Horngren , C. T., Cost Accountinq:A Managerial Emphasis,3rd ed, Prentice-Hall Inc.,1972...sector has used concepts of unit costs for 4 decades. Any managerial or cost accounting text discusses in some length unit costs . For Defense contractors...the Cost Accounting Standards Board (CASB) provides guidance for contract costs . Unit costs include direct, indirect, and general and administrative

  15. Calculating the Unit Cost Factors for Decommissioning Cost Estimation of the Nuclear Research Reactor

    International Nuclear Information System (INIS)

    Jeong, Kwan Seong; Lee, Dong Gyu; Jung, Chong Hun; Lee, Kune Woo

    2006-01-01

    The estimated decommissioning cost of nuclear research reactor is calculated by applying a unit cost factor-based engineering cost calculation method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning cost of nuclear research reactor is composed of labor cost, equipment and materials cost. Labor cost of decommissioning costs in decommissioning works are calculated on the basis of working time consumed in decommissioning objects. In this paper, the unit cost factors and work difficulty factors which are needed to calculate the labor cost in estimating decommissioning cost of nuclear research reactor are derived and figured out.

  16. Low cost balancing unit design

    Science.gov (United States)

    Golembiovsky, Matej; Dedek, Jan; Slanina, Zdenek

    2017-06-01

    This article deals with the design of a low-cost balancing system which consist of battery balancing units, accumulator pack units and coordinator unit with interface for higher level of battery management system. This solution allows decentralized mode of operation and the aim of this work is implementation of controlling and diagnostic mechanism into an electric scooter project realized at Technical university of Ostrava. In todays world which now fully enjoys the prime of electromobility, off-grid battery systems and other, it is important to seek the optimal balance between functionality and the economy side of BMS that being electronics which deals with secondary cells of batery packs. There were numerous sophisticated, but not too practical BMS models in the past, such as centralized system or standalone balance modules of individual cells. This article aims at development of standalone balance modules which are able to communicate with the coordinator, adjust their parameters and ensure their cells safety in case of a communication failure. With the current worldwide cutting cost trend in mind, the emphasis was put on the lowest price possible for individual component. The article is divided into two major categories, the first one being desing of power electronics with emphasis on quality, safety (cooling) and also cost. The second part describes development of a communication interface with reliability and cost in mind. The article contains numerous graphs from practical measurements. The outcome of the work and its possible future is defined in the conclusion.

  17. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  18. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2015-05-17

    Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

  19. Both Europe's and the United States' electrification

    International Nuclear Information System (INIS)

    Matly, M.

    2006-01-01

    While the United States quickly had the largest electrical indus in the world, electrification in rural areas ended about thirty years after most European countries. Public intervention is a deciding factor in completing electrification, and the late involvement by the American authorities explains the gap. However it would be wrong to oppose in Europe and in the United States a motivated public sector and little involved private companies. In both continents indeed, major private and public urban distributors were almost not involved in rural electrification processes, where local players prevailed: local communities around Europe, small and medium size business in some European countries such as France, co-operative companies in the United States. Additionally, there is an essential difference between electrification in Europe and in the United States. The former does not provide much more than lighting and its success leaves few traces in popular memories; the latter includes many facilities and services, changes the lives of rural populations and is celebrated a such. Whereas the colonial venture keep European economies away from their domestic markets, while in the United States the urban market growth contents large companies, the American co-operative movement is right to believe in the existence of a large electrical equipment market among farmers then considered poor and behind. It even uses the market to complete a more profitable and less costly electrification. Electricity stories that offer food for the thoughts of Third World decision makers and power companies, when they entrust most rural electrification to their large urban companies and deny the existence of a real equipment market in their own rural world. (author)

  20. Cost-effectiveness analysis evaluating fidaxomicin versus oral vancomycin for the treatment of Clostridium difficile infection in the United States.

    Science.gov (United States)

    Stranges, Paul M; Hutton, David W; Collins, Curtis D

    2013-01-01

    Fidaxomicin is a novel treatment for Clostridium difficile infections (CDIs). This new treatment, however, is associated with a higher acquisition cost compared with alternatives. The objective of this study was to evaluate the cost-effectiveness of fidaxomicin or oral vancomycin for the treatment of CDIs. We performed a cost-utility analysis comparing fidaxomicin with oral vancomycin for the treatment of CDIs in the United States by creating a decision analytic model from the third-party payer perspective. The incremental cost-effectiveness ratio with fidaxomicin compared with oral vancomycin was $67,576/quality-adjusted life-year. A probabilistic Monte Carlo sensitivity analysis showed that fidaxomicin had an 80.2% chance of being cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year. Fidaxomicin remained cost-effective under all fluctuations of both fidaxomicin and oral vancomycin costs. The decision analytic model was sensitive to variations in clinical cure and recurrence rates. Secondary analyses revealed that fidaxomicin was cost-effective in patients receiving concominant antimicrobials, in patients with mild to moderate CDIs, and when compared with oral metronidazole in patients with mild to moderate disease. Fidaxomicin was dominated by oral vancomycin if CDI was caused by the NAP1/Bl/027 Clostridium difficile strain and was dominant in institutions that did not compound oral vancomycin. Results of our model showed that fidaxomicin may be a more cost-effective option for the treatment of CDIs when compared with oral vancomycin under most scenarios tested. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Design and Implementation of the Intensive Care Unit Quality Management Registry: Monitoring Quality and Cost of an Adult Intensive Care Unit in a Greek State Hospital.

    Science.gov (United States)

    Kosmidis, Dimitrios; Koutsouki, Sotiria; Lampiri, Klairi; Nagy, Eva Ottilia; Papaioannou, Vasilios; Pneumatikos, Ioannis; Anastassopoulos, George

    2017-11-01

    Intensive care electronic registries have been instrumental in quality measurement, improvement, and assurance of intensive care. In this article, the development and pilot implementation of the Intensive Care Unit Quality Management Registry are described, with a particular focus on monitoring the quality and operational cost in an adult ICU at a northern Greek state hospital. A relational database was developed for a hospital ICU so that qualitative and financial data are recorded for further analysis needed for planning quality care improvement and enhanced efficiency. Key features of this database registry were low development cost, user friendliness, maximum data security, and interoperability in existing hospital information systems. The database included patient demographics, nursing and medical parameters, and quality and performance indicators as established in many national registries worldwide. Cost recording was based on a mixed approach: at patient level ("bottom-up" method) and at department level ("top-down" method). During the pilot phase of the database operation, regular monitoring of quality and cost data revealed several fields of quality excellence, while indicating room for improvement for others. Parallel recording and trending of multiple parameters showed that the database can be utilized for optimum ICU quality and cost management and also for further research purposes by nurses, physicians, and administrators.

  2. Terms, Trends, and Insights: PV Project Finance in the United States, 2017

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, David J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Schwabe, Paul D [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-10-23

    This brief is a compilation of data points and market insights that reflect the state of the project finance market for solar photovoltaic (PV) assets in the United States as of the third quarter of 2017. This information can generally be used as a simplified benchmark of the costs associated with securing financing for solar PV as well as the cost of the financing itself (i.e., the cost of capital). This work represents the second DOE sponsored effort to benchmark financing costs across the residential, commercial, and utility-scale PV markets, as part of its larger effort to benchmark the components of PV system costs.

  3. 7 CFR 1209.21 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1209.21 Section 1209.21... Definitions § 1209.21 State and United States. (a) State means any of the several States, the District of Columbia, and the Commonwealth of Puerto Rico. (b) United States means collectively the several States of...

  4. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Science.gov (United States)

    2010-10-01

    ... production inventory and include programmed extra units to cover replacement during the fabrication process... ADMINISTRATION CONTRACT MANAGEMENT GOVERNMENT PROPERTY Forms Preparation 1845.7101-3 Unit acquisition cost. (a... production costs (for assets produced or constructed). (5) Engineering, architectural, and other outside...

  5. Environmental aspects of engineering geological mapping in the United States

    Science.gov (United States)

    Radbruch-Hall, Dorothy H.

    1979-01-01

    Many engineering geological maps at different scales have been prepared for various engineering and environmental purposes in regions of diverse geological conditions in the United States. They include maps of individual geological hazards and maps showing the effect of land development on the environment. An approach to assessing the environmental impact of land development that is used increasingly in the United States is the study of a single area by scientists from several disciplines, including geology. A study of this type has been made for the National Petroleum Reserve in northern Alaska. In the San Francisco Bay area, a technique has been worked out for evaluating the cost of different types of construction and land development in terms of the cost of a number of kinds of earth science factors. ?? 1979 International Association of Engineering Geology.

  6. Utility-Scale Solar 2015: An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2016-08-17

    The utility-scale solar sector—defined here to include any ground-mounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar power (“CSP”) project that is larger than 5 MWAC in capacity—has led the overall U.S. solar market in terms of installed capacity since 2012. It is expected to maintain its market-leading position for at least another five years, driven in part by December 2015’s three-year extension of the 30% federal investment tax credit (“ITC”) through 2019 (coupled with a favorable switch to a “start construction” rather than a “placed in service” eligibility requirement, and a gradual phase down of the credit to 10% by 2022). In fact, in 2016 alone, the utility-scale sector is projected to install more than twice as much new capacity as it ever has previously in a single year. This unprecedented boom makes it difficult, yet more important than ever, to stay abreast of the latest utility-scale market developments and trends. This report—the fourth edition in an ongoing annual series—is intended to help meet this need, by providing in-depth, annually updated, data-driven analysis of the utility-scale solar project fleet in the United States. Drawing on empirical project-level data from a wide range of sources, this report analyzes not just installed project costs or prices—i.e., the traditional realm of most solar economic analyses—but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects throughout the United States. Given its current dominance in the market, utility-scale PV also dominates much of this report, though data from CPV and CSP projects are also presented where appropriate.

  7. 7 CFR 1160.104 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

  8. Refugee Resettlement Patterns and State-Level Health Care Insurance Access in the United States.

    Science.gov (United States)

    Agrawal, Pooja; Venkatesh, Arjun Krishna

    2016-04-01

    We sought to evaluate the relationship between state-level implementation of the Patient Protection and Affordable Care Act (ACA) and resettlement patterns among refugees. We linked federal refugee resettlement data to ACA expansion data and found that refugee resettlement rates are not significantly different according to state-level insurance expansion or cost. Forty percent of refugees have resettled to states without Medicaid expansion. The wide state-level variability in implementation of the ACA should be considered by federal agencies seeking to optimize access to health insurance coverage among refugees who have resettled to the United States.

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

    Science.gov (United States)

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

    2011-08-01

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

  10. Evolving reimbursement and pricing policies for devices in Europe and the United States should encourage greater value.

    Science.gov (United States)

    Sorenson, Corinna; Drummond, Michael; Burns, Lawton R

    2013-04-01

    Rising health care costs are an international concern, particularly in the United States, where spending on health care outpaces that of other industrialized countries. Consequently, there is growing desire in the United States and Europe to take a more value-based approach to health care, particularly with respect to the adoption and use of new health technology. This article examines medical device reimbursement and pricing policies in the United States and Europe, with a particular focus on value. Compared to the United States, Europe more formally and consistently considers value to determine which technologies to cover and at what price, especially for complex, costly devices. Both the United States and Europe have introduced policies to provide temporary coverage and reimbursement for promising technologies while additional evidence of value is generated. But additional actions are needed in both the United States and Europe to ensure wise value-based reimbursement and pricing policies for all devices, including the generation of better pre- and postmarket evidence and the development of new methods to evaluate value and link evidence of value to reimbursement.

  11. State cost sharing of training

    International Nuclear Information System (INIS)

    Montgomery, J.M.; Flater, D.A.; Hughes, D.R. Sr.; Lubenau, J.O.; Merges, P.J.; Mobley, M.H.; Raglin, K.A.

    1989-08-01

    In March 1988, The Office of Governmental and Public Affairs (GPA) completed a report (NUREG-1311) entitled, ''Funding the NRC Training Program for States.'' This report responded to a Commission's request for study of NRC's long-standing practice of paying the travel and per diem of state personnel who attend NRC sponsored training. In May 1988, the Chairman endorsed the report in most respects but asked for further study of a cost sharing of travel and per diem costs. As a result, the Director of GPA's State, Local and Indian Tribe Programs (SLITP) established a Task Force comprised of representatives from the Conference of Radiation Control Program Directors, Inc., the Agreement States and the NRC to look at ways that the states can share the costs of NRC training, particularly travel and per diem. At the request of the Director, GPA, the Task Force also looked at related cost and quantity issues associated with the NRC training program for state personnel. This report includes a discussion of NRC and state perspectives on the issue of sharing travel and per diem costs, a discussion of options, and recommendations for likely cost savings and quality of training improvement. 1 ref., 3 figs., 2 tabs

  12. The benefits and costs of new fuels and engines for light-duty vehicles in the United States.

    Science.gov (United States)

    Keefe, Ryan; Griffin, James P; Graham, John D

    2008-10-01

    Rising oil prices and concerns about energy security and climate change are spurring reconsideration of both automobile propulsion systems and the fuels that supply energy to them. In addition to the gasoline internal combustion engine, recent years have seen alternatives develop in the automotive marketplace. Currently, hybrid-electric vehicles, advanced diesels, and flex-fuel vehicles running on a high percentage mixture of ethanol and gasoline (E85) are appearing at auto shows and in driveways. We conduct a rigorous benefit-cost analysis from both the private and societal perspective of the marginal benefits and costs of each technology--using the conventional gasoline engine as a baseline. The private perspective considers only those factors that influence the decisions of individual consumers, while the societal perspective accounts for environmental, energy, and congestion externalities as well. Our analysis illustrates that both hybrids and diesels show promise for particular light-duty applications (sport utility vehicles and pickup trucks), but that vehicles running continuously on E85 consistently have greater costs than benefits. The results for diesels were particularly robust over a wide range of sensitivity analyses. The results from the societal analysis are qualitatively similar to the private analysis, demonstrating that the most relevant factors to the benefit-cost calculations are the factors that drive the individual consumer's decision. We conclude with a brief discussion of marketplace and public policy trends that will both illustrate and influence the relative adoption of these alternative technologies in the United States in the coming decade.

  13. Survey of State-Level Cost and Benefit Estimates of Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.; Barbose, G.; Bird, L.; Weaver, S.; Flores-Espino, F.; Kuskova-Burns, K.; Wiser, R.

    2014-05-01

    Most renewable portfolio standards (RPS) have five or more years of implementation experience, enabling an assessment of their costs and benefits. Understanding RPS costs and benefits is essential for policymakers evaluating existing RPS policies, assessing the need for modifications, and considering new policies. This study provides an overview of methods used to estimate RPS compliance costs and benefits, based on available data and estimates issued by utilities and regulators. Over the 2010-2012 period, average incremental RPS compliance costs in the United States were equivalent to 0.8% of retail electricity rates, although substantial variation exists around this average, both from year-to-year and across states. The methods used by utilities and regulators to estimate incremental compliance costs vary considerably from state to state and a number of states are currently engaged in processes to refine and standardize their approaches to RPS cost calculation. The report finds that state assessments of RPS benefits have most commonly attempted to quantitatively assess avoided emissions and human health benefits, economic development impacts, and wholesale electricity price savings. Compared to the summary of RPS costs, the summary of RPS benefits is more limited, as relatively few states have undertaken detailed benefits estimates, and then only for a few types of potential policy impacts. In some cases, the same impacts may be captured in the assessment of incremental costs. For these reasons, and because methodologies and level of rigor vary widely, direct comparisons between the estimates of benefits and costs are challenging.

  14. A large economic liquid metal reactor for United States utilities

    International Nuclear Information System (INIS)

    Rodwell, E.

    1985-01-01

    The United States has demonstrated its ability to build and operate small and medium sized liquid metal reactors and continues to operate the Experimental Breeder Reactor II and the Fast Flux Test Facility to demonstrate long life fuel designs. Similar-sized liquid metal reactors in Europe have been followed by a step-up to the 1200 MWe capacity of the Superphenix plant. To permit the United States to make a similar step-up in capacity, a 1320 MWe liquid metal reactor plant has been designed with the main emphasis on minimizing the specific capital cost in order to be competitive with light water reactor plant and fossil plant alternatives. The design is based on a four parallel heat transport loops arrangement and complies with current regulatory requirements. The primary heat transport loops are now being integrated into the reactor vessel to achieve further reduction in the capital cost

  15. Economic opportunity in Mexico and return migration from the United States.

    Science.gov (United States)

    Lindstrom, D P

    1996-08-01

    I analyze the influence of the economic characteristics of origin area on trip duration for Mexican migrants in the United States. I argue that migrants from economically dynamic areas in Mexico with favorable opportunities for employment and small capital investment have a larger incentive to stay in the United States longer and to withstand the psychic costs of separation from family and friends than do migrants from economically stagnant areas in Mexico, where the productive uses of savings are severely limited. In line with this argument we should expect investment opportunities in migrants' origin areas to be associated positively with migrants' trip duration in the United States. To test this hypothesis I use individual- and household-level data on U.S. migration experience collected in 13 Mexican communities. Evidence from parametric hazards models supports the idea that economic characteristics of origin areas influence the motivations and strategies of Mexican migrants in the United States.

  16. Cost-effectiveness of combination daclatasvir-sofosbuvir for treatment of genotype 3 chronic hepatitis C infection in the United States.

    Science.gov (United States)

    Saint-Laurent Thibault, Catherine; Moorjaney, Divya; Ganz, Michael L; Sill, Bruce; Hede, Shalini; Yuan, Yong; Gorsh, Boris

    2017-07-01

    A phase III trial evaluated the efficacy and safety of Daklinza (daclatasvir or DCV) in combination with sofosbuvir (SOF) for treatment of genotype (GT) 3 hepatitis C virus (HCV) patients. This study evaluated the cost-effectiveness of DCV + SOF vs SOF in combination with ribavirin (RBV) over a 20-year time horizon from the perspective of a United States (US) payer. A published Markov model was adapted to reflect US demographic characteristics, treatment patterns, costs of drug acquisition, monitoring, disease and adverse event management, and mortality risks. Clinical inputs came from the ALLY-3 and VALENCE trials. The primary outcome was the incremental cost-utility ratio. Life-years, incidence of complications, number of patients achieving sustained virological response (SVR), and the total cost per SVR were secondary outcomes. Costs (2014 USD) and quality-adjusted life years (QALYs) were discounted at 3% per year. Deterministic, probabilistic, and scenario sensitivity analyses were conducted. DCV + SOF was associated with lower costs and better effectiveness than SOF + RBV in the base case and in almost all scenarios (i.e. treatment-experienced, non-cirrhotic, time horizons of 5, 10, and 80 years). DCV + SOF was less costly, but also slightly less effective than SOF + RBV in the cirrhotic and treatment-naïve population scenarios. Results were sensitive to variations in the probability of achieving SVR for both treatment arms. DCV + SOF costs less than $50,000 per QALY gained in 79% of all probabilistic iterations compared with SOF + RBV. DCV + SOF is a dominant option compared with SOF + RBV in the US for the overall GT 3 HCV patient population.

  17. Renewable Energy Cost Modeling: A Toolkit for Establishing Cost-Based Incentives in the United States; March 2010 -- March 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, J. S.; Grace, R. C.; Rickerson, W. H.

    2011-05-01

    This report is intended to serve as a resource for policymakers who wish to learn more about establishing cost-based incentives. The report will identify key renewable energy cost modeling options, highlight the policy implications of choosing one approach over the other, and present recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, feed-in tariffs (FITs), or similar policies. These recommendations will be utilized in designing the Cost of Renewable Energy Spreadsheet Tool (CREST). Three CREST models will be publicly available and capable of analyzing the cost of energy associated with solar, wind, and geothermal electricity generators. The CREST models will be developed for use by state policymakers, regulators, utilities, developers, and other stakeholders to assist them in current and future rate-setting processes for both FIT and other renewable energy incentive payment structures and policy analyses.

  18. Low birth weight in the United States.

    Science.gov (United States)

    Goldenberg, Robert L; Culhane, Jennifer F

    2007-02-01

    Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

  19. Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002-20121.

    Science.gov (United States)

    Strollo, Sara; Lionakis, Michail S; Adjemian, Jennifer; Steiner, Claudia A; Prevots, D Rebecca

    2016-01-01

    Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis-associated hospitalizations in the United States. We extracted data for 33 states for 2002-2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005-2012 for men (annual change -3.9%) and women (annual change -4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease.

  20. The Direct Cost of Managing a Rare Disease: Assessing Medical and Pharmacy Costs Associated with Duchenne Muscular Dystrophy in the United States.

    Science.gov (United States)

    Thayer, Sarah; Bell, Christopher; McDonald, Craig M

    2017-06-01

    A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones. DMD patients were selected from a commercially insured claims database (2000-2009). Patients with claims suggestive of a non-DMD diagnosis or who were aged 30 years or older were excluded. Each DMD patient was matched by age, gender, and region to controls without DMD in a 1:10 ratio (DMD patients n = 75; controls n = 750). All-cause health care resource utilization, including emergency department, inpatient, outpatient, and physician office visits, and all-cause health care costs were examined over a minimum 1-year period. Costs were computed as total health-plan and patient-paid amounts of adjudicated medical claims (in annualized U.S. dollars). The average age of the DMD cohort was 13 years. Patients in the DMD cohort had a 10-fold increase in health care costs compared with controls ($23,005 vs. $2,277, P McDonald has been a consultant for GSK, Sarepta, PTC Therapeutics, Biomarin, and Catabasis on clinical trials regarding Duchenne muscular dystrophy clinical trial design, endpoint selection, and data analysis; Mitobridge for drug development; and Eli Lilly as part of a steering committee for clinical trials. Study concept and design were contributed primarily by Bell, along with Thayer and McDonald. Thayer collected the data, and data interpretation was performed by Thayer and Bell, along with McDonald. The manuscript was written by Thayer and Bell, along with McDonald, and revised by

  1. 31 CFR 800.225 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 800.225 Section 800... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.225 United States. The term United States or U.S. means the United States of America, the States of the United States, the District of Columbia, and any commonwealth...

  2. Unit costs in international economic evaluations: resource costing of the Schizophrenia Outpatient Health Outcomes Study.

    Science.gov (United States)

    Urdahl, H; Knapp, M; Edgell, E T; Ghandi, G; Haro, J M

    2003-01-01

    We present unit costs corresponding to resource information collected in the Schizophrenia Outpatient Health Outcomes (SOHO) Study. The SOHO study is a 3-year, prospective, observational study of health outcomes associated with antipsychotic treatment in out-patients treated for schizophrenia. The study is being conducted across 10 European countries (Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Spain and the UK) and includes over 10,800 patients and over 1000 investigators. To identify the best available unit costs of hospital admissions, day care and psychiatrist out-patient visits, a tariff-based approach was used. Unit costs were obtained for nine of the 10 countries and were adjusted to 2000 price levels by consumer price indices and converted to US dollars using purchasing power parity rates (and on to Euro). The paper illustrates the need to balance the search for sound unit costs with pragmatic solutions in the costing of international economic evaluations.

  3. Inpatient Financial Burden of Atopic Dermatitis in the United States

    DEFF Research Database (Denmark)

    Narla, Shanthi; Hsu, Derek Y; Thyssen, Jacob P

    2017-01-01

    Little is known about the inpatient burden of atopic dermatitis (AD). We sought to determine the risk factors and financial burden of hospitalizations for AD in the United States. Data were analyzed from the 2002-2012 National Inpatient Sample, including a 20% representative sample of all...... hospitalizations in the United States. Hospitalization rates for AD or eczema were highest in the northeast during the winter and south during the summer. Geometric mean cost of care (95% confidence interval) was lower for a primary diagnosis of AD or eczema versus no AD or eczema in adults ($3,502 [$3......,360-$3,651] vs. $6,849 [$6,775-$6,925]; P = 0.0004) and children ($2,716 [$2,542-$2,903] vs. $4,488 [$4,302-$4,682]; P = 0.0004). However, the high prevalence of hospitalization resulted in total inpatient costs of $8,288,083 per year for adults and $3,333,868 per year for children. In conclusion...

  4. 7 CFR 1150.106 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1150.106 Section 1150.106 Agriculture... Order Definitions § 1150.106 United States. United States means the 48 contiguous States in the continental United States. ...

  5. The economic burden of skin disease in the United States.

    Science.gov (United States)

    Dehkharghani, Seena; Bible, Jason; Chen, John G; Feldman, Steven R; Fleischer, Alan B

    2003-04-01

    Skin diseases and their complications are a significant burden on the nation, both in terms of acute and chronic morbidities and their related expenditures for care. Because accurately calculating the cost of skin disease has proven difficult in the past, we present here multiple comparative techniques allowing a more expanded approach to estimating the overall economic burden. Our aims were to (1) determine the economic burden of primary diseases falling within the realm of skin disease, as defined by modern clinical disease classification schemes and (2) identify the specific contribution of each component of costs to the overall expense. Costs were taken as the sum of several factors, divided into direct and indirect health care costs. The direct costs included inpatient hospital costs, ambulatory visit costs (further divided into physician's office visits, outpatient department visits, and emergency department visits), prescription drug costs, and self-care/over-the-counter drug costs. Indirect costs were calculated as the outlay of days of work lost because of skin diseases. The economic burden of skin disease in the United States is large, estimated at approximately $35.9 billion for 1997, including $19.8 billion (54%) in ambulatory care costs; $7.2 billion (20.2%) in hospital inpatient charges; $3.0 billion (8.2%) in prescription drug costs; $4.3 billion (11.7%) in over-the-counter preparations; and $1.6 billion (6.0%) in indirect costs attributable to lost workdays. Our determination of the economic burden of skin care in the United States surpasses past estimates several-fold, and the model presented for calculating cost of illness allows for tracking changes in national expenses for skin care in future studies. The amount of estimated resources devoted to skin disease management is far more than required to treat conditions such as urinary incontinence ($16 billion) and hypertension ($23 billion), but far less than required to treat musculoskeletal

  6. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  7. Braille in the United States: Its Production, Distribution, and Use.

    Science.gov (United States)

    Goldish, Louis Harvey

    The braille production system in the United States is described. Aspects treated are the following: the need for braille (the braille system), the market for braille (size and characteristics), sources of braille (producers and braille book source information), and present methods and costs of producing braille. Technological advances are…

  8. A proposed United States resource classification system

    International Nuclear Information System (INIS)

    Masters, C.D.

    1980-01-01

    Energy is a world-wide problem calling for world-wide communication to resolve the many supply and distribution problems. Essential to a communication problem are a definition and comparability of elements being communicated. The US Geological Survey, with the co-operation of the US Bureau of Mines and the US Department of Energy, has devised a classification system for all mineral resources, the principles of which, it is felt, offer the possibility of world communication. At present several other systems, extant or under development (Potential Gas Committee of the USA, United Nations Resource Committee, and the American Society of Testing and Materials) are internally consistent and provide easy communication linkage. The system in use by the uranium community in the United States of America, however, ties resource quantities to forward-cost dollar values rendering them inconsistent with other classifications and therefore not comparable. This paper develops the rationale for the new USGS resource classification and notes its benefits relative to a forward-cost classification and its relationship specifically to other current classifications. (author)

  9. 7 CFR 65.255 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false United States. 65.255 Section 65.255 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.255 United States. United States means the 50... United States. ...

  10. 7 CFR 1250.308 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1250.308 Section 1250.308 Agriculture... Research and Promotion Order Definitions § 1250.308 United States. United States means the 48 contiguous States of the United States of America and the District of Columbia. ...

  11. 7 CFR 1205.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

  12. 31 CFR 597.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 597.318 Section 597... General Definitions § 597.318 United States. The term United States means the United States, its territories, states, commonwealths, districts, and possessions, and all areas under the jurisdiction or...

  13. 7 CFR 1219.26 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1219.26 Section 1219.26 Agriculture..., AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.26 United States. United States means collectively the several 50 States of the United States, the District of...

  14. Investor perceptions of potential IFRS adoption in the United States

    NARCIS (Netherlands)

    Leung, P.Y.E.; Joos, P.P.M.

    2013-01-01

    This paper examines the stock market reaction to 15 events relating to IFRS adoption in the United States. The goal is to assess whether investors perceive the switch to IFRS as beneficial or costly. Our findings suggest that investors' reaction to IFRS adoption is more positive in cases where IFRS

  15. 78 FR 59817 - Revision to United States Marshals Service Fees for Services

    Science.gov (United States)

    2013-09-30

    .... 4(b). When a statute does not address issues of how to calculate fees or what costs to include in..., investment, productivity, innovation, or on the ability of United States-based enterprises to compete with...

  16. 7 CFR 1212.31 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1212.31 Section 1212.31 Agriculture..., Consumer Education, and Industry Information Order Definitions § 1212.31 United States. “United States... territories and possessions of the United States. ...

  17. 22 CFR 120.13 - United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false United States. 120.13 Section 120.13 Foreign... United States. United States, when used in the geographical sense, includes the several states, the Commonwealth of Puerto Rico, the insular possessions of the United States, the District of Columbia, the...

  18. 31 CFR 592.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 592.311 Section 592... § 592.311 United States. The term United States, when used in the geographic sense, means the several States, the District of Columbia, and any commonwealth, territory, or possession of the United States. ...

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

    Science.gov (United States)

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

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

  20. 7 CFR 1205.313 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.313 Section 1205.313 Agriculture... Research and Promotion Order Definitions § 1205.313 United States. United States means the 50 States of the United States of America. [31 FR 16758, Dec. 31, 1966. Redesignated at 56 FR 64472, Dec. 10, 1991] ...

  1. License renewal in the United States

    International Nuclear Information System (INIS)

    Brons, Jack

    2002-01-01

    Full text: Nuclear plants in the United States are licensed for 40 years, a length specified in the Atomic Energy Act of 1954, which laid out much of the regulatory basis for the commercial nuclear industry. The Act, however, made provision for license renewal. The original 40-year license period was chosen arbitrarily by the U.S. Congress because it was the typical period over which utilities recovered their investment in electricity generating plants. Nuclear plants, however, are subject to a rigorous program of Nuclear Regulatory Commission oversight, maintenance and equipment replacement. In effect, they must be in the same operating condition on the last day of their licenses as they were on the first. As the industry matured, it became apparent that there was no physical limitation on the continued operation of nuclear plants past 40 years. The industry turned its attention toward license renewal. When the issue was first raised, the NRC considered stringent process equivalent to seeking a new operating license for each plant. The complexity, length and cost of the process made it unlikely that many nuclear plants would seek license renewal. The nuclear industry worked successfully with NRC on the application of generic principles to license renewal, however, and in 1995, the NRC issued an efficient, tightly-focused rule that made license renewal a safe, viable option. To extend the operating license for a reactor, a company must demonstrate to the NRC that aging effects will be adequately managed during the renewal terms, thus ensuring equipment functionality. The rule allows licensees to apply for extensions of up to 20 years. The first license renewal application was filed in 1998 by the owner of the two-unit Calvert Cliffs plant. Shortly thereafter, an application was filed for the three-unit Oconee Nuclear Station. The NRC renewed the licenses for all five units in 2000, and since then, five more licenses have been renewed. The NRC has received 37

  2. Costs of occupational injuries in construction in the United States.

    Science.gov (United States)

    Waehrer, Geetha M; Dong, Xiuwen S; Miller, Ted; Haile, Elizabeth; Men, Yurong

    2007-11-01

    This paper presents costs of fatal and nonfatal injuries for the construction industry using 2002 national incidence data from the Bureau of Labor Statistics and a comprehensive cost model that includes direct medical costs, indirect losses in wage and household productivity, as well as an estimate of the quality of life costs due to injury. Costs are presented at the three-digit industry level, by worker characteristics, and by detailed source and event of injury. The total costs of fatal and nonfatal injuries in the construction industry were estimated at $11.5 billion in 2002, 15% of the costs for all private industry. The average cost per case of fatal or nonfatal injury is $27,000 in construction, almost double the per-case cost of $15,000 for all industry in 2002. Five industries accounted for over half the industry's total fatal and nonfatal injury costs. They were miscellaneous special trade contractors (SIC 179), followed by plumbing, heating and air-conditioning (SIC 171), electrical work (SIC 173), heavy construction except highway (SIC 162), and residential building construction (SIC 152), each with over $1 billion in costs.

  3. 31 CFR 542.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 542.310 Section 542.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  4. 31 CFR 548.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 548.310 Section 548.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  5. 31 CFR 546.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 546.310 Section 546.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  6. 31 CFR 586.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 586.318 Section 586...) KOSOVO SANCTIONS REGULATIONS General Definitions § 586.318 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  7. 31 CFR 537.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 537.318 Section 537.318 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....318 United States. The term United States means the United States, its territories and possessions...

  8. 31 CFR 585.316 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 585.316 Section 585.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 585.316 United States. The term United States means the United States, its...

  9. 31 CFR 575.319 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 575.319 Section 575.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....319 United States. The term United States means the United States, its territories and possessions...

  10. 31 CFR 539.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 539.312 Section 539.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 539.312 United States. The term United States means the United States, its...

  11. 31 CFR 551.309 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 551.309 Section 551.309 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....309 United States. The term United States means the United States, its territories and possessions...

  12. 31 CFR 587.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 587.310 Section 587...) MILOSEVIC SANCTIONS REGULATIONS General Definitions § 587.310 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  13. 31 CFR 547.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 547.310 Section 547.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 547.310 United States. The term United States means the United States, its...

  14. 31 CFR 598.317 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 598.317 Section 598.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 598.317 United States. The term United States means the United States, its territories and...

  15. 31 CFR 596.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 596.312 Section 596.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 596.312 United States. The term United States means the United States, including its...

  16. 31 CFR 538.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 538.314 Section 538.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 538.314 United States. The term United States means the United States, its territories and possessions...

  17. 31 CFR 543.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 543.310 Section 543.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 543.310 United States. The term United States means the United States, its territories and...

  18. 31 CFR 594.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 594.313 Section 594.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 594.313 United States. The term United States means the United States, its territories and...

  19. 31 CFR 588.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 588.310 Section 588.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 588.310 United States. The term United States means the United States, its territories and...

  20. 31 CFR 536.315 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 536.315 Section 536.315 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 536.315 United States. The term United States means the United States, its territories and...

  1. 31 CFR 544.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 544.310 Section 544.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 544.310 United States. The term United States means the United States, its...

  2. 31 CFR 545.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 545.313 Section 545.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 545.313 United States. The term United States means the United States, its territories and...

  3. 31 CFR 595.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 595.314 Section 595.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 595.314 United States. The term United States means the United States, its territories and possessions...

  4. 31 CFR 560.307 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 560.307 Section 560.307 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 560.307 United States. The term United States means the United States, including its territories and...

  5. 31 CFR 593.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 593.311 Section 593.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 593.311 United States. The term United States means the United States, its...

  6. 31 CFR 541.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 541.310 Section 541.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 541.310 United States. The term United States means the United States, its territories and possessions...

  7. 31 CFR 540.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 540.313 Section 540.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 540.313 United States. The term United States means the United States, its...

  8. Comparison of 2-Dose and 3-Dose 9-Valent Human Papillomavirus Vaccine Schedules in the United States: A Cost-effectiveness Analysis.

    Science.gov (United States)

    Laprise, Jean-François; Markowitz, Lauri E; Chesson, Harrell W; Drolet, Mélanie; Brisson, Marc

    2016-09-01

    A recent clinical trial using the 9-valent human papillomavirus virus (HPV) vaccine has shown that antibody responses after 2 doses are noninferior to those after 3 doses, suggesting that 2 and 3 doses may have comparable vaccine efficacy. We used an individual-based transmission-dynamic model to compare the population-level effectiveness and cost-effectiveness of 2- and 3-dose schedules of 9-valent HPV vaccine in the United States. Our model predicts that if 2 doses of 9-valent vaccine protect for ≥20 years, the additional benefits of a 3-dose schedule are small as compared to those of 2-dose schedules, and 2-dose schedules are likely much more cost-efficient than 3-dose schedules. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  9. [Unit cost variation in a social security company in Querétaro, México].

    Science.gov (United States)

    Villarreal-Ríos, Enrique; Campos-Esparza, Maribel; Garza-Elizondo, María E; Martínez-González, Lidia; Núñez-Rocha, Georgina M; Romero-Islas, Nestor R

    2006-01-01

    Comparing unit cost variation between departments and reasons for consultation in outpatient health services provided by a social security company from Querétaro, Mexico. A study of costs (in US dollars) was carried out in outpatient health service units during 2004. Fixed unit costs were estimated per department and adjusted for one year's productivity. Material, physical and consumer resources were included. Weighting was assigned to resources invested in each department. Unit cost was estimated by using the micro cost technique; medicaments, materials used during treatment and reagents were considered to be consumer items. Unit cost resulted from adding fixed unit cost to the variable unit cost corresponding to the reason for consulting. Units costs were then compared between the medical units. Unit cost per month for diabetic treatment varied from 34.8 US dollars, 32,2 US dollars to US 34 US dollars, pap smear screening test costs were 7,2 US dollars, 8,7 US dollars and 7,3 US dollars and dental treatment 27 US dollars, 33 US dollars, 6 and 28,7 US dollars. Unit cost variation was more important in the emergency room and the dental service.

  10. IEA Wind Task 26. Wind Technology, Cost and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States. 2007 - 2012

    Energy Technology Data Exchange (ETDEWEB)

    Vitina, Aisma [Ea Energy Analyses, Copenhagen (Denmark); Luers, Silke [Deutsche WindGuard, Varel (Germany); Wallasch, Anna-Kathrin [Deutsche WindGuard, Varel (Germany); Berkhout, Volker [Fraunhofer IWES (Germany); Duffy, Aidan [Dublin Inst. of Technology and Dublin Energy Lab (Ireland); Cleary, Brendan [Dublin Inst. of Technology and Dublin Energy Lab (Ireland); Husabo, Leif I. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Weir, David E. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Lacal-Arantegui, Roberto [European Commission, Ispra (Italy). Joint Research Centre; Hand, M. Maureen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Belyeu, Kathy [Belyeu Consulting, Tacoma Park, MD (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-12

    This report builds from a similar previous analysis (Schwabe et al., 2011) exploring the differences in cost of wind energy in 2008 among countries participating in IEA Wind Task 26 at that time. The levelized cost of energy (LCOE) is a widely recognized metric for understanding how technology, capital investment, operations, and financing impact the life-cycle cost of building and operating a wind plant. Schwabe et al. (2011) apply a spreadsheet-based cash flow model developed by the Energy Research Centre of the Netherlands (ECN) to estimate LCOE. This model is a detailed, discounted cash flow model used to represent the various cost structures in each of the participating countries from the perspective of a financial investor in a domestic wind energy project. This model is used for the present analysis as well, and comparisons are made for those countries who contributed to both reports, Denmark, Germany, and the United States.

  11. Reinventing primary care: lessons from Canada for the United States.

    Science.gov (United States)

    Starfield, Barbara

    2010-05-01

    Canada is, in many respects, culturally and economically similar to the United States, and until relatively recently, the two countries had similar health systems. However, since passage of the Canada Health Act in the 1970s, that nation's health statistics have become increasingly superior. Although the costs of Canada's health system are high by international standards, they are much lower than U.S. costs. This paper describes several factors likely to be responsible for Canada's better health at lower cost: universal financial coverage through a so-called single payer; features conducive to a strong primary care infrastructure; and provincial autonomy under general principles set by national law.

  12. Feasibility and Costs of Natural Gas as a Bridge to Deep Decarbonization in the United States

    Science.gov (United States)

    Jones, A. D.; McJeon, H. C.; Muratori, M.; Shi, W.

    2015-12-01

    Achieving emissions reductions consistent with a 2 degree Celsius global warming target requires nearly complete replacement of traditional fossil fuel combustion with near-zero carbon energy technologies in the United States by 2050. There are multiple technological change pathways consistent with this deep decarbonization, including strategies that rely on renewable energy, nuclear, and carbon capture and storage (CCS) technologies. The replacement of coal-fired power plants with natural gas-fired power plants has also been suggested as a bridge strategy to achieve near-term emissions reduction targets. These gas plants, however, would need to be replaced by near-zero energy technologies or retrofitted with CCS by 2050 in order to achieve longer-term targets. Here we examine the costs and feasibility of a natural gas bridge strategy. Using the Global Change Assessment (GCAM) model, we develop multiple scenarios that each meet the recent US Intended Nationally Determined Contribution (INDC) to reduce GHG emissions by 26%-28% below its 2005 levels in 2025, as well as a deep decarbonization target of 80% emissions reductions below 1990 levels by 2050. We find that the gas bridge strategy requires that gas plants be retired on average 20 years earlier than their designed lifetime of 45 years, a potentially challenging outcome to achieve from a policy perspective. Using a more idealized model, we examine the net energy system costs of this gas bridge strategy compared to one in which near-zero energy technologies are deployed in the near tem. We explore the sensitivity of these cost results to four factors: the discount rate applied to future costs, the length (or start year) of the gas bridge, the relative capital cost of natural gas vs. near-zero energy technology, and the fuel price of natural gas. The discount rate and cost factors are found to be more important than the length of the bridge. However, we find an important interaction as well. At low discount rates

  13. 7 CFR 1206.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1206.23 Section 1206.23 Agriculture... INFORMATION Mango Promotion, Research, and Information Order Definitions § 1206.23 United States. United... Rico, and the territories and possessions of the United States. ...

  14. An Economic Evaluation of Tofacitinib Treatment in Rheumatoid Arthritis: Modeling the Cost of Treatment Strategies in the United States.

    Science.gov (United States)

    Claxton, Lindsay; Jenks, Michelle; Taylor, Matthew; Wallenstein, Gene; Mendelsohn, Alan M; Bourret, Jeffrey A; Singh, Amitabh; Moynagh, Dermot; Gerber, Robert A

    2016-09-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Tofacitinib is approved in the United States for use in adults with moderately to severely active RA and an inadequate response or intolerance to methotrexate. To (a) evaluate, using an economic model, the treatment costs of an RA strategy including tofacitinib, compared with adalimumab, etanercept, certolizumab and tocilizumab biologic RA treatment strategies, which are commonly prescribed in the United States, and (b) assess the economic impact of monotherapy and combination therapy in patients who had an inadequate response to methotrexate therapy (MTX-IR analysis) and to combination therapy in patients who had an inadequate response to a tumor necrosis factor inhibitor (TNF-IR analysis). A transparent, Excel-based economic model with a decision-tree approach was developed to evaluate costs over a 1- and 2-year time horizon. The model compared tofacitinib 5 mg twice a day (BID) either as monotherapy or in combination with MTX with similarly labeled biologic therapies. Response to treatment was modeled as American College of Rheumatology (ACR) 20/50/70 response. ACR20 represented clinical response and determined whether patients continued therapy. ACR response rates at 6-month intervals were sourced from prescribing information and safety event rates from a published meta-analysis. Following an adverse event or a lack of response to treatment, it was assumed that 75% of patients switched to the next line of treatment (first to abatacept and then to rituximab). The perspective was that of a U.S. payer. Costs were reported in 2015 U.S. dollars and included drug wholesale acquisition costs, monitoring, drug administration, and treatment for minor and serious adverse events. The patient population eligible for treatment was based on the total number of members (i.e., RA and non-RA) in a payer organization; members with RA treated with biologic therapies were estimated using

  15. 7 CFR 1215.20 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1215.20 Section 1215.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... United States. United States means all of the States. Popcorn Board ...

  16. The welfare state, pensions, privatization: the case of Social Security in the United States.

    Science.gov (United States)

    Du Boff, R B

    1997-01-01

    In all high-income nations, the welfare state is under challenge, with particular concern voiced about the burden of retirement pensions on the public fisc and on younger workers. The strongest drive against social insurance is taking place in the United States, which has less of it than other nations and appears to be in the best position to meet future entitlement claims. In this article, the author examines the liabilities that the U.S. Social Security system is likely to incur over the next 35 years and finds that there is little danger that the system will fall into insolvency. Privatizing Social Security is not necessary to assure the integrity of future pension benefits. Furthermore, the cost-benefit ratio of privatization appears to be unfavorable, as borne out by the mandatory private pension plan in effect in Chile. Some wealthy nations will face greater demographic strains than the United States, but all need to retain the welfare state as a foundation for future changes in the world of work.

  17. Uber and Metropolitan Traffic Fatalities in the United States.

    Science.gov (United States)

    Brazil, Noli; Kirk, David S

    2016-08-01

    Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. 7 CFR 1280.127 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1280.127 Section 1280.127 Agriculture... INFORMATION ORDER Lamb Promotion, Research, and Information Order Definitions § 1280.127 United States. United States means collectively the 50 States and the District of Columbia. ...

  19. Analysis of Unit Process Cost for an Engineering-Scale Pyroprocess Facility Using a Process Costing Method in Korea

    Directory of Open Access Journals (Sweden)

    Sungki Kim

    2015-08-01

    Full Text Available Pyroprocessing, which is a dry recycling method, converts spent nuclear fuel into U (Uranium/TRU (TRansUranium metal ingots in a high-temperature molten salt phase. This paper provides the unit process cost of a pyroprocess facility that can process up to 10 tons of pyroprocessing product per year by utilizing the process costing method. Toward this end, the pyroprocess was classified into four kinds of unit processes: pretreatment, electrochemical reduction, electrorefining and electrowinning. The unit process cost was calculated by classifying the cost consumed at each process into raw material and conversion costs. The unit process costs of the pretreatment, electrochemical reduction, electrorefining and electrowinning were calculated as 195 US$/kgU-TRU, 310 US$/kgU-TRU, 215 US$/kgU-TRU and 231 US$/kgU-TRU, respectively. Finally the total pyroprocess cost was calculated as 951 US$/kgU-TRU. In addition, the cost driver for the raw material cost was identified as the cost for Li3PO4, needed for the LiCl-KCl purification process, and platinum as an anode electrode in the electrochemical reduction process.

  20. Unit Commitment With Dynamic Cycling Costs

    OpenAIRE

    Troy, Niamh; Flynn, Damian; Milligan, Michael R.; et al.

    2012-01-01

    Increased competition in the electricity sector and the integration of variable renewable energy sources is resulting in more frequent cycling of thermal plant. Thus, the wear-and-tear to generator components and the related costs are a growing concern for plant owners and system operators alike. This paper presents a formulation that can be implemented in a MIP dispatch model to dynamically model cycling costs based on unit operation. When implemented for a test system, the results show that...

  1. Chinese medicine education and its challenges in the United States.

    Science.gov (United States)

    Kwon, Yihyun

    2014-04-01

    Over the past 4 decades Chinese medicine (CM) has come increasingly into the spotlight in the United States as the clinical effectiveness of CM has been not only empirically well-tested over a long period of time but also proven by recent scientific research. It has proven cost effectiveness, safety, and is authorized for natural and holistic approaches. In consideration, CM is one of the underutilized health care professions in the United States with a promising future. However, CM faces many challenges in its education and system, its niche in the health care system as an independent profession, legal and ethical issues. This paper discusses the confronting issues in the United States: present education, standards of CM education with shifting first professional degree level, new delivery systems of CM education. Development of new research models, training of evidence-based practice, and implementation of integrative medicine into CM education also are the key issues in the current CM profession. This paper also discusses opportunities for the CM profession going beyond the current status, especially with a focus on fusion medicine.

  2. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Science.gov (United States)

    Franzblau, Lauren E.

    2013-01-01

    Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

  3. Impact of medical tourism on cosmetic surgery in the United States.

    Science.gov (United States)

    Franzblau, Lauren E; Chung, Kevin C

    2013-10-01

    Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  4. Utility-Scale Solar 2016: An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark; Seel, Joachim; LaCommare, Kristina Hamachi

    2017-09-19

    The utility-scale solar sector has led the overall U.S. solar market in terms of installed capacity since 2012. In 2016, the utility-scale sector installed more than 2.5 times as much new capacity as did the residential and commercial sectors combined, and is expected to maintain its dominant position for at least another five years. This report—the fifth edition in an ongoing annual series—provides data-driven analysis of the utility-scale solar project fleet in the United States. We analyze not just installed project prices, but also operating costs, capacity factors, and power purchase agreement ("PPA") prices from a large sample of utility-scale PV and CSP projects throughout the United States. Highlights from this year's edition include the following: Installation Trends: The use of solar tracking devices dominated 2016 installations, at nearly 80% of all new capacity. In a reflection of the ongoing geographic expansion of the market beyond California and the Southwest, the median long-term average insolation level at newly built project sites declined again in 2016. While new fixed-tilt projects are now seen predominantly in less-sunny regions, tracking projects are increasingly pushing into these same regions. The median inverter loading ratio has stabilized in 2016 at 1.3 for both tracking and fixed-tilt projects. Installed Prices: Median installed PV project prices within a sizable sample have fallen by two-thirds since the 2007-2009 period, to $2.2/WAC (or $1.7/WDC) for projects completed in 2016. The lowest 20th percentile of projects within our 2016 sample were priced at or below $2.0/WAC, with the lowest-priced projects around $1.5/WAC. Overall price dispersion across the entire sample and across geographic regions decreased significantly in 2016. Operation and Maintenance (“O&M”) Costs: What limited empirical O&M cost data are publicly available suggest that PV O&M costs were in the neighborhood of $18/kWAC-year, or $8/MWh, in 2016. These

  5. 7 CFR 1260.108 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1260.108 Section 1260.108 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Promotion and Research Order Definitions § 1260.108 United States. United States means the 50 States and the...

  6. 7 CFR 1221.32 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1221.32 Section 1221.32 Agriculture... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Definitions § 1221.32 United States. United States or U.S. means collectively the 50 States, the District of Columbia, the Commonwealth of...

  7. 7 CFR 1216.30 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1216.30 Section 1216.30 Agriculture... INFORMATION ORDER Peanut Promotion, Research, and Information Order Definitions § 1216.30 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  8. 7 CFR 1218.22 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1218.22 Section 1218.22 Agriculture... INFORMATION ORDER Blueberry Promotion, Research, and Information Order Definitions § 1218.22 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  9. Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–20121

    Science.gov (United States)

    Strollo, Sara; Lionakis, Michail S.; Adjemian, Jennifer; Steiner, Claudia A.

    2017-01-01

    Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis–associated hospitalizations in the United States. We extracted data for 33 states for 2002–2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005–2012 for men (annual change –3.9%) and women (annual change –4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease. PMID:27983497

  10. The Mini-Trial: A Valuable Alternative Dispute Resolution Tool for the United States Navy

    National Research Council Canada - National Science Library

    Morgan, Steven

    1997-01-01

    In order to avoid unnecessary, time consuming, and costly litigation, the Department of Defense, and more specifically the United States Navy, has adopted the use of alternative dispute resolution (ADR...

  11. 7 CFR 1210.315 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1210.315 Section 1210.315 Agriculture... PLAN Watermelon Research and Promotion Plan Definitions § 1210.315 United States. United States means each of the several States and the District of Columbia. [60 FR 10797, Feb. 28, 1995] National...

  12. Health Care Spending in the United States and Other High-Income Countries.

    Science.gov (United States)

    Papanicolas, Irene; Woskie, Liana R; Jha, Ashish K

    2018-03-13

    Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations. Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used. In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant

  13. Assessment report on uranium in the United States of America

    International Nuclear Information System (INIS)

    1980-10-01

    Assessment of the uranium resources in the United States as of October 1, 1980, indicates a range of reserves, in mean values, from 645 thousand tons of U 3 O 8 (in the $30 per pound of U 3 O 8 cost category) to 1.122 million tons (in the $100 per pound of U 3 O 8 category). Ranges of potential resources are also shown for the same cost categories: from 885 thousand to over 2 million tons of U 3 O 8 in the probable class; 346 thousand to over 1 million tons in the possible class; and 311 thousand to nearly 700 thousand tons in the speculative class. There are an estimated 140 thousand tons of U 3 O 8 that could be recovered as a byproduct of phosphate and copper mining through the year 2009. Production capability studies indicate that the demand could be satisfied from currently estimated resources if there is a transition from current production of lower cost resources to production from the $50 per pound of U 3 O 8 resources by the mid 1990s. If, due to foreign competition or other market forces, production incentives are not maintained, domestic production potential will not be realized, and the United States could become dependent on foreign sources for much of its U 3 O 8

  14. Salmonellosis Hospitalizations in the United States: Associated Chronic Conditions, Costs, and Hospital Outcomes, 2011, Trends 2000-2011.

    Science.gov (United States)

    Cummings, Patricia L; Kuo, Tony; Javanbakht, Marjan; Shafir, Shira; Wang, May; Sorvillo, Frank

    2016-01-01

    Hospitalized salmonellosis patients with concurrent chronic conditions may be at increased risk for adverse outcomes, increasing the costs associated with hospitalization. Identifying important modifiable risk factors for this predominantly foodborne illness may assist hospitals, physicians, and public health authorities to improve management of these patients. The objectives of this study were to (1) quantify the burden of salmonellosis hospitalizations in the United States, (2) describe hospitalization characteristics among salmonellosis patients with concurrent chronic conditions, and (3) examine the relationships between salmonellosis and comorbidities by four hospital-related outcomes. A retrospective analysis of salmonellosis discharges was conducted using the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample for 2011. A supplemental trend analysis was performed for the period 2000-2011. Hospitalization characteristics were examined using multivariable regression modeling, with a focus on four outcome measures: in-hospital death, total amount billed by hospitals for services, length of stay, and disease severity. In 2011, there were 11,032 total salmonellosis diagnoses; 7496 were listed as the primary diagnosis, with 86 deaths (case-fatality rate = 1.2%). Multivariable regression analyses revealed a greater number of chronic conditions (≥4) among salmonellosis patients was associated with higher mean total amount billed by hospitals for services, longer length of stay, and greater disease severity (p ≤ 0.05). From 2000 to 2011, hospital discharges for salmonellosis increased by 27.2%, and the mean total amount billed by hospitals increased nearly threefold: $9,777 (2000) to $29,690 (2011). Observed increases in hospitalizations indicate the burden of salmonellosis remains substantial in the United States. The positive association between increased number of chronic conditions and the four hospital-related outcomes affirms

  15. State review United States of America. Risks and risk assessment according to the law of the United States of America

    International Nuclear Information System (INIS)

    Feldmann, F.J.

    1980-01-01

    In the chapter 'Risk Assessment in Atomic Energy Law of the United States' of this report you find among other things the Atomic Energy Act, the approval conditions, General Design Criteria for Nuclear Power Plants, the defense-in-depth concept, probabilistic safety studies, probabilistic probability assessments in the case of external influences onto nuclear power plants, quantitative analyses of the consequences of conceivable accidents, reduction of radiation exposure, the National Environmental Policy Act, the environmental compatibility declaration, the so-called residual risk under the environmental aspect, the classification of the accidents into 9 types, new developments concerning accident analysis, effects of the nuclear fuel cycle on environment, indicial decisions. The chapter about 'Risk Assessment in Civil Law, Criminal Law and Law on Protection of the Environment', deals among other things with the Law on nuisance, the Clean Air Act, the Federal Environmental Pesticide Control Act. In 'Problems of the Cost-Efficiency-Analysis' the significance and purpose of this analysis, the availability of data and information, the monetary quantification of risks and costs, alternatives and the danger of misuse are illustrated. (HSCH) [de

  16. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    Science.gov (United States)

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  17. The Development of Logistics Services in the United States

    OpenAIRE

    Yang, Yeonglin H; San Diego State University

    2015-01-01

    This research studies third party logistics (3PL) providers in the United States to investigate how the industry has strategically developed its service offerings in response to the customers’ growing needs in managing global supply chains. Logistics management has significant impacts on various aspects of supply chains such as response time, total supply chain cost, sourcing risk, customer service, security, etc. The results show that 3PL services vary based on industry served, region served...

  18. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Directory of Open Access Journals (Sweden)

    Lauren E. Franzblau, BS

    2013-10-01

    Full Text Available Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  19. International trade and air pollution: estimating the economic costs of air emissions from waterborne commerce vessels in the United States.

    Science.gov (United States)

    Gallagher, Kevin P

    2005-10-01

    Although there is a burgeoning literature on the effects of international trade on the environment, relatively little work has been done on where trade most directly effects the environment: the transportation sector. This article shows how international trade is affecting air pollution emissions in the United States' shipping sector. Recent work has shown that cargo ships have been long overlooked regarding their contribution to air pollution. Indeed, ship emissions have recently been deemed "the last unregulated source of traditional air pollutants". Air pollution from ships has a number of significant local, national, and global environmental effects. Building on past studies, we examine the economic costs of this increasing and unregulated form of environmental damage. We find that total emissions from ships are largely increasing due to the increase in foreign commerce (or international trade). The economic costs of SO2 pollution range from dollars 697 million to dollars 3.9 billion during the period examined, or dollars 77 to dollars 435 million on an annual basis. The bulk of the cost is from foreign commerce, where the annual costs average to dollars 42 to dollars 241 million. For NOx emissions the costs are dollars 3.7 billion over the entire period or dollars 412 million per year. Because foreign trade is driving the growth in US shipping, we also estimate the effect of the Uruguay Round on emissions. Separating out the effects of global trade agreements reveals that the trade agreement-led emissions amounted to dollars 96 to dollars 542 million for SO2 between 1993 and 2001, or dollars 10 to dollars 60 million per year. For NOx they were dollars 745 million for the whole period or dollars 82 million per year. Without adequate policy responses, we predict that these trends and costs will continue into the future.

  20. Comparing the cost effectiveness of nature-based and coastal adaptation: A case study from the Gulf Coast of the United States.

    Science.gov (United States)

    Reguero, Borja G; Beck, Michael W; Bresch, David N; Calil, Juliano; Meliane, Imen

    2018-01-01

    Coastal risks are increasing from both development and climate change. Interest is growing in the protective role that coastal nature-based measures (or green infrastructure), such as reefs and wetlands, can play in adapting to these risks. However, a lack of quantitative information on their relative costs and benefits is one principal factor limiting their use more broadly. Here, we apply a quantitative risk assessment framework to assess coastal flood risk (from climate change and economic exposure growth) across the United States Gulf of Mexico coast to compare the cost effectiveness of different adaptation measures. These include nature-based (e.g. oyster reef restoration), structural or grey (e.g., seawalls) and policy measures (e.g. home elevation). We first find that coastal development will be a critical driver of risk, particularly for major disasters, but climate change will cause more recurrent losses through changes in storms and relative sea level rise. By 2030, flooding will cost $134-176.6 billion (for different economic growth scenarios), but as the effects of climate change, land subsidence and concentration of assets in the coastal zone increase, annualized risk will more than double by 2050 with respect to 2030. However, from the portfolio we studied, the set of cost-effective adaptation measures (with benefit to cost ratios above 1) could prevent up to $57-101 billion in losses, which represents 42.8-57.2% of the total risk. Nature-based adaptation options could avert more than $50 billion of these costs, and do so cost effectively with average benefit to cost ratios above 3.5. Wetland and oyster reef restoration are found to be particularly cost-effective. This study demonstrates that the cost effectiveness of nature-based, grey and policy measures can be compared quantitatively with one another, and that the cost effectiveness of adaptation becomes more attractive as climate change and coastal development intensifies in the future. It also

  1. Cost Analysis of Leed Certified United States Navy Buildings

    Science.gov (United States)

    2011-08-03

    be accumulated in order to offset initial investment costs - St = Savings in operational costs in year t associated with a given alternative - ∆I0...ior Non-Structural Elements er.o• 2 1 Construction Waste ManagenMnt Oivort 50% fro m Disposal Crocllt 22 Construction Waste Managemen t , Divert 75... Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding

  2. Potential of Hot-Dry-Rock Geothermal Energy in the Eastern United States

    Energy Technology Data Exchange (ETDEWEB)

    None

    1993-11-01

    This is subtitled, ''A report to the United States Congress under Section 2502 of Public Law 102-486 (The Energy Policy Act of 1992)''. It documents a workshop held by the U.S.G.S. (in Philadelphia, January 1993) as required by EPACT 1992. The workshop concluded that under present (1993) economic and technological constraints, mining heat for power electrical power generation is not feasible in the eastern United States. The main issues are the costs of drilling very deep wells and the general applicability of hydrofracturing technology to compressional stress field typical of the eastern U.S. (DJE-2005)

  3. Toll Facilities in the United States - Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  4. The unit cost factors and calculation methods for decommissioning - Cost estimation of nuclear research facilities

    International Nuclear Information System (INIS)

    Kwan-Seong Jeong; Dong-Gyu Lee; Chong-Hun Jung; Kune-Woo Lee

    2007-01-01

    Available in abstract form only. Full text of publication follows: The uncertainties of decommissioning costs increase high due to several conditions. Decommissioning cost estimation depends on the complexity of nuclear installations, its site-specific physical and radiological inventories. Therefore, the decommissioning costs of nuclear research facilities must be estimated in accordance with the detailed sub-tasks and resources by the tasks of decommissioning activities. By selecting the classified activities and resources, costs are calculated by the items and then the total costs of all decommissioning activities are reshuffled to match with its usage and objectives. And the decommissioning cost of nuclear research facilities is calculated by applying a unit cost factor method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning costs of nuclear research facilities are composed of labor cost, equipment and materials cost. Of these three categorical costs, the calculation of labor costs are very important because decommissioning activities mainly depend on labor force. Labor costs in decommissioning activities are calculated on the basis of working time consumed in decommissioning objects and works. The working times are figured out of unit cost factors and work difficulty factors. Finally, labor costs are figured out by using these factors as parameters of calculation. The accuracy of decommissioning cost estimation results is much higher compared to the real decommissioning works. (authors)

  5. Estimating Renewable Energy Economic Potential in the United States. Methodology and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Austin; Beiter, Philipp; Heimiller, Donna; Davidson, Carolyn; Denholm, Paul; Melius, Jennifer; Lopez, Anthony; Hettinger, Dylan; Mulcahy, David; Porro, Gian

    2016-08-01

    This report describes a geospatial analysis method to estimate the economic potential of several renewable resources available for electricity generation in the United States. Economic potential, one measure of renewable generation potential, may be defined in several ways. For example, one definition might be expected revenues (based on local market prices) minus generation costs, considered over the expected lifetime of the generation asset. Another definition might be generation costs relative to a benchmark (e.g., a natural gas combined cycle plant) using assumptions of fuel prices, capital cost, and plant efficiency. Economic potential in this report is defined as the subset of the available resource technical potential where the cost required to generate the electricity (which determines the minimum revenue requirements for development of the resource) is below the revenue available in terms of displaced energy and displaced capacity. The assessment is conducted at a high geospatial resolution (more than 150,000 technology-specific sites in the continental United States) to capture the significant variation in local resource, costs, and revenue potential. This metric can be a useful screening factor for understanding the economic viability of renewable generation technologies at a specific location. In contrast to many common estimates of renewable energy potential, economic potential does not consider market dynamics, customer demand, or most policy drivers that may incent renewable energy generation.

  6. Oil Vulnerabilities and United States Strategy

    Science.gov (United States)

    2007-02-08

    Mazda, Mercedes - Benz , Ford, Mercury, and Nissan offer flexible fuel vehicles in the United States. Ethanol is currently produced in the United States...USAWC STRATEGY RESEARCH PROJECT OIL VULNERABILITIES AND UNITED STATES STRATEGY by Colonel Shawn P. Walsh...Colleges and Schools, 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting

  7. Cost-effectiveness of elbasvir/grazoprevir use in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and chronic kidney disease in the United States.

    Science.gov (United States)

    Elbasha, E; Greaves, W; Roth, D; Nwankwo, C

    2017-04-01

    Among patients with chronic kidney disease (CKD) in the United States, HCV infection causes significant morbidity and mortality and results in substantial healthcare costs. A once-daily oral regimen of elbasvir/grazoprevir (EBR/GZR) for 12 weeks was found to be a safe and efficacious treatment for HCV in patients with CKD. We evaluated the cost-effectiveness of EBR/GZR in treatment-naïve and treatment-experienced CKD patients compared with no treatment (NoTx) and pegylated interferon plus ribavirin (peg-IFN/RBV) using a computer-based model of the natural history of chronic HCV genotype 1 infection, CKD and liver disease. Data on baseline characteristics of the simulated patients were obtained from NHANES, 2000-2010. Model inputs were estimated from published studies. Cost of treatment with EBR/GZR and peg-INF/RBV were based on wholesale acquisition cost. All costs were from a third-party payer perspective and were expressed in 2015 U.S. dollars. We estimated lifetime incidence of liver-related complications, liver transplantation, kidney transplantation, end-stage live disease mortality and end-stage renal disease mortality; lifetime quality-adjusted life years (QALY); and incremental cost-utility ratios (ICUR). The model predicted that EBR/GZR will significantly reduce the incidence of liver-related complications and prolong life in patients with chronic HCV genotype 1 infection and CKD compared with NoTx or use of peg-IFN/RBV. EBR/GZR-based regimens resulted in higher average remaining QALYs and higher costs (11.5716, $191 242) compared with NoTx (8.9199, $156 236) or peg-INF/RBV (10.2857, $186 701). Peg-IFN/RBV is not cost-effective, and the ICUR of EBR/GZR compared with NoTx was $13 200/QALY. Treatment of a patient on haemodialysis with EBR/GZR resulted in a higher ICUR ($217 000/QALY). Assuming a threshold of $100 000 per QALY gained for cost-effectiveness, use of elbasvir/grazoprevir to treat an average patient with CKD can be considered cost

  8. 31 CFR 596.313 - United States person.

    Science.gov (United States)

    2010-07-01

    ... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.313 United States person. The term United States person means any United States...

  9. Diabetes among Latinos in the Southwestern United States: border health and binational cooperation

    Directory of Open Access Journals (Sweden)

    Ryan P. Casey

    2014-12-01

    Full Text Available This analysis reviews cooperation between the four border states of the United States of America (Arizona, California, New Mexico, and Texas and international partners in Mexico with regard to type 2 diabetes among Latinos. Binational cooperation, academic collaboration, preventative health initiatives, and efforts to improve health care access for the border population are highlighted. This meta-analysis of the literature points out causative factors of the increased type 2 diabetes prevalence among Latinos in the United States; an inverse correlation between diabetes and education and socioeconomic level; contributing factors, including barriers with language, health care payment, transportation, and underestimating diabetes implications; and a lack of social and environmental support for disease management. Medical and indirect costs in socioeconomic terms are also included. Cooperation between the United States and Mexico may be beneficial to promoting further collaborative efforts between these nations, and serve as a template for greater cooperative efforts to mitigate the substantial public health and socioeconomic implications of type 2 diabetes globally.

  10. Nuclear development in the United States

    International Nuclear Information System (INIS)

    Brewer, S.

    1983-01-01

    The history of the nuclear development in the United States has been one of international cooperation relations so far. The United States is to offer the technical information on atomic energy utilization to foreign countries in exchange for the guarantee that they never attempt to have or develop nuclear weapons. Actually, the United States has supplied the technologies on nuclear fuel cycle and other related fields to enable other countries to achieve economical and social progress. The Department of Energy clarified the public promise of the United States regarding the idea of international energy community. The ratio of nuclear power generation to total electric power supply in the United States exceeded 12%, and will exceed 20% by 1990. Since 1978, new nuclear power station has not been ordered, and some of the contracted power stations were canceled. The atomic energy industry in the United States prospered at the beginning of 1970s, but lost the spirit now, mainly due to the institutional problems rather than the technical ones. As the policy of the government to eliminate the obstacles, the improvement of the procedure for the permission and approval, the establishment of waste disposal capability, the verification of fast breeder reactor technology and the promotion of commercial fuel reprocessing were proposed. The re-establishment of the United States as the reliable supplier of atomic energy service is the final aim. (Kako, I.)

  11. Mapping water availability, projected use and cost in the western United States

    Science.gov (United States)

    Tidwell, Vincent C.; Moreland, Barbara D.; Zemlick, Katie M.; Roberts, Barry L.; Passell, Howard D.; Jensen, Daniel; Forsgren, Christopher; Sehlke, Gerald; Cook, Margaret A.; King, Carey W.; Larsen, Sara

    2014-05-01

    New demands for water can be satisfied through a variety of source options. In some basins surface and/or groundwater may be available through permitting with the state water management agency (termed unappropriated water), alternatively water might be purchased and transferred out of its current use to another (termed appropriated water), or non-traditional water sources can be captured and treated (e.g., wastewater). The relative availability and cost of each source are key factors in the development decision. Unfortunately, these measures are location dependent with no consistent or comparable set of data available for evaluating competing water sources. With the help of western water managers, water availability was mapped for over 1200 watersheds throughout the western US. Five water sources were individually examined, including unappropriated surface water, unappropriated groundwater, appropriated water, municipal wastewater and brackish groundwater. Also mapped was projected change in consumptive water use from 2010 to 2030. Associated costs to acquire, convey and treat the water, as necessary, for each of the five sources were estimated. These metrics were developed to support regional water planning and policy analysis with initial application to electric transmission planning in the western US.

  12. WIC's promotion of infant formula in the United States

    Directory of Open Access Journals (Sweden)

    Kent George

    2006-04-01

    Full Text Available Abstract Background The United States' Special Supplemental Nutrition Program for Women, Infants and Children (WIC distributes about half the infant formula used in the United States at no cost to the families. This is a matter of concern because it is known that feeding with infant formula results in worse health outcomes for infants than breastfeeding. Discussion The evidence that is available indicates that the WIC program has the effect of promoting the use of infant formula, thus placing infants at higher risk. Moreover, the program violates the widely accepted principles that have been set out in the International Code of Marketing of Breast-milk Substitutes and in the human right to adequate food. Summary There is no good reason for an agency of government to distribute large quantities of free infant formula. It is recommended that the large-scale distribution of free infant formula by the WIC program should be phased out.

  13. 78 FR 70274 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-11-25

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  14. 78 FR 3398 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-01-16

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  15. AP1000 construction and operating costs

    International Nuclear Information System (INIS)

    Winters, J.W.; Corletti, M.M.; Thompson, M.

    2001-01-01

    Market analysis of the U.S. electricity generating market indicates that the generating cost of competitive new generating capacity must be less than $0.03/kw-hr. When such factors as an attractive return on investment and payback period are considered for a new nuclear electric generating facility, this results in the requirement to have an overnight capital cost of approximately $1000/kw. Industry executives indicate that any new nuclear plant must be able to compete in the de-regulated generation wholesale marketplace and provide a return to the shareholders. Against this standard, the costs of advanced nuclear power plants currently available are still too high. In the United States, the Utility Requirements Document for advanced light water reactor plants included a cost goal that was based on the cost of coal generated electricity at the time the document was written. Since that time, the cost of new generating capacity and the overall operating cost of generating electricity has gone down. This is a result of low natural gas prices, more efficient plants in general and the current record breaking reductions in outage times and operating costs for nuclear plants. The plant designs resulting from the United States advanced light water reactor plant programs received Design Certification from the United States Nuclear Regulatory Commission. Some are being deployed, with variations, in countries other than the United States. But they can not compete today with other sources of central station generation in the United States. (author)

  16. AP1000 construction and operating costs

    Energy Technology Data Exchange (ETDEWEB)

    Winters, J.W.; Corletti, M.M. [Westinghouse Electric Corp., Pittsburgh, PA (United States); Thompson, M

    2001-07-01

    Market analysis of the U.S. electricity generating market indicates that the generating cost of competitive new generating capacity must be less than $0.03/kw-hr. When such factors as an attractive return on investment and payback period are considered for a new nuclear electric generating facility, this results in the requirement to have an overnight capital cost of approximately $1000/kw. Industry executives indicate that any new nuclear plant must be able to compete in the de-regulated generation wholesale marketplace and provide a return to the shareholders. Against this standard, the costs of advanced nuclear power plants currently available are still too high. In the United States, the Utility Requirements Document for advanced light water reactor plants included a cost goal that was based on the cost of coal generated electricity at the time the document was written. Since that time, the cost of new generating capacity and the overall operating cost of generating electricity has gone down. This is a result of low natural gas prices, more efficient plants in general and the current record breaking reductions in outage times and operating costs for nuclear plants. The plant designs resulting from the United States advanced light water reactor plant programs received Design Certification from the United States Nuclear Regulatory Commission. Some are being deployed, with variations, in countries other than the United States. But they can not compete today with other sources of central station generation in the United States. (author)

  17. Experience in verification regimes. United States On-Site Inspection Agency

    International Nuclear Information System (INIS)

    Reppert, J.

    1998-01-01

    Experiences are described of the United States On-site Inspection Agency in verification regimes all over the world where it has been applied in the last 30 years. The challenge for the future is to extend the benefits of the applied tools to all states in all regions to enhance stability and to create conditions for peace at lower levels of armaments than currently exist. The USA need to engage states currently caught in cycles of violence and arms escalation. They must examine technologies which together with on-site aspects of verification or transparency regimes can provide a comprehensive picture at affordable costs. They foresee a growth in combined training with new states entering for the first time into regime that include arms control and transparency measure

  18. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities

    International Nuclear Information System (INIS)

    1993-01-01

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco's refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R ampersand D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ''unit cost'' portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible' to estimate the likely future impacts, costs, and sources of oil spills

  19. Nuclear fuel cycle cost estimation and sensitivity analysis of unit costs on the basis of an equilibrium model

    International Nuclear Information System (INIS)

    Kim, S. K.; Ko, W. I.; You, S. R.; Gao, R. X.

    2015-01-01

    This paper examines the difference in the value of the nuclear fuel cycle cost calculated by the deterministic and probabilistic methods on the basis of an equilibrium model. Calculating using the deterministic method, the direct disposal cost and Pyro-SFR (sodium-cooled fast reactor) nuclear fuel cycle cost, including the reactor cost, were found to be 66.41 mills/kWh and 77.82 mills/kWh, respectively (1 mill = one thousand of a dollar, i.e., 10-3 $). This is because the cost of SFR is considerably expensive. Calculating again using the probabilistic method, however, the direct disposal cost and Pyro-SFR nuclear fuel cycle cost, excluding the reactor cost, were found be 7.47 mills/kWh and 6.40 mills/kWh, respectively, on the basis of the most likely value. This is because the nuclear fuel cycle cost is significantly affected by the standard deviation and the mean of the unit cost that includes uncertainty. Thus, it is judged that not only the deterministic method, but also the probabilistic method, would also be necessary to evaluate the nuclear fuel cycle cost. By analyzing the sensitivity of the unit cost in each phase of the nuclear fuel cycle, it was found that the uranium unit price is the most influential factor in determining nuclear fuel cycle costs.

  20. United States housing, 2012

    Science.gov (United States)

    Delton Alderman

    2013-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing completions for single and multifamily units, and sales and construction. This report will be updated annually.

  1. United States electric industry : restructuring in review

    International Nuclear Information System (INIS)

    Slocum Hollis, S.

    2004-01-01

    This paper provides a detailed review of the United States electric power industry. The aim of the review was to clarify and better define current industry procedures and practices in light of significant and recent restructuring. In addition, recent bankruptcies and the power blackout in 2003 have raised concerns over industry practices. Issues concerning Independent System Operators (ISO) and regional transmission organizations were evaluated, with reference to an evolution and implementation of Regional Transmission Organization (RTO) policy, including a cost-benefit analysis. A background of RTO formations was provided with reference to consolidation, selection process and transfer of assets. Standard market design, network access and pricing issues were reviewed, as well as market and reliability concerns. Issues concerning affiliate treatment, shortages and the effect of sale of securities were presented. Various approaches to congestion management were examined, with examples from California and New England. Market monitoring issues, investigations and hearings were also examined, with examples and orders, including details of refunds. Measures to improve reliability were reviewed, including: management systems, benefit margins, requirements, assurance agreements and reserve markets. Issues concerning information access were presented, including: Open Access Same-time Information System (OASIS) requirements; tagging; standard business practices and protocols; and quarterly report practices and protocols. Interconnection policies were reviewed with reference to applicability, service options and pricing. The issue of variations was examined, with case examples concerning cost allocation, contract rights and treatment of specific costs. Jurisdiction issues concerning corporate realignments and power exchanges were presented, as well as specific services and state-federal relations. Issues concerning mergers and merger policy were also discussed, with reference

  2. Defense Finance and Accounting Service Administration of Unit Costs

    National Research Council Canada - National Science Library

    Lay, F

    1996-01-01

    ...) of products or outputs produced. Audit Objectives. We conducted this part of our audit to find out whether unit costs for goods and services provided by DFAS were determined in accordance with DoD policies and based on actual costs incurred...

  3. The United States Special Operations Command Civil Military Engagement Program - A Model for Military-Interagency Low Cost / Small Footprint Activities

    Science.gov (United States)

    2014-05-02

    advance United States goals and objectives with less than optimal budgets. Gabriel Marcella provides an interagency perspective regarding the United...The Department of State mission is to “integrate 9 Gabriel Marcella , “Affairs of the State,” In...Christopher. "Implementing the QDDR." Interagency Journal 3-1 (Winter), 2012: 8. Marcella , Gabriel. Strategic Studies Institute: The Interagency

  4. Cost of umbilical cord blood units released for transplantation.

    Science.gov (United States)

    Sirchia, G; Rebulla, P; Tibaldi, S; Lecchi, L

    1999-06-01

    A large number of institutions have started programs banking umbilical cord blood (UCB) for allogeneic unrelated-donor and related-donor transplantation. However, limited information is available on the financial issues surrounding these activities. The aim of this study was to determine the fee per UCB unit released for transplantation that would allow cost recovery after 10 years. Three organizational models were considered suitable to provide units for five UCB transplants per 1 million population per year, a figure that would translate into an annual need for 280 units in Italy. Models A, B, and C included, respectively, seven networked banks, each with an inventory of 1,500 units; two networked banks, each with an inventory of 5,000 units; and one bank with an inventory of 10,000 units. It was estimated that it would take 3 years to develop the cryopreserved inventory and that approximately 3 percent of the inventory could be released and replaced each year during the 7-year interval between the fourth and tenth years of activity. The data on the costs of labor, reagents and diagnostics, disposables, depreciation and maintenance, laboratory tests, and overhead, as well as the operational data used in the analysis were collected at the Milano Cord Blood Bank in 1996. Fees of US $15,061, $12,666, and $11,602 per unit released during the fourth through the tenth years of activity allow full cost recovery (principle and interest) under Models A, B, and C, respectively. Although UCB procurement costs compare favorably with those of other hematopoietic cell sources, these results and the current fee of US $15,300 used in some institutions show that UCB is an expensive resource. Therefore, judicious planning of banking programs with high quality standards is necessary to prevent economic losses. The advantages of lower fees associated with the centralized banking approach of Model C should be balanced with the more flexible collection offered by Model A.

  5. Thermoeconomic cost analysis of CO_2 compression and purification unit in oxy-combustion power plants

    International Nuclear Information System (INIS)

    Jin, Bo; Zhao, Haibo; Zheng, Chuguang

    2015-01-01

    Highlights: • Thermoeconomic cost analysis for CO_2 compression and purification unit is conducted. • Exergy cost and thermoeconomic cost occur in flash separation and mixing processes. • Unit exergy costs for flash separator and multi-stream heat exchanger are identical. • Multi-stage CO_2 compressor contributes to the minimum unit exergy cost. • Thermoeconomic performance for optimized CPU is enhanced. - Abstract: High CO_2 purity products can be obtained from oxy-combustion power plants through CO_2 compression and purification unit (CPU) based on phase separation method. To identify cost formation process and potential energy savings for CPU, detailed thermoeconomic cost analysis based on structure theory of thermoeconomics is applied to an optimized CPU (with double flash separators). It is found that the largest unit exergy cost occurs in the first separation process while the multi-stage CO_2 compressor contributes to the minimum unit exergy cost. In two flash separation processes, unit exergy costs for the flash separator and multi-stream heat exchanger are identical but their unit thermoeconomic costs are different once monetary cost for each device is considered. For cost inefficiency occurring in CPU, it mainly derives from large exergy costs and thermoeconomic costs in the flash separation and mixing processes. When compared with an unoptimized CPU, thermoeconomic performance for the optimized CPU is enhanced and the maximum reduction of 5.18% for thermoeconomic cost is attained. To achieve cost effective operation, measures should be taken to improve operations of the flash separation and mixing processes.

  6. 31 CFR 500.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 500.520..., Authorizations and Statements of Licensing Policy § 500.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  7. 31 CFR 515.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 515.520..., Authorizations, and Statements of Licensing Policy § 515.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  8. TRAINING OF THE STATE PRESIDENT'S UNIT

    African Journals Online (AJOL)

    The primary function of the State President's Unit is to protect the head of state - not his person as is generally believed, but his authority over the state. Ironically, the ceremonial performances of the State President's Unit lead people to believe that they are only capable of doing drill exer- cises. However, upon investigating.

  9. Study of geothermal prospects in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    1976-08-20

    The commercial development potential of 13 underdeveloped geothermal prospects in the Western United States has been examined and the prospects have been ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. This criterion is obtained principally from expected reservoir temperatures and depths. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data. The Roosevelt, Utah, prospect ranks first in development potential followed in order by Beowawe, Nevada; Coso Hot Springs, California; Long Valley, California; and Brady's Hot Springs, Nevada.

  10. Study of geothermal prospects in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    1975-01-01

    The commercial development potential of 13 underdeveloped geothermal prospects in the western United States has been examined and the prospects have been ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. This criterion is obtained principally from expected reservoir temperatures and depths. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data. The Roosevelt, Utah, prospect ranks first in development potential followed in order by Beowawe, Nevada; Coso Hot Springs, California; Long Valley, California; and Brady's Hot Springs, Nevada.

  11. Proposal for broader United States-Russian transparency of nuclear arms reductions

    International Nuclear Information System (INIS)

    Percival, C.M.; Ingle, T.H.; Bieniawski, A.J.

    1995-01-01

    During the January 1994 Summit Presidents Clinton and Yeltsin agreed on the goal of ensuring the ''transparency and irreversibility'' of the nuclear arms reduction process. As a result, negotiations are presently underway between the United States Government and the Russian Federation to confirm the stockpiles of plutonium and highly enriched uranium removed from nuclear weapons. In December 1994 the United States presented a paper to the Russian Federation proposing additional measures to provide broader transparency of nuclear arms reduction. The US Department of Energy is studying the implementation of these broader transparency measures at appropriate DOE facilities. The results of the studies include draft protocols for implementation, assessments of the implementation procedures and the impacts on the facilities and estimates of the cost to implement these measures at various facilities

  12. The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case–Control Analysis in the Southwestern United States

    Science.gov (United States)

    Mapel, Douglas; Roberts, Melissa; Overhiser, Andrew; Mason, Andrew

    2013-01-01

    Background Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States. Methods We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori-related condition in years 2006 through 2010 using utilization data. Medical record abstraction of 400 cases was conducted to obtain additional clinical information. Results A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55. Conclusions Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed. PMID:23067108

  13. Factors associated with variations in hospital expenditures for acute heart failure in the United States.

    Science.gov (United States)

    Ziaeian, Boback; Sharma, Puza P; Yu, Tzy-Chyi; Johnson, Katherine Waltman; Fonarow, Gregg C

    2015-02-01

    Relatively little contemporary data are available that describe differences in acute heart failure (AHF) hospitalization expenditures as a function of patient and hospital characteristics, especially from a population-based investigation. This study aimed to evaluate factors associated with variations in hospital expenditures for AHF in the United States. A cross-sectional analysis using discharge data from the 2011 Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, was conducted. Discharges with primary International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis codes for AHF in adults were included. Costs were estimated by converting Nationwide Inpatient Sample charge data using the Healthcare Cost and Utilization Project Cost-to-Charge Ratio File. Discharges with highest (≥80th percentile) versus lowest (≤20th percentile) costs were compared for patient characteristics, hospital characteristics, utilization of procedures, and outcomes. Of the estimated 1 million AHF hospital discharges, the mean cost estimates were $10,775 per episode. Younger age, higher percentage of obesity, atrial fibrillation, pulmonary disease, fluid/electrolyte disturbances, renal insufficiency, and greater number of cardiac/noncardiac procedures were observed in stays with highest versus lowest costs. Highest-cost discharges were more likely to be observed in urban and teaching hospitals. Highest-cost AHF discharges also had 5 times longer length of stay, were 9 times more costly, and had higher in-hospital mortality (5.6% vs 3.5%) compared with discharges with lowest costs (all P heart failure hospitalizations are costly. Expenditures vary markedly among AHF hospitalizations in the United States, with substantial differences in patient and hospital characteristics, procedures, and in-hospital outcomes among discharges with highest compared with lowest costs. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Assessment of cost of innovation versus the value of health gains associated with treatment of chronic hepatitis C in the United States: The quality-adjusted cost of care.

    Science.gov (United States)

    Younossi, Zobair M; Park, Haesuk; Dieterich, Douglas; Saab, Sammy; Ahmed, Aijaz; Gordon, Stuart C

    2016-10-01

    New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. A decision-analytic Markov model. Published literature and clinical trial data. Life Time. Third-party payer. This study compared four approved regimens in treatment-naïve genotype 1 chronic hepatitis C patients, including pegylated interferon and ribavirin (PR), first generation triple therapy (boceprevir + PR and telaprevir + PR), second generation triple therapy (sofosbuvir + PR and simeprevir + PR) and all-oral DAA regimens (ledipasvir/sofosbuvir and ombitasvir + paritaprevir/ritonavir + dasabuvir ± ribavirin). Quality-adjusted cost of care (QACC). QACC was defined as the increase in treatment cost minus the increase in the patient's quality-adjusted life years (QALYs) when valued at $50,000 per QALY. All-oral therapy improved the average sustained virologic response (SVR) rate to 96%, thereby offsetting the high drug acquisition cost of $85,714, which resulted in the highest benefit based on the efficiency frontier. Furthermore, while oral therapies increased HCV drug costs by $48,350, associated QALY gains decreased quality-adjusted cost of care by $14,120 compared to dual therapy. When the value of a QALY was varied from $100,000 to $300,000, the quality adjusted cost of care compared to dual therapy ranged from - $21,234 to - $107,861, - $89,007 to - $293,130, - $176,280 to - $500,599 for first generation triple, second generation triple, and all-oral therapies, respectively. Primary efficacy and safety measurements for drug regimens were sourced from clinical trials data rather than a real

  15. State laws on tobacco control--United States, 1998.

    Science.gov (United States)

    Fishman, J A; Allison, H; Knowles, S B; Fishburn, B A; Woollery, T A; Marx, W T; Shelton, D M; Husten, C G; Eriksen, M P

    1999-06-25

    State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors' access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products. Legislation effective through December 31, 1998. CDC identified laws addressing tobacco control by using an on-line legal research database. CDC's findings were verified with the National Cancer Institute's State Cancer Legislative Database. Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have enacted new restrictions or strengthened existing legislation that addresses smoke-free indoor air, minors' access to tobacco, tobacco advertising, and tobacco taxes. Five states strengthened their smoke-free indoor air legislation. All states and Washington, D.C., continued to prohibit the sale and distribution of tobacco products to minors; however, 21 states expanded minors' access laws by designating enforcement authorities, adding license suspension or revocation for sale to minors, or requiring signage. Since the 1995 report, eight additional states (a total of 19 states and Washington, D.C.) now ban vending machines from areas accessible to minors. Thirteen states restrict advertising of tobacco products, an increase of four states since the 1995 report. Although the number of states that tax cigarettes and smokeless tobacco did not change, 13 states increased excise taxes on cigarettes, and five states increased excise taxes on smokeless tobacco products. The average state excise tax on cigarettes is 38.9 cents per pack, an increase of 7.4 cents compared with the average tax in the 1995 report. State laws addressing tobacco control vary in relation to restrictiveness, enforcement and penalties, preemptions, and exceptions. The data summarizing state tobacco-control laws are available through CDC

  16. Near-term deployment of carbon capture and sequestration from biorefineries in the United States.

    Science.gov (United States)

    Sanchez, Daniel L; Johnson, Nils; McCoy, Sean T; Turner, Peter A; Mach, Katharine J

    2018-05-08

    Capture and permanent geologic sequestration of biogenic CO 2 emissions may provide critical flexibility in ambitious climate change mitigation. However, most bioenergy with carbon capture and sequestration (BECCS) technologies are technically immature or commercially unavailable. Here, we evaluate low-cost, commercially ready CO 2 capture opportunities for existing ethanol biorefineries in the United States. The analysis combines process engineering, spatial optimization, and lifecycle assessment to consider the technical, economic, and institutional feasibility of near-term carbon capture and sequestration (CCS). Our modeling framework evaluates least cost source-sink relationships and aggregation opportunities for pipeline transport, which can cost-effectively transport small CO 2 volumes to suitable sequestration sites; 216 existing US biorefineries emit 45 Mt CO 2 annually from fermentation, of which 60% could be captured and compressed for pipeline transport for under $25/tCO 2 A sequestration credit, analogous to existing CCS tax credits, of $60/tCO 2 could incent 30 Mt of sequestration and 6,900 km of pipeline infrastructure across the United States. Similarly, a carbon abatement credit, analogous to existing tradeable CO 2 credits, of $90/tCO 2 can incent 38 Mt of abatement. Aggregation of CO 2 sources enables cost-effective long-distance pipeline transport to distant sequestration sites. Financial incentives under the low-carbon fuel standard in California and recent revisions to existing federal tax credits suggest a substantial near-term opportunity to permanently sequester biogenic CO 2 This financial opportunity could catalyze the growth of carbon capture, transport, and sequestration; improve the lifecycle impacts of conventional biofuels; support development of carbon-negative fuels; and help fulfill the mandates of low-carbon fuel policies across the United States. Copyright © 2018 the Author(s). Published by PNAS.

  17. Electric trade in the United States 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1994, the wholesale trade market totaled 1.9 trillion kilowatthours, about 66% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1994 (ELECTRA), is the fifth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1994.

  18. Radiation protection standards in the United States

    International Nuclear Information System (INIS)

    Mills, W.A.; Arsenault, F.J.; Conti, E.F.

    1988-01-01

    Standards to protect workers and members of the general public against any harmful effects of ionizing radiation are numerous and complex in the United States. Many Federal agencies have protection responsibilities, our Congress limits the discretionary authority given to these agencies in providing for this protection, and our court system appears at times to render judgments that are illogical to our sense of the degree of radiological protection required. To many our standards appear to be overprotective in that they have, at best, marginal health benefits and without question are costly to implement. Government agencies, the Congress, industry, professional organizations, and others have expressed their concerns and interests regarding standards in a variety of ways

  19. Electric trade in the United States 1994

    International Nuclear Information System (INIS)

    1998-08-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1994, the wholesale trade market totaled 1.9 trillion kilowatthours, about 66% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1994 (ELECTRA), is the fifth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1994

  20. Estimating the cost-effectiveness of stroke units in France compared with conventional care.

    Science.gov (United States)

    Launois, R; Giroud, M; Mégnigbêto, A C; Le Lay, K; Présenté, G; Mahagne, M H; Durand, I; Gaudin, A F

    2004-03-01

    The incidence of stroke in France is estimated at between 120 000 and 150 000 cases per year. This modeling study assessed the clinical and economic benefits of establishing specialized stroke units compared with conventional care. Data from the Dijon stroke registry were used to determine healthcare trajectories according to the degree of autonomy and organization of patient care. The relative risks of death or institutionalization or death or dependence after passage through a stroke unit were compared with conventional care. These risks were then inserted with the costing data into a Markov model to estimate the cost-effectiveness of stroke units. Patients cared for in a stroke unit survive more trimesters without sequelae in the 5 years after hospitalization than those cared for conventionally (11.6 versus 8.28 trimesters). The mean cost per patient at 5 years was estimated at 30 983 for conventional care and 34 638 in a stroke unit. An incremental cost-effectiveness ratio for stroke units of 1359 per year of life gained without disability was estimated. The cost-effectiveness ratio for stroke units is much lower than the threshold (53 400 ) of acceptability recognized by the international scientific community. This finding justifies organizational changes in the management of stroke patients and the establishment of stroke units in France.

  1. Analyzing the United States Department of Transportation's Implementation Strategy for High Speed Rail: Three Case Studies

    Science.gov (United States)

    Robinson, Ryan

    High-speed rail (HSR) has become a major contributor to the transportation sector with a strong push by the Obama Administration and the Department of Transportation to implement high-speed rail in the United States. High-speed rail is a costly transportation alternative that has the potential displace some car and airport travel while increase energy security and environmental sustainability. This thesis will examine the United States high-speed rail implementation strategy by comparing it to the implementation strategies of France, Japan, and Germany in a multiple case study under four main criteria of success: economic profitability, reliability, safety, and ridership. Analysis will conclude with lessons to be taken away from the case studies and applied to the United States strategy. It is important to understand that this project has not been established to create a comprehensive implementation plan for high-speed rail in the United States; rather, this project is intended to observe the depth and quality of the current United States implementation strategy and make additional recommendations by comparing it with France, Japan, and Germany.

  2. The costs of producing a unit of blood in Zimbabwe

    NARCIS (Netherlands)

    Mafirakureva, Nyashadzaishe; Nyoni, Herbert; Nkomo, Sisodwa Z; Jacob, Jeffery S; Chikwereti, Radhi; Musekiwa, Zamile; Khoza, Star; Mvere, David A; Emmanuel, Jean C; Postma, Maarten J; van Hulst, Marinus

    2015-01-01

    BACKGROUND: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method. STUDY DESIGN AND METHODS: A management accounting approach, based on

  3. Cost-Benefit Analysis of Nanoparticle Albumin-Bound Paclitaxel versus Solvent-Based Paclitaxel for the Treatment of Metastatic Breast Cancer in the United States

    Science.gov (United States)

    Vichansavakul, Kittaya

    had some limitations because they were conducted from a narrow perspective such as payer and provider point of views. The studies also considered only direct costs in their analysis. In fact, conducting economic evaluations from a narrow perspective and leaving out indirect costs might undermine the true benefit of the interventions for society. A cost-benefit analysis measures all costs and benefits in monetary units. It incorporates both health outcomes gained from individuals and the value gained to society in order to maximize the usage of resources effectively. This thesis conducted a cost-benefit analysis to compare nab-paclitaxel and generic paclitaxel in treating metastatic breast cancer from a societal perspective in the United States. The results showed that nab-paclitaxel is a cost-benefit strategy regardless of the different costs and benefits due to the extra 3 years of living it provides. In all models, when nab-paclitaxel was compared to generic paclitaxel, nab-paclitaxel showed cost-benefit to society. However, the results of generic paclitaxel were dependent on the total medical costs. Performing a cost-benefit analysis of nab-paclitaxel from a societal perspective is important to understand the true benefit of interventions. Furthermore, considering both direct and indirect costs, as well as benefits, of this drug is vital because the economic profile of nab-paclitaxel would be improved.

  4. 31 CFR 515.334 - United States national.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States national. 515.334 Section 515.334 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... of the United States, and which has its principal place of business in the United States. [61 FR...

  5. 7 CFR 1212.32 - United States Customs Service.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States Customs Service. 1212.32 Section 1212... § 1212.32 United States Customs Service. “United States Customs Service” or “Customs” means the United States Customs and Border Protection, an agency of the Department of Homeland Security. Honey Packers and...

  6. Terrestrial Carbon Sequestration in National Parks: Values for the Conterminous United States

    Science.gov (United States)

    Richardson, Leslie A.; Huber, Christopher; Zhu, Zhi-Liang; Koontz, Lynne

    2015-01-01

    Lands managed by the National Park Service (NPS) provide a wide range of beneficial services to the American public. This study quantifies the ecosystem service value of carbon sequestration in terrestrial ecosystems within NPS units in the conterminous United States for which data were available. Combining annual net carbon balance data with spatially explicit NPS land unit boundaries and social cost of carbon estimates, this study calculates the net metric tons of carbon dioxide sequestered annually by park unit under baseline conditions, as well as the associated economic value to society. Results show that, in aggregate, NPS lands in the conterminous United States are a net carbon sink, sequestering more than 14.8 million metric tons of carbon dioxide annually. The associated societal value of this service is estimated at approximately $582.5 million per year. While this analysis provides a broad overview of the annual value of carbon sequestration on NPS lands averaged over a five year baseline period, it should be noted that carbon fluxes fluctuate from year to year, and there can be considerable variation in net carbon balance and its associated value within a given park unit. Future research could look in-depth at the spatial heterogeneity of carbon flux within specific NPS land units.

  7. Investigations of the unit generation costs of the nuclear power plants

    International Nuclear Information System (INIS)

    Guntay, S.

    1977-01-01

    An extensive study has been carried out to investigate the unit generation costs of different reactor types. The study analyzes the following: i) development of capital costs, ii) Fuel cycle costs, iii) operation and maintenance costs, iv) local and foreign finance requirements for an arbitrary reactor type

  8. Cost unit accounting based on a clinical pathway: a practical tool for DRG implementation.

    Science.gov (United States)

    Feyrer, R; Rösch, J; Weyand, M; Kunzmann, U

    2005-10-01

    Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals.

  9. How the United States exports managed care to developing countries.

    Science.gov (United States)

    Waitzkin, H; Iriart, C

    2001-01-01

    As their expansion slows in the United States, managed care organizations will continue to enter new markets abroad. Investors view the opening of managed care in Latin America as a lucrative business opportunity. As public-sector services and social security funds are cut back, privatized, and reorganized under managed care, with the support of international lending agencies such as the World Bank, the effects of these reforms on access to preventive and curative services will hold great importance throughout the developing world. Many groups in Latin America are working on alternative projects that defend health as a public good, and similar movements have begun in Africa and Asia. Increasingly, this organizing is being recognized not only as part of a class struggle but also as part of a struggle against economic imperialism--which has now taken on the new appearance of rescuing less developed countries from rising health care costs and inefficient bureaucracies through the imposition of neoliberal managed-care solutions exported from the United States.

  10. Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology.

    Science.gov (United States)

    Tan, Siok Swan; Bakker, Jan; Hoogendoorn, Marga E; Kapila, Atul; Martin, Joerg; Pezzi, Angelo; Pittoni, Giovanni; Spronk, Peter E; Welte, Robert; Hakkaart-van Roijen, Leona

    2012-01-01

    The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology. A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology was developed on the basis of the availability of data at the seven ICU departments. It entailed the application of the bottom-up approach for "hotel and nutrition" and the top-down approach for "diagnostics," "consumables," and "labor." Direct costs per ICU day ranged from €1168 to €2025. Even though the distribution of costs varied by cost component, labor was the most important cost driver at all departments. The costs for "labor" amounted to €1629 at department G but were fairly similar at the other departments (€711 ± 115). Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. United States comparative costs and absenteeism of diabetic ophthalmic conditions.

    Science.gov (United States)

    Brook, Richard A; Kleinman, Nathan L; Patel, Sunil; Smeeding, Jim E; Beren, Ian A; Turpcu, Adam

    2015-06-01

    This retrospective cohort study examined the impact of diabetic macular edema (DME), diabetic retinopathy (DR), or diabetes on annual health benefit costs and absenteeism in US employees. Claims data from 2001 to 2012 was extracted from the Human Capital Management Services Group Research Reference Database on annual direct/indirect health benefit costs and absences for employees aged ≥ 18 years. Employees with DME, DR, or diabetes were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Employees were divided into two groups, drivers or nondrivers, and examined in separate analyses. For drivers and nondrivers, the DME, DR, and diabetes cohorts were compared with their respective control groups (without diabetes). Two-part regression models controlled for demographics and job-related characteristics. A total of 39,702 driver and 426,549 nondriver employees were identified as having ≥ 1 year's continuous health plan enrollment. Direct medical costs for drivers with DME, DR, or diabetes were $6470, $8021, and $5102, respectively (>2.8 times higher and statistically significant compared with driver controls). Nondrivers with DME and DR incurred significantly higher sick leave and short-term disability costs compared with the nondrivers with diabetes and nondriver controls. In drivers with DME, the majority of days of absence were for short- and long-term disability (12.41 and 11.43 days, respectively). In drivers with DR, the majority of days of absence were for short-term disability (10.70 days). In nondrivers with DME and nondrivers with DR, the majority of days of absence were for sick leave (5.74 and 4.93 days, respectively) and short-term disability (5.08 and 4.93 days, respectively). DME and DR are associated with substantial direct medical cost and absenteeism in this real-world sample of medically insured employees. This research highlights the negative impact of DME and DR on annual costs and absenteeism

  12. Alcohol price elasticities in control and license states in the United States, 1982-99.

    Science.gov (United States)

    Trolldal, Björn; Ponicki, William

    2005-08-01

    The demand for alcohol has been demonstrated repeatedly to be sensitive to price changes. However, estimated price elasticities vary by study region and over time. One explanation for these variations might be that different countries or parts of countries have had different alcohol control systems. The hypothesis addressed in this study was that a regulated market leads to higher transaction costs associated with purchasing alcohol, which in turn increases the full price of the beverages (the nominal cash price plus transaction costs). As a result, the cash price of alcohol represents a smaller part of the full price in a highly regulated market. Assuming that customers respond primarily to changes in full price, the demand for alcohol should be less sensitive to changes in cash price where regulation is stricter. This study examined whether variations in price elasticities were a function of the different regulatory systems in control and license states in the United States during the period 1982-99. Time-series cross-sectional analyses (in 50 states over 18 years) were conducted. Elasticities were estimated using a multiplicative model based upon first-differences of time-series within states. Disposable income and other socio-demographic variables were used as control variables. All data were obtained from archival sources. The demand for spirits and beer were significantly more sensitive to price changes in license states than in control states. The estimated price elasticity for wine sales was also somewhat larger in license states, but not significantly so. The lower price elasticities for spirits and beer in the control states support the hypothesis that customers respond primarily to changes in the full price of alcohol.

  13. Teen Pregnancy in the United States

    Science.gov (United States)

    ... United States: the contribution of abstinence and improved contraceptive use. Am J Public Health. 2007;97(1):150-6. Lindberg LD, Santelli JS, Desai, S. Understanding the Decline in Adolescent Fertility in the United States, 2007–2012. J ...

  14. Estimating the unit costs of public hospitals and primary healthcare centers.

    Science.gov (United States)

    Younis, Mustafa Z; Jaber, Samer; Mawson, Anthony R; Hartmann, Michael

    2013-01-01

    Many factors have affected the rise of health expenditures, such as high-cost medical technologies, changes in disease patterns and increasing demand for health services. All countries allocate a significant portion of resources to the health sector. In 2008, the gross domestic product of Palestine was estimated to be at $6.108bn (current price) or about $1697 per capita. Health expenditures are estimated at 15.6% of the gross domestic product, almost as much as those of Germany, Japan and other developed countries. The numbers of hospitals, hospital beds and primary healthcare centers in the country have all increased. The Ministry of Health (MOH) currently operates 27 of 76 hospitals, with a total of 3074 beds, which represent 61% of total beds of all hospitals in the Palestinian Authorities area. Also, the MOH is operating 453 of 706 Primary Health Care facilities. By 2007, about 40 000 people were employed in different sectors of the health system, with 33% employed by the MOH. This purpose of this study was to develop a financing strategy to help cover some or all of the costs involved in operating such institutions and to estimate the unit cost of primary and secondary programs and departments. A retrospective study was carried out on data from government hospitals and primary healthcare centers to identify and analyze the costs and output (patient-related services) and to estimate the unit cost of health services provided by hospitals and PHCs during the year 2008. All operating costs are assigned and allocated to the departments at MOH hospitals and primary health care centers (PPHCs) and are identified as overhead departments, intermediate-service and final-service departments. Intermediate-service departments provide procedures and services to patients in the final-service departments. The costs of the overhead departments are distributed to the intermediate-service and final-service departments through a step-down method, according to allocation

  15. Costs for Hospital Stays in the United States, 2011

    Science.gov (United States)

    ... Lauren M. Wier, M.P.H., and Claudia Steiner, M.D., M.P.H. Introduction Health care ... Truven Health Analytics), Wier, LM (Truven Health Analytics), Steiner, C (AHRQ). Costs for Hospital Stays in the ...

  16. Neuroscience Intermediate-Level Care Units Staffed by Intensivists: Clinical Outcomes and Cost Analysis.

    Science.gov (United States)

    Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin

    2017-01-01

    With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality

  17. [Activity-based costing methodology to manage resources in intensive care units].

    Science.gov (United States)

    Alvear V, Sandra; Canteros G, Jorge; Jara M, Juan; Rodríguez C, Patricia

    2013-11-01

    An accurate estimation of resources use by individual patients is crucial in hospital management. To measure financial costs of health care actions in intensive care units of two public regional hospitals in Chile. Prospective follow up of 716 patients admitted to two intensive care units during 2011. The financial costs of health care activities was calculated using the Activity-Based Costing methodology. The main activities recorded were procedures and treatments, monitoring, response to patient needs, patient maintenance and coordination. Activity-Based Costs, including human resources and assorted indirect costs correspond to 81 to 88% of costs per disease in one hospital and 69 to 80% in the other. The costs associated to procedures and treatments are the most significant and are approximately $100,000 (Chilean pesos) per day of hospitalization. The second most significant cost corresponds to coordination activities, which fluctuates between $86,000 and 122,000 (Chilean pesos). There are significant differences in resources use between the two hospitals studied. Therefore cost estimation methodologies should be incorporated in the management of these clinical services.

  18. Immigration Enforcement Within the United States

    Science.gov (United States)

    2006-04-06

    Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Policy Issues...Remained in the United States, (Washington: Center for Immigration Studies, May 2002). Immigration Enforcement Within the United States Introduction ...interior enforcement lack a border component. For example, fugitive taskforces, investigations of alien slavery and sweatshops , and employer sanctions do

  19. Direct medical mental health care costs of schizophrenia in France, Germany and the United Kingdom - findings from the European Schizophrenia Cohort (EuroSC).

    Science.gov (United States)

    Heider, Dirk; Bernert, Sebastian; König, Hans-Helmut; Matschinger, Herbert; Hogh, Theresa; Brugha, Traolach S; Bebbington, Paul E; Azorin, Michel; Angermeyer, Matthias C; Toumi, Mondher

    2009-05-01

    To quantify and compare the resource consumption and direct costs of medical mental health care of patients suffering from schizophrenia in France, Germany and the United Kingdom. In the European Cohort Study of Schizophrenia, a naturalistic two-year follow-up study, patients were recruited in France (N=288), Germany (N=618), and the United Kingdom (N=302). Data about the use of services and medication were collected. Unit cost data were obtained and transformed into United States Dollar Purchasing Power Parities (USD-PPP). Mean service use and costs were estimated using between-effects regression models. In the French/German/UK sample estimated means for a six-month period were respectively 5.7, 7.5 and 6.4 inpatient days, and 11.0, 1.3, and 0.7 day-clinic days. After controlling for age, sex, number of former hospitalizations and psychopathology (CGI score), mean costs were 3700/2815/3352 USD-PPP. Service use and estimated costs varied considerably between countries. The greatest differences were related to day-clinic use. The use of services was not consistently higher in one country than in the others. Estimated costs did not necessarily reflect the quantity of service use, since unit costs for individual types of service varied considerably between countries.

  20. Modeling the Health Effects of Expanding e-Cigarette Sales in the United States and United Kingdom: A Monte Carlo Analysis.

    Science.gov (United States)

    Kalkhoran, Sara; Glantz, Stanton A

    2015-10-01

    The prevalence of electronic cigarette (e-cigarette) use is increasing. Population health effects will depend on cigarette smoking behaviors, levels of dual use with conventional cigarettes, and e-cigarette toxicity. To evaluate potential health effects of various scenarios of increasing promotion and use of e-cigarettes. A base case model was developed using data on actual cigarette and e-cigarette use patterns that quantifies transitions from an initial state of no cigarette or e-cigarette use to 1 of 5 final states: never use of cigarettes or e-cigarettes, cigarette use, e-cigarette use, dual use of cigarettes and e-cigarettes, or quit. Seven scenarios were created that cover a range of use patterns, depending on how the e-cigarette market might develop, as well as a range of possible long-term health effects of e-cigarette use. Scenarios for changes from the base case were evaluated using Monte Carlo simulations. Separate sets of base case model parameters were evaluated for the US and UK populations. We assigned unitless health "costs" for each final state on a scale of 0 to 100. Population health "costs" were compared with the base case (status quo) assuming e-cigarette use health "costs" from 1% to 50% as dangerous as conventional cigarette use health costs. Compared with the base case, a harm reduction scenario in which e-cigarette use increases only among smokers who are interested in quitting with more quit attempts and no increased initiation of e-cigarette use among nonsmokers, and another scenario in which e-cigarettes are taken up only by youth who would have smoked conventional cigarettes, had population-level health benefits regardless of e-cigarette health costs in both the United States and United Kingdom. Conversely, scenarios in which e-cigarette promotion leads to renormalization of cigarette smoking or e-cigarettes are used primarily by youth who never would have smoked showed net health harms across all e-cigarette health costs. In other

  1. Development of a Carbon Management Geographic Information System (GIS) for the United States

    Energy Technology Data Exchange (ETDEWEB)

    Howard Herzog; Holly Javedan

    2009-12-31

    In this project a Carbon Management Geographical Information System (GIS) for the US was developed. The GIS stored, integrated, and manipulated information relating to the components of carbon management systems. Additionally, the GIS was used to interpret and analyze the effect of developing these systems. This report documents the key deliverables from the project: (1) Carbon Management Geographical Information System (GIS) Documentation; (2) Stationary CO{sub 2} Source Database; (3) Regulatory Data for CCS in United States; (4) CO{sub 2} Capture Cost Estimation; (5) CO{sub 2} Storage Capacity Tools; (6) CO{sub 2} Injection Cost Modeling; (7) CO{sub 2} Pipeline Transport Cost Estimation; (8) CO{sub 2} Source-Sink Matching Algorithm; and (9) CO{sub 2} Pipeline Transport and Cost Model.

  2. Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States.

    Science.gov (United States)

    Meyers, Juliana L; Madhwani, Shweta; Rausch, Debora; Candrilli, Sean D; Krishnarajah, Girishanthy; Yan, Songkai

    2017-08-03

    Few peer-reviewed publications present real-world United States (US) data describing resource utilization and costs associated with herpes zoster (HZ) and postherpetic neuralgia (PHN). The primary objective of this analysis (GSK study identifier: HO-14-14270) was to assess direct costs associated with HZ and PHN in the US using a retrospective managed care insurance claims database. Patients ≥ 50 y at HZ diagnosis were selected. Patients were excluded if they were immunocompromised before diagnosis or received an HZ vaccine at any time. A subsample of patients with PHN was identified. Each patient with HZ was matched to ≤ 4 controls without HZ based on age, sex, and health plan enrollment. Incremental differences in mean HZ-related costs ("incremental costs") were assessed overall and stratified by age. Multivariable regression models controlled for the effect of demographic characteristics, prediagnosis costs, and comorbidity burden on costs using a recycled predictions approach. Overall, 142,519 patients with HZ (9,470 patients [6.6%] had PHN) and 357,907 matched controls without HZ were identified. Resource utilization was greater among patients with HZ than controls. After adjusting for demographic and clinical characteristics, annual incremental health care costs for HZ patients vs. controls were $1,210 for patients aged 50-59 years, $1,629 for those 60-64 years, $1,876 for those 65-69 years, $2,643 for those 70-79 years, and $3,804 for those 80+ years; adjusted annual incremental costs among PHN patients vs. controls were $4,670 for patients 50-59 years, $6,133 for those 60-64 years, $6,451 for those 65-69 years, $8,548 for those 70-79 years, and $11,147 for those 80+ years. HZ is associated with a significant cost burden, which increases with advancing patient age. Vaccination may reduce costs associated with HZ through case avoidance.

  3. United States Earthquake Early Warning System: How Theory and Analysis Can Save America Before the Big One Happens

    Science.gov (United States)

    2017-12-01

    Documentation for 201447 Spending more on ShakeAlert now and including sustainable operating costs can be justified. In a 2016 publication in...Seismological Research Letters, entitled “ Benefits and Costs of Earthquake Early Warning,” Strauss and Allen determine that “according to FEMA’s cost ...statistical life in the United States is USD 6.6 million.”48 As such, the benefits outweigh the costs as the earthquake early warning system alone would

  4. The impact of unit cost reductions on gross profit: Increasing or decreasing returns?

    Directory of Open Access Journals (Sweden)

    Ely Dahan

    2011-09-01

    Full Text Available We suggest that marketers actively participate in reducing unit costs during new product development, consistent with the theme of integrated marketing and manufacturing. Most marketing managers misjudge the impact on gross profit of reducing variable unit manufacturing costs, mistakenly believing that such cost reductions yield decreasing or linear returns while they actually generate increasing returns.

  5. Global Lessons In Frugal Innovation To Improve Health Care Delivery In The United States.

    Science.gov (United States)

    Bhatti, Yasser; Taylor, Andrea; Harris, Matthew; Wadge, Hester; Escobar, Erin; Prime, Matt; Patel, Hannah; Carter, Alexander W; Parston, Greg; Darzi, Ara W; Udayakumar, Krishna

    2017-11-01

    In a 2015 global study of low-cost or frugal innovations, we identified five leading innovations that scaled successfully in their original contexts and that may provide insights for scaling such innovations in the United States. We describe common themes among these diverse innovations, critical factors for their translation to the United States to improve the efficiency and quality of health care, and lessons for the implementation and scaling of other innovations. We highlight promising trends in the United States that support adapting these innovations, including growing interest in moving care out of health care facilities and into community and home settings; the growth of alternative payment models and incentives to experiment with new approaches to population health and care delivery; and the increasing use of diverse health professionals, such as community health workers and advanced practice providers. Our findings should inspire policy makers and health care professionals and inform them about the potential for globally sourced frugal innovations to benefit US health care.

  6. Development of sinkholes resulting from man's activities in the Eastern United States

    Science.gov (United States)

    Newton, John G.

    1987-01-01

    Development of induced sinkholes in carbonate terranes in the Eastern United States has resulted in costly damage and water pollution. Previously, detailed investigations of sinkholes were limited to Alabama and Missouri, with the most comprehensive being in Alabama. An investigation of the remainder of the area was made in 1981 to regionalize previous findings. More than 850 sites of sinkhole development have been identified in 19 States. It is estimated that more than 6,500 sinkholes or related features have formed at these sites. Most have occurred since 1950. Based on information available, States most impacted are Alabama, Florida, Georgia, Missouri, Pennsylvania, and Tennessee.

  7. The United States and the Arab Gulf Monarchies

    International Nuclear Information System (INIS)

    Kechichian, J.A.

    1999-01-01

    The United States has enduring strategic interests in the Persian Gulf region. To understand these interests and the Usa policy towards the Arab Gulf Monarchies, the french institute of international relations (IFRI) proposes this document. The following chapters are detailed: the United States and the Arab Gulf Monarchies, overview, Chief Unites States Objective: Access to oil, re-evaluating United States Foreign Policy in the Gulf, the second term (Usa strategy). (A.L.B.)

  8. Velocity Model for CO2 Sequestration in the Southeastern United States Atlantic Continental Margin

    Science.gov (United States)

    Ollmann, J.; Knapp, C. C.; Almutairi, K.; Almayahi, D.; Knapp, J. H.

    2017-12-01

    The sequestration of carbon dioxide (CO2) is emerging as a major player in offsetting anthropogenic greenhouse gas emissions. With 40% of the United States' anthropogenic CO2 emissions originating in the southeast, characterizing potential CO2 sequestration sites is vital to reducing the United States' emissions. The goal of this research project, funded by the Department of Energy (DOE), is to estimate the CO2 storage potential for the Southeastern United States Atlantic Continental Margin. Previous studies find storage potential in the Atlantic continental margin. Up to 16 Gt and 175 Gt of storage potential are estimated for the Upper Cretaceous and Lower Cretaceous formations, respectively. Considering 2.12 Mt of CO2 are emitted per year by the United States, substantial storage potential is present in the Southeastern United States Atlantic Continental Margin. In order to produce a time-depth relationship, a velocity model must be constructed. This velocity model is created using previously collected seismic reflection, refraction, and well data in the study area. Seismic reflection horizons were extrapolated using well log data from the COST GE-1 well. An interpolated seismic section was created using these seismic horizons. A velocity model will be made using P-wave velocities from seismic reflection data. Once the time-depth conversion is complete, the depths of stratigraphic units in the seismic refraction data will be compared to the newly assigned depths of the seismic horizons. With a lack of well control in the study area, the addition of stratigraphic unit depths from 171 seismic refraction recording stations provides adequate data to tie to the depths of picked seismic horizons. Using this velocity model, the seismic reflection data can be presented in depth in order to estimate the thickness and storage potential of CO2 reservoirs in the Southeastern United States Atlantic Continental Margin.

  9. Modeling the Health Effects of Expanding e-Cigarette Sales in the United States and United Kingdom

    Science.gov (United States)

    Kalkhoran, Sara; Glantz, Stanton A.

    2015-01-01

    IMPORTANCE The prevalence of electronic cigarette (e-cigarette) use is increasing. Population health effects will depend on cigarette smoking behaviors, levels of dual use with conventional cigarettes, and e-cigarette toxicity. OBJECTIVE To evaluate potential health effects of various scenarios of increasing promotion and use of e-cigarettes. DESIGN, SETTING, AND PARTICIPANTS A base case model was developed using data on actual cigarette and e-cigarette use patterns that quantifies transitions from an initial state of no cigarette or e-cigarette use to 1 of 5 final states: never use of cigarettes or e-cigarettes, cigarette use, e-cigarette use, dual use of cigarettes and e-cigarettes, or quit. Seven scenarios were created that cover a range of use patterns, depending on how the e-cigarette market might develop, as well as a range of possible long-term health effects of e-cigarette use. Scenarios for changes from the base case were evaluated using Monte Carlo simulations. Separate sets of base case model parameters were evaluated for the US and UK populations. MAIN OUTCOMES AND MEASURES We assigned unitless health “costs” for each final state on a scale of 0 to 100. Population health “costs” were compared with the base case (status quo) assuming e-cigarette use health “costs” from 1% to 50% as dangerous as conventional cigarette use health costs. RESULTS Compared with the base case, a harm reduction scenario in which e-cigarette use increases only among smokers who are interested in quitting with more quit attempts and no increased initiation of e-cigarette use among nonsmokers, and another scenario in which e-cigarettes are taken up only by youth who would have smoked conventional cigarettes, had population-level health benefits regardless of e-cigarette health costs in both the United States and United Kingdom. Conversely, scenarios in which e-cigarette promotion leads to renormalization of cigarette smoking or e-cigarettes are used primarily by youth

  10. Photovoltaic power stations in Germany and the United States: A comparative study by data envelopment analysis

    International Nuclear Information System (INIS)

    Sueyoshi, Toshiyuki; Goto, Mika

    2014-01-01

    gases. However, the FIT poses a large financial burden to consumers with a massive increase in renewable energy installation like in Germany and Spain. Therefore, it is necessary for the United States to consider how to align a policy with a speed of technology innovation to balance between the benefit and the cost derived from the policy implementation on renewable energy. In addition, this study discusses policy issues regarding cost allocation due to FIT among stakeholders related to the electric power industry. At the end, this study proposes a new type of wholesale electricity market that provides simultaneous trading on electricity and greenhouse gas emissions by fully utilizing modern computer science technology that exists in universities and national laboratories of the United States. - Highlights: • This study compares photovoltaic power stations in Germany and the United States. • A total of one hundred sixty PV power stations are used for the international comparison. • Germany is more efficient than the United States in terms of solar and land usages. • Feed-In Tariff (FIT) may be effective at the state level in the United States

  11. Cost and utilisation of hospital based delivery care in Empowered Action Group (EAG) states of India.

    Science.gov (United States)

    Mohanty, Sanjay K; Srivastava, Akanksha

    2013-10-01

    Large scale investment in the National Rural Health Mission is expected to increase the utilization and reduce the cost of maternal care in public health centres in India. The objective of this paper is to examine recent trends in the utilization and cost of hospital based delivery care in the Empowered Action Group (EAG) states of India. The unit data from the District Level Household Survey 3, 2007-2008 is used in the analyses. The coverage and the cost of hospital based delivery at constant price is analyzed for five consecutive years preceding the survey. Descriptive and multivariate analyses are used to understand the socio-economic differentials in cost and utilization of delivery care. During 2004-2008, the utilization of delivery care from public health centres has increased in all the eight EAG states. Adjusting for inflation, the household cost of delivery care has declined for the poor, less educated and in public health centres in the EAG states. The cost of delivery care in private health centres has not shown any significant changes across the states. Results of the multivariate analyses suggest that time, state, place of residence, economic status; educational attainment and delivery characteristics of mother are significant predictors of hospital based delivery care in India. The study demonstrates the utility of public spending on health care and provides a thrust to the ongoing debate on universal health coverage in India.

  12. Overview of causes and costs of injuries in Massachusetts: a methodology for analysis of state data.

    Science.gov (United States)

    Schuster, M; Cohen, B B; Rodgers, C G; Walker, D K; Friedman, D J; Ozonoff, V V

    1995-01-01

    Massachusetts has developed the first State profile of the causes and costs of injury based on the national study, "Cost of Injury in the United States: A Report to Congress." Incidence of fatal injuries is based on Massachusetts data; nonfatal hospitalized injuries, on Massachusetts age and sex rates and U.S. cause data; and nonhospitalized injuries, on U.S. rates applied to Massachusetts census data. Lifetime costs per injured person are based on national data adjusted for higher personal health care expenditures and for higher mean annual earnings in Massachusetts. The estimated total lifetime cost for the 1.4 million injuries that occurred in 1989 is $4.4 billion--$1.7 billion for health care and $2.7 billion for lost earnings. Injuries attributed to motor vehicles and falls account for more than half of the total cost. The other cause categories are poisonings, fire-burns, firearms, drowings-near drownings, and other. For every person who dies from an injury, 17 people are hospitalized, and an estimated 535 people require outpatient treatment, consultation, or restricted activity. Development of a State-based cost report can be useful in monitoring the contribution of injuries to health status and in planning effective injury prevention strategies in a community-based health care system. The methodology described in this paper can be replicated by other States through accessing their State-specific mortality and hospital discharge data bases. PMID:7610211

  13. 78 FR 46686 - Privacy Act of 1974; Treasury/United States Mint .013-United States Mint National Electronic...

    Science.gov (United States)

    2013-08-01

    ... available publicly. FOR FURTHER INFORMATION CONTACT: For general questions and privacy issues, please... DEPARTMENT OF THE TREASURY Privacy Act of 1974; Treasury/United States Mint .013--United States... Privacy Act of 1974, as amended, 5 U.S.C. 552a, the Department of the Treasury (``Treasury'') and the...

  14. States reducing solar's soft costs

    Energy Technology Data Exchange (ETDEWEB)

    Meehan, Chris

    2012-07-01

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

  15. An Unlikely Trusting Relationship? The United States and Japan since 1945

    DEFF Research Database (Denmark)

    Ruzicka, Jan; Keating, Vincent

    The U.S.-Japanese security relationship since 1945 has provided a fertile ground for the study of international politics. Constructivists have used it to demonstrate that security is ultimately dependent on cultural norms and identity. Realists, on the other hand, maintain that the relationship...... is best understood in terms of alliance politics where one state (Japan) passes the costs of its own defence onto its ally (the United States). Given the previously-identified weaknesses in both explanations, this article explores whether the relationship could better serve as an example of a trusting...... relationship in international politics by focussing on the mutual reduction of hedging strategies....

  16. 39 CFR 221.1 - The United States Postal Service.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false The United States Postal Service. 221.1 Section 221.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.1 The United States Postal Service. The United States Postal Service was established as an...

  17. UNITED STATES DURING THE COLD WAR 1945-1990

    Directory of Open Access Journals (Sweden)

    Novita Mujiyati

    2016-02-01

    Full Text Available United States and the Soviet Union is a country on the part of allies who emerged as the winner during World War II. However, after reaching the Allied victory in the situation soon changed, man has become an opponent. United States and the Soviet Union are competing to expand the influence and power. To compete the United States strive continuously strengthen itself both in the economic and military by establishing a defense pact and aid agencies in the field of economy. During the Cold War the two are not fighting directly in one of the countries of the former Soviet Union and the United States. However, if understood, teradinya the Korean War and the Vietnam War is a result of tensions between the two countries and is a direct warfare conducted by the United States and the Soviet Union. Cold War ended in conflict with the collapse of the Soviet Union and the United States emerged as the winner of the country.

  18. 78 FR 27857 - United States Standards for Wheat

    Science.gov (United States)

    2013-05-13

    ... RIN 0580-AB12 United States Standards for Wheat AGENCY: Grain Inspection, Packers and Stockyards... (GIPSA) is revising the United States Standards for Wheat under the United States Grain Standards Act (USGSA) to change the definition of Contrasting classes (CCL) in the class Hard White wheat. This change...

  19. Tuberculosis along the United States-Mexico border, 1993-2001.

    Science.gov (United States)

    Schneider, Eileen; Laserson, Kayla F; Wells, Charles D; Moore, Marisa

    2004-07-01

    Tuberculosis (TB) is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1) describe the epidemiological situation of TB, (2) identify TB risk factors, and (3) discuss tuberculosis program strategies. We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1) Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas), (2) persons in those four border states who had been born in the United States, and (3) Mexican-born persons in the 46 other states of the United States, which do not border Mexico. For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7%) were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P pulmonary tuberculosis patients who were 18-64 years of age and residing in the four border states, the Mexican-born patients were 3.6 times as likely as the United States-born patients were to have resistance to at least isoniazid and rifampin (i. e., to have multidrug-resistant TB) and twice as likely to have isoniazid resistance

  20. Global Entrepreneurship and the United States

    Science.gov (United States)

    2010-09-01

    Global Entrepreneurship and the United States by Zoltan J. Acs Laszlo Szerb Ruxton, MD 21204 for under contract number SBAHQ-09...SUBTITLE Global Entrepreneurship and the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...3 2.1. Assessing Entrepreneurship ..................................................................................4 2.2. Stages of Development

  1. 75 FR 25925 - United States Mint

    Science.gov (United States)

    2010-05-10

    ... Committee May 25, 2010 Public Meeting. SUMMARY: Pursuant to United States Code, Title 31, section 5135(b)(8... scheduled for May 25, 2010. Date: May 25, 2010. Time: 9 a.m. to 12 p.m. Location: 8th Floor Board Room, United States Mint, 801 9th Street, NW., Washington, DC 20220. Subject: Review and discuss obverse and...

  2. The price of surgery: markup of operative procedures in the United States.

    Science.gov (United States)

    Gani, Faiz; Makary, Martin A; Pawlik, Timothy M

    2017-02-01

    Despite cost containment efforts, the price for surgery is not subject to any regulations. We sought to characterize and compare variability in pricing for commonly performed major surgical procedures across the United States. Medicare claims corresponding to eight major surgical procedures (aortic aneurysm repair, aortic valvuloplasty, carotid endartectomy, coronary artery bypass grafting, esophagectomy, pancreatectomy, liver resection, and colectomy) were identified using the Medicare Provider Utilization and Payment Data Physician and Other Supplier Public Use File for 2013. For each procedure, total charges, Medicare-allowable costs, and total payments were recorded. A procedure-specific markup ratio (MR; ratio of total charges to Medicare-allowable costs) was calculated and compared between procedures and across states. Variation in MR was compared using a coefficient of variation (CoV). Among all providers, the median MR was 3.5 (interquartile range: 3.1-4.0). MR was noted to vary by procedure; ranging from 3.0 following colectomy to 6.0 following carotid endartectomy (P < 0.001). MR also varied for the same procedure; varying the least after liver resection (CoV = 0.24), while coronary artery bypass grafting pricing demonstrated the greatest variation in MR (CoV = 0.53). Compared with the national average, MR varied by 36% between states ranging from 1.8 to 13.0. Variation in MR was also noted within the same state varying by 15% within the state of Arkansas (CoV = 0.15) compared with 51% within the state of Wisconsin (CoV = 0.51). Significant variation was noted for the price of surgery by procedure as well as between and within different geographical regions. Greater scrutiny and transparency in the price of surgery is required to promote cost containment. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. 31 CFR 515.330 - Person within the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person within the United States. 515... Definitions § 515.330 Person within the United States. (a) The term person within the United States, includes: (1) Any person, wheresoever located, who is a resident of the United States; (2) Any person actually...

  4. 20 CFR 416.215 - You leave the United States.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false You leave the United States. 416.215 Section... Eligible § 416.215 You leave the United States. You lose your eligibility for SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30...

  5. 37 CFR 1.412 - The United States Receiving Office.

    Science.gov (United States)

    2010-07-01

    ... Information § 1.412 The United States Receiving Office. (a) The United States Patent and Trademark Office is a Receiving Office only for applicants who are residents or nationals of the United States of America. (b) The... “United States Receiving Office” or by the abbreviation “RO/US.” (c) The major functions of the Receiving...

  6. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

  7. Unit Cost of Medical Services at Different Hospitals in India

    Science.gov (United States)

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  8. Environmental remediation cost in Fukushima area. Trial calculation using the unit cost factor method

    International Nuclear Information System (INIS)

    Ishikura, Takeshi; Fujita, Reiko

    2013-01-01

    In order to perform environmental remediation in Fukushima area in a swift and adequate way, it is necessary to obtain perspective of total cost and allocate resources adequately. At present such had not been fixed as what decontamination method should be applied to relevant contaminated places in Fukushima area or what disposition and processing process should be applied to radioactive soils and wastes produced by decontamination, it would be difficult to assess the cost exactly. But it would be better to calculate rough cost on trial and then upgrade the accuracy of the cost gradually based on latest knowledge. Cleanup subcommittee of AESJ utilized published process flow and unit cost and based on original proposed scenario: soils produced by decontamination were classified into intermediate storage facility and controllable processing place based on their contamination concentration and with limited reuse, rough estimated cost was obtained as 6 - 9 trillion yen for basic case. (T. Tanaka)

  9. The Japanese Labor Market in a Comparative Perspective with the United States. A Transaction-Cost Interpretation.

    Science.gov (United States)

    Hashimoto, Masanori

    A comparison is made of some of the notable features of the Japanese and U.S. labor markets. In Japan, as compared to the United States, for example, levels of employment tenure are higher, employer-employee attachment stronger, earnings-tenure profiles more steeply sloped, layoffs and dismissals much less frequent, and joint consultation and…

  10. Highly-resolved modeling of personal transportation energy consumption in the United States

    International Nuclear Information System (INIS)

    Muratori, Matteo; Moran, Michael J.; Serra, Emmanuele; Rizzoni, Giorgio

    2013-01-01

    This paper centers on the estimation of the total primary energy consumption for personal transportation in the United States, to include gasoline and/or electricity consumption, depending on vehicle type. The bottom-up sector-based estimation method introduced here contributes to a computational tool under development at The Ohio State University for assisting decision making in energy policy, pricing, and investment. In order to simulate highly-resolved consumption profiles three main modeling steps are needed: modeling the behavior of drivers, generating realistic driving profiles, and simulating energy consumption of different kinds of vehicles. The modeling proposed allows for evaluating the impact of plug-in electric vehicles on the electric grid – especially at the distribution level. It can serve as a tool to compare different vehicle types and assist policy-makers in estimating their impact on primary energy consumption and the role transportation can play to reduce oil dependency. - Highlights: • Modeling primary energy consumption for personal transportation in the United States. • Behavior of drivers has been simulated in order to establish when driving events occur and the length of each event. • Realistic driving profiles for each driving event are generated using a stochastic model. • The model allows for comparing the initial cost of different vehicles and their expected energy-use operating cost. • Evaluation of the impact of PEVs on the electric grid – especially at the distribution level – can be performed

  11. Impact of trucking network flow on preferred biorefinery locations in the southern United States

    Science.gov (United States)

    Timothy M. Young; Lee D. Han; James H. Perdue; Stephanie R. Hargrove; Frank M. Guess; Xia Huang; Chung-Hao Chen

    2017-01-01

    The impact of the trucking transportation network flow was modeled for the southern United States. The study addresses a gap in existing research by applying a Bayesian logistic regression and Geographic Information System (GIS) geospatial analysis to predict biorefinery site locations. A one-way trucking cost assuming a 128.8 km (80-mile) haul distance was estimated...

  12. Availability and cost functions for periodically inspected preventively maintained units

    International Nuclear Information System (INIS)

    Vaurio, J.K.

    1999-01-01

    Unavailability and cost rate functions are developed for components whose failures can occur randomly but they are detected only by periodic testing or inspections. If a failure occurs between consecutive inspections, the unit remains failed until the next inspection. Components are renewed by preventive maintenance periodically, or by repair or replacement after a failure, whichever occurs first (age-replacement). The model takes into account finite repair and maintenance durations as well as costs due to testing, repair, maintenance and lost production or accidents. For normally operating units the time-related penalty is loss of production. For standby safety equipment it is the expected cost of an accident that can happen when the component is down due to a dormant failure, repair or maintenance. The objective of maintenance optimization is to minimize the total cost rate by proper selection of two intervals, one for inspections and one for replacements. General conditions and techniques are developed for solving optimal test and maintenance intervals, with and without constraints on the production loss or accident rate. Insights are gained into how the optimal intervals depend on various cost parameters and reliability characteristics

  13. A GIS cost model to assess the availability of freshwater, seawater, and saline groundwater for algal biofuel production in the United States.

    Science.gov (United States)

    Venteris, Erik R; Skaggs, Richard L; Coleman, Andre M; Wigmosta, Mark S

    2013-05-07

    A key advantage of using microalgae for biofuel production is the ability of some algal strains to thrive in waters unsuitable for conventional crop irrigation such as saline groundwater or seawater. Nonetheless, the availability of sustainable water supplies will provide significant challenges for scale-up and development of algal biofuels. We conduct a partial techno-economic assessment based on the availability of freshwater, saline groundwater, and seawater for use in open pond algae cultivation systems. We explore water issues through GIS-based models of algae biofuel production, freshwater supply (constrained to less than 5% of mean annual flow per watershed) and costs, and cost-distance models for supplying seawater and saline groundwater. We estimate that, combined, these resources can support 9.46 × 10(7) m(3) yr(-1) (25 billion gallons yr(-1)) of renewable biodiesel production in the coterminous United States. Achievement of larger targets requires the utilization of less water efficient sites and relatively expensive saline waters. Despite the addition of freshwater supply constraints and saline water resources, the geographic conclusions are similar to our previous results. Freshwater availability and saline water delivery costs are most favorable for the coast of the Gulf of Mexico and Florida peninsula, where evaporation relative to precipitation is moderate. As a whole, the barren and scrub lands of the southwestern U.S. have limited freshwater supplies, and large net evaporation rates greatly increase the cost of saline alternatives due to the added makeup water required to maintain pond salinity. However, this and similar analyses are particularly sensitive to knowledge gaps in algae growth/lipid production performance and the proportion of freshwater resources available, key topics for future investigation.

  14. Lean Six Sigma to Reduce Intensive Care Unit Length of Stay and Costs in Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Trzeciak, Stephen; Mercincavage, Michael; Angelini, Cory; Cogliano, William; Damuth, Emily; Roberts, Brian W; Zanotti, Sergio; Mazzarelli, Anthony J

    Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. Before-and-after cohort study. Multidisciplinary intensive care unit (ICU) in an academic medical center. Adult patients admitted to the ICU and treated with PMV, as defined by diagnosis-related group (DRG). We implemented a clinical redesign intervention based on LSS principles. We identified eight distinct processes in preparing patients with PMV for post-acute care. Our clinical redesign included reengineering daily patient care rounds ("Lean ICU rounds") to reduce variation and waste in these processes. We compared hospital LOS and direct cost per case in patients with PMV before (2013) and after (2014) our LSS intervention. Among 259 patients with PMV (131 preintervention; 128 postintervention), median hospital LOS decreased by 24% during the intervention period (29 vs. 22 days, p < .001). Accordingly, median hospital direct cost per case decreased by 27% ($66,335 vs. $48,370, p < .001). We found that a LSS-based clinical redesign reduced hospital LOS and the costs of care for patients with PMV.

  15. Incremental cost of PACS in a medical intensive care unit

    Science.gov (United States)

    Langlotz, Curtis P.; Cleff, Bridget; Even-Shoshan, Orit; Bozzo, Mary T.; Redfern, Regina O.; Brikman, Inna; Seshadri, Sridhar B.; Horii, Steven C.; Kundel, Harold L.

    1995-05-01

    Our purpose is to determine the incremental costs (or savings) due to the introduction of picture archiving and communication systems (PACS) and computed radiology (CR) in a medical intensive care unit (MICU). Our economic analysis consists of three measurement methods. The first method is an assessment of the direct costs to the radiology department, implemented in a spreadsheet model. The second method consists of a series of brief observational studies to measure potential changes in personnel costs that might not be reflected in administrative claims. The third method (results not reported here) is a multivariate modeling technique which estimates the independent effect of PACS/CR on the cost of care (estimated from administrative claims data), while controlling for clinical case- mix variables. Our direct cost model shows no cost savings to the radiology department after the introduction of PACS in the medical intensive care unit. Savings in film supplies and film library personnel are offset by increases in capital equipment costs and PACS operation personnel. The results of observational studies to date demonstrate significant savings in clinician film-search time, but no significant change in technologist time or lost films. Our model suggests that direct radiology costs will increase after the limited introduction of PACS/CR in the MICU. Our observational studies show a small but significant effect on clinician film search time by the introduction of PACS/CR in the MICU, but no significant effect on other variables. The projected costs of a hospital-wide PACS are currently under study.

  16. Financial impact of spinal cord stimulation on the healthcare budget: a comparative analysis of costs in Canada and the United States.

    Science.gov (United States)

    Kumar, Krishna; Bishop, Sharon

    2009-06-01

    Many institutions with spinal cord stimulation (SCS) programs fail to realize that besides the initial implantation cost, budgetary allocation must be made to address annual maintenance costs as well as complications as they arise. Complications remain the major contributing factor to the overall expense of SCS. The authors present a formula that, when applied, provides a realistic representation of the actual costs necessary to implant and maintain SCS systems in Canada and the US. The authors performed a retrospective analysis of 197 cases involving SCS (161 implanted and 36 failed trial stimulations) between 1995 and 2006. The cost of patient workup, initial implantation, annual maintenance, and resources necessary to resolve complications were assessed for each case and a unit cost applied. The total cost allocated for each case was determined by summing across healthcare resource headings. Using the same parameters, the unit cost was calculated in both Canadian (CAD) and US dollars (USD) at 2007 prices. The cost of implanting a SCS system in Canada is $21,595 (CAD), in US Medicare $32,882 (USD), and in US Blue Cross Blue Shield (BCBS) $57,896 (USD). The annual maintenance cost of an uncomplicated case in Canada is $3539 (CAD), in US Medicare $5071 (USD), and in BCBS $7277 (USD). The mean cost of a complication was $5191 in Canada (range $136-18,837 [CAD]). In comparison, in the US the figures were $9649 (range $381-28,495) for Medicare and $21,390 (range $573-54,547) for BCBS (both USD). Using these calculations a formula was derived as follows: the annual maintenance cost (a) was added to the average annual cost per complication per patient implanted (b); the sum was then divided by the implantation cost (c); and the result was multiplied by 100 to obtain a percentage (a + b / c x 100). To make this budgetary cap universally applicable, the results from the application of the formula were averaged, resulting in an 18% premium. For budgeting purposes the

  17. The United States and the Kurds: Case Studies in United States Engagement

    National Research Council Canada - National Science Library

    Lambert, Peter

    1997-01-01

    ..., between 1969- 1975, and 1990-1996. Both eras saw the United States able to influence events relating to the Kurds in support of a larger regional policy, only to find no easy solution to the Kurdish quest for autonomy...

  18. Agricultural subsidies in the United States and their effect on two annual Chilean crops: corn and wheat

    Directory of Open Access Journals (Sweden)

    José Díaz Osorio

    2006-09-01

    Full Text Available The development strategies for Chile have been oriented toward a greater commercial openness. Chile and the United States signed a Free Trade Agreement (FTA that has triggered controversies between producers directed to the internal market due to the production and export subsidies that this country carries out. This study analyzed the effect of subsidies granted by the United States to wheat (Tritricum aestivum and corn (Zea mays growers (Farm Bill 2002. For the study, Technical Standard sheet were drawn up, from which were determined the direct production costs and the gross margins. The variables used (market prices, subsidies, freight costs and tariffs and determining the average variable costs allowed us to do a sensitivity analysis, thus establishing the minimum level of production that national farmers must achieve in order to maintain competitiveness while a free trade is in force. The signing of a trade agreement could provoke the eventual withdrawal of many Chilean producers from the business arena while at the same time, favoring consumers with lower prices for the goods derived from these grains.

  19. [Cost at the first level of care].

    Science.gov (United States)

    Villarreal-Ríos, E; Montalvo-Almaguer, G; Salinas-Martínez, M; Guzmán-Padilla, J E; Tovar-Castillo, N H; Garza-Elizondo, M E

    1996-01-01

    To estimate the unit cost of 15 causes of demand for primary care per health clinic in an institutional (social security) health care system, and to determine the average cost at the state level. The cost of 80% of clinic visits was estimated in 35 of 40 clinics in the social security health care system in the state of Nuevo Leon, Mexico. The methodology for fixed costs consisted of: departmentalization, inputs, cost, weights and construction of matrices. Variable costs were estimated for standard patients by type of health care sought and with the consensus of experts; the sum of fixed and variable costs gave the unit cost. A computerized model was employed for data processing. A large variation in unit cost was observed between health clinics studied for all causes of demand, in both metropolitan and non-metropolitan areas. Prenatal care ($92.26) and diarrhea ($93.76) were the least expensive while diabetes ($240.42) and hypertension ($312.54) were the most expensive. Non-metropolitan costs were higher than metropolitan costs (p < 0.05); controlling for number of physician's offices showed that this was determined by medical units with only one physician's office. Knowledge of unit costs is a tool that, when used by medical administrators, allows adequate health care planning and efficient allocation of health resources.

  20. United States Stateplane Zones - NAD83

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1983) represents the State Plane Coordinate System (SPCS) Zones for the 1983 North American Datum within United States.

  1. United States Stateplane Zones - NAD27

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1927) represents the State Plane Coordinate System (SPCS) Zones for the 1927 North American Datum within United States.

  2. Policy drivers and barriers for coal-to-liquids (CtL) technologies in the United States

    International Nuclear Information System (INIS)

    Vallentin, Daniel

    2008-01-01

    Because of a growing dependence on oil imports, powerful industrial, political and societal stakeholders in the United States are trying to enhance national energy security through the conversion of domestic coal into synthetic hydrocarbon liquid fuels-so-called coal-to-liquids (CtL) processes. However, because of the technology's high costs and carbon intensity, its market deployment is strongly affected by the US energy, technology and climate policy setting. This paper analyses and discusses policy drivers and barriers for CtL technologies in the United States and reaches the conclusion that an increasing awareness of global warming among US policy-makers raises the requirements for the technology's environmental performance and, thus, limits its potential to regional niche markets in coal-producing states or strategic markets, such as the military, with specific security and fuel requirements

  3. Economic benefits of the Mediterranean-style diet consumption in Canada and the United States

    Directory of Open Access Journals (Sweden)

    Mohammad M.H. Abdullah

    2015-06-01

    Full Text Available Background: The Mediterranean-style diet (MedDiet is an established healthy-eating behavior that has consistently been shown to favorably impact cardiovascular health, thus likely improving quality of life and reducing costs associated with cardiovascular disease (CVD. Data on the economic benefits of MedDiet intakes are, however, scarce. Objective: The objective of this study was to estimate the annual healthcare and societal cost savings that would accrue to the Canadian and American public, independently, as a result of a reduction in the incidence of CVD following adherence to a MedDiet. Design: A variation in cost-of-illness analysis entailing three stages of estimations was developed to 1 identify the proportion of individuals who are likely to adopt a MedDiet in North America, 2 assess the impact of the MedDiet intake on CVD incidence reduction, and 3 impute the potential savings in costs associated with healthcare and productivity following the estimated CVD reduction. To account for the uncertainty factor, a sensitivity analysis of four scenarios, including ideal, optimistic, pessimistic, and very-pessimistic assumptions, was implemented within each of these stages. Results: Significant improvements in CVD-related costs were evident with varying MedDiet adoption and CVD reduction rates. Specifically, CAD $41.9 million to 2.5 billion in Canada and US $1.0–62.8 billion in the United States were estimated to accrue as total annual savings in economic costs, given the ‘very-pessimistic’ through ‘ideal’ scenarios. Conclusions: Closer adherence to dietary behaviors that are consistent with the principles of the MedDiet is expected to contribute to a reduction in the monetary burdens of CVD in Canada, the United States, and possibly other parts of the world.

  4. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  5. Market power and state costs of HIV/AIDS drugs.

    Science.gov (United States)

    Leibowitz, Arleen A; Sood, Neeraj

    2007-03-01

    We examine whether U.S. states can use their market power to reduce the costs of supplying prescription drugs to uninsured and underinsured persons with HIV through a public program, the AIDS Drug Assistance Program (ADAP). Among states that purchase drugs from manufacturers and distribute them directly to clients, those that purchase a greater volume pay lower average costs per prescription. Among states depending on retail pharmacies to distribute drugs and then claiming rebates from manufacturers, those that contract with smaller numbers of pharmacy networks have lower average costs. Average costs per prescription do not differ between the two purchase methods.

  6. United States Domestic Research Reactor Infrastructure - TRIGA Reactor Fuel Support

    International Nuclear Information System (INIS)

    Morrell, Douglas

    2008-01-01

    The purpose of the United State Domestic Research Reactor Infrastructure Program is to provide fresh nuclear reactor fuel to United States universities at no, or low, cost to the university. The title of the fuel remains with the United States government and when universities are finished with the fuel, the fuel is returned to the United States government. The program is funded by the United States Department of Energy - Nuclear Energy division, managed by Department of Energy - Idaho Field Office, and contracted to the Idaho National Laboratory's Management and Operations Contractor - Battelle Energy Alliance. Program has been at Idaho since 1977 and INL subcontracts with 26 United States domestic reactor facilities (13 TRIGA facilities, 9 plate fuel facilities, 2 AGN facilities, 1 Pulstar fuel facility, 1 Critical facility). University has not shipped fuel since 1968 and as such, we have no present procedures for shipping spent fuel. In addition: floor loading rate is unknown, many interferences must be removed to allow direct access to the reactor tank, floor space in the reactor cell is very limited, pavement ends inside our fence; some of the surface is not finished. The whole approach is narrow, curving and downhill. A truck large enough to transport the cask cannot pull into the lot and then back out (nearly impossible / refused by drivers); a large capacity (100 ton), long boom crane would have to be used due to loading dock obstructions. Access to the entrance door is on a sidewalk. The campus uses it as a road for construction equipment, deliveries and security response. Large trees are on both sides of sidewalk. Spent fuel shipments have never been done, no procedures approved or in place, no approved casks, no accident or safety analysis for spent fuel loading. Any cask assembly used in this facility will have to be removed from one crane, moved on the floor and then attached to another crane to get from the staging area to the reactor room. Reactor

  7. Overcoming the Challenges in Implementing Type 2 Diabetes Mellitus Prevention Programs Can Decrease the Burden on Healthcare Costs in the United States

    Directory of Open Access Journals (Sweden)

    Kritika Subramanian

    2017-01-01

    Full Text Available Theoretically, identifying prediabetics would reduce the diabetic burden on the American healthcare system. As we expect the prevalence rate of prediabetes to continue increasing, we wonder if there is a better way of managing prediabetics and reducing the economic cost on the healthcare system. To do so, understanding the demographics and behavioral factors of known prediabetics was important. For this purpose, responses of prediabetic/borderline diabetes patients from the most recent publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS survey were analyzed. The findings showed that there was a correlation between household income, geographic residence in the US, and risk for developing diabetes mellitus type 2, aside from the accepted risk factors such as high BMI. In conclusion, implementation of the National Diabetes Prevention Program is a rational way of reducing the burden of DM on the healthcare system both economically and by prevalence. However, difficulties arise in ensuring patient compliance to the program and providing access to all regions and communities of the United States. Technology incorporation in the NDPP program would maintain a low-cost implementation by the healthcare system, be affordable and accessible for all participants, and decrease economic burden attributed to diabetes mellitus.

  8. Assessing the Risk of Establishment of Rhagoletis cerasi (Diptera: Tephritidae) in the United States and Globally.

    Science.gov (United States)

    Wakie, Tewodros T; Yee, Wee L; Neven, Lisa G

    2018-05-28

    The European cherry fruit fly, Rhagoletis cerasi (L.) (Diptera: Tephritidae), is a highly destructive pest of cherries (Prunus spp.) (Rosaceae) in Europe and Asia. In 2016, R. cerasi was detected in Ontario, Canada, and in 2017 in New York State, USA, the first records of this pest in North America. The initial detections in Canada caused concern for the major cherry-growing states of Michigan, Washington, Oregon, and California in the United States. Establishment of R. cerasi in the United States could restrict cherry exports to other markets and increase costs needed for fly control, but it is unknown if R. cerasi can establish in U.S. commercial cherry regions. Here, we used the CLIMEX ecological niche model to determine the risk of establishment of R. cerasi in the United States and globally. Within the United States under a no-irrigation scenario, R. cerasi would establish in the East and West Coasts; however, under an irrigation scenario, its distribution would expand to the major cherry-growing regions in the interior of central and eastern Washington and in California. Results also showed that if introduced, R. cerasi would likely establish in eastern China, Japan, the Koreas, Australia, New Zealand, South America, South Africa, Mexico, and Canada. Host plant (Prunus spp. and Lonicera spp. [Caprifoliaceae]) presence, although not included in models, would affect fly establishment. Our results stress the importance of surveying for R. cerasi to prevent its spread and establishment within the United States and other countries.

  9. Competitiveness through change: institutional restructuring of the United States uranium enrichment enterprise

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1987-01-01

    The position of the United States programme of uranium enrichment under the Department of Energy is explained. Its competitiveness has improved over the past few years by normalising supply and demand and by streamlining the costs of gaseous diffusion plant production. The historical aspects of the uranium enrichment service are explained. Revised criteria to describe the guidelines to cover pricing, contracting and other crucial functions are under discussion. Two aspects of the new criteria of particular interest -restrictions on foreign-origin uranium and recovery of Government costs - are noted. Possible private sector involvement in uranium enrichment is discussed. Technological innovations are explained and equipment illustrated. These should improve the industry's competitiveness. (U.K.)

  10. Geological studies of the COST No. B-3 Well, United States Mid-Atlantic continental slope area

    Science.gov (United States)

    Scholle, Peter A.

    1980-01-01

    The COST No. B-3 well is the first deep stratigraphic test to be drilled on the Continental Slope off the Eastern United States. The well was drilled in 2,686 ft (819 m) of water in the Baltimore Canyon trough area to a total depth of 15,820 ft (4,844 m) below the drill platform. It penetrated a section composed of mudstones, calcareous mudstones, and limestones of generally deep water origin to a depth of about 8.200 ft (2,500 m) below the drill floor. Light-colored, medium- to coarse-grained sandstones with intercalated gray and brown shales, micritic limestones, and minor coal and dolomite predominate from about 8,200 to 12,300 ft (2,500 to 3,750 m). From about 12,300 ft (3,750 m) to the bottom, the section consists of limestones (including oolitic and intraclastic grainstones) with interbedded fine-to medium-grained sandstones, dark-colored fissile shales, and numerous coal seams. Biostratigraphic examination has shown that the section down to approximately 6,000 ft (1,830 m) is Tertiary. The boundary between the Lower and Upper Cretaceous sections is placed between 8,600 and 9,200 ft (2,620 and 2,800 m) by various workers. Placement of the Jurassic-Cretaceous boundary shows an even greater range based on different organisms; it is placed variously between 12,250 and 13,450 ft (3,730 and 5,000 m). The oldest unit penetrated in the well is considered to be Upper Jurassic (Kimmeridgian) by some workers and Middle Jurassic (Callovian) by others. The Lower Cretaceous and Jurassic parts of the section represent nonmarine to shallow-marine shelf sedimentation. Upper Cretaceous and Tertiary units reflect generally deeper water conditions at the B-3 well site and show a general transition from deposition at shelf to slope water depths. Examination of cores, well cuttings, and electric logs indicates that potential hydrocarbon-reservoir units are present throughout the Jurassic and Cretaceous section. Porous and moderately permeable limestones and sandstones have been

  11. State-Level Estimates of Obesity-Attributable Costs of Absenteeism

    Science.gov (United States)

    Andreyeva, Tatiana; Luedicke, Joerg; Wang, Y. Claire

    2014-01-01

    Objective To provide state-level estimates of obesity-attributable costs of absenteeism among working adults in the U.S. Methods Nationally-representative data from the National Health and Nutrition Examination Survey (NHANES) for 1998–2008 and from the Behavioral Risk Factor Surveillance System (BRFSS) for 2012 are examined. The outcome is obesity-attributable workdays missed in the previous year due to health, and their costs to states. Results Obesity, but not overweight, is associated with a significant increase in workdays absent, from 1.1 to 1.7 extra days missed annually compared to normal weight employees. Obesity-attributable absenteeism among American workers costs the nation an estimated $8.65 billion per year. Conclusion Obesity imposes a considerable financial burden on states, accounting for 6.5%–12.6% of total absenteeism costs in the workplace. State legislature and employers should seek effective ways to reduce these costs. PMID:25376405

  12. 31 CFR 103.39 - Person outside the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Person outside the United States. 103... Person outside the United States. For the purposes of this subpart, a remittance or transfer of funds, or... the United States, shall be deemed to be a remittance or transfer to a person outside the United...

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

    Science.gov (United States)

    Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

    2009-01-01

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

  14. Energy problems of the United States

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2006-01-01

    The united states are the third world producer of oil which accounts for 440% of world production and 20 million barrels/day of which 60% are imported. That dependence on imports is likely to increase in the next decades. Such supplies and their security are therefore a fundamental factor of the United States foreign policy in combination with their political, economic and strategic objectives in a world both unsure and dangerous

  15. Household pesticide usage in the United States.

    Science.gov (United States)

    Savage, E P; Keefe, T J; Wheeler, H W; Mounce, L; Helwic, L; Applehans, F; Goes, E; Goes, T; Mihlan, G; Rench, J; Taylor, D K

    1981-01-01

    A total of 10,000 U.S. households in 25 standard metropolitan statistical areas and 25 counties were included in the United States. More than 8,200 households granted an interview. Nine of every ten households in the United States used some types of pesticide in their house, garden, or yard. Households in the southeastern United States used the most pesticides. Although more than 500 different pesticide formulations were used by the sampled households, 15 pesticides accounted for 65.5% of all pesticides reported in this study. Thirteen of these 15 pesticides were insecticides, one was a herbicide, and one was a rodenticide.

  16. The value of group purchasing organizations in the United States.

    Science.gov (United States)

    Rooney, Curtis

    2011-01-01

    This article examines the valuable role of group purchasing organizations (GPOs) in hospital purchasing in the United States. For over 100 years old GPOs have helped hospitals and other health care providers realize savings and create contracting efficiencies by aggregating purchasing volume to negotiate discounts with manufacturers, distributors and other vendors. The US has recently enacted a series of healthcare reforms to correct some of the historical concerns regarding cost, quality and access. GPOs are expected to continue to play a critical role in the business of hospital purchasing and may potential export that other countries may wish to examine.

  17. Gaps in vaccine financing for underinsured children in the United States.

    Science.gov (United States)

    Lee, Grace M; Santoli, Jeanne M; Hannan, Claire; Messonnier, Mark L; Sabin, James E; Rusinak, Donna; Gay, Charlene; Lett, Susan M; Lieu, Tracy A

    2007-08-08

    The number of new vaccines recommended for children and adolescents has nearly doubled during the past 5 years, and the cost of fully vaccinating a child has increased dramatically in the past decade. Anecdotal reports from state policy makers and clinicians suggest that new gaps have arisen in financial coverage of vaccines for children who are underinsured (ie, have private insurance that does not cover all recommended vaccines). In 2000, approximately 14% of children were underinsured for vaccines in the United States. To describe variation among states in the provision of new vaccines to underinsured children and to identify barriers to state purchase and distribution of new vaccines. A 2-phase mixed-methods study of state immunization program managers in the United States. The first phase included 1-hour qualitative telephone interviews conducted from November to December 2005 with 9 program managers chosen to represent different state vaccine financing policies. The second phase incorporated findings from phase 1 to develop a national telephone and paper-based survey of state immunization program managers that was conducted from January to June 2006. Percentage of states in which underinsured children are unable to receive publicly purchased vaccines in the private or public sectors. Immunization program managers from 48 states (96%) participated in the study. Underinsured children were not eligible to receive publicly purchased meningococcal conjugate or pneumococcal conjugate vaccines in the private sector in 70% and 50% of states, respectively, or in the public sector in 40% and 17% of states, respectively. Due to limited financing for new vaccines, 10 states changed their policies for provision of publicly purchased vaccines between 2004 and early 2006 to restrict access to selected new vaccines for underinsured children. The most commonly cited barriers to implementation in underinsured children were lack of sufficient federal and state funding to

  18. Consideration concerning the costs of the 300 kW wind units developed in Romania

    International Nuclear Information System (INIS)

    Gyulai, F.; Bej, A.

    1995-01-01

    A demonstrative wind farm with four research units, 300 kW each, is in developing stage in Romania. The article shows economic analysis of these experimental wind units and their cost structure focusing in component costs, performance, manufacturing technology and installing work. (author)

  19. Consideration concerning the costs of the 300 kW wind units developed in Romania

    Energy Technology Data Exchange (ETDEWEB)

    Gyulai, F; Bej, A [Technical Univ. of Timisoara (Romania). Wind Energy Research Center

    1996-12-31

    A demonstrative wind farm with four research units, 300 kW each, is in developing stage in Romania. The article shows economic analysis of these experimental wind units and their cost structure focusing in component costs, performance, manufacturing technology and installing work. (author)

  20. Consideration concerning the costs of the 300 kW wind units developed in Romania

    Energy Technology Data Exchange (ETDEWEB)

    Gyulai, F.; Bej, A. [Technical Univ. of Timisoara (Romania). Wind Energy Research Center

    1995-12-31

    A demonstrative wind farm with four research units, 300 kW each, is in developing stage in Romania. The article shows economic analysis of these experimental wind units and their cost structure focusing in component costs, performance, manufacturing technology and installing work. (author)

  1. Understanding barriers to commercial-scale carbon capture and sequestration in the United States: An empirical assessment

    International Nuclear Information System (INIS)

    Davies, Lincoln L.; Uchitel, Kirsten; Ruple, John

    2013-01-01

    Although a potentially useful climate change mitigation tool, carbon capture and sequestration (CCS) efforts in the United States remain mired in demonstration and development. Prior studies suggest numerous reasons for this stagnation. This article empirically assesses those claims. Using an anonymous opinion survey completed by 229 CCS experts, we identified four primary barriers to CCS commercialization: (1) cost and cost recovery, (2) lack of a price signal or financial incentive, (3) long-term liability risks, and (4) lack of a comprehensive regulatory regime. These results give empirical weight to previous studies suggesting that CCS cost (and cost recovery) and liability risks are primary barriers to the technology. However, the need for comprehensive rather than piecemeal CCS regulation represents an emerging concern not previously singled out in the literature. Our results clearly show that the CCS community sees fragmented regulation as one of the most significant barriers to CCS deployment. Specifically, industry is united in its preference for a federal regulatory floor that is subject to state-level administration and sensitive to local conditions. Likewise, CCS experts share broad confidence in the technology's readiness, despite continued calls for commercial-scale demonstration projects before CCS is widely deployed. - Highlights: • We developed and distributed a unique CCS opinion survey. • Our analysis confirmed cost and liability as primary barriers to CCS deployment. • We identified regulatory barriers to CCS not previously singled out in the literature. • We address the need for comprehensive rather than piecemeal CCS regulation

  2. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.

    Science.gov (United States)

    Padula, William V; Larson, Richard A; Dusetzina, Stacie B; Apperley, Jane F; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A; Silver, Richard T; Simonsson, Bengt; Conti, Rena M

    2016-07-01

    We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs. We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct. Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. © The Author 2016. Published by Oxford University Press.

  3. Evaluation of syngas production unit cost of bio-gasification facility using regression analysis techniques

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Yangyang; Parajuli, Prem B.

    2011-08-10

    Evaluation of economic feasibility of a bio-gasification facility needs understanding of its unit cost under different production capacities. The objective of this study was to evaluate the unit cost of syngas production at capacities from 60 through 1800Nm 3/h using an economic model with three regression analysis techniques (simple regression, reciprocal regression, and log-log regression). The preliminary result of this study showed that reciprocal regression analysis technique had the best fit curve between per unit cost and production capacity, with sum of error squares (SES) lower than 0.001 and coefficient of determination of (R 2) 0.996. The regression analysis techniques determined the minimum unit cost of syngas production for micro-scale bio-gasification facilities of $0.052/Nm 3, under the capacity of 2,880 Nm 3/h. The results of this study suggest that to reduce cost, facilities should run at a high production capacity. In addition, the contribution of this technique could be the new categorical criterion to evaluate micro-scale bio-gasification facility from the perspective of economic analysis.

  4. A comparative study of Japan and United States nuclear enterprise: Industry structure and construction experience

    International Nuclear Information System (INIS)

    Hinman, G.W.; Lowinger, T.C.

    1987-01-01

    Both Japan and the United States have undertaken major programs to utilize nuclear power for central station electricity generation. Over the past 20 years, the Japanese have developed their own construction and government regulatory institutions and now have an essentially independent domestic nuclear power program. Nuclear construction and government oversight of nuclear power have developed somewhat differently in Japan and the United States, reflecting to some extent the two countries' different business and social cultures. In the United States the vendor and utility industries are much more fragmented than those in Japan, and construction projects are carried out on a more competitive basis. The Japanese industry operates through a few well-established consortia while the U.S. industry does not. Relations among the national government, the vendors, and the electric utilities tend to be cooperative in Japan while they are more adversarial in the Untied States. This paper discusses these topics in a framework of a comparative study of the countries' nuclear industries. Whether because of the factors mentioned above or for other reasons the success of nuclear power in Japan and the United States has differed dramatically in recent years. This paper compares the performance of the nuclear enterprise in these two countries in terms of the physical attributes of the plants themselves, the labor required to build them, and the construction times required. It also discusses the relationship between initial estimates of costs and schedules and actual results achieved. On all counts, recent Japanese performance has been better than in the United States

  5. Eye on China and United States

    Directory of Open Access Journals (Sweden)

    Milad Mahyari

    2016-07-01

    Full Text Available United States strives to force the Chinese into agreement of increasing the value of their exchange rate to help the USA avoid inflation As China did not come into an agreement with the USA, Tariffs are being put on Chinese products entering USA. However China as began to add tariff on poultry received from the US as well. China was previously not named in the legislation permitting US to add tariff on their goods. But recently a bill was passed giving the commerce department the ability to place important tariffs on all countries to undervalue their currency. The bill passed in legislation had the support of 99 republicans. China has been managing their currency in a manner that makes their goods cheaper to sell and American goods more expensive. The Chinese manipulation of their currency has been quite expensive for the USA, as it has cost them $1.5 billion jobs increasing the percentage of unemployment greatly and significantly. This imposition of tariffs on Chinese goods could result in effecting $300 billion dollars worth of their products. It is obvious that the Americans are attempting to improve and acknowledge their growth and power. As predictions have developed over this conflict, arguing the fact that China will not negotiate with the USA at this point rather fight back and also approach in adding tariffs on USimports. However, this reaction by the Chinese will only worsen the scenario and result in the possible inflation of the US economy or worldwide trade war. This is a very sensitive time for the United States as their biggest hopes are dependent on the Chinese. But it doesn’t look like they will be too satisfied with the outcome.

  6. The United States Geological Survey: 1879-1989

    Science.gov (United States)

    Rabbitt, Mary C.

    1989-01-01

    The United States Geological Survey was established on March 3, 1879, just a few hours before the mandatory close of the final session of the 45th Congress, when President Rutherford B. Hayes signed the bill appropriating money for sundry civil expenses of the Federal Government for the fiscal year beginning July 1, 1879. The sundry civil expenses bill included a brief section establishing a new agency, the United States Geological Survey, placing it in the Department of the Interior, and charging it with a unique combination of responsibilities: 'classification of the public lands, and examination of the geological structure, mineral resources, and products of the national domain.' The legislation stemmed from a report of the National Academy of Sciences, which in June 1878 had been asked by Congress to provide a plan for surveying the Territories of the United States that would secure the best possible results at the least possible cost. Its roots, however, went far back into the Nation's history. The first duty enjoined upon the Geological Survey by the Congress, the classification of the public lands, originated in the Land Ordinance of 1785. The original public lands were the lands west of the Allegheny Mountains claimed by some of the colonies, which became a source of contention in writing the Articles of Confederation until 1781 when the States agreed to cede their western lands to Congress. The extent of the public lands was enormously increased by the Louisiana Purchase in 1803 and later territorial acquisitions. At the beginning of Confederation, the decision was made not to hold the public lands as a capital asset, but to dispose of them for revenue and to encourage settlement. The Land Ordinance of 1785 provided the method of surveying and a plan for disposal of the lands, but also reserved 'one-third part of all gold, silver, lead, and copper mines to be sold or otherwise disposed of, as Congress shall thereafter direct,' thus implicitly requiring

  7. A Bicultural Analysis of the Cost of Caring: Nursing Burnout in the United States and the Philippines.

    Science.gov (United States)

    Turnipseed, David L.; Turnipseed, Patricia H.

    1997-01-01

    Questionnaires completed by 129 U.S. nurses and 71 from the Philippines revealed higher levels of emotional exhaustion and feelings of personal accomplishment in the United States. The Filipino work environment was rated higher for supervisor support, autonomy, control, and innovation. U.S. nurses reported greater work pressure. (SK)

  8. Unit costs for house spraying and bednet impregnation with residual insecticides in Colombia: a management tool for the control of vector-borne disease.

    Science.gov (United States)

    Kroeger, A; Ayala, C; Medina Lara, A

    2002-06-01

    A study of unit costs and cost components of two malaria-control strategies (house spraying and bednet impregnation with residual insecticides) was undertaken in 11 malaria-endemic states (departamentos) of Colombia, using data provided by control staff on self-administered questionnaires. The accuracy of the data was verified by personal visits, telephone conversations and complementary information from 10 other states. Allthe financial-cost components of the malaria-control operations carried out in the previous 6 months and the results of the control operations themselves (including the numbers of houses sprayed and numbers of bednets impregnated/day) were recorded. The information was stratified according to whether the target communities were 'near' or 'far away' from an operational base, the far-away communities being those that needed overnight stays by the control staff. The main variables analysed were unit costs/house treated, and annual cost/person protected. The results show that house spraying was generally more expensive for the health services than bednet impregnation. This is particularly the case in 'nearby' communities, where most of those at-risk live. In such communities, spraying one house was 7.2 times more expensive than impregnating one bednet. Even if only those sleeping under an impregnated net were assumed to be protected, the unit costs/person protected in a 'nearby' community were twice as high for house spraying than for bednet impregnation. In 'nearby' communities, where technicians could return to the operational base each evening, insecticides made up 80% of the total spraying costs and 42% of the costs of bednet impregnation. In 'far-away' communities, however, salaries and 'per diems' were the most important cost components, representing, respectively, 23% and 22% of the costs of spraying, and 34% plus 27% of the costs of impregnation. Insecticide wastage and non-use of discounts on insecticide prices (available through the

  9. 75 FR 13345 - Pricing for Certain United States Mint Products

    Science.gov (United States)

    2010-03-19

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for Certain United States Mint Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of First Spouse Bronze Medals and 2010 First Spouse Bronze Medal Series: Four...

  10. Health insurance premium increases for the 5 largest school districts in the United States, 2004-2008.

    Science.gov (United States)

    Cantillo, John R

    2010-03-01

    Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers-Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace.

  11. Delivery Unit Costs for Antiretroviral Treatment and Prevention of Mother-to-Child-Transmission of HIV

    Science.gov (United States)

    Galárraga, Omar; Wirtz, Veronika J.; Figueroa-Lara, Alejandro; Santa-Ana-Tellez, Yared; Coulibaly, Ibrahima; Viisainen, Kirsi; Medina-Lara, Antonieta; Korenromp, Eline L.

    2013-01-01

    Background As antiretroviral treatment (ART) for HIV/AIDS is scaled-up globally, information on per-person costs is critical to improve efficiency in service delivery and maximize coverage and health impact. Objective To review studies on delivery unit costs for adult and pediatric ART provision per-patient-year, and prevention of mother-to-child transmission (PMTCT) interventions per mother-infant pair screened or treated, in low- and middle-income countries. Methods Systematic review of English, French and Spanish publications from 2001 to 2009, reporting empirical costing that accounted for at least antiretroviral (ARV) medicines, laboratory testing and personnel. Expenditures were analyzed by country income level and cost component. All costs were standardized to 2009 US dollars. Results Analyses covered 29 eligible, comprehensive costing studies. In the base case, in low-income countries (LIC), median, ART cost per patient-year was $792 (mean: $839, range: $682-$1089); for lower-middle-income countries (LMIC), the median was $932 (mean: $1246, range: $156-$3904); and for upper-middle-income countries (UMIC) the median was $1454 (mean: $2783, range: $1230-$5667). ARV drugs were largest component of overall ART cost in all settings (62%, 50% and 47% in LIC, LMIC and UMIC respectively). Out of 26 ART studies, 14 report which drug regimes were used, and only one study explicitly reported second line treatment costs. The second cost driver was laboratory cost in LIC and LMIC (14% and 19.5%) whereas it was personnel costs in UMIC (26%). Two studies specified the types of laboratory tests costed, and three studies specifically included above-facility-level personnel costs. Three studies reported detailed PMTCT costs, and two studies reported on pediatric ART. Conclusions There is a paucity of data on the full ART and PMTCT delivery unit costs, in particular for low-and middle-income countries. Heterogeneity in activities costed and insufficient detail regarding

  12. 22 CFR 22.3 - Remittances in the United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Remittances in the United States. 22.3 Section...-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.3 Remittances in the United States. (a) Type of remittance. Remittances shall be in the form of: (1) Check or bank draft drawn on a bank in the United States; (2) money...

  13. Political gender inequality and infant mortality in the United States, 1990-2012.

    Science.gov (United States)

    Homan, Patricia

    2017-06-01

    Although gender inequality has been recognized as a crucial factor influencing population health in the developing world, research has not yet thoroughly documented the role it may play in shaping U.S. infant mortality rates (IMRs). This study uses administrative data with fixed-effects and random-effects models to (1) investigate the relationship between political gender inequality in state legislatures and state infant mortality rates in the United States from 1990 to 2012, and (2) project the population level costs associated with women's underrepresentation in 2012. Results indicate that higher percentages of women in state legislatures are associated with reduced IMRs, both between states and within-states over time. According to model predictions, if women were at parity with men in state legislatures, the expected number of infant deaths in the U.S. in 2012 would have been lower by approximately 14.6% (3,478 infant deaths). These findings underscore the importance of women's political representation for population health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. [Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

    Science.gov (United States)

    Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

    2008-05-01

    The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

  15. Electric trade in the United States, 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    Wholesale trade in electricity plays an important role for the US electric utility industry. Wholesale, or bulk power, transactions allow electric utilities to reduce power costs, increase power supply options, and improve reliability. In 1996, the wholesale trade market totaled 2.3 trillion kilowatthours, over 73% of total sales to ultimate consumers. This publication, Electric Trade in the United States 1996 (ELECTRA), is the sixth in a series of reports on wholesale power transactions prepared by the Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA). The electric trade data are published biennially. The first report presented 1986 data, and this report provides information on the electric power industry during 1996. The electric trade data collected and presented in this report furnish important information on the wholesale structure found within the US electric power industry. The patterns of interutility trade in the report support analyses of wholesale power transactions and provide input for a broader understanding of bulk power market issues that define the emerging national electric energy policies. The report includes information on the quantity of power purchased, sold, exchanged, and wheeled; the geographical locations of transactions and ownership classes involved; and the revenues and costs. 1 fig., 43 tabs.

  16. The United States nuclear liability regime under the Price-Anderson Act

    International Nuclear Information System (INIS)

    Brown, O. F.

    2011-01-01

    The 1958 U. S. Price-Anderson Act created the worlds first national nuclear liability regime. It now provides US $12,6 Billion of nuclear liability coverage for the 104 nuclear power plants in the United States, by far the highest monetary coverage of any nuclear liability regime in the world. Each power plant operator provides nuclear hazards coverage for anyone liable through a combination of private insurance from the American nuclear insurance pool (now US$ 375 million) and a retrospective assessment (now US$111,9 million per power plant per incident plus 5 percent for claims and costs). The United States in 2008 ratified the International Atomic Energy Agency's Convention on Supplementary Compensation for Nuclear Damage (CSC). and is promoting it as the basis for a more global nuclear liability regime uniting States that are party to the Vienna Convention or the Paris Convention, or have a domestic law consistent with the CSC Annex. The CSC Annex was written to grad father the Price-Anderson Acts economic channeling of liability to the installation operator. The omnibus feature of Price-Anderson is similar to the legal channeling of all liability to the installation operator under the international nuclear liability conventions and domestic laws of many other countries. The Price-Anderson system (like the Vienna and Paris Conventions) does not provide liability coverage for nuclear damage to or loss of use of on-site property. (Author)

  17. The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

    Science.gov (United States)

    Oettinger, Gerald S.

    2011-01-01

    This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

  18. The United Kingdom: Issues for the United States

    National Research Council Canada - National Science Library

    Archick, Kristin

    2007-01-01

    ...; and more recently, from the UK's strong support in countering terrorism and confronting Iraq. The United States and Britain also share a mutually beneficial trade and economic relationship, and are each other's biggest foreign direct investors...

  19. CNSS plant concept, capital cost, and multi-unit station economics

    Energy Technology Data Exchange (ETDEWEB)

    1984-07-01

    United Engineers and Constructors (UE and C) and the Babcock and Wilcox Company (B and W) have performed several studies over the last eight years related to small integral pressurized water reactors. These reactors include the 365 MWt (100 MWe) Consolidated Nuclear Steam Generator (CNSG) and the 1200 MWt Consolidated Nuclear Steam System (CNSS). The studies, mostly performed under contract to the Oak Ridge National Laboratory, have led to a 1250 MWt (400 MWe) Consolidated Nuclear Steam System (CNSS) plant concept, with unique design and cost features. This report contains an update of earlier studies of the CNSS reactor and balance-of-plant concept design, capital costs, and multi-unit plant economics incorporating recent design developments, improvements, and post-TMI-2 upgrades. The economic evaluation compares the total system economic impact of a phased, three stage 400 MWe CNSS implementation program, i.e., a three-unit station, to the installation of a single 1200 MWe Pressurized Water Reactor (PWR) into a typical USA utility system.

  20. CNSS plant concept, capital cost, and multi-unit station economics

    International Nuclear Information System (INIS)

    1984-07-01

    United Engineers and Constructors (UE and C) and the Babcock and Wilcox Company (B and W) have performed several studies over the last eight years related to small integral pressurized water reactors. These reactors include the 365 MWt (100 MWe) Consolidated Nuclear Steam Generator (CNSG) and the 1200 MWt Consolidated Nuclear Steam System (CNSS). The studies, mostly performed under contract to the Oak Ridge National Laboratory, have led to a 1250 MWt (400 MWe) Consolidated Nuclear Steam System (CNSS) plant concept, with unique design and cost features. This report contains an update of earlier studies of the CNSS reactor and balance-of-plant concept design, capital costs, and multi-unit plant economics incorporating recent design developments, improvements, and post-TMI-2 upgrades. The economic evaluation compares the total system economic impact of a phased, three stage 400 MWe CNSS implementation program, i.e., a three-unit station, to the installation of a single 1200 MWe Pressurized Water Reactor (PWR) into a typical USA utility system

  1. Radiation therapy facilities in the United States

    International Nuclear Information System (INIS)

    Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah; Minsky, Bruce D.; Bach, Peter B.

    2006-01-01

    Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA), as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care

  2. 75 FR 13345 - Pricing for Certain 2010 United States Mint Products

    Science.gov (United States)

    2010-03-19

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for Certain 2010 United States Mint Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 United States Mint Presidential $1 Coin and First Spouse Medal...

  3. Economic feasibility of producing sweet sorghum as an ethanol feedstock in the southeastern United States

    International Nuclear Information System (INIS)

    Linton, Joseph A.; Miller, J. Corey; Little, Randall D.; Petrolia, Daniel R.; Coble, Keith H.

    2011-01-01

    This study examines the feasibility of producing sweet sorghum (Sorghum bicolor (L.) Moench) as an ethanol feedstock in the southeastern United States through representative counties in Mississippi. We construct enterprise budgets along with estimates of transportation costs to estimate sweet sorghum producers' breakeven costs for producing and delivering sweet sorghum biomass. This breakeven cost for the sweet sorghum producer is used to estimate breakeven costs for the ethanol producer based on wholesale ethanol price, production costs, and transportation and marketing costs. Stochastic models are developed to estimate profits for sweet sorghum and competing crops in two representative counties in Mississippi, with sweet sorghum consistently yielding losses in both counties. -- Highlights: → We examine the economic feasibility of sweet sorghum as an ethanol feedstock. → We construct enterprise budgets along with estimates of transportation costs. → We estimate breakeven costs for producing and delivering sweet sorghum biomass. → Stochastic models determine profits for sweet sorghum in two Mississippi counties.

  4. Renewable energy policy design and framing influence public support in the United States

    Science.gov (United States)

    Stokes, Leah C.; Warshaw, Christopher

    2017-08-01

    The United States has often led the world in supporting renewable energy technologies at both the state and federal level. However, since 2011 several states have weakened their renewable energy policies. Public opinion will probably be crucial for determining whether states expand or contract their renewable energy policies in the future. Here we show that a majority of the public in most states supports renewable portfolio standards, which require a portion of the electricity mix to come from renewables. However, policy design and framing can strongly influence public support. Using a survey experiment, we show that effects of renewable portfolio standards bills on residential electricity costs, jobs and pollution, as well as bipartisan elite support, are all important drivers of public support. In many states, these bills' design and framing can push public opinion above or below majority support.

  5. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities. [Task 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-15

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco`s refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R&D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ``unit cost`` portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible` to estimate the likely future impacts, costs, and sources of oil spills.

  6. Intergenerational educational mobility in Denmark and the United States

    DEFF Research Database (Denmark)

    Andrade, Stefan Bastholm; Thomsen, Jens-Peter

    2018-01-01

    An overall finding in comparative mobility studies is that intergenerational mobility is greater in Scandinavia than in liberal welfare-state countries like the United States and United Kingdom. However, in a recent study, Landersø and Heckman (L & H) (2017) argue that intergenerational educational...... mobility in Denmark and the United States is remarkably similar. L & H’s findings run contrary to widespread beliefs and have been echoed in academia and mass media on both sides of the Atlantic Ocean. In this article, we reanalyze educational mobility in Denmark and the United States using the same data...... sources as L & H. We apply several different methodological approaches from economics and sociology, and we consistently find that educational mobility is higher in Denmark than in the United States....

  7. Environmental protection uranium recovery issues in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Peake, R.T.; Cherepy, A.; Rosnick, R.; Schultheisz, D.; Setlow, L. [U.S. Environmental Protection Agency, Washington, DC (United States)

    2011-07-01

    Uranium recovery activities in the United States were at a standstill just a few years ago. Demand for processed uranium yellowcake has increased, as has its price, though the price is down since the Fukushima reactor accident. Interest in producing uranium has increased, too. Currently the most preferred, low-cost uranium extraction method in the United States is in-situ leach (ISL) recovery where the geohydrology is conducive to injection, mobilization and pumping. A number of applications for new ISL and conventional mills have recently been submitted or are expected to be submitted for licensing by the Nuclear Regulatory Commission (NRC). In the United States, the Environmental Protection Agency (EPA) has developed Health and Environmental Protection Standards for Uranium and Thorium Mill Tailings under the authority of the Uranium Mill Tailings Radiation Control Act of 1978 (UMTRCA). These standards are found in the Code of Federal Regulations, Title 40, Part 192 (40 CFR Part 192). The NRC develops implementing regulations for 40 CFR Part 192 and then NRC or delegated States enforce the NRC and EPA regulations. Facilities regulated under 40 CFR Part 192 include conventional uranium and thorium mills as well as in-situ leach operations, which are considered to be 'milling underground' for regulatory purposes. However, there are no explicit standards for ISL operations in 40 CFR Part 192. In addition, EPA has determined that portions of the operations at uranium recovery operations, specifically the radon emissions from tailings impoundments, are covered by Section 112 of the Clean Air Act as a source of hazardous air pollutants (HAPs). EPA addresses these operations in 40 CFR Part 61, Subpart W. EPA is in the process of reviewing both 40 CFR Part 192 and 40 CFR Part 61, Subpart W for possible revision. This paper presents some of the issues related to uranium recovery that are being considered in the current regulatory review. (author)

  8. Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  9. Governance Based on Cost Analysis (Unit Cost Analysis for Vocational Schools

    Directory of Open Access Journals (Sweden)

    Chandra Situmeang

    2018-02-01

    Full Text Available This study aims to calculate unit cost to produce one middle-level vocational school graduate (in Indonesian terms known as "Sekolah Menengah Kejuruan” abbreviated as SMK. The calculation is required because operational grant funds (in Indonesian terms known as antuan Operasional Sekolah abbreviated as BOS are distributed so far to the same extent in all areas of Indonesia and for all majors. This is most likely less than optimal because in fact there are very basic characteristics differences including; Economic capacity of each region, the cost standard for each region, and the type of department in the school. Based on this, the researcher assumed that cost analysis should be done by considering these things as a basis to provide BOS funds tailored to specific characteristics. The data to be analyzed in this research is North Sumatra province data. This research is conducted in two stages, which in this report only completed the first phase which is a survey in North Sumatra region. Stages of survey to obtain data which then analyzed with related data such as community income, learning outcomes through the value of national examinations, tuition fee, and conditions of learning facilities. The research is funded by the ministries of research, technology and higher education through competing grant schemes for fiscal year 2017 and 2018. The result of correlation analysis between the variables shows that there is a strong relationship between the average income with average tuition paid by the community and between average tuition paid by the community with Quality Level of Education Facilities. The result of correlation analysis also shows a moderate relationship between the average tuition with learning outcomes measured through average national exam and relationship between quality level of education facilities with average national exam. While the relationship between average income with average national exam does not have a strong

  10. State nuclear initiatives in the United States

    International Nuclear Information System (INIS)

    Strauss, P.L.; Stoiber, C.R.

    1977-01-01

    The paper deals with State nuclear initiatives regarding the role of nuclear power in the energy future of the United States. The question of whether and under what circumstances nuclear facilities should be used to generate electricity was put to the popular vote in several States in 1976. Some general principles of Federal-State relations are discussed with specific reference to nuclear regulations. The initiative mechanism itself is described as well as its legal form and background. The parallel developments in the State and Federal legislative consideration of nuclear issues is reviewed and the suggested reasons for the defeat of the proposals in the seven States concerned are discussed. Finally, the author draws some conclusions on the effects of the 1976 initiatives on future decision-making in the US on energy policy in general and nuclear power in particular. (NEA) [fr

  11. 27 CFR 479.89 - Transfers to the United States.

    Science.gov (United States)

    2010-04-01

    ... Transfers to the United States. A firearm may be transferred to the United States or any department... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false Transfers to the United States. 479.89 Section 479.89 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO...

  12. Inpatient burden of constipation in the United States: an analysis of national trends in the United States from 1997 to 2010.

    Science.gov (United States)

    Sethi, Saurabh; Mikami, Sage; Leclair, John; Park, Richard; Jones, Mike; Wadhwa, Vaibhav; Sethi, Nidhi; Cheng, Vivian; Friedlander, Elizabeth; Bollom, Andrea; Lembo, Anthony

    2014-02-01

    Constipation is one of the most common outpatient diagnoses in primary care and gastroenterology clinics; however, there is limited data on the inpatient burden of constipation in the United States. The aim of this study was to evaluate inpatient admission rates, length of stay, and associated costs related to constipation from 1997 to 2010. We analyzed the National Inpatient Sample Database for all patients in which constipation (ICD-9 codes: 564.0-564.09) was the principal discharge diagnosis from 1997 to 2010. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by utilizing the Spearman's coefficient to describe various trends. Between 1997 and 2010, the number of hospitalizations for patients with a primary discharge diagnosis of constipation increased from 21,190 patients to 48,450 (Phospital stay increased only slightly from 3.0 days to 3.1 days (b=0.008 (0.003-0.014); P=0.004). The mean charges per hospital discharge for constipation increased from $8869 in 1997 (adjusted for long-term inflation) to $17,518 in 2010 (b=745.4 (685.3-805.6); Pconstipation discharges, patients in the 1-17 years age group had the highest frequency of constipation per 10,000 discharges. The number of inpatient discharges for constipation and associated costs has significantly increased between 1997 and 2010.

  13. The Future Potential of Waver Power in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Mirko Previsic; Jeff Epler; Maureen Hand; Donna Heimiller; Walter Short; Kelly Eurek

    2012-09-20

    The theoretical ocean wave energy resource potential exceeds 50% of the annual domestic energy demand of the United States, is located close to coastal population centers, and, although variable in nature, may be more consistent and predictable than some other renewable generation technologies. As a renewable electricity generation technology, ocean wave energy offers a low air pollutant option for diversifying the U.S. electricity generation portfolio. Furthermore, the output characteristics of these technologies may complement other renewable technologies. This study addresses the following: (1) The theoretical, technical and practical potential for electricity generation from wave energy (2) The present lifecycle cost profile (Capex, Opex, and Cost of Electricity) of wave energy conversion technology at a reference site in Northern California at different plant scales (3) Cost of electricity variations as a function of deployment site, considering technical, geo-spatial and and electric grid constraints (4) Technology cost reduction pathways (5) Cost reduction targets at which the technology will see significant deployment within US markets, explored through a series of deployment scenarios RE Vision Consulting, LLC (RE Vision), engaged in various analyses to establish current and future cost profiles for marine hydrokinetic (MHK) technologies, quantified the theoretical, technical and practical resource potential, performed electricity market assessments and developed deployment scenarios. RE Vision was supported in this effort by NREL analysts, who compiled resource information, performed analysis using the ReEDSa model to develop deployment scenarios, and developed a simplified assessment of the Alaska and Hawaii electricity markets.

  14. Low Temperature Geothermal Resource Assessment for Membrane Distillation Desalination in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Akar, Sertac; Turchi, Craig

    2017-05-01

    Substantial drought and declines in potable groundwater in the United States over the last decade has increased the demand for fresh water. Desalination of saline water such as brackish surface or groundwater, seawater, brines co-produced from oil and gas operations, industrial wastewater, blow-down water from power plant cooling towers, and agriculture drainage water can reduce the volume of water that requires disposal while providing a source of high-quality fresh water for industrial or commercial use. Membrane distillation (MD) is a developing technology that uses low-temperature thermal energy for desalination. Geothermal heat can be an ideal thermal-energy source for MD desalination technology, with a target range of $1/m3 to $2/m3 for desalinated water depending on the cost of heat. Three different cases were analyzed to estimate levelized cost of heat (LCOH) for integration of MD desalination technology with low-grade geothermal heat: (1) residual heat from injection brine at a geothermal power plant, (2) heat from existing underutilized low-temperature wells, and (3) drilling new wells for low-temperature resources. The Central and Western United States have important low-temperature (<90 degrees C) geothermal resource potential with wide geographic distribution, but these resources are highly underutilized because they are inefficient for power production. According to the USGS, there are 1,075 identified low temperature hydrothermal systems, 55 low temperature sedimentary systems and 248 identified medium to high temperature geothermal systems in the United States. The estimated total beneficial heat potential from identified low temperature hydrothermal geothermal systems and residual beneficial heat from medium to high temperature systems is estimated as 36,300 MWth, which could theoretically produce 1.4 to 7 million m3/day of potable water, depending on desalination efficiency.

  15. An ecoregional approach to the economic valuation of land- and water-based recreation in the United States

    Science.gov (United States)

    Gajana Bhat; John Bergsrom; R. Jeff. Teasley

    1998-01-01

    This paper describes a framework for estimating the economic value of outdoor recreation across different ecoregions. Ten ecoregions in the continental United States were defined based on similarly functioning ecosystem characters. The individual travel cost method was employed to estimate recreation demand functions for activities such...

  16. 32 CFR 516.54 - Witnesses for the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Witnesses for the United States. 516.54 Section..., Travel, and Expenses of Witnesses § 516.54 Witnesses for the United States. (a) Status of witness. A military member authorized to appear as a witness for the United States, including those authorized to...

  17. 32 CFR 150.21 - Appeals by the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Appeals by the United States. 150.21 Section 150... the United States. (a) Restricted filing. Only a representative of the government designated by the Judge Advocate General of the respective service may file an appeal by the United States under Article...

  18. United States housing, first quarter 2013

    Science.gov (United States)

    Delton Alderman

    2014-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing under construction, and housing completions for single and multifamily units, and sales and construction. This report will be updated regularly.

  19. Shopping around for hospital services: a comparison of the United States and Canada.

    Science.gov (United States)

    Bell, C M; Crystal, M; Detsky, A S; Redelmeier, D A

    1998-04-01

    Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries. To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket. Cross-sectional telephone survey conducted May 1996 to April 1997. The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000. Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency. Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; Preplacement ($26805 vs $10651; Preplacement in the United States. US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket.

  20. 78 FR 29318 - Notice of Public Meeting of the Assembly of the Administrative Conference of the United States

    Science.gov (United States)

    2013-05-20

    ... United States makes recommendations to administrative agencies, the President, Congress, and the Judicial... improve the adjudication process for Social Security disability claims at the administrative law judge... benefit-cost analyses that accompany proposed and final rules. Science in the Administrative Process. This...

  1. The cost of failing states and the limits to sovereignty

    OpenAIRE

    Chauvet, Lisa; Collier, Paul; Hoeffler, Anke

    2007-01-01

    In this paper, we estimate the costs of state failure, both for the failing state itself and for its neighbours. In our analysis, the cost of failure arises from two distinct sources: organized violence due to the incapacity of the state to ensure its own citizens’ security and low quality of regulation and public goods due to poor governance. To estimate the cost of failure, we proceed in two steps. First we estimate the annual loss of growth induced by state failure. Then we cumulate this l...

  2. An Assessment of the Economic Potential of Offshore Wind in the United States from 2015 to 2030

    Energy Technology Data Exchange (ETDEWEB)

    Beiter, Philipp [National Renewable Energy Lab. (NREL), Golden, CO (United States); Musial, Walter [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kilcher, Levi [National Renewable Energy Lab. (NREL), Golden, CO (United States); Maness, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Smith, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-03-29

    This study describes an assessment of the spatial variation of levelized cost of energy (LCOE) and levelized avoided cost of energy to understand the economic viability of fixed-bottom and floating offshore wind technologies across major U.S. coastal areas between 2015 and 2030. In particular, this study offers insights into the available offshore wind resource by region at different levels of LCOE and an assessment of the economically viable resource capacity in the United States.

  3. Arsenic in Ground Water of the United States

    Science.gov (United States)

    ... Team More Information Arsenic in groundwater of the United States Arsenic in groundwater is largely the result of ... Gronberg (2011) for updated arsenic map. Featured publications United States Effects of human-induced alteration of groundwater flow ...

  4. Public policies for managing urban growth and protecting open space: policy instruments and lessons learned in the United States

    Science.gov (United States)

    David N. Bengston; Jennifer O. Fletcher

    2003-01-01

    The public sector in the United States has responded to growing concern about the social and environmental costs of sprawling development patterns by creating a wide range of policy instruments designed to manage urban growth and protect open space. These techniques have been implemented at the local, regional, state and, to a limited extent, national levels. This...

  5. Smoking in the United States Air Force: Trends, Most Prevalent Diseases and their Association with Cost

    Science.gov (United States)

    2011-09-01

    alcohol use (University of Minnesota, 2010). Tobacco use is one of the most significant health issues that the U.S. military faces today . In 2002, it...rates among the active duty members of the Air Force of the United States. Smoking is a severe phenomenon for the Air Force today because it is...allurement. In addition, they launch special tobacco products for women, the so called “ feminized cigarettes”, trying to create more female smokers

  6. Vaccination benefits and cost-sharing policy for non-institutionalized adult Medicaid enrollees in the United States

    OpenAIRE

    Stewart, Alexandra M.; Lindley, Megan C.; Chang, Kristen H.M.; Cox, Marisa A.

    2013-01-01

    Medicaid is the largest funding source of health services for the poorest people in the United States. Medicaid enrollees have greater health care, needs, and higher health risks than other individuals in the country and, experience disproportionately low rates of preventive care. Without, Medicaid coverage, poor uninsured adults may not be vaccinated or would, rely on publicly-funded programs that provide vaccinations. We examined each programs’ policies related to benefit coverage and, copa...

  7. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  8. Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending.

    Science.gov (United States)

    Wouters, Olivier J; Kanavos, Panos G; McKEE, Martin

    2017-09-01

    Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States. Regulators should make it easier for generic drugs to reach the market. Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use. To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. Rising drug prices are putting pressure on health care budgets. Policymakers are assessing how they can save money through generic drugs. We compared generic drug prices and market shares in 13 European countries, using data from 2013, to assess the amount of variation that exists between countries. To place these results in context, we reviewed evidence from recent studies on the prices and use of generics in Europe and the United States. We also surveyed peer-reviewed studies, gray literature, and books published since 2000 to (1) outline existing generic drug policies in European countries and the United States; (2) identify ways to increase generic drug use and to promote price competition among generic drug companies; and (3) explore barriers to implementing reform of generic drug policies, using a historical example from the United States as a case study. The prices and market shares of generics vary widely across Europe. For example, prices charged by manufacturers in Switzerland are, on average, more than 2.5 times those in Germany and more than 6 times those in the United Kingdom, based on the results of a commonly used price index. The proportion of prescriptions filled with generics ranges from 17% in Switzerland to 83% in the United Kingdom. By comparison, the United States has historically had low generic drug prices and high rates of generic drug use (84% in 2013), but has in recent years experienced sharp price increases for some off-patent products. There are policy

  9. 76 FR 13168 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Science.gov (United States)

    2011-03-10

    ... average unit costs of residential energy in a Federal Register notice entitled, ``Energy Conservation... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy AGENCY: Office of Energy Efficiency...

  10. Enrichment situation outside the United States

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Different enrichment technologies are briefly characterized which include gaseous diffusion, which is presently the production mainstay of the United States and France; the gaseous centrifuge which is the production plant for Urenco and the technology for future United States enrichment expansion; the aero-dynamic processes which include the jet nozzle (also known as the Becker process) and the fixed-wall centrifuge (also known as the Helikon process); chemical processes; laser isotope separation processes (also referred to in the literature as LIS); and plasma technology

  11. Health Insurance Premium Increases for the 5 Largest School Districts in the United States, 2004–2008

    Science.gov (United States)

    Cantillo, John R.

    2010-01-01

    Background Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. Objective To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Methods Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. Results The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers—Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Conclusions Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace. PMID:25126311

  12. Leading Causes of Death in Females United States

    Science.gov (United States)

    ... and Health Issues at Work Health Equity Leading Causes of Death in Females, United States Recommend on Facebook Tweet ... to current and previous listings for the leading causes of death in females in the United States. Please note ...

  13. Sizing Combined Heat and Power Units and Domestic Building Energy Cost Optimisation

    OpenAIRE

    Dongmin Yu; Yuanzhu Meng; Gangui Yan; Gang Mu; Dezhi Li; Simon Le Blond

    2017-01-01

    Many combined heat and power (CHP) units have been installed in domestic buildings to increase energy efficiency and reduce energy costs. However, inappropriate sizing of a CHP may actually increase energy costs and reduce energy efficiency. Moreover, the high manufacturing cost of batteries makes batteries less affordable. Therefore, this paper will attempt to size the capacity of CHP and optimise daily energy costs for a domestic building with only CHP installed. In this paper, electricity ...

  14. Cost and usage patterns of antibiotics in a tertiary care neurosurgical unit

    Directory of Open Access Journals (Sweden)

    Manish Singh Sharma

    2012-01-01

    Full Text Available Objectives: The routine use of prophylactic antibiotics in neurosurgery has been shown to significantly reduce surgical site infection rates. The documentation of non-surgical site, nosocomial infections in neurosurgical patients remains limited, despite this being a stimulus for prolific antibiotic usage. The actual quantum of antibiotic use in neurosurgery and its role in infection control remain both undocumented and controversial. The authors address this issue with a cost-effectiveness study using historical controls. Materials and Methods: Bacteriologically positive body fluid samples were used to quantify infection rates in the year 2006 and compared with those in the year 1997. Itemized drug lists obtained from dedicated neurosurgical intensive care units and wards were used to quantify antibiotic usage and calculate their costs. Results were compared using both historical and internal controls. The monetary conversion factor used was INR 40=US$1. Results: A total of 3114 consecutive elective and emergency neurosurgical procedures were performed during the study period. 329 patients (10.6% were recorded to have bacteriologically positive body fluid samples, and 100,250 units of antibiotics were consumed costing Rs. 14,378,227.5 ($359,455.7. On an average, an operated patient received 32.2 units of antibiotics valued at Rs. 4,617 ($115.4. The crude infection rates were recorded to have reduced significantly in comparison to 1997, but did not differ between mirror intra-departmental units with significantly different antibiotic usage. Conclusions: Antibiotics accounted for 31% of the per capita cost of consumables for performing a craniotomy in the year 2006. This estimate should be factored into projecting future package costs.

  15. Achievable Steps Toward Building a National Health Information Infrastructure in the United States

    OpenAIRE

    Stead, William W.; Kelly, Brian J.; Kolodner, Robert M.

    2005-01-01

    Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have th...

  16. Estimating Renewable Energy Economic Potential in the United States: Methodology and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Austin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Beiter, Philipp [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States); Davidson, Carolyn [National Renewable Energy Lab. (NREL), Golden, CO (United States); Denholm, Paul [National Renewable Energy Lab. (NREL), Golden, CO (United States); Melius, Jennifer [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lopez, Anthony [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hettinger, Dylan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mulcahy, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Porro, Gian [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-08-01

    The report describes a geospatial analysis method to estimate the economic potential of several renewable resources available for electricity generation in the United States. Economic potential, one measure of renewable generation potential, is defined in this report as the subset of the available resource technical potential where the cost required to generate the electricity (which determines the minimum revenue requirements for development of the resource) is below the revenue available in terms of displaced energy and displaced capacity.

  17. 33 CFR 2.38 - Waters subject to the jurisdiction of the United States; waters over which the United States has...

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Waters subject to the jurisdiction of the United States; waters over which the United States has jurisdiction. 2.38 Section 2.38 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL JURISDICTION...

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

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P

    2012-07-01

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

  19. Unites States and the oil of the Middle-East

    International Nuclear Information System (INIS)

    Noel, P.

    2005-08-01

    The author discusses different aspects of the United States intervention and behavior in the Middle-East petroleum management. The Iraq and Iran potentials are largely under used. The Saudi Arabia defines its own oil policy, but benefits of the Unites States military help. The United States intervention is in the domain of the security of flux on the world market. (A.L.B.)

  20. An assessment of the cyber security legislation and its impact on the United States electrical sector

    Science.gov (United States)

    Born, Joshua

    The purpose of this research was to examine the cyber-security posture for the United States' electrical grid, which comprises a major component of critical infrastructure for the country. The United States electrical sector is so vast, that the Department of Homeland Security (DHS) estimates, it contains more than 6,413 power plants (this includes 3,273 traditional electric utilities and 1,738 nonutility power producers) with approximately 1,075 gigawatts of energy produced on a daily basis. A targeted cyber-security attack against the electric grid would likely have catastrophic results and could even serve as a precursor to a physical attack against the United States. A recent report by the consulting firm Black and Veatch found that one of the top five greatest concerns for United States electric utilities is the risk that cybersecurity poses to their industry and yet, only one-third state they are currently prepared to meet the increasingly likely threat. The report goes on to state, "only 32% of electric utilities surveyed had integrated security systems with the proper segmentation, monitoring and redundancies needed for cyber threat protection. Another 48 % said they did not" Recent estimates indicate that a large-scale cyber-attack against this sector could cost the United States economy as much as a trillion dollars within a weeks' time. Legislative efforts in the past have primarily been focused on creating mandates that encourage public and private partnership, which have been not been adopted as quickly as desired. With 85 % of all electric utilities being privately owned, it is key that the public and private sector partner in order to mitigate risks and respond as a cohesive unit in the event of a major attack. Keywords: Cybersecurity, Professor Riddell, cyber security, energy, intelligence, outlook, electrical, compliance, legislation, partnerships, critical infrastructure.

  1. The geothermal KWh cost

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    Numerous factors can influence the cost of geothermal electricity production: the size and power of production units, the conversion technology used (Rankine cycle or water steam), the resource quality (dry vapor or water-vapor mixing), the resource depth, the drilling activity in the country and the work people costs. In the United States of America the geothermal kWh cost ranges from 2.5 to 8.5 US cents, while in Italy and Nicaragua it ranges from 3 and 10 cents and from 5.7 to 6 cents, respectively. Results of a comparative study of the kWh production cost from different energy sources is also summarized. (J.S.). 1 tab

  2. Complications of cesarean deliveries among HIV-infected women in the United States

    Science.gov (United States)

    Kourtis, Athena P.; Ellington, Sascha; Pazol, Karen; Flowers, Lisa; Haddad, Lisa; Jamieson, Denise J.

    2015-01-01

    Objective To compare rates of complications associated with cesarean delivery in HIV-infected and HIV-uninfected women in the United States and to investigate trends in such complications across four study cycles spanning the implementation of HAART in the United States (1995–1996, 2000–2001, 2005–2006, 2010–2011). Design The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project is the largest all-payer hospital inpatient care database in the United States; when weighted to account for the complex sampling design, nationally representative estimates are derived. After restricting the study sample to women aged 15–49 years, our study sample consisted of approximately 1 090 000 cesarean delivery hospitalizations annually. Methods Complications associated with cesarean deliveries were categorized as infection, hemorrhage, or surgical trauma, based on groups of specific International Classification of Diseases 9th revision codes. Length of hospitalization, hospital charges, and in-hospital deaths were also examined. Results The rate of complications significantly decreased during the study periods for HIV-infected and HIV-uninfected women. However, rates of infectious complications and surgical trauma associated with cesarean deliveries remained higher among HIV-infected, compared with HIV-uninfected women in 2010–2011, as did prolonged hospital stay and in-hospital deaths. Length of hospitalization decreased over time for cesarean deliveries of HIV-infected women to a greater extent compared with HIV-uninfected women. Conclusion In the United States, rates of cesarean delivery complications decreased from 1995 to 2011. However, rates of infection, surgical trauma, hospital deaths, and prolonged hospitalization are still higher among HIV-infected women. Clinicians should remain alert to this persistently increased risk of cesarean delivery complications among HIV-infected women. PMID:25574961

  3. Extended state observer based fuzzy model predictive control for ultra-supercritical boiler-turbine unit

    International Nuclear Information System (INIS)

    Zhang, Fan; Wu, Xiao; Shen, Jiong

    2017-01-01

    Highlights: • A novel ESOFMPC is proposed based on the combination of ESO and stable MPC. • The improved ESO can overcome unknown disturbances on any channel of MIMO system. • Nonlinearity and disturbance of boiler-turbine unit can be handled simultaneously. - Abstract: The regulation of ultra-supercritical (USC) boiler-turbine unit in large-scale power plants is vulnerable to various unknown disturbances, meanwhile, the internal nonlinearity makes it a challenging task for wide range load tracking. To overcome these two issues simultaneously, an extended state observer based fuzzy model predictive control is proposed for the USC boiler-turbine unit. Firstly, the fuzzy model of a 1000-MW coal-fired USC boiler-turbine unit is established through the nonlinearity analysis. Then a fuzzy stable model predictive controller is devised on the fuzzy model using output cost function for the purpose of wide range load tracking. An improved linear extended state observer, which can estimate plant behavior variations and unknown disturbances regardless of the direct feedthrough characteristic of the system, is synthesized with the predictive controller to enhance its disturbance rejection property. Closed-loop stability of the overall control system is guaranteed. Simulation results on a 1000-MW USC boiler-turbine unit model demonstrate the effectiveness of the proposed approach.

  4. 78 FR 17648 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Science.gov (United States)

    2013-03-22

    ... Conservation Program for Consumer Products: Representative Average Unit Costs of Energy'', dated April 26, 2012... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy AGENCY: Office of Energy Efficiency...

  5. Variation in cash price of the generic medications most prescribed by dermatologists in pharmacies across the United States.

    Science.gov (United States)

    Alghanem, Noor; Abokwidir, Manal; Fleischer, Alan B; Feldman, Steven R; Alghanem, Ward

    2017-03-01

    The United States has the highest drug costs in the world. Consumers complain about large price differences at pharmacies on generic drugs. To evaluate variation in cash prices of generic medications most prescribed in dermatology across different drugstores and states in United States. The 11 generic drugs most prescribed by dermatologists according to National Ambulatory Medical Care Survey were assessed. By using Google, the most common used pharmacies in United States were listed, which are located at a random selection of six states. By calling the first available number of each pharmacy in the six states and asking about the generic cash price of the smallest stock size and the most prescribed type, the data were collected. Drug prices varied; the median cumulative price of the 11 medications was highest at Rite Aid ($1226) and lowest at Walmart ($795.34) with 35% difference. The prices at CVS differed by 20% across different states; however, the prices at Walmart, Rite Aid and Walgreens were consistent. New York has the highest and Iowa the lowest prices, especially at CVS, ($1160.79) versus ($931.32). There are varieties in the prices for the generic medications in different pharmacies and States.

  6. Food irradiation in the United States

    International Nuclear Information System (INIS)

    Pauli, G.H.

    1991-01-01

    Since 1963, some irradiated foods have been permitted for sale in the United States. Yet, at this time, commercial application has been limited to irradiation of a relatively small fraction of the spices and seasonings used as ingredients in other foods. The current situation regarding irradiated foods in the United States and how it developed is discussed. The author writes from experience gained as a Government regulator concerned primarily with ensuring safety of food and therefore this is stressed together with the crucial role played by consumers and industry. (author)

  7. Rise and fall of nuclear power in the United States and the limits of regulation

    International Nuclear Information System (INIS)

    Del Sesto, S.L.

    1982-01-01

    This paper documents the rapid growth of nuclear power in the United States and its subsequent decline in the late 1970s. It demonstrates that the increase in numbers of new orders for nuclear plants created pressures for additional licensing complexity to insure safety and provide public intervenors with opportunities to participate in the regulatory process. The resulting protraction of the licensing process combined with increasing political opposition to nuclear power caused construction delays and bureaucratic bottlenecks at a time when soaring interest rates and double-digit inflation have pushed the cost of building new facilities out of the reach of the financially battered utility industry. Together with a downturn in demand for electricity and increasing uncertainty over nuclear power, no reactor orders have been placed since late 1978. It is argued that renewed growth of nuclear power in the United States is unlikely, especially in a regulatory environment which fosters increased costs of electricity to consumers and a simultaneous abrogation of the economies of scale. The consequences of the impending atrophication of the nuclear industry in America and its effects on future energy mixes and long-term national interests must be considered in future nuclear policies and reforms

  8. Frequent Exertion and Frequent Standing at Work, by Industry and Occupation Group - United States, 2015.

    Science.gov (United States)

    Shockey, Taylor M; Luckhaupt, Sara E; Groenewold, Matthew R; Lu, Ming-Lun

    2018-01-12

    Repeated exposure to occupational ergonomic hazards, such as frequent exertion (repetitive bending or twisting) and frequent standing, can lead to injuries, most commonly musculoskeletal disorders (1). Work-related musculoskeletal disorders have been estimated to cost the United States approximately $2.6 billion in annual direct and indirect costs (2). A recent literature review provided evidence that prolonged standing at work also leads to adverse health outcomes, such as back pain, physical fatigue, and muscle pain (3). To determine which industry and occupation groups currently have the highest prevalence rates of frequent exertion at work and frequent standing at work, CDC analyzed data from the 2015 National Health Interview Survey (NHIS) Occupational Health Supplement (OHS) regarding currently employed adults in the United States. By industry, the highest prevalence of both frequent exertion and frequent standing at work was among those in the agriculture, forestry, fishing, and hunting industry group (70.9%); by occupation, the highest prevalence was among those in the construction and extraction occupation group (76.9%). Large differences among industry and occupation groups were found with regard to these ergonomic hazards, suggesting a need for targeted interventions designed to reduce workplace exposure.

  9. How Medicaid and Other Public Policies Affect Use of Tobacco Cessation Therapy, United States, 2010–2014

    Science.gov (United States)

    Brantley, Erin; Bysshe, Tyler; Steinmetz, Erika; Bruen, Brian K.

    2016-01-01

    Introduction State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers. Methods We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014. Results Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels. Conclusions States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs. PMID:27788063

  10. Estimated Human and Economic Burden of Four Major Adult Vaccine-Preventable Diseases in the United States, 2013.

    Science.gov (United States)

    McLaughlin, John M; McGinnis, Justin J; Tan, Litjen; Mercatante, Annette; Fortuna, Joseph

    2015-08-01

    Low uptake of routinely recommended adult immunizations is a public health concern. Using data from the peer-reviewed literature, government disease-surveillance programs, and the US Census, we developed a customizable model to estimate human and economic burden caused by four major adult vaccine-preventable diseases (VPD) in 2013 in the United States, and for each US state individually. To estimate the number of cases for each adult VPD for a given population, we multiplied age-specific incidence rates obtained from the literature by age-specific 2013 Census population data. We then multiplied the estimated number of cases for a given population by age-specific, estimated medical and indirect (non-medical) costs per case. Adult VPDs examined were: (1) influenza, (2) pneumococcal disease (both invasive disease and pneumonia), (3) herpes zoster (shingles), and (4) pertussis (whooping cough). Sensitivity analyses simulated the impact of various epidemiological scenarios on the total estimated economic burden. Estimated US annual cost for the four adult VPDs was $26.5 billion (B) among adults aged 50 years and older, $15.3B (58 %) of which was attributable to those 65 and older. Among adults 50 and older, influenza, pneumococcal disease, herpes zoster, and pertussis made up $16.0B (60 %), $5.1B (19 %), $5.0B (19 %), and $0.4B (2 %) of the cost, respectively. Among those 65 and older, they made up $8.3B (54 %), $3.8B (25 %), $3.0B (20 %), and 0.2B (1 %) of the cost, respectively. Most (80-85 %) pneumococcal costs stemmed from nonbacteremic pneumococcal pneumonia (NPP). Cost attributable to adult VPD in the United States is substantial. Broadening adult immunization efforts beyond influenza only may help reduce the economic burden of adult VPD, and a pneumococcal vaccination effort, primarily focused on reducing NPP, may constitute a logical starting place. Sensitivity analyses revealed that a pandemic influenza season or change in size of the US elderly population

  11. Political Gender Inequality and Infant Mortality in the United States, 1990–2012

    Science.gov (United States)

    Homan, Patricia

    2017-01-01

    Although gender inequality has been recognized as a crucial factor influencing population health in the developing world, research has not yet thoroughly documented the role it may play in shaping U.S. infant mortality rates (IMRs). This study uses administrative data with fixed-effects and random-effects models to (1) investigate the relationship between political gender inequality in state legislatures and state infant mortality rates in the United States from 1990 to 2012, and (2) project the population level costs associated with women’s underrepresentation in 2012. Results indicate that higher percentages of women in state legislatures are associated with reduced IMRs, both between states and within-states over time. According to model predictions, if women were at parity with men in state legislatures, the expected number of infant deaths in the U.S. in 2012 would have been lower by approximately 14.6% (3,478 infant deaths). These findings underscore the importance of women’s political representation for population health. PMID:28458098

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

    Science.gov (United States)

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

    1998-10-01

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

  13. Pathways to Deep Decarbonization in the United States

    Science.gov (United States)

    Torn, M. S.; Williams, J.

    2015-12-01

    Limiting anthropogenic warming to less than 2°C will require a reduction in global net greenhouse gas (GHG) emissions on the order of 80% below 1990 levels by 2050. Thus, there is a growing need to understand what would be required to achieve deep decarbonization (DD) in different economies. We examined the technical and economic feasibility of such a transition in the United States, evaluating the infrastructure and technology changes required to reduce U.S. GHG emissions in 2050 by 80% below 1990 levels. Using the PATHWAYS and GCAM models, we found that this level of decarbonization in the U.S. can be accomplished with existing commercial or near-commercial technologies, while providing the same level of energy services and economic growth as a reference case based on the U.S. DOE Annual Energy Outlook. Reductions are achieved through high levels of energy efficiency, decarbonization of electric generation, electrification of most end uses, and switching the remaining end uses to lower carbon fuels. Incremental energy system cost would be equivalent to roughly 1% of gross domestic product, not including potential non-energy benefits such as avoided human and infrastructure costs of climate change. Starting now on the deep decarbonization path would allow infrastructure stock turnover to follow natural replacement rates, which reduces costs, eases demand on manufacturing, and allows gradual consumer adoption. Energy system changes must be accompanied by reductions in non-energy and non-CO2 GHG emissions.

  14. Estimating the economic impact of climate change on the freshwater sportsfisheries of the Northeastern United States

    Energy Technology Data Exchange (ETDEWEB)

    Pendleton, L. [Univ. of Southern California, Los Angeles, CA (United States). Dept. of Economics; Mendelsohn, R. [Yale Univ., New Haven, CT (United States). School of Forestry and Environmental Studies

    1997-06-06

    This study links models of global climate circulation, ecology, and economic valuation (hedonic travel cost and random utility models) to value the impact of global warming on freshwater sportfishing in the Northeast. An origin-specific linear random utility model (RUM) is introduced. The results of the RUM are shown to be comparable to those of a hedonic travel cost model. A doubling of atmospheric carbon dioxide is predicted to generate between a $4.6 million loss and a $20.5 million net benefit for the Northeastern United States, depending on the climate scenario.

  15. The State Geologic Map Compilation (SGMC) geodatabase of the conterminous United States

    Science.gov (United States)

    Horton, John D.; San Juan, Carma A.; Stoeser, Douglas B.

    2017-06-30

    The State Geologic Map Compilation (SGMC) geodatabase of the conterminous United States (https://doi. org/10.5066/F7WH2N65) represents a seamless, spatial database of 48 State geologic maps that range from 1:50,000 to 1:1,000,000 scale. A national digital geologic map database is essential in interpreting other datasets that support numerous types of national-scale studies and assessments, such as those that provide geochemistry, remote sensing, or geophysical data. The SGMC is a compilation of the individual U.S. Geological Survey releases of the Preliminary Integrated Geologic Map Databases for the United States. The SGMC geodatabase also contains updated data for seven States and seven entirely new State geologic maps that have been added since the preliminary databases were published. Numerous errors have been corrected and enhancements added to the preliminary datasets using thorough quality assurance/quality control procedures. The SGMC is not a truly integrated geologic map database because geologic units have not been reconciled across State boundaries. However, the geologic data contained in each State geologic map have been standardized to allow spatial analyses of lithology, age, and stratigraphy at a national scale.

  16. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

    Science.gov (United States)

    Ackerman, Stacey J; Polly, David W; Knight, Tyler; Holt, Tim; Cummings, John

    2014-01-01

    Introduction Low back pain is common and originates in the sacroiliac (SI) joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US). Methods A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3), an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date), and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars) were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592) per privately-insured patient (N=78,533). Among patients with lumbar spinal fusion (N=434), attributable 3-year mean costs were $91,720 (SD $75,502) per patient compared to $15,776 (SD $27,542) per patient among patients without lumbar spinal fusion (N=78,099). Overall, inpatient hospitalizations (19.4%), hospital outpatient visits and procedures (14.0%), and outpatient pain medications (9.6%) accounted for the largest proportion of costs. The estimated 3-year insurance payments attributable to SI joint disruption

  17. Recent Trends in Out-of-Hospital Births in the United States.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2013-01-01

    Although out-of-hospital births are still relatively rare in the United States, it is important to monitor trends in these births, as they can affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs. Trends and characteristics of home and birth center births are analyzed to more completely profile contemporary out-of-hospital births in the United States. National birth certificate data were used to examine a recent increase in out-of-hospital births. After a gradual decline from 1990 to 2004, the number of out-of-hospital births increased from 35,578 in 2004 to 47,028 in 2010. In 2010, 1 in 85 US infants (1.18%) was born outside a hospital; about two-thirds of these were born at home, and most of the rest were born in birth centers. The proportion of home births increased by 41%, from 0.56% in 2004 to 0.79% in 2010, with 10% of that increase occurring in the last year. The proportion of birth center births increased by 43%, from 0.23% in 2004 to 0.33% in 2010, with 14% of the increase in the last year. About 90% of the total increase in out-of hospital births from 2004 to 2010 was a result of increases among non-Hispanic white women, and 1 in 57 births to non-Hispanic white women (1.75%) in 2010 was an out-of-hospital birth. Most home and birth center births were attended by midwives. Home and birth center births in the United States are increasing, and the rate of out-of-hospital births is now at the highest level since 1978. There has been a decline in the risk profile of out-of-hospital births, with a smaller proportion of out-of-hospital births in 2010 than in 2004 occurring to adolescents and unmarried women and fewer preterm, low-birth-weight, and multiple births. © 2013 This article is a U.S. Government work and is in the public domain in the United States.

  18. Exporting Rambutan to United States: One Reality?

    International Nuclear Information System (INIS)

    Ahmad Zainuri Mohd Dzomir; Zainon Othman; Mohd Sidek Othman

    2011-01-01

    Rambutan is a one of commodity that are passed by United States of America authority to be market in that states. The main condition for the approval is the exporter must use irradiation technology as quarantine treatment to monitor the insects in there. United States of America's Agriculture Department (USDA-APHIS) has make early survey to the facilities involved in exporting process chain to overview Malaysia preparedness for this purpose. This paper work will discussed the possibility of this exporting implemented based on conditions rule by the USDA. (author)

  19. Pediatric traumatic amputations and hospital resource utilization in the United States, 2003.

    Science.gov (United States)

    Conner, Kristen A; McKenzie, Lara B; Xiang, Huiyun; Smith, Gary A

    2010-01-01

    Despite the severity of consequences associated with traumatic amputation, little is known about the epidemiology or healthcare resource burden of amputation injuries, and even less is known about these injuries in the pediatric population. An analysis of patients aged lawn mower, motorized vehicle or explosives/fireworks, and children's hospital type were associated with longer LOS. Pediatric traumatic amputations contribute substantially to the health resource burden in the United States, resulting in 21 million dollars in inpatient charges annually. More effective interventions to prevent these costly injuries among children must be implemented.

  20. The anatomy of health care in the United States.

    Science.gov (United States)

    Moses, Hamilton; Matheson, David H M; Dorsey, E Ray; George, Benjamin P; Sadoff, David; Yoshimura, Satoshi

    2013-11-13

    Health care in the United States includes a vast array of complex interrelationships among those who receive, provide, and finance care. In this article, publicly available data were used to identify trends in health care, principally from 1980 to 2011, in the source and use of funds ("economic anatomy"), the people receiving and organizations providing care, and the resulting value created and health outcomes. In 2011, US health care employed 15.7% of the workforce, with expenditures of $2.7 trillion, doubling since 1980 as a percentage of US gross domestic product (GDP) to 17.9%. Yearly growth has decreased since 1970, especially since 2002, but, at 3% per year, exceeds any other industry and GDP overall. Government funding increased from 31.1% in 1980 to 42.3% in 2011. Despite the increases in resources devoted to health care, multiple health metrics, including life expectancy at birth and survival with many diseases, shows the United States trailing peer nations. The findings from this analysis contradict several common assumptions. Since 2000, (1) price (especially of hospital charges [+4.2%/y], professional services [3.6%/y], drugs and devices [+4.0%/y], and administrative costs [+5.6%/y]), not demand for services or aging of the population, produced 91% of cost increases; (2) personal out-of-pocket spending on insurance premiums and co-payments have declined from 23% to 11%; and (3) chronic illnesses account for 84% of costs overall among the entire population, not only of the elderly. Three factors have produced the most change: (1) consolidation, with fewer general hospitals and more single-specialty hospitals and physician groups, producing financial concentration in health systems, insurers, pharmacies, and benefit managers; (2) information technology, in which investment has occurred but value is elusive; and (3) the patient as consumer, whereby influence is sought outside traditional channels, using social media, informal networks, new public sources

  1. 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)

  2. Wheat rusts in the United States in 2016

    Science.gov (United States)

    In 2016, wheat stripe rust caused by Puccinia striiformis f. sp. graminis was widespread throughout the United States. Cool temperatures and abundant rainfall in the southern Great Plains allowed stripe rust to become widely established and spread throughout the Great Plains and eastern United State...

  3. Mobile dental units: leasing or buying? A dollar-cost analysis.

    Science.gov (United States)

    Arevalo, Oscar; Saman, Daniel M; Bonaime, Alice; Skelton, Judy

    2010-01-01

    The decision to acquire a mobile dental unit is based on a standard capital budgeting analysis. The next step is to determine whether to obtain the use of the mobile dental unit by borrowing and purchasing or by leasing. As a financing mechanism, leases are simply another way of borrowing money to pay for the asset. To compare lease vs. debt as financial vehicles to acquiring a mobile dental unit. An estimate for a new mobile unit was obtained. Lease and loan proposals from financial lenders were collected. A cost of capital rate was chosen for comparison. Cash flows associated with borrowing and leasing vs. buying were determined fortwo different scenarios: for profit (FP) vs. not-for-profit (NFP), at 5 years. A dollar-cost analysis was utilized to determine the option with the lowest capitalized value. There was a net advantage to buying vs. leasing for both for FP and NFP organizations. Due to tax advantages, owning and leasing were substantially less expensive for FP than for NFP. Slight decreases in the monthly lease payments would make leasing competitive to the buying approach. Exploring alternative financing vehicles may allow dental programs to expand their services through the acquisition of a mobile unit. Though programs generally own assets, it is the use of the asset which is important rather than the ownership. Dental programs can find leasing an attractive alternative by offering access to capital with cash-flow advantages.

  4. The Syrian Refugee Crisis: A Comparison of Responses by Germany, Sweden, the United Kingdom, and the United States

    Directory of Open Access Journals (Sweden)

    Nicole Ostrand

    2015-07-01

    Full Text Available The conflict in Syria between the government of Bashar al-Assad and various other forces, which started in the spring of 2011, continues to cause displacement within the country and across the region. By the end of 2014, an estimated 7.6 million people were internally displaced and 3.7 million Syrians had fled the country since the conflict began (OCHA 2014; UNHCR 2015a. The refugee situation caused by the Syrian conflict is dire, and it has placed enormous strain on neighboring countries. Lebanon, Jordan, Iraq, Egypt, and Turkey host massive numbers of Syrian refugees, and Syrians have been seeking protection beyond these countries in increasing numbers since 2011.This paper looks at the burdens and costs of the Syrian refugee crisis and considers how they have, or have not, been shared by the international community at large, and in particular by Germany, Sweden, the United Kingdom, and the United States. It also considers to what degree Syrians have been able to find protection in states outside the region. Germany and Sweden, by the end of 2014, had provided protection to the largest number of Syrian refugees outside the region. Although Germany, Sweden, the United Kingdom, and the United States differ in the level of protection provided to Syrians, all four states have increased protection to Syrians via resettlement and asylum (and in the case of the US temporary protected status since 2012. Despite this, the degree of protection provided by the four states is modest in relation to that provided by neighboring countries to Syria, and far more could be done. This paper also argues that the international community as a whole has not sufficiently contributed toward alleviating the burden caused by the Syrian refugee influx, in terms of both financial assistance and refugee resettlement.The paper puts forward two general recommendations to reduce the strain on neighboring countries: increase the level of burden sharing by the international

  5. United States National Seismographic Network

    International Nuclear Information System (INIS)

    Buland, R.

    1993-09-01

    The concept of a United States National Seismograph Network (USNSN) dates back nearly 30 years. The idea was revived several times over the decades. but never funded. For, example, a national network was proposed and discussed at great length in the so called Bolt Report (U. S. Earthquake Observatories: Recommendations for a New National Network, National Academy Press, Washington, D.C., 1980, 122 pp). From the beginning, a national network was viewed as augmenting and complementing the relatively dense, predominantly short-period vertical coverage of selected areas provided by the Regional Seismograph Networks (RSN's) with a sparse, well-distributed network of three-component, observatory quality, permanent stations. The opportunity finally to begin developing a national network arose in 1986 with discussions between the US Geological Survey (USGS) and the Nuclear Regulatory Commission (NRC). Under the agreement signed in 1987, the NRC has provided $5 M in new funding for capital equipment (over the period 1987-1992) and the USGS has provided personnel and facilities to develop. deploy, and operate the network. Because the NRC funding was earmarked for the eastern United States, new USNSN station deployments are mostly east of 105 degree W longitude while the network in the western United States is mostly made up of cooperating stations (stations meeting USNSN design goals, but deployed and operated by other institutions which provide a logical extension to the USNSN)

  6. 37 CFR 1.413 - The United States International Searching Authority.

    Science.gov (United States)

    2010-07-01

    ... Processing Provisions General Information § 1.413 The United States International Searching Authority. (a... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false The United States International Searching Authority. 1.413 Section 1.413 Patents, Trademarks, and Copyrights UNITED STATES PATENT...

  7. United States Attorney Prosecutions

    Science.gov (United States)

    1993-10-01

    property of CocaCola Bottling Company, Fayetteville, North Carolina, of a value in excess of $100.00, in violation of Title 18 United States Code, Section...another, to-wit: a Cocacola soft drink machine, the amount of damage to said personal property being more than $200.00, in violation of North Carolina

  8. 77 FR 48542 - United States

    Science.gov (United States)

    2012-08-14

    ... litigation.'' United States v. Armour and Co., 402 U.S. 673, 681 (1971). Section 5 of the Clayton Act... relief in consent judgment that contained recitals in which defendants asserted their innocence); Armour...

  9. United States Strategy for Mexico

    National Research Council Canada - National Science Library

    Centner, Robert C

    2005-01-01

    The security and stability of Mexico is of national interest to the United States, and a strong, effective alliance between the two countries is pivotal to our national defense strategy and economic prosperity...

  10. Low Temperature Geothermal Resource Assessment for Membrane Distillation Desalination in the United States: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Akar, Sertac; Turchi, Craig

    2016-10-01

    Substantial drought and declines in potable groundwater in the United States over the last decade has increased the demand for fresh water. Desalination of saline water such as brackish surface or groundwater, seawater, brines co-produced from oil and gas operations, industrial wastewater, blow-down water from power plant cooling towers, and agriculture drainage water can reduce the volume of water that requires disposal while providing a source of high-quality fresh water for industrial or commercial use. Membrane distillation (MD) is a developing technology that uses low-temperature thermal energy for desalination. Geothermal heat can be an ideal thermal-energy source for MD desalination technology, with a target range of $1/m3 to $2/m3 for desalinated water depending on the cost of heat. Three different cases were analyzed to estimate levelized cost of heat (LCOH) for integration of MD desalination technology with low-grade geothermal heat: (1) residual heat from injection brine at a geothermal power plant, (2) heat from existing underutilized low-temperature wells, and (3) drilling new wells for low-temperature resources. The Central and Western United States have important low-temperature (<90 degrees C) geothermal resource potential with wide geographic distribution, but these resources are highly underutilized because they are inefficient for power production. According to the USGS, there are 1,075 identified low temperature hydrothermal systems, 55 low temperature sedimentary systems and 248 identified medium to high temperature geothermal systems in the United States. The estimated total beneficial heat potential from identified low temperature hydrothermal geothermal systems and residual beneficial heat from medium to high temperature systems is estimated as 36,300 MWth, which could theoretically produce 1.4 to 7 million m3/day of potable water, depending on desalination efficiency.

  11. NCHS - Injury Mortality: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury...

  12. Assessment of Cost Variation in Solid and Hollow Floor Construction in Lagos State

    Directory of Open Access Journals (Sweden)

    Oluwaseun Sunday Dosumu

    2013-12-01

    Full Text Available The differences in construction methods between different forms of slabs construction tend to result into variation in the cost of the slabs for any building project. Thus, this study aims at assessing the variation in construction cost among various construction methods available for hollow and solid floors in construction projects within Lagos State. The research design for this study was a survey design approach and the population of the study are active professionals (Architects, Civil Engineers, Builders, Quantity Surveyors, Consultant and contractors because they are the major participants in the construction activities of the construction industry in Lagos State, Nigeria. The research is based on 46 returned questionnaires out of the 60 that was administered. The data from the questionnaires were analyzed using descriptive tools such as frequencies, percentage and mean values. The hypotheses were tested with paired sample t-test and it was found that the system or method of slab construction well known to the respondents is cast in situ, precast and semi-precast. The study also shows that the cost of in-situ solid slabs are higher than that of hollow slab which is an indication that solid slab construction is more expensive than hollow slab construction provided the hollow slab is a one-way hollow floor and not waffle floor. In pre cast solid slab construction the cost of transportation of units to sites, cost of expertise required in the construction process and the cost of fabrication off site are the three highest and most expensive aspects of precast solid slab while cost of erection and placement and the cost of grouting and topping if required are less expensive. Therefore there is difference in the cost of construction between the solid and hollow slabs but the difference is not appreciable. The study's major recommendation is that, adequate and careful analysis must be done in the choice of floor system being adopted for any

  13. Asian Immigration: The View from the United States.

    Science.gov (United States)

    Gardner, Robert W.

    1992-01-01

    Examines contemporary Asian immigration to the United States from a U.S. perspective. Analyzes immigration policies and data on recent immigration from Asia. Discusses impacts concerning the United States and the immigrants themselves and speculates on future immigration. The composition of Asian immigration might change, and the number might…

  14. 26 CFR 1.956-2 - Definition of United States property.

    Science.gov (United States)

    2010-04-01

    ..., which is— (i) Tangible property (real or personal) located in the United States; (ii) Stock of a... year ending June 30, 1964, R Corporation's increase in earnings invested in United States property for... United States property during its taxable year 1965, S Corporation's increase in earnings invested in...

  15. Cervical cancer prevention: new guidelines in the United States and new opportunities for low- and middle-income countries.

    Science.gov (United States)

    Waxman, Alan G

    2013-06-01

    Developments from late 2011 to early 2013, including consensus conferences and the introduction of low-cost, rapid-turnaround testing of human papillomavirus, will change prevention strategies for cervical cancer in the United States and in low- and middle-income countries. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Licensed pertussis vaccines in the United States: History and current state

    OpenAIRE

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that w...

  17. 7 CFR 631.7 - Conservation treatment eligible for cost sharing.

    Science.gov (United States)

    2010-01-01

    ..., conservation practices, or identifiable units eligible for GPCP cost sharing in the state. (b) The designated... conservation systems, practices, or identifiable units eligible for GPCP cost sharing in the county. ... 7 Agriculture 6 2010-01-01 2010-01-01 false Conservation treatment eligible for cost sharing. 631...

  18. The impact of liberalization on the scope of efficiency improvement in electricity-generating portfolios for the United States and Switzerland

    Energy Technology Data Exchange (ETDEWEB)

    Krey, B.; Zweifel, P. [Socioeconomic Institute, Zurich (Switzerland)

    2008-09-15

    In this study, Markowitz mean-variance portfolio theory is applied to electricity-generating technologies of the United States and Switzerland. Both an investor (focused on changes in return) and a current user (focused on return in levels) view are adopted to determine efficient frontiers of electricity generation technologies in terms of expected return and risk as of 2003. Since shocks in generation costs per kWh (the inverse of returns) are correlated, Seemingly Unrelated Regression Estimation (SURE) is used to filter out the systematic components of the covariance matrix. Results suggest that risk-averse investors and risk-neutral current users in the United States are considerably closer to their efficiency frontier than their Swiss counterparts. This may be due to earlier and more thorough deregulation of electricity markets in the United States. (orig.)

  19. Nations United: The United Nations, the United States, and the Global Campaign Against Terrorism. A Curriculum Unit & Video for Secondary Schools.

    Science.gov (United States)

    Houlihan, Christina; McLeod, Shannon

    This curriculum unit and 1-hour videotape are designed to help students understand the purpose and functions of the United Nations (UN) and explore the relationship between the United Nations and the United States. The UN's role in the global counterterrorism campaign serves as a case study for the unit. The students are asked to develop a basic…

  20. Is there a water–energy nexus in electricity generation? Long-term scenarios for the western United States

    International Nuclear Information System (INIS)

    Ackerman, Frank; Fisher, Jeremy

    2013-01-01

    Water is required for energy supply, and energy is required for water supply, creating problems as demand for both resources grows. We analyze this “water–energy nexus” as it affects long-run electricity planning in the western United States. We develop four scenarios assuming: no new constraints; limits on carbon emissions; limits on water use; and combined carbon and water limits. We evaluate these scenarios through 2100 under a range of carbon and water prices. The carbon-reducing scenarios become cost-effective at carbon prices of about $50–$70 per ton of CO 2 , moderately high but plausible within the century. In contrast, the water-conserving scenarios are not cost-effective until water prices reach thousands of dollars per acre-foot, well beyond foreseeable levels. This is due in part to the modest available water savings: our most and least water-intensive scenarios differ by less than 1% of the region's water consumption. Under our assumptions, Western electricity generation could be reshaped by the cost of carbon emissions, but not by the cost of water, over the course of this century. Both climate change and water scarcity are of critical importance, but only in the former is electricity generation central to the problem and its solutions. - Highlights: • We model long-run electricity supply and demand for the western United States. • We evaluate the costs of carbon-reducing and water-conserving scenarios. • Carbon-reducing scenarios become cost-effective at carbon prices of $50–70 per ton CO 2 . • Water-conserving scenarios are only cost-effective above $4000/acre-foot of water. • Electricity planning is central to climate policy, but much less so to water planning

  1. 36 CFR 14.22 - Reimbursement of costs.

    Science.gov (United States)

    2010-07-01

    ... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit, or other means... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit or other means... shall reimburse the United States for costs incurred by the United States in monitoring the construction...

  2. Outlooks for Wind Power in the United States: Drivers and Trends under a 2016 Policy Environment

    Energy Technology Data Exchange (ETDEWEB)

    Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ho, Jonathan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Stehly, Tyler [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heimiller, Donna [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-12-01

    Over the past decade, wind power has become one of the fastest growing electricity generation sources in the United States. Despite this growth, the U.S. wind industry continues to experience year-to-year fluctuations across the manufacturing and supply chain as a result of dynamic market conditions and changing policy landscapes. Moreover, with advancing wind technologies, ever-changing fossil fuel prices, and evolving energy policies, the long-term future for wind power is highly uncertain. In this report, we present multiple outlooks for wind power in the United States, to explore the possibilities of future wind deployment. The future wind power outlooks presented rely on high-resolution wind resource data and advanced electric sector modeling capabilities to evaluate an array of potential scenarios of the U.S. electricity system. Scenario analysis is used to explore drivers, trends, and implications for wind power deployment over multiple periods through 2050. Specifically, we model 16 scenarios of wind deployment in the contiguous United States. These scenarios span a wide range of wind technology costs, natural gas prices, and future transmission expansion. We identify conditions with more consistent wind deployment after the production tax credit expires as well as drivers for more robust wind growth in the long run. Conversely, we highlight challenges to future wind deployment. We find that the degree to which wind technology costs decline can play an important role in future wind deployment, electric sector CO2 emissions, and lowering allowance prices for the Clean Power Plan.

  3. Estimated United States Transportation Energy Use 2005

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C A; Simon, A J; Belles, R D

    2011-11-09

    A flow chart depicting energy flow in the transportation sector of the United States economy in 2005 has been constructed from publicly available data and estimates of national energy use patterns. Approximately 31,000 trillion British Thermal Units (trBTUs) of energy were used throughout the United States in transportation activities. Vehicles used in these activities include automobiles, motorcycles, trucks, buses, airplanes, rail, and ships. The transportation sector is powered primarily by petroleum-derived fuels (gasoline, diesel and jet fuel). Biomass-derived fuels, electricity and natural gas-derived fuels are also used. The flow patterns represent a comprehensive systems view of energy used within the transportation sector.

  4. Solving unit commitment and economic load dispatch problems ...

    African Journals Online (AJOL)

    Economic Load Dispatch (ELD) and Unit Commitment (UC) are very important applications to predict the optimized cost of load in a power system. UC determines working states for existing generating units under some operational constraints and then optimizing the operation cost for all running units w.r.t. load demand ...

  5. United States of America National Report

    International Nuclear Information System (INIS)

    1992-01-01

    The United States has produced this report as part of the preparations for the United Nations Conference on Environment and Development (UNCED) to be held in Brazil in June 1992. It summarizes this nation's efforts to protect and enhance the quality of the human environment in concert with its efforts to provide economic well-being during the two decades since the United Nations Conference on the Human Environment was held in Stockholm. The information presented in this report is primarily and deliberately retrospective. It is an attempt to portray the many human, economic and natural resources of the United States, to describe resource use and the principal national laws and programs established to protect these resources, and to analyze key issues on the agenda of UNCED. This analysis is presented in terms of past and present conditions and trends, measures of progress made in responding to the key issues, and a summary of government activities, underway or pending, to address ongoing or newly emerging national environmental and resource management problems

  6. African Journals Online: United States Minor Outlying Islands

    African Journals Online (AJOL)

    African Journals Online: United States Minor Outlying Islands. Home > African Journals Online: United States Minor Outlying Islands. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles ...

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

    Science.gov (United States)

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

    2009-01-01

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

  8. RESEARCH: An Ecoregional Approach to the Economic Valuation of Land- and Water-Based Recreation in the United States

    Science.gov (United States)

    Bhat; Bergstrom; Teasley; Bowker; Cordell

    1998-01-01

    / This paper describes a framework for estimating the economic value of outdoor recreation across different ecoregions. Ten ecoregions in the continental United States were defined based on similarly functioning ecosystem characters. The individual travel cost method was employed to estimate recreation demand functions for activities such as motor boating and waterskiing, developed and primitive camping, coldwater fishing, sightseeing and pleasure driving, and big game hunting for each ecoregion. While our ecoregional approach differs conceptually from previous work, our results appear consistent with the previous travel cost method valuation studies.KEY WORDS: Recreation; Ecoregion; Travel cost method; Truncated Poisson model

  9. Refugee Status Required for Resettlement in the United States

    Science.gov (United States)

    2017-06-09

    STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART ...the American public’s concerns. 50 APPENDIX A UNITED STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART Source: US Citizenship and Immigration...TITLE AND SUBTITLE Refugee Status Required for Resettlement in the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  10. Assessment of Ports for Offshore Wind Development in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Elkinton, Chris [DNV GL; Blatiak, Alicia; Ameen, Hafsa

    2014-03-21

    quayside and storage area are typically greater for offshore wind components than for more conventional cargo handling. As a result, most U.S. ports will likely require soil strength improvements before they can fully support offshore wind project construction. As U.S. ports and offshore wind developers look to work together on specific projects, they will encounter synergies and challenges. The challenges they face will include identifying sources of funding for the facility improvements required, and addressing ports’ typical desire to engage in long-term partnerships on the order of 10-20 years. Early projects will especially feel these challenges as they set the precedent for these partnerships in the United States. This study seeks to provide information about gaps, costs, and opportunities to aid these discussions.

  11. Patterns of Daily Costs Differ for Medical and Surgical Intensive Care Unit Patients.

    Science.gov (United States)

    Gershengorn, Hayley B; Garland, Allan; Gong, Michelle N

    2015-12-01

    Published studies suggest hospital costs on Day 1 in the intensive care unit (ICU) far exceed those of subsequent days, when costs are relatively stable. Yet, no study stratified patients by ICU type. To determine whether daily cost patterns differ by ICU type. We performed a retrospective study of adults admitted to five ICUs (two surgical: quaternary surgical ICU [SICU quat] and quaternary cardiac surgical ICU [CSICU quat]; two medical: tertiary medical ICU [MICU tertiary] and quaternary medical ICU [MICU quat]; one general: community medical surgical ICU [MSICU comm]) at Montefiore Medical Center in the Bronx, New York during 2013. After excluding costs clearly accrued outside the ICU, daily hospital costs were merged with clinical data. Patterns of daily unadjusted costs were evaluated in each ICU using median regression. Generalized estimating equations with first-order autocorrelation were used to identify factors independently associated with daily costs. Unadjusted daily costs were higher on Day 1 than on subsequent days only for surgical ICUs-SICU quat (median [interquartile range], $2,636 [$1,834-$4,282] on Day 1 vs. $1,840 [$1,501-$2,332] on Day 2; P cost from Days 1 to 2. After multivariate adjustment, there remained a significant decrease in cost from ICU Day 1 to 2 in surgical units with statistically similar Day 1 and 2 costs for other ICUs. Higher Day 1 costs are not seen in patients admitted to medical/nonsurgical ICUs.

  12. Latin America and the United States: What Do United States History Textbooks Tell Us?

    Science.gov (United States)

    Fleming, Dan B.

    1982-01-01

    Evaluates how U.S.-Latin American relations are presented in high school U.S. history textbooks. An examination of 10 textbooks published between 1977-81 revealed inadequate coverage of Latin American cultural diversity and United States foreign policy from the Latin American perspective. (AM)

  13. Preparation of School Psychologists in the United States

    Science.gov (United States)

    Joyce-Beaulieu, Diana; Rossen, Eric

    2014-01-01

    School psychology in the United States continues to evolve in response to shifts in the country's demographic characteristics, an increasing focus on the importance of child mental health, together with health and education reforms. The landscape of school psychological services in the United States also is shaped through the changing roles and…

  14. Does Disconformity in State Corporate Income Tax Systems Affect Compliance Cost Burdens?

    OpenAIRE

    Gupta, Sanjay; Mills, Lillian F.

    2003-01-01

    Prior multistate tax research on differences in state tax rules, while investigating the effects on revenue, investment, and tax burden, is silent regarding the effect on compliance costs. We investigate factors that explain state income tax compliance costs for large firms. We find that state compliance costs increase in the number of filing states and entities (or in the number of state tax returns), firm size, and variables proxying for state tax complexity. Our evidence that multistate di...

  15. United States position on severe accidents

    International Nuclear Information System (INIS)

    Ross, D.F.

    1988-01-01

    The United States policy on severe accidents was published in 1985 for both new plant applications and for existing plants. Implementation of this policy is in progress. This policy, aided by a related safety goal policy and by analysis capabilities emerging from improved understanding of accident phenomenology, is viewed as a logical development from the pioneering work in the WASH-1400 Reactor Safety Study published by the United States Nuclear Regulatory Commission (NRC) in 1975. This work provided an estimate of the probability and consequences of severe accidents which, prior to that time, had been mostly evaluated by somewhat arbitrary assumptions dating back 30 years. The early history of severe accident evaluation is briefly summarized for the period 1957-1979. Then, the galvanizing action of Three Mile Island Unit 2 (TMI-2) on severe accident analysis, experimentation and regulation is reviewed. Expressions of US policy in the form of rulemaking, severe accident policy, safety research, safety goal policy and court decisions (on adequacy of safety) are discussed. Finally, the NRC policy as of March 1988 is stated, along with a prospective look at the next few years. (author). 19 refs

  16. Understanding human trafficking in the United States.

    Science.gov (United States)

    Logan, T K; Walker, Robert; Hunt, Gretchen

    2009-01-01

    The topic of modern-day slavery or human trafficking has received increased media and national attention. However, to date there has been limited research on the nature and scope of human trafficking in the United States. This article describes and synthesizes nine reports that assess the U.S. service organizations' legal representative knowledge of, and experience with, human trafficking cases, as well as information from actual cases and media reports. This article has five main goals: (a) to define what human trafficking is, and is not; (b) to describe factors identified as contributing to vulnerability to being trafficked and keeping a person entrapped in the situation; (c) to examine how the crime of human trafficking differs from other kinds of crimes in the United States; (d) to explore how human trafficking victims are identified; and, (e) to provide recommendations to better address human trafficking in the United States.

  17. Utility-Scale Solar 2013: An empirical analysis of project cost, performance, and pricing trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Weaver, Samantha [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-09-17

    Other than the SEGS I-IX parabolic trough projects built in the 1980s, virtually no large-scale or "utility-scale" solar projects-defined here to include any ground-mounted photovoltaic ("PV"), concentrating photovoltaic ("CPV"), or concentrating solar power ("CSP" or solar thermal) project larger than 5 MWAC-existed in the United States prior to 2007.

  18. Rates and Outcomes of Parathyroidectomy for Secondary Hyperparathyroidism in the United States.

    Science.gov (United States)

    Kim, Sun Moon; Long, Jin; Montez-Rath, Maria E; Leonard, Mary B; Norton, Jeffrey A; Chertow, Glenn M

    2016-07-07

    Secondary hyperparathyroidism is common among patients with ESRD. Although medical therapy for secondary hyperparathyroidism has changed dramatically over the last decade, rates of parathyroidectomy for secondary hyperparathyroidism across the United States population are unknown. We examined temporal trends in rates of parathyroidectomy, in-hospital mortality, length of hospital stay, and costs of hospitalization. Using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, a representative national database on hospital stay regardless of age and payer in the United States, we identified parathyroidectomies for secondary hyperparathyroidism from 2002 to 2011. Data from the US Renal Data System reports were used to calculate the rate of parathyroidectomy. We identified 32,971 parathyroidectomies for secondary hyperparathyroidism between 2002 and 2011. The overall rate of parathyroidectomy was approximately 5.4/1000 patients (95% confidence interval [95% CI], 5.0/1000 to 6.0/1000). The rate decreased from 2003 (7.9/1000 patients; 95% CI, 6.2/1000 to 9.6/1000), reached a nadir in 2005 (3.3/1000 patients; 95% CI, 2.6/1000 to 4.0/1000), increased again through 2006 (5.4/1000 patients; 95% CI, 4.4/1000 to 6.4/1000), and remained stable since that time. Rates of in-hospital mortality decreased from 1.7% (95% CI, 0.8% to 2.6%) in 2002 to 0.8% (95% CI, 0.1% to 1.6%) in 2011 (P for trend secondary hyperparathyroidism have not declined in recent years. Copyright © 2016 by the American Society of Nephrology.

  19. Changing World, Unchanging Accounting? Cost Systems for Hungarian Agricultural Companies

    OpenAIRE

    Zoltán Musinszki

    2011-01-01

    The literature of agricultural cost accounting has defined the definition of cost centres and cost bearers, the contents of the accounts, the procedures and methods for cost accounting and unit cost calculation without any significant changes for decades now. Do the agricultural companies set up and operate their own cost allocation and unit cost calculation systems on procedures made for state owned farms and cooperatives, or do they align their cost system with the challenges of our times? ...

  20. Costing of a State-Wide Population Based Cancer Awareness and Early Detection Campaign in a 2.67 Million Population of Punjab State in Northern India.

    Science.gov (United States)

    Thakur, Js; Prinja, Shankar; Jeet, Gursimer; Bhatnagar, Nidhi

    2016-01-01

    Punjab state is particularly reporting a rising burden of cancer. A 'door to door cancer awareness and early detection campaign' was therefore launched in the Punjab covering about 2.67 million population, wherein after initial training accredited social health activists (ASHAs) and other health staff conducted a survey for early detection of cancer cases based on a twelve point clinical algorithm. To ascertain unit cost for undertaking a population-based cancer awareness and early detection campaign. Data were collected using bottom-up costing methods. Full economic costs of implementing the campaign from the health system perspective were calculated. Options to meet the likely demand for project activities were further evaluated to examine their worth from the point of view of long-term sustainability. The campaign covered 97% of the state population. A total of 24,659 cases were suspected to have cancer and were referred to health facilities. At the state level, incidence and prevalence of cancer were found to be 90 and 216 per 100,000, respectively. Full economic cost of implementing the campaign in pilot district was USD 117,524. However, the financial cost was approximately USD 6,301. Start-up phase of campaign was more resource intensive (63% of total) than the implementation phase. The economic cost per person contacted and suspected by clinical algorithm was found to be USD 0.20 and USD 40 respectively. Cost per confirmed case under the campaign was 7,043 USD. The campaign was able to screen a reasonably large population. High to high economic cost points towards the fact that the opportunity cost of campaign put a significant burden on health system and other programs. However, generating awareness and early detection strategy adopted in this campaign seems promising in light of fact that organized screening is not in place in India and in many developing countries.

  1. 42 CFR 410.175 - Alien absent from the United States.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Alien absent from the United States. 410.175... Alien absent from the United States. (a) Medicare does not pay Part B benefits for services furnished to... during the first full calendar month the alien is back in the United States. [53 FR 6634, Mar. 2, 1988] ...

  2. 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...

  3. Wind Energy Finance in the United States: Current Practice and Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Schwabe, Paul D. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Feldman, David J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Settle, Donald E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Fields, Jason [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-08-08

    In the United States, investment in wind energy has averaged nearly $13.6 billion annually since 2006 with more than $140 billion invested cumulatively over that period (BNEF 2017). This sizable investment activity demonstrates the persistent appeal of wind energy and its increasing role in the U.S electricity generation portfolio. Despite its steady investment levels over the last decade, some investors still consider wind energy as a specialized asset class. Limited familiarity with the asset class both limit the pool of potential investors and drive up costs for investors. This publication provides an overview of the wind project development process, capital sources and financing structures commonly used, and traditional and emerging procurement methods. It also provides a high-level demonstration of how financing rates impact a project's all-in cost of energy. The goal of the publication is to provide a representative and wide-ranging resource for the wind development and financing processes.

  4. Inventory of power plants in the United States. [By state within standard Federal Regions, using county codes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-12-01

    The purpose of this inventory of power plants is to provide a ready reference for planners whose focus is on the state, standard Federal region, and/or national level. Thus the inventory is compiled alphabetically by state within standard Federal regions. The units are listed alphabetically within electric utility systems which in turn are listed alphabetically within states. The locations are identified to county level according to the Federal Information Processing Standards Publication Counties and County Equivalents of the States of the United States. Data compiled include existing and projected electrical generation units, jointly owned units, and projected construction units.

  5. Norovirus in the United States

    Centers for Disease Control (CDC) Podcasts

    2013-09-09

    Dr. Aron Hall, a CDC epidemiologist specializing in norovirus, discusses the impact of norovirus in the United States.  Created: 9/9/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/17/2013.

  6. 2016 State of Wind Development in the United States by Region

    Energy Technology Data Exchange (ETDEWEB)

    Baranowski, Ruth [National Renewable Energy Lab. (NREL), Golden, CO (United States); Oteri, Frank [National Renewable Energy Lab. (NREL), Golden, CO (United States); Baring-Gould, Ian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tegen, Suzanne [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-04-19

    Significant expansion of wind energy development will be required to achieve the scenarios outlined in the U.S. Department of Energy's (DOE)'s Wind Vision: 20% wind energy by 2030 and 35% wind energy by 2050. Wind energy currently provides nearly 5% of the nation's electricity but has the potential to provide much more. The wind industry and the DOE's Wind Energy Technologies Office are addressing technical wind energy challenges, such as reducing turbine costs and increasing energy production and reliability. The Office recognizes that public acceptance of wind energy can be challenging, depending on the proximity of proposed wind farms to local populations. Informed decision makers and communities equipped with unbiased information about the benefits and impacts of wind energy development are better prepared to navigate the sometimes contentious development process. In 2014, DOE established six Regional Resource Centers (RRCs) across the United States to communicate unbiased, credible information about wind energy to stakeholders through regional networks. The RRCs provide ready access to this information to familiarize the public with wind energy; raise awareness about potential benefits and issues; and disseminate data on siting considerations such as turbine sound and wildlife habitat protection. This document summarizes the status and drivers for U.S. wind energy development during 2016. RRC leaders provided a report of wind energy development in their regions, which was combined with findings from National Renewable Energy Laboratory (NREL) researchers to provide an account of the state of the regions, as well as updates on developments in individual states. NREL researchers and state partners added updates for all states that are not directly supported by an RRC. Accounts for each region include updates on renewable portfolio standards, the Clean Power Plan, workforce development, manufacturing and economic development, and individual

  7. Fragmentation of Continental United States Forests

    Science.gov (United States)

    Kurt H. Riitters; James D. Wickham; Robert V. O' Neill; K. Bruce Jones; Elizabeth R. Smith; John W. Coulston; Timothy G. Wade; Jonathan H. Smith

    2002-01-01

    We report a multiple-scale analysis of forest fragmentation based on 30-m (0.09 ha pixel-1) land- cover maps for the conterminous United States. Each 0.09-ha unit of forest was classified according to fragmentation indexes measured within the surrounding landscape, for five landscape sizes including 2.25, 7.29, 65.61, 590.49, and 5314.41 ha....

  8. Trial by jury in the United States

    Directory of Open Access Journals (Sweden)

    Lochhead Robert

    2015-10-01

    Full Text Available Th e Republic of Moldova is considering the adoption of trial by jury in select criminal cases. Th e following article is intended to contribute to the discussion of that proposal. Th e article will briefl y describe the history of juries under the English common law and as adopted by the United States. It will then outline some of the basic procedures in trials by jury as currently practiced in the United States federal court system.

  9. CEDAW in the Eyes of the United States

    Directory of Open Access Journals (Sweden)

    Al Shraideh Saleh

    2017-12-01

    Full Text Available Despite the large number of reservations registered by Member countries, making it one of the, if not the, most heavily reserved human rights treaties; the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW has managed to achieve a very high rate of states’ membership [1]. Currently, 187 countries out of the 193 United Nations Members are parties to CEDAW [2]. What is strange to digest, however, is the fact that the United States is one of the seven countries that are yet to ratify the Convention [3]. This article provides an insight into the position of the United States from the ratification of CEDAW. It examines the merits of arguments made for and against the ratification and their rationale to provide a better understanding that explains what is considered by many as a buzzling stand of the United States from the Convention.

  10. An Examination of Information Technology and Its Perceived Quality Issues in Single System Hospitals in the United States

    Science.gov (United States)

    Byrd, Linda W.

    2009-01-01

    The safety and quality of healthcare is of great concern in the United States. The positive effects of information technology reported in past research, especially case studies, has encouraged expectations that information technology may increase the quality of healthcare while reducing costs of healthcare. The goals of this study was to examine…

  11. The impact of TTIP agreement on the European Union-United States coal trade potential

    Directory of Open Access Journals (Sweden)

    Olkuski Tadeusz

    2016-01-01

    Full Text Available The main aim of the paper is to assess the impact of currently negotiated TTIP agreement (Transatlantic Trade and Investment Partnership on the use of hard coal in the EU and the US. Hard coal is the most important fuel in global electricity generation. This also applies to the United States, a leading manufacturer and exporter of this energy source. The US coal is exported to the EU market. The article presents the estimated exports of hard coal from the US to the EU. Due to the fact that price has a major impact on the size of exports, the paper presents the estimated prices, including freight costs, of power coal for the analyzed scenarios. According to one scenario, the US and European prices will be equalized (including freight costs by 2020, while from 2025 on the comparative advantage and competitiveness of the US hard coal will decrease. Taking into account the fact that the export of coal from the United States is free from customs duties, the acceptance of TIPP should not affect the currently existing trade between the two continents and the amount of exported coal. Nevertheless, the question of hard coal economy cannot be separated from other sectors of the energy market, which can be significantly affected by the future agreement.

  12. Global context for the United States Forest Sector in 2030

    Science.gov (United States)

    James Turner; Joseph Buongiorno; Shushuai Zhu; Jeffrey P. Prestemon

    2005-01-01

    The purpose of this study was to identify markets for, and competitors to, the United States forest industries in the next 30 years. The Global Forest Products Model was used to make predictions of international demand, supply, trade, and prices, conditional on the last RPA Timber Assessment projections for the United States. It was found that the United States, Japan...

  13. A functional intranet for the United States Coast Guard Unit

    OpenAIRE

    Hannah, Robert Todd.

    1998-01-01

    Approved for public release; distribution in unlimited. This thesis describes the complete development process of a friendly functional Intranet for an operational United States Coast Guard (USCG) electronic Support Unit (ESU) in Alameda, California. The final product is suitable for immediate use. It may also be used as a prototype for future Intranet development efforts. The methodology used to develop a finished, working product provides the core subject matter for this thesis. The disc...

  14. 2011 Cost of Wind Energy Review

    Energy Technology Data Exchange (ETDEWEB)

    Tegen, S.; Lantz, E.; Hand, M.; Maples, B.; Smith, A.; Schwabe, P.

    2013-03-01

    This report describes the levelized cost of energy (LCOE) for a typical land-based wind turbine installed in the United States in 2011, as well as the modeled LCOE for a fixed-bottom offshore wind turbine installed in the United States in 2011. Each of the four major components of the LCOE equation are explained in detail, such as installed capital cost, annual energy production, annual operating expenses, and financing, and including sensitivity ranges that show how each component can affect LCOE. These LCOE calculations are used for planning and other purposes by the U.S. Department of Energy's Wind Program.

  15. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  16. The state of amphibians in the United States

    Science.gov (United States)

    Muths, E.; Adams, M.J.; Grant, E.H.C.; Miller, D.; Corn, P.S.; Ball, L.C.

    2012-01-01

    More than 25 years ago, scientists began to identify unexplained declines in amphibian populations around the world. Much has been learned since then, but amphibian declines have not abated and the interactions among the various threats to amphibians are not clear. Amphibian decline is a problem of local, national, and international scope that can affect ecosystem function, biodiversity, and commerce. This fact sheet provides a snapshot of the state of the amphibians and introduces examples to illustrate the range of issues in the United States.

  17. Inventory of power plants in the United States, 1993

    International Nuclear Information System (INIS)

    1994-12-01

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), U.S. Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended

  18. Inventory of power plants in the United States, 1993

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), U.S. Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended.

  19. Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico.

    Science.gov (United States)

    Shah, Minesh P; Lopman, Benjamin A; Tate, Jacqueline E; Harris, John; Esparza-Aguilar, Marcelino; Sanchez-Uribe, Edgar; Richardson, Vesta; Steiner, Claudia A; Parashar, Umesh D

    2018-02-19

    Previous studies have found a strong correlation between internet search and public health surveillance data. Less is known about how search data respond to public health interventions, such as vaccination, and the consistency of responses in different countries. In this study, we aimed to study the correlation between internet searches for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. We compared time series of internet searches for "rotavirus" from Google Trends with rotavirus laboratory reports from the United States and United Kingdom and with hospitalizations for acute gastroenteritis in the United States and Mexico. Using time and location parameters, Google quantifies an internet query share (IQS) to measure the relative search volume for specific terms. We analyzed the correlation between IQS and laboratory and hospitalization data before and after national vaccine introductions. There was a strong positive correlation between the rotavirus IQS and laboratory reports in the United States (R2 = 0.79) and United Kingdom (R2 = 0.60) and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States (R2 = 0.87) and Mexico (R2 = 0.69) (P United States and by 70% (95% CI, 55%-86%) in Mexico. In the United Kingdom, there was a loss of seasonal variation after vaccine introduction. Rotavirus internet search data trends mirrored national rotavirus laboratory trends in the United States and United Kingdom and gastroenteritis-hospitalization data in the United States and Mexico; lower correlations were found after rotavirus vaccine introduction. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  20. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    1979-02-01

    The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

  1. Licensed pertussis vaccines in the United States. History and current state.

    Science.gov (United States)

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that waning protection following licensed acellular pertussis vaccines have been significant factors in the widespread reappearance of pertussis.

  2. The United States initiative for international radioactive source management (ISRM)

    International Nuclear Information System (INIS)

    Naraine, N.; Karhnak, J.

    1999-01-01

    The United States takes seriously the potential problems from uncontrolled radioactive sources. To address these problems, the United States Department of State is leading the development of an initiative for International Radioactive Source Management (ISRM). The Department of State, through a number of Federal and state agencies, regulatory bodies and private industry, will endeavor to provide coordinated support to the international community, particularly through IAEA, to assist in the development and implementation of risk-based clearance levels to support import/export of radioactive contaminated metals and the tracking, management, identification, remediation, and disposition of 'lost sources' entering nation states and targeted industries. The United States believes that the international control of radioactive sources is critical in avoiding wide-spread contamination of the world metal supply. Thus the initiative has four objectives: (1) Protect sources from becoming lost (Tracking management); (2) Identify primary locations where sources have been lost (Stop future losses); (3) Locate lost sources (monitor and retrieve); and (4) Educate and train (deploy knowledge and technology). A number of efforts already underway in the United States support the overall initiative. The EPA has provided a grant to the Conference of Radiation Program Control Directors (CRCPD) to develop a nation-wide program for the disposition of orphaned radioactive sources. This program now has internet visibility and a toll-free telephone number to call for assistance in the disposal of sources. The Nuclear Regulatory Commission (NRC), the Department of Energy (DOE), and other government agencies as well as private companies are assisting CRCPD in this program. The NRC has begun a program to improve control of radioactive sources in the United States, and also intends to promulgate a regulation defining conditions for the release of materials from licensed facilities. The DOE is

  3. Antiabortion violence in the United States.

    Science.gov (United States)

    Russo, Jennefer A; Schumacher, Kristin L; Creinin, Mitchell D

    2012-11-01

    This study was conducted to determine if an association exists between the amount of harassment and violence directed against abortion providers and the restrictiveness of state laws relating to family planning. We used responses from a July 2010 survey of 357 abortion providers in 50 states to determine their experience of antiabortion harassment and violence. Their responses were grouped and analyzed in relation to a published grading of state laws in the United States (A, B, C, D and F) as they relate to restrictions on family planning services. Group by group comparison of respondents illustrates that the difference in the number of reported incidents of minor vandalism by group is statistically significant (A vs. C, p=.07; A vs. D, p=.017; A vs. F, p=.0002). Incidents of harassment follow a similar pattern. There were no differences noted overall for violence or major vandalism. Major violence, including eight murders, is a new occurrence in the last two decades. Harassment of abortion providers in the United States has an association with the restrictiveness of state abortion laws. In the last two decades, murder of abortion providers has become an unfortunate part of the violence. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Administrative waste in the U.S. health care system in 2003: the cost to the nation, the states, and the District of Columbia, with state-specific estimates of potential savings.

    Science.gov (United States)

    Himmelstein, David U; Woolhandler, Steffie; Wolfe, Sidney M

    2004-01-01

    This report provides nationwide and state-specific estimates of U.S. health care administration spending and potential savings in 2003 were the United States to institute a Canadian-style national health insurance system. The United States wastes more on health care bureaucracy than it would cost to provide health care to all its uninsured. Administrative expenses will consume at least dollar 399.4 billion of a total health expenditure of dollar 1,660.5 billion in 2003. Streamlining administrative overhead to Canadian levels would save approximately dollar 286.0 billion in 2003, dollar 6,940 for each of the 41.2 million Americans who were uninsured as of 2001. This is substantially more than would be needed to provide full insurance coverage. The cost of excess health bureaucracy in individual states is equally striking. For example, Massachusetts, with 560,000 uninsured state residents, could save about dollar 8,556 million in 2003 (dollar 16,453 per uninsured resident of that state) if it streamlined administration to Canadian levels. New Mexico, with 373,000 uninsured, could save dollar 1,500 million on health bureaucracy (dollar 4,022 per uninsured resident). Only a single-payer national health insurance system could garner these massive administrative savings, allowing universal coverage without any increase in total health spending. Because incremental reforms necessarily preserve the current fragmented and duplicative payment structure, they cannot achieve significant bureaucratic savings.

  5. Masturbation in the United States.

    Science.gov (United States)

    Das, Aniruddha

    2007-01-01

    Using data from the nationally representative National Health and Social Life Survey, this study queried the correlates of masturbation in the United States in 1992. Among those aged 18-60, 38% (CI, 35-41) of women and 61% (CI, 57-65) of men reported any masturbation over the preceding year. The system of factors underlying masturbation was similar for both genders, consistent with a convergence in gender patterns of sexual expression in the United States. Among both women and men, masturbation responded to a stable sexualized personality pattern, catalyzed by early-life factors and manifested in current sexual traits. Strikingly, the masturbation-partnered sex linkage, often conceptualized either as compensating for unsatisfying sex or complementing a satisfactory sex life, appeared to be bimodal for both genders. For some, masturbation complemented an active and pleasurable sex life, while among others, it compensated for a lack of partnered sex or satisfaction in sex.

  6. Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak.

    Science.gov (United States)

    Pike, Jamison; Tippins, Ashley; Nyaku, Mawuli; Eckert, Maribeth; Helgenberger, Louisa; Underwood, J Michael

    2017-10-13

    After 20years with no reported measles cases, on May 15, 2014 the Centers for Disease Control and Prevention (CDC) was notified of two cases testing positive for measles-specific immunoglobulin M (IgM) antibodies in the Federated States of Micronesia (FSM). Under the Compact of Free Association, FSM receives immunization funding and technical support from the United States (US) domestic vaccination program managed by the Centers for Disease Control and Prevention (CDC). In a collaborative effort, public health officials and volunteers from FSM and the US government worked to respond and contain the measles outbreak through an emergency mass vaccination campaign, contact tracing, and other outbreak investigation activities. Contributions were also made by United Nations Children's Emergency Fund (UNICEF) and World Health Organization (WHO). Total costs incurred as a result of the outbreak were nearly $4,000,000; approximately $10,000 per case. Direct medical costs (≈$141,000) were incurred in the treatment of those individuals infected, as well as lost productivity of the infected and informal caregivers (≈$250,000) and costs to contain the outbreak (≈$3.5 million). We assessed the economic burden of the 2014 measles outbreak to FSM, as well as the economic responsibilities of the US. Although the US paid the majority of total costs of the outbreak (≈67%), examining each country's costs relative to their respective economy illustrates a far greater burden to FSM. We demonstrate that while FSM was heavily assisted by the US in responding to the 2014 Measles Outbreak, the outbreak significantly impacted their economy. FSM's economic burden from the outbreak is approximately equivalent to their entire 2016 Fiscal Year budget dedicated to education. Published by Elsevier Ltd.

  7. Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

    Science.gov (United States)

    Schwartz, Jennifer A T; Pearson, Steven D

    2013-06-24

    Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

  8. Cost-Benefit Analysis of Telemedicine Systems/Units in Greek Remote Areas.

    Science.gov (United States)

    Kouskoukis, Marios-Nikolaos; Botsaris, Charalambos

    2017-06-01

    Telemedicine units and information technology systems provide special healthcare services to remote populations using telecommunication technology, in order to reduce or even remove the usual and typical face-to-face contact between doctor and patient. This innovative approach to medical care delivery has been expanding for several years and currently covers various medical specialties. To facilitate installation of telemedicine systems/units in Greek remote areas, this article presents results of a cost-benefit analysis for two Greek islands, Patmos and Leros, using specific economic criteria. Net present value (NPV), internal rate of return (IRR), and payback period were calculated, in order to monetize the economic benefits and the costs savings, estimate the depreciation of each project, and highlight the social benefits. Costs were reduced (through saved air medical transportations) by €19,005 for Patmos and €78,225 for Leros each year. NPV and IRR were positive; NPV was €29,608 for Patmos and €293,245 for Leros, and IRR was 21.5% for Patmos and 140.5% for Leros. Each project depreciated faster than the 5-year life-cycle period, and specifically in 3.13 years for Patmos and in 0.70 years for Leros. The establishment of telemedicine systems/units in Patmos and Leros was evaluated and assessed positively, with large savings, economical and social, gained by reducing or even removing the face-to-face contact between doctor and patient. Telemedicine systems/units seem to be a promising solution, especially in Greece, where the problem of primary healthcare services in remote/inaccessible areas is of great concern.

  9. Research on Anoplophora glabripennis in the United States

    Science.gov (United States)

    Robert A. Haack

    2003-01-01

    In the mid-1990s it was estimated that more than 400 exotic (non-native) forest insects had already become established in the United States (HAACK and BYLER, 1993; MATTSON et al., 1994; NIEMELA and MATTSON, 1996). This number has continued to grow with new exotics discovered annually in the United States (HAACK, 2002; HAACK and POLAND, 2001; HAACK et al., 2002). One...

  10. Progress along developmental tracks for electronic health records implementation in the United States

    Directory of Open Access Journals (Sweden)

    Hollar David W

    2009-03-01

    Full Text Available Abstract The development and implementation of electronic health records (EHR have occurred slowly in the United States. To date, these approaches have, for the most part, followed four developmental tracks: (a Enhancement of immunization registries and linkage with other health records to produce Child Health Profiles (CHP, (b Regional Health Information Organization (RHIO demonstration projects to link together patient medical records, (c Insurance company projects linked to ICD-9 codes and patient records for cost-benefit assessments, and (d Consortia of EHR developers collaborating to model systems requirements and standards for data linkage. Until recently, these separate efforts have been conducted in the very silos that they had intended to eliminate, and there is still considerable debate concerning health professionals access to as well as commitment to using EHR if these systems are provided. This paper will describe these four developmental tracks, patient rights and the legal environment for EHR, international comparisons, and future projections for EHR expansion across health networks in the United States.

  11. Leading Causes of Death in Males United States, 2010

    Science.gov (United States)

    ... What’s this? Submit What’s this? Submit Button Leading Causes of Death in Males and Females, United States Recommend on ... to current and previous listings for the leading causes of death for males and females in the United States. ...

  12. 76 FR 18198 - European Union-United States Atlantis Program

    Science.gov (United States)

    2011-04-01

    ... DEPARTMENT OF EDUCATION European Union-United States Atlantis Program AGENCY: Office of...)--Special Focus Competition: European Union-(EU) United States (U.S.) Atlantis Program Notice inviting... and Culture, European Commission for funding under a separate but parallel EU competition. Within this...

  13. Development of Water Quality Modeling in the United States

    Science.gov (United States)

    This presentation describes historical trends in water quality model development in the United States, reviews current efforts, and projects promising future directions. Water quality modeling has a relatively long history in the United States. While its origins lie in the work...

  14. Solar energy in the United States

    International Nuclear Information System (INIS)

    Ochoa, D.; Slaoui, A.; Soler, R.; Bermudez, V.

    2009-01-01

    Written by a group of five French experts who visited several research centres, innovating companies and solar power stations in the United States, this report first proposes an overview of solar energy in the United States, indicating and commenting the respective shares of different renewable energies in the production, focusing on the photovoltaic energy production and its RD sector. The second part presents industrial and research activities in the solar sector, and more specifically photovoltaic technologies (silicon and thin layer technology) and solar concentrators (thermal solar concentrators, photovoltaic concentrators). The last chapter presents the academic research activities in different universities (California Tech Beckman Institute, Stanford, National Renewable Energy Laboratory, Colorado School of Mines)

  15. 75 FR 22551 - United States Standards for Grades of Frozen Blueberries

    Science.gov (United States)

    2010-04-29

    ...] United States Standards for Grades of Frozen Blueberries AGENCY: Agricultural Marketing Service, USDA... United States Standards for Grades of Frozen Blueberries. After considering the comments received... . The United States Standards for Grades of Frozen Blueberries are available by accessing the AMS Web...

  16. Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain.

    Science.gov (United States)

    González-Ramallo, V J; Mirón-Rubio, M; Mujal, A; Estrada, O; Forné, C; Aragón, B; Rivera, A J

    2017-07-01

    The aim of this study was to assess the direct healthcare costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home (HaH) units in Spain. An observational, multicentre, economic evaluation of retrospective cohorts was conducted. Patients were treated at home by the HaH units of three Spanish hospitals between January 2012 and December 2013. From the cost accounting of HaH OPAT (staff, pharmacy, transportation, diagnostic tests and structural), the cost of each outpatient course was obtained following a top-down strategy based on the use of resources. Costs associated with inpatient stay, if any, were estimated based on length of stay and ICD-9-CM diagnosis. There were 1324 HaH episodes in 1190 patients (median age 70 years). The median (interquartile range) stay at home was 10 days (7-15 days). Of the OPAT episodes, 91.5% resulted in cure or improvement on completion of intravenous therapy. The mean total cost of each infectious episode was €6707 [95% confidence interval (CI) €6189-7406]. The mean cost per OPAT episode was €1356 (95% CI €1247-1560), mainly distributed between healthcare staff costs (46%) and pharmacy costs (39%). The mean cost of inpatient hospitalisation of an infectious episode was €4357 (95% CI €3947-4977). The cost per day of inpatient hospitalisation was €519, whilst the cost per day of OPAT was €98, meaning a saving of 81%. This study shows that OPAT administered by HaH units resulted in lower costs compared with inpatient care in Spain. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  17. Towards Greater Harmonisation of Decommissioning Cost Estimates

    International Nuclear Information System (INIS)

    O'Sullivan, Patrick; ); Laraia, Michele; ); LaGuardia, Thomas S.

    2010-01-01

    The NEA Decommissioning Cost Estimation Group (DCEG), in collaboration with the IAEA Waste Technology Section and the EC Directorate-General for Energy and Transport, has recently studied cost estimation practices in 12 countries - Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Slovakia, Spain, Sweden, the United Kingdom and the United States. Its findings are to be published in an OECD/NEA report entitled Cost Estimation for Decommissioning: An International Overview of Cost Elements, Estimation Practices and Reporting Requirements. This booklet highlights the findings contained in the full report. (authors)

  18. Valuing setting-based recreation for selected visitors to national forests in the southern United States

    Science.gov (United States)

    Kavita Sardana; John C. Bergstrom; J. M.  Bowker

    2016-01-01

    In this study we estimate selected visitors’ demand and value for recreational trips to settings such as developed vs. undeveloped sites in U.S. national forests in the Southern United States using the travel cost method. The setting-based approach allows for valuation of multi-activity trips to particular settings. The results from an adjusted Poisson lognormal...

  19. Implementation of cargo MagLev in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Rose, Chris R [Los Alamos National Laboratory; Peterson, Dean E [Los Alamos National Laboratory; Leung, Eddie M [MAGTEC ENGINEERING

    2008-01-01

    Numerous studies have been completed in the United States, but no commercial MagLev systems have been deployed. Outside the U.S., MagLev continues to attract funding for research, development and implementation. A brief review of recent global developments in MagLev technology is given followed by the status of MagLev in the U.S. The paper compares the cost of existing MagLev systems with other modes of transport, notes that the near-term focus of MagLev development in the U.S. should be for cargo, and suggests that future MagLev systems should be for very high speed cargo. The Los Angeles to Port of Los Angeles corridor is suggested as a first site for implementation. The benefits of MagLev are described along with suggestions on how to obtain funding.

  20. Power from Perspective: Potential future United States energy portfolios

    International Nuclear Information System (INIS)

    Tonn, Bruce; Healy, K.C.; Gibson, Amy; Ashish, Ashutosh; Cody, Preston; Beres, Drew; Lulla, Sam; Mazur, Jim; Ritter, A.J.

    2009-01-01

    This paper presents United States energy portfolios for the year 2030, developed from seven different Perspectives. The Perspectives are characterized by different weights placed on fourteen defining values (e.g., cost, social acceptance). The portfolios were constructed to achieve three primary goals, energy independence, energy security, and greenhouse gas reductions. The portfolios are also evaluated over a comprehensive set of secondary criteria (e.g., economic growth, technical feasibility). It is found that very different portfolios based on very different defining values can achieve the three primary goals. Commonalities among the portfolios include reliance upon cellulosic ethanol, nuclear power, and energy efficiency to meet year 2030 energy demands. It is concluded that the US energy portfolio must be diverse and to achieve national energy goals will require an explicit statement of goals, a strong role for government, and coordinated action across society

  1. 77 FR 64031 - United States-Peru Trade Promotion Agreement

    Science.gov (United States)

    2012-10-18

    ... Trade Promotion Agreement AGENCIES: U.S. Customs and Border Protection, Department of Homeland Security... tariff treatment and other customs-related provisions of the United States-Peru Trade Promotion Agreement... other customs-related provisions of the United States-Peru Trade Promotion Agreement (PTPA). Please...

  2. Inching toward incrementalism: federalism, devolution, and health policy in the United States and the United Kingdom.

    Science.gov (United States)

    Sparer, Michael S; France, George; Clinton, Chelsea

    2011-02-01

    In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.

  3. THE UNITED STATES EDUCATIONAL SYSTEM

    OpenAIRE

    David Suriñach Fernández

    2017-01-01

    The United States educational system is very complex. Due to the fact a big number of agents take play of its regulation, the differences between the education from one State compared to the education from another, or even between school districts, might be considerable. The last two largest federal education initiatives, No Child Left Behind and Race to the Top, have had a huge impact on the American education system. The escalation of the standardized test throughout the whole country as a ...

  4. The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

    Science.gov (United States)

    Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

    2013-10-01

    To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

  5. Inventory of Power Plants in the United States, October 1992

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-27

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), US Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended. The report is organized into the following chapters: Year in Review, Operable Electric Generating Units, and Projected Electric Generating Unit Additions. Statistics presented in these chapters reflect the status of electric generating units as of December 31, 1992.

  6. The provider cost of treating tuberculosis in Bauchi State, Nigeria

    Directory of Open Access Journals (Sweden)

    Nisser Ali Umar

    2011-09-01

    Full Text Available The study was aimed at assessing the economic cost shouldered by government, as providers, in the provision of free tuberculosis (TB diagnosis and treatment services in Bauchi State, northern Nigeria. A cost analysis study was designed and questionnaires administered by the principal investigators to officers in charge of 27 randomly sampled government TB services providers across the State of Bauchi. Seventeen of these centers were primary care centers, 9 secondary care providers and one was a tertiary care provider. Data was also collected from personnel and projects records in the State Ministry of Health, of Works as well as the Ministry of Budget and Planning. The cost of buildings, staff and equipment replacement, laboratory, radiology and drugs in facilities were assessed and costs attributable tuberculosis inpatient, outpatient and directly observed therapy (DOT services were estimated from the total cost based on the proportion of TB cases in the total patient pool accessing those services. The average proportion of TB patients in facilities was 3.4% in overall, 3.3% among inpatients and 3.1% in the outpatient population. The average cost spent to treat a patient with TB was estimated at US $227.14. The cost of inpatient care averaged $16.95/patient; DOT and outpatient services was $133.34/patient, while the overhead cost per patient was $30.89. The overall cost and all computed cost elements, except for DOT services, were highest in the tertiary center and least expensive in the infectious diseases hospital partly due to the higher administrative and other overhead recurrent spending in the tertiary health facility while the lower overhead cost observed in the infectious diseases hospital could be due to the economy of scale as a result of the relative higher number of TB cases seen in the facility operating with relatively same level of resources as other facilities in the state.

  7. Financial Barriers and Lapses in Treatment and Care of HIV-Infected Adults in a Southern State in the United States.

    Science.gov (United States)

    Wohl, David A; Kuwahara, Rita K; Javadi, Kamran; Kirby, Christine; Rosen, David L; Napravnik, Sonia; Farel, Claire

    2017-11-01

    Antiretroviral (ARV) adherence has largely been considered from the perspective of an individual's behavior with less attention given to potential structural causes for lapses in treatment, such as the cost of medications and care. HIV medication expense is typically covered by third party payers. However, private insurance premiums and deductibles may rise, or policies terminated such as with a change in employment. Likewise, a patient's eligibility for publicly funded coverage like state AIDS Drug Assistance Programs (ADAP) or Medicaid can also be lost. We conducted a one-time survey of a sample of 300 patients receiving HIV care at a single large academic center in the south of United States to examine lapses in HIV therapy due to financial reasons. We found that during the prior year, financial issues including medication cost or coverage led to a lapse in ARVs in 10% (n = 31) of participants. However, of the 42% (n = 125) participants who had been enrolled in ADAP at any time during the prior year, 21% (n = 26) reported an ARV lapse due to problems with ADAP or medication cost. Respondents cited ADAP's required semi-annual renewal process and other administrative issues as the cause of ARV lapses. The median duration of missed ARVs was 2 weeks (range of financial burdens to care by respondents. In conclusion, although conducted at a single medical center and one state, this study suggests that a significant minority of HIV-infected patients encounter financial barriers to ARV access, and this is paradoxically more common among those enrolled in the state ADAP. Streamlining, supporting, and simplifying ADAP renewal procedures will likely reduce lapses in ARV adherence and persistence.

  8. A preliminary design and BOP cost analysis of M-C Power`s MCFC commerical unit

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T.P. [Bechtel Corp, San Francisco, CA (United States)

    1996-12-31

    M-C Power Corporation plans to introduce its molten carbonate fuel cell (MCFC) market entry unit in the year 2000 for distributed and on-site power generation. Extensive efforts have been made to analyze the cell stack manufacturing costs. The major objective of this study is to conduct a detailed analysis of BOP costs based on an initial design of the market entry unit.

  9. 78 FR 63052 - United States-Panama Trade Promotion Agreement

    Science.gov (United States)

    2013-10-23

    ...-Panama Trade Promotion Agreement AGENCY: U.S. Customs and Border Protection, Department of Homeland... Trade Promotion Agreement entered into by the United States and the Republic of Panama. DATES: Interim... and the Republic of Panama (the ``Parties'') signed the United States-Panama Trade Promotion Agreement...

  10. United States Military in Central Asia: Beyond Operation Enduring Freedom

    Science.gov (United States)

    2009-10-23

    Malinowski , advocacy director for Human Rights Watch, stated, “the United States is most effective in promoting liberty around the world when people...26 U.S. President, The National Security Strategy of the United States of America, page? 27 Thomas Malinowski , “Testimony

  11. 31 CFR Appendix D to Subpart A of... - United States Secret Service

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Secret Service D...—United States Secret Service 1. In general. This appendix applies to the United States Secret Service. 2. Public reading room. The United States Secret Service will provide a room on an ad hoc basis when...

  12. 76 FR 68271 - To Modify the Harmonized Tariff Schedule of the United States

    Science.gov (United States)

    2011-11-03

    ... the Convention and do not run counter to the national economic interest of the United States. I have... United States obligations under the Convention and do not run counter to the national economic interest of the United States. 7. On June 6, 2003, the United States and Chile entered into the United States...

  13. Economic Indicators of the Farm Sector. Costs of Production, 1986.

    Science.gov (United States)

    Economic Research Service (USDA), Washington, DC.

    This report contains 121 tables that estimate the costs of production of various commodities on United States farms in 1986. The report first assesses costs and returns on a per-unit basis, such as one acre or one animal, under three sections of a budget: cash receipts, cash expenses, and economic costs. The budgets are based on national…

  14. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

    Directory of Open Access Journals (Sweden)

    Ackerman SJ

    2014-02-01

    Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Tim Holt,4 John Cummings5 1Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 5Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and originates in the sacroiliac (SI joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US. Methods: A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3, an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date, and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results: The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592 per privately-insured patient (N=78,533. Among patients with lumbar spinal fusion (N=434, attributable 3-year

  15. Human prion diseases in the United States.

    Directory of Open Access Journals (Sweden)

    Robert C Holman

    Full Text Available BACKGROUND: Prion diseases are a family of rare, progressive, neurodegenerative disorders that affect humans and animals. The most common form of human prion disease, Creutzfeldt-Jakob disease (CJD, occurs worldwide. Variant CJD (vCJD, a recently emerged human prion disease, is a zoonotic foodborne disorder that occurs almost exclusively in countries with outbreaks of bovine spongiform encephalopathy. This study describes the occurrence and epidemiology of CJD and vCJD in the United States. METHODOLOGY/PRINCIPAL FINDINGS: Analysis of CJD and vCJD deaths using death certificates of US residents for 1979-2006, and those identified through other surveillance mechanisms during 1996-2008. Since CJD is invariably fatal and illness duration is usually less than one year, the CJD incidence is estimated as the death rate. During 1979 through 2006, an estimated 6,917 deaths with CJD as a cause of death were reported in the United States, an annual average of approximately 247 deaths (range 172-304 deaths. The average annual age-adjusted incidence for CJD was 0.97 per 1,000,000 persons. Most (61.8% of the CJD deaths occurred among persons >or=65 years of age for an average annual incidence of 4.8 per 1,000,000 persons in this population. Most deaths were among whites (94.6%; the age-adjusted incidence for whites was 2.7 times higher than that for blacks (1.04 and 0.40, respectively. Three patients who died since 2004 were reported with vCJD; epidemiologic evidence indicated that their infection was acquired outside of the United States. CONCLUSION/SIGNIFICANCE: Surveillance continues to show an annual CJD incidence rate of about 1 case per 1,000,000 persons and marked differences in CJD rates by age and race in the United States. Ongoing surveillance remains important for monitoring the stability of the CJD incidence rates, and detecting occurrences of vCJD and possibly other novel prion diseases in the United States.

  16. Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999-2004.

    Science.gov (United States)

    Dunning, Kari K; Davis, Kermit G; Cook, Chad; Kotowski, Susan E; Hamrick, Chris; Jewell, Gregory; Lockey, James

    2010-03-01

    Musculoskeletal disorders (MSDs) are a tremendous burden on industry in the United States. However, there is limited understanding of the unique issues relating to specific industry sectors, specifically the frequency and costs of different MSDs. Claim data from 1999 to 2004 from the Ohio Bureau of Workers' Compensation were analyzed as a function of industry sector (NAICS industry-sector categories) and anatomical region (ICD-9 codes). Almost 50% of the claims were lumbar spine (26.9%) or hand/wrist (21.7%). The majority of claims were from manufacturing (25.1%) and service (32.8%) industries. The industries with the highest average costs per claim were transportation, warehouse, and utilities and construction. Across industries, the highest costs per claim were consistently for the lumbar spine, shoulder, and cervical spine body regions. This study provides insight into the severity (i.e., medical and indemnity costs) of MSDs across multiple industries, providing data for prioritizing of resources for research and interventions. 2009 Wiley-Liss, Inc.

  17. Site productivity and forest carbon stocks in the United States: Analysis and implications for forest offset project planning

    Science.gov (United States)

    Coeli M. Hoover; James E. Smith

    2012-01-01

    The documented role of United States forests in sequestering carbon, the relatively low cost of forest-based mitigation, and the many co-benefits of increasing forest carbon stocks all contribute to the ongoing trend in the establishment of forest-based carbon offset projects. We present a broad analysis of forest inventory data using site quality indicators to provide...

  18. Assessing the role of federal community assistance programs to develop biomass utilization capacity in the Western United States

    Science.gov (United States)

    Dennis R. Becker; Mark Nechodom; Adam Barnett; Tad Mason; Eini C. Lowell; John Shelly; Dean Graham

    2008-01-01

    As forest biomass utilization becomes cost effective to harvest, more areas at risk of catastrophic wildfire can be thinned of dense brush and small-diameter trees. In an effort to increase biomass utilization, the USDA Forest Service granted more than $36 million in National Fire Plan-Economic Action Program funds in the Western United States during fiscal years 2001...

  19. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Science.gov (United States)

    2010-10-01

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

  20. Competitive Electricity Market Regulation in the United States: A Primer

    Energy Technology Data Exchange (ETDEWEB)

    Flores-Espino, Francisco [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tian, Tian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chernyakhovskiy, Ilya [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chernyakhovskiy, Ilya [National Renewable Energy Lab. (NREL), Golden, CO (United States); Miller, Mackay [National Grid, Warwick (United Kingdom)

    2016-12-01

    The electricity system in the United States is a complex mechanism where different technologies, jurisdictions and regulatory designs interact. Today, two major models for electricity commercialization operate in the United States. One is the regulated monopoly model, in which vertically integrated electricity providers are regulated by state commissions. The other is the competitive model, in which power producers can openly access transmission infrastructure and participate in wholesale electricity markets. This paper describes the origins, evolution, and current status of the regulations that enable competitive markets in the United States.