Science.gov

Sample records for potential cost-effective alternative

  1. Deregulation and Nuclear Training: Cost Effective Alternatives

    SciTech Connect

    Richard P. Coe; Patricia A. Lake

    2000-11-12

    Training is crucial to the success of any organization. It is also expensive, with some estimates exceeding $50 billion annually spent on training by U.S. corporations. Nuclear training, like that of many other highly technical organizations, is both crucial and costly. It is unlikely that the amount of training can be significantly reduced. If anything, current trends indicate that training needs will probably increase as the industry and workforce ages and changes. With the advent of energy deregulation in the United States, greater pressures will surface to make the costs of energy more cost-competitive. This in turn will drive businesses to more closely examine existing costs and find ways to do things in a more cost-effective way. The commercial nuclear industry will be no exception, and nuclear training will be equally affected. It is time for nuclear training and indeed the entire nuclear industry to begin using more aggressive techniques to reduce costs. This includes the need for nuclear training to find alternatives to traditional methods for the delivery of cost-effective high-quality training that meets regulatory requirements and produces well-qualified personnel capable of working in an efficient and safe manner. Computer-based and/or Web-based training are leading emerging technologies.

  2. Emission control cost-effectiveness of alternative-fuel vehicles

    SciTech Connect

    Wang, Q.; Sperling, D.; Olmstead, J.

    1993-06-14

    Although various legislation and regulations have been adopted to promote the use of alternative-fuel vehicles for curbing urban air pollution problems, there is a lack of systematic comparisons of emission control cost-effectiveness among various alternative-fuel vehicle types. In this paper, life-cycle emission reductions and life-cycle costs were estimated for passenger cars fueled with methanol, ethanol, liquefied petroleum gas, compressed natural gas, and electricity. Vehicle emission estimates included both exhaust and evaporative emissions for air pollutants of hydrocarbon, carbon monoxide, nitrogen oxides, and air-toxic pollutants of benzene, formaldehyde, 1,3-butadiene, and acetaldehyde. Vehicle life-cycle cost estimates accounted for vehicle purchase prices, vehicle life, fuel costs, and vehicle maintenance costs. Emission control cost-effectiveness presented in dollars per ton of emission reduction was calculated for each alternative-fuel vehicle types from the estimated vehicle life-cycle emission reductions and costs. Among various alternative-fuel vehicle types, compressed natural gas vehicles are the most cost-effective vehicle type in controlling vehicle emissions. Dedicated methanol vehicles are the next most cost-effective vehicle type. The cost-effectiveness of electric vehicles depends on improvements in electric vehicle battery technology. With low-cost, high-performance batteries, electric vehicles are more cost-effective than methanol, ethanol, and liquified petroleum gas vehicles.

  3. Thresholds for the cost-effectiveness of interventions: alternative approaches.

    PubMed

    Marseille, Elliot; Larson, Bruce; Kazi, Dhruv S; Kahn, James G; Rosen, Sydney

    2015-02-01

    Many countries use the cost-effectiveness thresholds recommended by the World Health Organization's Choosing Interventions that are Cost-Effective project (WHO-CHOICE) when evaluating health interventions. This project sets the threshold for cost-effectiveness as the cost of the intervention per disability-adjusted life-year (DALY) averted less than three times the country's annual gross domestic product (GDP) per capita. Highly cost-effective interventions are defined as meeting a threshold per DALY averted of once the annual GDP per capita. We argue that reliance on these thresholds reduces the value of cost-effectiveness analyses and makes such analyses too blunt to be useful for most decision-making in the field of public health. Use of these thresholds has little theoretical justification, skirts the difficult but necessary ranking of the relative values of locally-applicable interventions and omits any consideration of what is truly affordable. The WHO-CHOICE thresholds set such a low bar for cost-effectiveness that very few interventions with evidence of efficacy can be ruled out. The thresholds have little value in assessing the trade-offs that decision-makers must confront. We present alternative approaches for applying cost-effectiveness criteria to choices in the allocation of health-care resources. PMID:25883405

  4. Cost Effectiveness of Alternative Route Special Education Teacher Preparation

    ERIC Educational Resources Information Center

    Sindelar, Paul T.; Dewey, James F.; Rosenberg, Michael S.; Corbett, Nancy L.; Denslow, David; Lotfinia, Babik

    2012-01-01

    In this study, the authors estimated costs of alternative route preparation to provide states a basis for allocating training funds to maximize production. Thirty-one special education alternative route program directors were interviewed and completed cost tables. Two hundred and twenty-four program graduates were also surveyed. The authors…

  5. Cost-effectiveness of nitrogen mitigation by alternative household wastewater management technologies.

    PubMed

    Wood, Alison; Blackhurst, Michael; Hawkins, Troy; Xue, Xiaobo; Ashbolt, Nicholas; Garland, Jay

    2015-03-01

    Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain uncertain. This paper addresses two key questions: (1) what are the total costs, nitrogen mitigation potential, and cost-effectiveness of a range of conventional and alternative municipal wastewater treatment technologies, and (2) what uncertainties influence these outcomes and how can we improve our understanding of these technologies? We estimate a household nitrogen mass balance for various household wastewater treatment systems and combine this mass balance with life cycle cost assessment to calculate the cost-effectiveness of nitrogen mitigation, which we define as nitrogen removed from the local watershed. We apply our methods to Falmouth, MA, where failing septic systems have caused heightened eutrophication in local receiving water bodies. We find that flushing and dry (composting) urine-diversion toilets paired with conventional septic systems for greywater management demonstrate the lowest life cycle cost and highest cost-effectiveness (dollars per kilogram of nitrogen removed from the watershed). Composting toilets are also attractive options in some cases, particularly best-case nitrogen mitigation. Innovative/advanced septic systems designed for high-level nitrogen removal are cost-competitive options for newly constructed homes, except at their most expensive. A centralized wastewater treatment plant is the most expensive and least cost-effective option in all cases. Using a greywater recycling system with any treatment technology increases the cost without adding any nitrogen removal benefits. Sensitivity analysis shows that these results are robust considering a range of cases and uncertainties. PMID:25575282

  6. Potential cost-effectiveness of the nonavalent human papillomavirus (HPV) vaccine.

    PubMed

    Drolet, Mélanie; Laprise, Jean-François; Boily, Marie-Claude; Franco, Eduardo L; Brisson, Marc

    2014-05-01

    Randomized clinical trials are currently examining the efficacy of a nonavalent human papillomavirus (HPV) vaccine, including HPV-types 6/11/16/18/31/33/45/52/58. Evidence on the cost-effectiveness of the nonavalent is required for timely policy-decisions. We compared the potential cost-effectiveness of the nonavalent and quadrivalent HPV vaccines. We used a multi-type individual-based transmission-dynamic model of HPV infection and diseases, 70-year time-horizon, 3% discount rate and healthcare payer perspective. We calibrated the model to Canadian sexual behavior and epidemiologic data, and estimated Quality-Adjusted Life-Years (QALYs) lost and costs ($CAN 2010) from the literature. Under base-case assumptions (vaccinating 10-year-old girls, 80% coverage, 95$/dose, vaccine-type efficacy = 95%, cross-protection for the quadrivalent vaccine, duration of vaccine-type protection (cross-protection) = 20 (10) years), using the quadrivalent and nonavalent vaccines is estimated to cost $15,528 [12,056; 19,140] and $12,203 [9,331; 17,292] per QALY-gained, respectively. At equal price, the nonavalent vaccine is more cost-effective than the quadrivalent vaccine, even when assuming both shorter duration of protection (nonavalent = 20 years vs. quadrivalent = lifelong) and lower vaccine-type efficacy (nonavalent = 85% vs. quadrivalent = 95%). However, the additional cost per dose of the nonavalent vaccine should not exceed $11 to remain more cost-effective than the quadrivalent vaccine, and $24 to represent a cost-effective alternative to the quadrivalent vaccine (using a $40,000/QALY-gained threshold). The nonavalent vaccine can be a cost-effective alternative to the quadrivalent vaccine, even in scenarios where nonavalent vaccine efficacy is 85%. However, because most cervical cancers are caused by HPV-16/18, it is unlikely that the nonavalent would be used if its efficacy against these types is lower than current HPV vaccines. PMID:24174175

  7. Cost-effective management alternatives for Snake River Chinook salmon: a biological-economic synthesis.

    PubMed

    Halsing, David L; Moore, Michael R

    2008-04-01

    The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can

  8. Cost-effective management alternatives for Snake river chinook salmon: A biological-economic synthesis

    USGS Publications Warehouse

    Halsing, D.L.; Moore, M.R.

    2008-01-01

    The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can

  9. A PRELIMINARY METHODOLOGY FOR EVALUATING THE COST-EFFECTIVENESS OF ALTERNATIVE INDOOR AIR QUALITY APPROACHES

    EPA Science Inventory

    The report defines a simplified methodology that can be used by indoor air quality (IAQ) diagnosticians, architects/engineers, building owners/operators, and the scientific community for preliminary comparison of the cost-effectiveness of alternative IAQ control measures for any ...

  10. SICS--a cost effective alternative to phacoemulsification for developing countries in Nepal.

    PubMed

    Nowak, Rafał

    2008-01-01

    Millions of people worldwide are blind from mature cataracts. The developing countries cannot afford expensive modern technologies to treat these cases. A cost effective, fast, machine independent procedure is necessary The purpose of this study is to describe such a technique, little known in Poland--manual small incision cataract surgery (SICS), where the whole nucleus is removed through a self-sealing sclero-corneal tunnel. Within the last several years SICS has become the main way of cataract removal in underserved populations of Asia, with Nepal as an example. Thus, the developing countries have developed a cost effective alternative to phacoemulsification with a very good clinical outcome. PMID:18669094

  11. Cost-effective alternatives for mitigating Cryptosporidium risk in drinking water and enhancing ecosystem services

    NASA Astrophysics Data System (ADS)

    Bryan, B. A.; Kandulu, J. M.

    2009-08-01

    Under the multibarrier paradigm, water quality management barriers that mitigate risk to consumers are required at multiple points from the catchment to the tap. We present a cost-effectiveness analysis of 13 catchment- and treatment-based management alternatives for mitigating Cryptosporidium risk in the Myponga water supply catchment, South Australia. A broad range of costs and benefits are identified and valued, including setup, operation and maintenance, and opportunity costs, and benefits for ecosystem services including water quality, biodiversity, carbon sequestration, and farm production services. The results suggest that the cost-effectiveness of investment in water quality management can be substantially enhanced by considering the costs of management and the benefits for ecosystem services, in addition to Cryptosporidium removal effectiveness. Cost-effectiveness of investment in management alternatives is dependent upon the desired level of Cryptosporidium removal effectiveness by both the catchment and treatment barriers. The combination of a spatially targeted 25% restriction in water course access of nondairy cattle and treatment by enhanced coagulation provides the most (net) cost-effective Cryptosporidium risk mitigation strategy. This combination may achieve 0.614 log removal at a net cost of A0.7 million and (net) cost-effectiveness of A1.14 million per log removal. Additional risk mitigation can be achieved through the addition of ultraviolet irradiation treatment, higher levels of water course access restriction for cattle, and the adoption of dung beetles in the catchment. Economic valuation of a range of costs and benefits of management priorities can support cost-effective water quality management investment decisions and inform elements of policy design such as cost-sharing arrangements and spatial targeting.

  12. Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

    PubMed

    Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

    2014-02-01

    Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value. PMID

  13. A Potential Cost Effective Liquefaction Mitigation Countermeasure: Induced Partial Saturation

    SciTech Connect

    Bian Hanbing; Jia Yun; Shahrour, Isam

    2008-07-08

    This work is devoted to illustrate the potential liquefaction mitigation countermeasure: Induced Partial Saturation. Firstly the potential liquefaction mitigation method is briefly introduced. Then the numerical model for partially saturated sandy soil is presented. At last the dynamic responses of liquefiable free filed with different water saturation is given. It shows that the induced partial saturation is efficiency for preventing the liquefaction.

  14. On the potential cost effectiveness of scientific audits.

    PubMed

    Click, J L

    1989-09-01

    inefficient process for uncovering scientific fraud (5, 6, 9). Data from a survey of university scientists was also presented, indicating ". . . a reluctance to take prompt, corrective action not only when an investigator suspects another of misconduct but also should the investigator discover flaws in his or her own published reports-whether the flaws were the result of honest error or fraud"; (10). The uncritical acceptance by established scientists that the self-correcting process works compounds the problem. The Editor of Science has written that";. . . 99.9999 percent of reports are accurate and truthful. . ."; (8). If indeed only 0.0001% of published reports were inaccurate or untruthful, there would be little justification for scientific audits. However, congressional testimony from the National Institutes of Health (NIH) revealed that";. . . the NIH Director's office has handled an average of 15-20 allegations and reports of misconduct annually in its extramural programs, which supports the work of approximately 50,000 scientists"; (11). As I shall attempt to demonstrate, since NIH alone receives fraud-related complaints concerning the work of at least 0.03% of scientists it supports in other institutions, and since evidence indicates that the incidence of fraud is considerably greater than 0.03% (10, 12), the need to audit data is justifiable on the basis of being cost effective. PMID:26859058

  15. Potential Cost-Effective Opportunities for Methane Emission Abatement

    SciTech Connect

    Warner, Ethan; Steinberg, Daniel; Hodson, Elke; Heath, Garvin

    2015-08-01

    The energy sector was responsible for approximately 84% of carbon dioxide equivalent (CO2e) greenhouse gas (GHG) emissions in the U.S. in 2012 (EPA 2014a). Methane is the second most important GHG, contributing 9% of total U.S. CO2e emissions. A large portion of those methane emissions result from energy production and use; the natural gas, coal, and oil industries produce approximately 39% of anthropogenic methane emissions in the U.S. As a result, fossil-fuel systems have been consistently identified as high priority sectors to contribute to U.S. GHG reduction goals (White House 2015). Only two studies have recently attempted to quantify the abatement potential and cost associated with the breadth of opportunities to reduce GHG emissions within natural gas, oil, and coal supply chains in the United States, namely the U.S. Environmental Protection Agency (EPA) (2013a) and ICF (2014). EPA, in its 2013 analysis, estimated the marginal cost of abatement for non-CO2 GHG emissions from the natural gas, oil, and coal supply chains for multiple regions globally, including the United States. Building on this work, ICF International (ICF) (2014) provided an update and re-analysis of the potential opportunities in U.S. natural gas and oil systems. In this report we synthesize these previously published estimates as well as incorporate additional data provided by ICF to provide a comprehensive national analysis of methane abatement opportunities and their associated costs across the natural gas, oil, and coal supply chains. Results are presented as a suite of marginal abatement cost curves (MACCs), which depict the total potential and cost of reducing emissions through different abatement measures. We report results by sector (natural gas, oil, and coal) and by supply chain segment - production, gathering and boosting, processing, transmission and storage, or distribution - to facilitate identification of which sectors and supply chain

  16. An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

    PubMed

    Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

    2016-05-01

    Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed. PMID:27096406

  17. A comparison of estimates of cost-effectiveness of alternative fuels and vehicles for reducing emissions

    SciTech Connect

    Hadder, G.R.

    1995-11-01

    The cost-effectiveness ratio (CER) is a measure of the monetary value of resources expended to obtain reductions in emissions of air pollutants. The CER can lead to selection of the most effective sequence of pollution reduction options. Derived with different methodologies and technical assumptions, CER estimates for alternative fuel vehicles (AFVs) have varied widely among pervious studies. In one of several explanations of LCER differences, this report uses a consistent basis for fuel price to re-estimate CERs for AFVs in reduction of emissions of criteria pollutants, toxics, and greenhouse gases. The re-estimated CERs for a given fuel type have considerable differences due to non-fuel costs and emissions reductions, but the CERs do provide an ordinal sense of cost-effectiveness. The category with CER less than $5,000 per ton includes compressed natural gas and ed Petroleum gas vehicles; and E85 flexible-fueled vehicles (with fuel mixture of 85 percent cellulose-derived ethanol in gasoline). The E85 system would be much less attractive if corn-derived ethanol were used. The CER for E85 (corn-derived) is higher with higher values placed on the reduction of gas emissions. CER estimates are relative to conventional vehicles fueled with Phase 1 California reformulated gasoline (RFG). The California Phase 2 RFG program will be implemented before significant market penetration by AFVs. CERs could be substantially greater if they are calculated incremental to the Phase 2 RFG program. Regression analysis suggests that different assumptions across studies can sometimes have predictable effects on the CER estimate of a particular AFV type. The relative differences in cost and emissions reduction assumptions can be large, and the effect of these differences on the CER estimate is often not predictable. Decomposition of CERs suggests that methodological differences can make large contributions to CER differences among studies.

  18. Lung cancer deaths from indoor radon and the cost effectiveness and potential of policies to reduce them

    PubMed Central

    Read, Simon; McGale, Paul; Darby, Sarah

    2009-01-01

    Objective To determine the number of deaths from lung cancer related to radon in the home and to explore the cost effectiveness of alternative policies to control indoor radon and their potential to reduce lung cancer mortality. Design Cost effectiveness analysis. Setting United Kingdom. Data sources Epidemiological data on risks from indoor radon and from smoking, vital statistics on deaths from lung cancer, survey information on effectiveness and costs of radon prevention and remediation. Main outcome measures Estimated number of deaths from lung cancer related to indoor radon, lifetime risks of death from lung cancer before and after various potential interventions to control radon, the cost per quality adjusted life year (QALY) gained from different policies for control of radon, and the potential of those policies to reduce lung cancer mortality. Results The mean radon concentration in UK homes is 21 becquerels per cubic metre (Bq/m3). Each year around 1100 deaths from lung cancer (3.3% of all deaths from lung cancer) are related to radon in the home. Over 85% of these arise from radon concentrations below 100 Bq/m3 and most are caused jointly by radon and active smoking. Current policy requiring basic measures to prevent radon in new homes in selected areas is highly cost effective, and such measures would remain cost effective if extended to the entire UK, with a cost per QALY gained of £11 400 ( €12 200; $16 913). Current policy identifying and remediating existing homes with high radon levels is, however, neither cost effective (cost per QALY gained £36 800) nor effective in reducing lung cancer mortality. Conclusions Policies requiring basic preventive measures against radon in all new homes throughout the UK would be cost effective and could complement existing policies to reduce smoking. Policies involving remedial work on existing homes with high radon levels cannot prevent most radon related deaths, as these are caused by moderate exposure

  19. Cost-Effectiveness of Alternative Blood-Screening Strategies for West Nile Virus in the United States

    PubMed Central

    Korves, Caroline T; Goldie, Sue J; Murray, Megan B

    2006-01-01

    Background West Nile virus (WNV) is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. Methods and Findings We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire) to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding US$1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings. Conclusions In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for

  20. Technological Minimalism: A Cost-Effective Alternative for Course Design and Development.

    ERIC Educational Resources Information Center

    Lorenzo, George

    2001-01-01

    Discusses the use of minimum levels of technology, or technological minimalism, for Web-based multimedia course content. Highlights include cost effectiveness; problems with video streaming, the use of XML for Web pages, and Flash and Java applets; listservs instead of proprietary software; and proper faculty training. (LRW)

  1. The ARIEL Document Delivery System: A Cost-Effective Alternative to the Fax.

    ERIC Educational Resources Information Center

    Landes, Sonja

    1997-01-01

    ARIEL is a high-speed, high-quality, cost-effective document delivery system that runs on the Internet. Advantages over the fax include no long-distance phone charges, high image resolution, original source can be scanned, can send/receive simultaneously, does not require dedicated equipment, and documents can be stored and forwarded later.…

  2. Cost-Effectiveness of Alternative Approaches for Motivating Activity in Sedentary Adults: Results of Project STRIDE

    PubMed Central

    Sevick, Mary Ann; Napolitano, Melissa A.; Papandonatos, George D.; Gordon, Adam J.; Reiser, Lorraine M.; Marcus, Bess H.

    2009-01-01

    Objective To evaluate the cost-effectiveness of non face-to-face interventions for increasing physical activity in sedentary adults. The study took place in Providence, Rhode Island between the years 2000 and 2004. Methods 239 participants were randomized to: Phone, Print, or a contact control. Phone and Print groups were mailed regular surveys regarding their level of physical activity, motivational readiness and self-efficacy. Surveys were scanned by a computer expert system to generate feedback reports. Phone group participants received feedback by telephone. Print group participants received feedback by mail. The contact control group received mailings unrelated to physical activity. Intervention costs were assessed prospectively, from a payer perspective. Physical activity was measured using the Physical Activity Recall. Ambulatory health service use was assessed via monthly surveys. Results The Print intervention was more economically efficient than the Phone intervention in engaging participants in a more active lifestyle. Conclusion The Print intervention provides an efficient approach to increasing physical activity. Research is needed to determine the cost-effectiveness of the intervention in a more diverse population, within the context of the health service delivery system, and over a longer period of time. PMID:17573103

  3. Cost-effectiveness of alternative strategies for integrating MRI into breast cancer screening for women at high risk

    PubMed Central

    Ahern, C H; Shih, Y-C T; Dong, W; Parmigiani, G; Shen, Y

    2014-01-01

    Background: Magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer. We evaluated the cost-effectiveness of alternative screening strategies involving MRI. Methods: Using a microsimulation model, we generated life histories under different risk profiles, and assessed the impact of screening on quality-adjusted life-years, and lifetime costs, both discounted at 3%. We compared 12 screening strategies combining annual or biennial MRI with mammography and clinical breast examination (CBE) in intervals of 0.5, 1, or 2 years vs without, and reported incremental cost-effectiveness ratios (ICERs). Results: Based on an ICER threshold of $100 000/QALY, the most cost-effective strategy for women at 25% lifetime risk was to stagger MRI and mammography plus CBE every year from age 30 to 74, yielding ICER $58 400 (compared to biennial MRI alone). At 50% lifetime risk and with 70% reduction in MRI cost, the recommended strategy was to stagger MRI and mammography plus CBE every 6 months (ICER=$84 400). At 75% lifetime risk, the recommended strategy is biennial MRI combined with mammography plus CBE every 6 months (ICER=$62 800). Conclusions: The high costs of MRI and its lower specificity are limiting factors for annual screening schedule of MRI, except for women at sufficiently high risk. PMID:25137022

  4. Potential Cost-Effectiveness of Prenatal Distribution of Misoprostol for Prevention of Postpartum Hemorrhage in Uganda

    PubMed Central

    Lubinga, Solomon J.; Atukunda, Esther C.; Wasswa-Ssalongo, George; Babigumira, Joseph B.

    2015-01-01

    Background In settings where home birth rates are high, prenatal distribution of misoprostol has been advocated as a strategy to increase access to uterotonics during the third stage of labor to prevent postpartum hemorrhage (PPH). Our objective was to project the potential cost-effectiveness of this strategy in Uganda from both governmental (the relevant payer) and modified societal perspectives. Methods and Findings To compare prenatal misoprostol distribution to status quo (no misoprostol distribution), we developed a decision analytic model that tracked the delivery pathways of a cohort of pregnant women from the prenatal period, labor to delivery without complications or delivery with PPH, and successful treatment or death. Delivery pathway parameters were derived from the Uganda Demographic and Health Survey. Incidence of PPH, treatment efficacy, adverse event and case fatality rates, access to misoprostol, and health resource use and cost data were obtained from published literature and supplemented with expert opinion where necessary. We computed the expected incidence of PPH, mortality, disability adjusted life years (DALYs), costs and incremental cost effectiveness ratios (ICERs). We conducted univariate and probabilistic sensitivity analyses to examine robustness of our results. In the base-case analysis, misoprostol distribution lowered the expected incidence of PPH by 1.0% (95% credibility interval (CrI): 0.55%, 1.95%), mortality by 0.08% (95% CrI: 0.04%, 0.13%) and DALYs by 0.02 (95% CrI: 0.01, 0.03). Mean costs were higher with prenatal misoprostol distribution from governmental by US$3.3 (95% CrI: 2.1, 4.2) and modified societal (by US$1.3; 95% CrI: -1.6, 2.8) perspectives. ICERs were US$191 (95% CrI: 82, 443) per DALY averted from a governmental perspective, and US$73 (95% CI: -86, 256) per DALY averted from a modified societal perspective. Conclusions Prenatal distribution of misoprostol is potentially cost-effective in Uganda and should be

  5. Cost-Effectiveness of Nitrogen Mitigation by Alternative Household Wastewater Management Technologies

    EPA Science Inventory

    Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain ...

  6. Cost-Effectiveness of Retrospective Search Systems.

    ERIC Educational Resources Information Center

    King, Donald W.; Caldwell, Nancy W.

    The purpose of the present study is to explore cost-effectiveness factors that affect the choice among alternative system designs for retrospective searching services. A cost-effectiveness model that may be used to evaluate potential systems was derived, and a statement of the general magnitude of costs that the American Psychological Association…

  7. Strategies for cost-effective carbon reductions: A sensitivity analysis of alternative scenarios

    SciTech Connect

    Gumerman, Etan; Koomey, Jonathan G.; Brown, Marilyn

    2001-07-11

    Analyses of alternative futures often present results for a limited set of scenarios, with little if any sensitivity analysis to identify the factors affecting the scenario results. This approach creates an artificial impression of certainty associated with the scenarios considered, and inhibits understanding of the underlying forces. This paper summarizes the economic and carbon savings sensitivity analysis completed for the Scenarios for a Clean Energy Future study (IWG, 2000). Its 19 sensitivity cases provide insight into the costs and carbon-reduction impacts of a carbon permit trading system, demand-side efficiency programs, and supply-side policies. Impacts under different natural gas and oil price trajectories are also examined. The results provide compelling evidence that policy opportunities exist to reduce carbon emissions and save society money.

  8. Cheese whey: A cost-effective alternative for hyaluronic acid production by Streptococcus zooepidemicus.

    PubMed

    Amado, Isabel R; Vázquez, José A; Pastrana, Lorenzo; Teixeira, José A

    2016-05-01

    This study focuses on the optimisation of cheese whey formulated media for the production of hyaluronic acid (HA) by Streptococcus zooepidemicus. Culture media containing whey (W; 2.1g/L) or whey hydrolysate (WH; 2.4 g/L) gave the highest HA productions. Both W and WH produced high yields on protein consumed, suggesting cheese whey is a good nitrogen source for S. zooepidemicus production of HA. Polysaccharide concentrations of 4.0 g/L and 3.2g/L were produced in W and WH in a further scale-up to 5L bioreactors, confirming the suitability of the low-cost nitrogen source. Cheese whey culture media provided high molecular weight (>3000 kDa) HA products. This study revealed replacing the commercial peptone by the low-cost alternative could reduce HA production costs by up to a 70% compared to synthetic media. PMID:26769504

  9. Friction drive and bogies for OWL's main axes, technological step backwards or cost effective alternative?

    NASA Astrophysics Data System (ADS)

    Brunetto, Enzo; Koch, Franz; Biancat Marchet, F.; Dimmler, Martin

    2003-01-01

    The drive and bearing technologies have a major impact on the static and dynamic performances of a steerable telescope. The costs related to the complexity of the design and its Reliability, Availability, Maintainability and Safety (RAMS) are not negligible. The design constraints of Extremely Large Telescopes (ELT) depart from those applicable to the current generation of 8 to 10 meter class telescopes, thus suggesting that alternative solutions should be investigated. This paper discusses the feasibility of implementing a design based on friction drives and bogies, tailored to OWL"s azimuthal and altitude degrees of freedom. The estimated static and dynamic performance of the mechanical structure, the achievable angular resolution, the optimal distribution of loads and stresses, the RAMS performance and finally its cost efficiency, make this solution particularly attractive.

  10. Bearing repair services offer a cost-effective alternative to expensive replacement

    SciTech Connect

    2009-02-15

    The article, based on a presentation during MINExpo 2008, explains how advancement is bearing design, material, maintenance and repair methods have greatly improved the potential for and popularity of bearing repair as an effective way to extend bearing life. The Trinken Co. offers a variety of service options including repair, recertification, reconditioning and remanufacturing. Benefits of a quality repair program are outlined. 2 photos.

  11. Cyanide Scavenging by a Cobalt Schiff-Base Macrocycle: A Cost-Effective Alternative to Corrinoids.

    PubMed

    Lopez-Manzano, Elisenda; Cronican, Andrea A; Frawley, Kristin L; Peterson, Jim; Pearce, Linda L

    2016-06-20

    The complex of cobalt(II) with the ligand 2,12-dimethyl-3,7,11,17-tetraazabicyclo-[11.3.1]heptadeca-1(17)2,11,13,15-pentaene (CoN4[11.3.1]) has been shown to bind two molecules of cyanide in a cooperative fashion with an association constant of 2.7 (±0.2) × 10(5). In vivo, irrespective of whether it is initially administered as the Co(II) or Co(III) cation, EPR spectroscopic measurements on blood samples show that at physiological levels of reductant (principally ascorbate) CoN4[11.3.1] becomes quantitatively reduced to the Co(II) form. However, following addition of sodium cyanide, a dicyano Co(III) species is formed, both in blood and in buffered aqueous solution at neutral pH. In keeping with other cobalt-containing cyanide-scavenging macrocycles like cobinamide and cobalt(III) meso-tetra(4-N-methylpyridyl)porphine, we found that CoN4[11.3.1] exhibits rapid oxygen turnover in the presence of the physiological reductant ascorbate. This behavior could potentially render CoN4[11.3.1] cytotoxic and/or interfere with evaluations of the antidotal capability of the complex toward cyanide through respirometric measurements, particularly since cyanide rapidly inhibits this process, adding further complexity. A sublethal mouse model was used to assess the effectiveness of CoN4[11.3.1] as a potential cyanide antidote. The administration of CoN4[11.3.1] prophylactically to sodium cyanide-intoxicated mice resulted in the time required for the surviving animals to recover from "knockdown" (unconsciousness) being significantly decreased (3 ± 2 min) compared to that of the controls (22 ± 5 min). All observations are consistent with the demonstrated antidotal activity of CoN4[11.3.1] operating through a cyanide-scavenging mechanism, which is associated with a Co(II) → Co(III) oxidation of the cation. To test for postintoxication neuromuscular sequelae, the ability of mice to remain in position on a rotating cylinder (RotaRod test) was assessed during and after recovery

  12. The potential cost-effectiveness of vaccination against herpes zoster and post-herpetic neuralgia.

    PubMed

    Brisson, Marc; Pellissier, James M; Camden, Stéphanie; Quach, Caroline; De Wals, Philippe

    2008-01-01

    A clinical trial has shown that a live-attenuated varicella-zoster virus vaccine is effective against herpes zoster (HZ) and post-herpetic neuralgia (PHN). The aim of this study was to examine the cost-effectiveness of vaccination against HZ and PHN in Canada. A cohort model was developed to estimate the burden of HZ and the cost-effectiveness of HZ vaccination, using Canadian population-based data. Different ages at vaccination were examined and probabilistic sensitivity analysis was performed. The economic evaluation was conducted from the ministry of health perspective and 5% discounting was used for costs and benefits. In Canada (population = 30 million), we estimate that each year there are 130,000 new cases of HZ, 17,000 cases of PHN and 20 deaths. Most of the pain and suffering is borne by adults over the age of 60 years and is due to PHN. Vaccinating 65-year-olds (HZ efficacy = 63%, PHN efficacy = 67%, no waning, cost/course = $150) is estimated to cost $33,000 per QALY-gained (90% CrI: 19,000-63,000). Assuming the cost per course of HZ vaccination is $150, probabilistic sensitivity analysis suggest that vaccinating between 65 and 75 years of age will likely yield cost-effectiveness ratios below $40,000 per Quality-Adjusted Life-Year (QALY) gained, while vaccinating adults older than 75 years will yield ratios less than $70,000 per QALY-gained. These results are most sensitive to the duration of vaccine protection and the cost of vaccination. In conclusion, results suggest that vaccinating adults between the ages of 65 and 75 years is likely to be cost-effective and thus to be a judicious use of scarce health care resources. PMID:18382137

  13. Potential benefits of R and D directed toward increasing the cost-effectiveness of energy use

    SciTech Connect

    Anderson, T.D.

    1982-03-17

    The need for energy research programs directed toward increasing the cost-effectiveness of energy use is discussed. Benefits reaped by society as a consequence of successful completion of a research activity are economic, environmental, health and safety, security, and long term; emphasis is placed on the economic benefits from research projects on the demand side (i.e., energy end-use sectors). Each end-use sector was examined and data on the amount of energy consumed and the estimated cost of that energy are compiled.

  14. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY)...

  15. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true Must we ensure that travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 70-INTERNAL...

  16. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY)...

  17. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY)...

  18. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY)...

  19. A tutorial for analysing the cost-effectiveness of alternative methods for assessing chemical toxicity: the case of acute oral toxicity prediction.

    PubMed

    Norlen, Hedvig; Worth, Andrew P; Gabbert, Silke

    2014-05-01

    Compared with traditional animal methods for toxicity testing, in vitro and in silico methods are widely considered to permit a more cost-effective assessment of chemicals. However, how to assess the cost-effectiveness of alternative methods has remained unclear. This paper offers a user-oriented tutorial for applying cost-effectiveness analysis (CEA) to alternative (non-animal) methods. The purpose is to illustrate how CEA facilitates the identification of the alternative method, or the combination of methods, that offers the highest information gain per unit of cost. We illustrate how information gains and costs of single methods and method combinations can be assessed. By using acute oral toxicity as an example, we apply CEA to a set of four in silico methods (ToxSuite, TOPKAT, TEST, ADMET Predictor), one in vitro method (the 3T3 Neutral Red Uptake cytotoxicity assay), and various combinations of these methods. Our results underline that in silico tools are more cost-effective than the in vitro test. Battery combinations of alternative methods, however, do not necessarily outperform single methods, because additional information gains from the battery are easily outweighed by additional costs. PMID:24901905

  20. Sun-dried raisins are a cost-effective alternative to Sports Jelly Beans in prolonged cycling.

    PubMed

    Rietschier, Helena L; Henagan, Tara M; Earnest, Conrad P; Baker, Birgitta L; Cortez, Cory C; Stewart, Laura K

    2011-11-01

    The purpose of this study was to examine the effects of a natural carbohydrate (CHO) source in the form of sun-dried raisins (SDRs) vs. Sports Jelly Beans™ (SJBs) on endurance performance in trained cyclists and triathletes. Ten healthy men (18-33 years) completed 1 water-only acclimatization exercise trial and 2 randomized exercise trials administered in a crossover fashion. Each trial consisted of a 120-minute constant-intensity glycogen depletion period followed by a 10-km time trial (TT). During each experimental trial, participants consumed isocaloric amounts of SDRs or SJBs in 20-minute intervals. Measurements included time to complete 10-km TT, power output during 10-km TT, blood glucose levels and respiratory exchange ratio during glycogen depletion period, rate of perceived exertion (RPE), 'flow' questionnaire responses, and a hedonic (i.e., pleasantness) sensory acceptance test. There were no significant differences in endurance performance for TT time (SDRs vs. SJBs, 17.3 ± 0.4 vs. 17.3 ± 0.4 seconds) or power (229.3 ± 13.0 vs. 232.0 ± 13.6 W), resting blood glucose levels (5.8 ± 04 mmol·L(-1) for SDRs and 5.4 ± 0.2 mmol·L(-1) for SJBs), RPE, or flow experiences between SDR and SJB trials. However, the mean sensory acceptance scores were significantly higher for the SDRs compared to the SJBs (50.7 ± 1.7 vs. 44.3 ± 2.7). Consuming SDRs or SJBs during 120 minutes of intense cycling results in similar subsequent TT performances and are equally effective in maintaining blood glucose levels during exercise. Therefore, SDRs are a natural, pleasant, cost-effective CHO alternative to commercial SJBs that can be used during moderate- to high-intensity endurance exercise. PMID:21881533

  1. Incorporating the productivity benefits into the assessment of cost effective energy savings potential using conservation supply curves

    SciTech Connect

    Laitner, John A.; Ruth, Michael; Worrell, Ernst

    2001-07-24

    We review the relationship between energy efficiency improvement measures and productivity in industry. We propose a method to include productivity benefits in the economic assessment of the potential for energy efficiency improvement. The paper explores the implications of how this change in perspective might affect the evaluation of energy-efficient technologies for a study of the iron and steel industry in the U.S. It is found that including productivity benefits explicitly in the modeling parameters would double the cost-effective potential for energy efficiency improvement, compared to an analysis excluding those benefits. We provide suggestions for future research for this important area.

  2. Study of the Cost-Effectiveness of Retrospective Search Systems.

    ERIC Educational Resources Information Center

    King, Donald W.; Caldwell, Nancy W.

    The purpose of this study was to explore cost-effectiveness factors that affect the choice among alternative systems. A cost-effectiveness model that may be used to evaluate potential systems was derived and a statement of the general magnitude of costs that the American Psychological Association (APA) can expect in implementing and operating…

  3. Lean systems approaches to health technology assessment: a patient-focused alternative to cost-effectiveness analysis.

    PubMed

    Bridges, John F P

    2006-12-01

    Many countries now use health technology assessment (HTA) to review new and emerging technologies, especially with regard to reimbursement, pricing and/or clinical guidelines. One of the common, but not universal, features of these systems is the use of economic evaluation, normally cost-effectiveness analysis (CEA), to confirm that new technologies offer value for money. Many have criticised these systems as primarily being concerned with cost containment, rather than advancing the interests of patients or innovators. This paper calls into question the underlying principles of CEA by arguing that value in the healthcare system may in fact be unconstrained. It is suggested that 'lean management principles' can be used not only to trim waste from the health system, but as a method of creating real incentives for innovation and value creation. Following the lean paradigm, this value must be defined purely from the patients' perspective, and the entire health system needs to work towards the creation of such value. This paper offers as a practical example a lean approach to HTA, arguing that such an approach would lead to better incentives for innovation in health, as well as more patient-friendly outcomes in the long run. PMID:23389493

  4. Cost Effective Prototyping

    NASA Technical Reports Server (NTRS)

    Wickman, Jerry L.; Kundu, Nikhil K.

    1996-01-01

    This laboratory exercise seeks to develop a cost effective prototype development. The exercise has the potential of linking part design, CAD, mold development, quality control, metrology, mold flow, materials testing, fixture design, automation, limited parts production and other issues as related to plastics manufacturing.

  5. Cost-effectiveness analysis of the direct and indirect impact of intranasal live attenuated influenza vaccination strategies in children: alternative country profiles

    PubMed Central

    Gibson, Edward; Begum, Najida; Martinón-Torres, Federico; Safadi, Marco Aurélio; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-01-01

    Background Influenza poses a significant burden on healthcare systems and society, with under-recognition in the paediatric population. Existing vaccination policies (largely) target the elderly and other risk groups where complications may arise. Objective The goal of this study was to evaluate the cost-effectiveness of annual paediatric vaccination (in 2–17-year-olds) with live attenuated influenza vaccination (LAIV), as well as the protective effect on the wider population in England and Wales (base). The study aimed to demonstrate broad applications of the model in countries where epidemiological and transmission data is limited and that have sophisticated vaccination policies (Brazil, Spain, and Taiwan). Methods The direct and indirect impact of LAIV in the paediatric cohort was simulated using an age-stratified dynamic transmission model over a 5-year time horizon of daily cycles and applying discounting of 3.5% in the base case. Pre-existing immunity structure was based on a 1-year model run. Sensitivity analyses were conducted. Results In the base case for England and Wales, the annual paediatric strategy with LAIV was associated with improvements in influenza-related events and quality-adjusted life years (QALYs) lost, yielding an incremental cost per QALY of £6,208. The model was robust to change in the key input parameters. The probabilistic analysis demonstrated LAIV to be cost effective in more than 99% of iterations, assuming a willingness-to-pay threshold of £30,000. Incremental costs per QALY for Brazil were £2,817, and for the cases of Spain and Taiwan the proposed strategy was dominant over the current practice. Conclusion In addition to existing policies, annual paediatric vaccination using LAIV provides a cost-effective strategy that offers direct and indirect protection in the wider community. Paediatric vaccination strategies using LAIV demonstrated clinical and economic benefits over alternative (current vaccination) strategies in

  6. Potential of renewable and alternative energy sources

    NASA Astrophysics Data System (ADS)

    Konovalov, V.; Pogharnitskaya, O.; Rostovshchikova, A.; Matveenko, I.

    2015-11-01

    The article deals with application potential of clean alternative renewable energy sources. By means of system analysis the forecast for consumption of electrical energy in Tomsk Oblast as well as main energy sources of existing energy system have been studied up to 2018. Engineering potential of renewable and alternative energy sources is evaluated. Besides, ranking in the order of their efficiency descending is performed. It is concluded that Tomsk Oblast has high potential of alternative and renewable energy sources, among which the most promising development perspective is implementation of gasification stations to save fuel consumed by diesel power stations as well as building wind-power plants.

  7. An Analytical Process Model for Cost-Effectiveness/Productivity Evaluations of Alternative Educational Programs. Technical Report No. 390 (Parts, 1, 2, and 3).

    ERIC Educational Resources Information Center

    Marinelli, Joseph J.

    The purposes of this study were (1) to ascertain the state of the art with regard to cost effectiveness and productivity analyses in education and (2) to develop an appropriate cost effectiveness analytical process model for education. Chapters I through III present a review of the literature on cost effectiveness analysis, cost benefit analysis,…

  8. Potential interactions between alternative therapies and warfarin.

    PubMed

    Heck, A M; DeWitt, B A; Lukes, A L

    2000-07-01

    Potential and documented interactions between alternative therapy agents and warfarin are discussed. An estimated one third of adults in the United States use alternative therapies, including herbs. A major safety concern is potential interactions of alternative medicine products with prescription medications. This issue is especially important with respect to drugs with narrow therapeutic indexes, such as warfarin. Herbal products that may potentially increase the risk of bleeding or potentiate the effects of warfarin therapy include angelica root, arnica flower, anise, asafoetida, bogbean, borage seed oil, bromelain, capsicum, celery, chamomile, clove, fenugreek, feverfew, garlic, ginger ginkgo, horse chestnut, licorice root, lovage root, meadowsweet, onion, parsley, passionflower herb, poplar, quassia, red clover, rue, sweet clover, turmeric, and willow bark. Products that have been associated with documented reports of potential interactions with warfarin include coenzyme Q10, danshen, devil's claw, dong quai, ginseng, green tea, papain, and vitamin E. Interpretation of the available information on herb-warfarin interactions is difficult because nearly all of it is based on in vitro data, animal studies, or individual case reports. More study is needed to confirm and assess the clinical significance of these potential interactions. There is evidence that a wide range of alternative therapy products have the potential to interact with warfarin. Pharmacists and other health care professionals should question all patients about use of alternative therapies and report documented interactions to FDA's MedWatch program. PMID:10902065

  9. Exploring the Potential Health Impact and Cost-Effectiveness of AIDS Vaccine within a Comprehensive HIV/AIDS Response in Low- and Middle-Income Countries

    PubMed Central

    Harmon, Thomas M.; Fisher, Kevin A.; McGlynn, Margaret G.; Stover, John; Warren, Mitchell J.; Teng, Yu; Näveke, Arne

    2016-01-01

    Background The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs). This article describes additional modeling which looks more closely at the potential health impact and cost-effectiveness of AIDS vaccination in LMICs as part of UNAIDS IFE. Methods An epidemiological model was used to explore the potential impact of AIDS vaccination in LMICs in combination with other interventions through 2070. Assumptions were based on perspectives from research, vaccination and public health experts, as well as observations from other HIV/AIDS interventions and vaccination programs. Sensitivity analyses varied vaccine efficacy, duration of protection, coverage, and cost. Results If UNAIDS IFE goals were fully achieved, new annual HIV infections in LMICs would decline from 2.0 million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced in 2027 with three doses, strong uptake and five years of protection would reduce annual new infections by 44% over the first decade, by 65% the first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS vaccine would be cost-effective within a wide range of scenarios. Interpretation Even a modestly effective vaccine could contribute strongly to a sustainable response to HIV/AIDS and be cost-effective, even with optimistic assumptions about other interventions. Higher efficacy would provide even greater impact and cost-effectiveness, and would support broader access. Vaccine efficacy and cost per regimen are critical in achieving cost-effectiveness, with cost per regimen being particularly critical in low-income countries and at lower efficacy levels. PMID:26731116

  10. The Potential to Forgo Social Welfare Gains through Overrelianceon Cost Effectiveness/Cost Utility Analyses in the Evidence Base for Public Health

    PubMed Central

    Cohen, D. R.; Patel, N.

    2009-01-01

    Economic evaluations of clinical treatments most commonly take the form of cost effectiveness or cost utility analyses. This is appropriate since the main—sometimes the only—benefit of such interventions is increased health. The majority of economic evaluations in public health, however, have also been assessed using these techniques when arguably cost benefit analyses would in many cases have been more appropriate, given its ability to take account of nonhealth benefits as well. An examination of the nonhealth benefits from a sample of studies featured in a recent review of economic evaluations in public health illustrates how overfocusing on cost effectiveness/cost utility analyses may lead to forgoing potential social welfare gains from programmes in public health. Prior to evaluation, programmes should be considered in terms of the potential importance of nonhealth benefits and where these are considerable would be better evaluated by more inclusive economic evaluation techniques. PMID:20049165

  11. Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

    PubMed Central

    Cambiano, Valentina; Ford, Deborah; Mabugu, Travor; Napierala Mavedzenge, Sue; Miners, Alec; Mugurungi, Owen; Nakagawa, Fumiyo; Revill, Paul; Phillips, Andrew

    2015-01-01

    Background Studies have demonstrated that self-testing for human immunodeficiency virus (HIV) is highly acceptable among individuals and could allow cost savings, compared with provider-delivered HIV testing and counseling (PHTC), although the longer-term population-level effects are uncertain. We evaluated the cost-effectiveness of introducing self-testing in 2015 over a 20-year time frame in a country such as Zimbabwe. Methods The HIV synthesis model was used. Two scenarios were considered. In the reference scenario, self-testing is not available, and the rate of first-time and repeat PHTC is assumed to increase from 2015 onward, in line with past trends. In the intervention scenario, self-testing is introduced at a unit cost of $3. Results We predict that the introduction of self-testing would lead to modest savings in healthcare costs of $75 million, while averting around 7000 disability-adjusted life-years over 20 years. Findings were robust to most variations in assumptions; however, higher cost of self-testing, lower linkage to care for people whose diagnosis is a consequence of a positive self-test result, and lower threshold for antiretroviral therapy eligibility criteria could lead to situations in which self-testing is not cost-effective. Conclusions This analysis suggests that introducing self-testing offers some health benefits and may well save costs. PMID:25767214

  12. The Cost-effectiveness of Welcome to Medicare Visual Acuity Screening and a Possible Alternative Welcome to Medicare Eye Evaluation Among Persons Without Diagnosed Diabetes Mellitus

    PubMed Central

    Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Hoerger, Thomas J.; Zhang, Ping; Klein, Barbara Eden Kobrin; Lee, Kris E.; Klein, Ronald; Saaddine, Jinan B.

    2013-01-01

    Objective To estimate the cost-effectiveness of visual acuity screening performed in primary care settings and of dilated eye evaluations performed by an eye care professional among new Medicare enrollees with no diagnosed eye disorders. Medicare currently reimburses visual acuity screening for new enrollees during their initial preventive primary care health check, but dilated eye evaluations may be a more cost-effective policy. Design Monte Carlo cost-effectiveness simulation model with a total of 50 000 simulated patients with demographic characteristics matched to persons 65 years of age in the US population. Results Compared with no screening policy, dilated eye evaluations increased quality-adjusted life-years (QALYs) by 0.008 (95% credible interval [CrI], 0.005–0.011) and increased costs by $94 (95% CrI, −$35 to $222). A visual acuity screening increased QALYs in less than 95% of the simulations (0.001 [95% CrI, −0.002 to 0.004) and increased total costs by $32 (95% CrI, −$97 to $159) per person. The incremental cost-effectiveness ratio of a visual acuity screening and an eye examination compared with no screening were $29 000 and $12 000 per QALY gained, respectively. At a willingness-to-pay value of $15 000 or more per QALY gained, a dilated eye evaluation was the policy option most likely to be cost-effective. Conclusions The currently recommended visual acuity screening showed limited efficacy and cost-effectiveness compared with no screening. In contrast, a new policy of reimbursement for Welcome to Medicare dilated eye evaluations was highly cost-effective. PMID:22232367

  13. Cellular membrane potentials induced by alternating fields

    PubMed Central

    Grosse, Constantino; Schwan, Herman P.

    1992-01-01

    Membrane potentials induced by external alternating fields are usually derived assuming that the membrane is insulating, that the cell has no surface conductance, and that the potentials are everywhere solutions of the Laplace equation. This traditional approach is reexamined taking into account membrane conductance, surface admittance, and space charge effects. We find that whenever the conductivity of the medium outside the cell is low, large corrections are needed. Thus, in most of the cases where cells are manipulated by external fields (pore formation, cell fusion, cell rotation, dielectrophoresis) the field applied to the cell membrane is significantly reduced, sometimes practically abolished. This could have a strong bearing on present theories of pore formation, and of the influence of weak electric fields on membranes. PMID:19431866

  14. Cost-effectiveness of controlling emissions for various alternative-fuel vehicle types, with vehicle and fuel price subsidies estimated on the basis of monetary values of emission reductions

    SciTech Connect

    Wang, M.Q.

    1993-12-31

    Emission-control cost-effectiveness is estimated for ten alternative-fuel vehicle (AFV) types (i.e., vehicles fueled with reformulated gasoline, M85 flexible-fuel vehicles [FFVs], M100 FFVs, dedicated M85 vehicles, dedicated M100 vehicles, E85 FFVS, dual-fuel liquefied petroleum gas vehicles, dual-fuel compressed natural gas vehicles [CNGVs], dedicated CNGVs, and electric vehicles [EVs]). Given the assumptions made, CNGVs are found to be most cost-effective in controlling emissions and E85 FFVs to be least cost-effective, with the other vehicle types falling between these two. AFV cost-effectiveness is further calculated for various cases representing changes in costs of vehicles and fuels, AFV emission reductions, and baseline gasoline vehicle emissions, among other factors. Changes in these parameters can change cost-effectiveness dramatically. However, the rank of the ten AFV types according to their cost-effectiveness remains essentially unchanged. Based on assumed dollars-per-ton emission values and estimated AFV emission reductions, the per-vehicle monetary value of emission reductions is calculated for each AFV type. Calculated emission reduction values ranged from as little as $500 to as much as $40,000 per vehicle, depending on AFV type, dollar-per-ton emission values, and baseline gasoline vehicle emissions. Among the ten vehicle types, vehicles fueled with reformulated gasoline have the lowest per-vehicle value, while EVs have the highest per-vehicle value, reflecting the magnitude of emission reductions by these vehicle types. To translate the calculated per-vehicle emission reduction values to individual AFV users, AFV fuel or vehicle price subsidies are designed to be equal to AFV emission reduction values. The subsidies designed in this way are substantial. In fact, providing the subsidies to AFVs would change most AFV types from net cost increases to net cost decreases, relative to conventional gasoline vehicles.

  15. Is genetic ultrasound cost-effective?

    PubMed

    DeVore, Greggory R

    2003-04-01

    During the past 10 years, investigators have reported studies examining the potential of second-trimester genetic sonography to identify fetuses at risk for trisomy 21. The consensus among most investigators is that genetic sonography offers an alternative to universal amniocentesis in high-risk women and lowers the loss rate of normal fetuses subjected to amniocentesis because of risk factors associated with advanced maternal age or abnormal maternal-serum screening. Although there is now consensus that genetic sonography may be a useful screening tool, there has been a paucity of data regarding its cost-effectiveness. In this review, 3 studies are examined and cost-effectiveness of genetic sonography evaluated. The first study compared genetic sonography and universal amniocentesis and found that genetic sonography was cost-effective if the sensitivity is 75% or higher, resulted in a savings to the healthcare system of 9%, and decreased the loss rate of normal fetuses following amniocentesis by 87%. The second study examined the use of genetic sonography in women less than 35 years of age who underwent maternal-serum triple-marker serum screening. Women who were screen negative but who were classified as moderate risk for trisomy 21 (risk 1:191 to 1:1,000) were offered genetic sonography. Amniocentesis was offered only if the genetic sonogram was abnormal. The study demonstrated that the use of genetic sonography in this group of patients increased the detection rate of trisomy 21, was cost effective, and was a safe procedure. The third study examined the use of genetic sonography in women 35 years of age and older who declined amniocentesis following second-trimester genetic counseling. Genetic sonography was offered to this group of patients followed by amniocentesis if an abnormal ultrasound finding was present. The data were analyzed for various acceptance rates of amniocentesis by the patient when informed of the ultrasound findings. Examination of the data

  16. Testing the cost-effectiveness of three alternative teams in implementing the Regional Center for Training (RCT) follow-up system in satellite centers.

    PubMed

    Heda, Z; Khalid, M; Osman, M

    1993-01-01

    The Regional Training Center (RTC) was established at the OB/GYN Hospital, Ain Shams University, to overcome the shortage of trained service providers in the Egyptian family planning program. Over the past three years, RTC has successfully met the training needs for family planning services in Egypt. As part of the RTC's efforts, nine Satellite Training Centers (STCs) were established to provide quality training for service providers in nine governorates in Egypt. The RTC role in family planning activities is described. A study was conducted to test different teams in the implementation of the RTC follow-up system in three governorates in upper Egypt. The study was a cost-effectiveness analysis designed to determine which team best implements the follow-up system, with the ultimate goal of providing policymakers and program administrators with a better understanding of the role of the follow-up of trainees in providing high quality family planning services. The study was conducted during May-December 1991 using a sample of three STCs. The study produced valuable information for improving training logistics, clinical training, use of audiovisual equipment, record keeping, and overcoming training problems at STCs. The information clearly showed the importance of the follow-up system in providing administrators and decisionmakers with information needed to assess the operations and performance of STCs. Furthermore, the strengths and weaknesses of training at the STCs were revealed, giving useful insights for quality improvement. The use of RTC staff is the most cost-effective approach to follow-up at the STCs. PMID:12179785

  17. Cost-effectiveness analysis of sandhill crane habitat management

    USGS Publications Warehouse

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

    2013-01-01

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

  18. Efficient and cost-effective alternative treatment for recurrent urinary tract infections and interstitial cystitis in women: a two-case report.

    PubMed

    Mansour, Anthony; Hariri, Essa; Shelh, Samar; Irani, Ralph; Mroueh, Mohamad

    2014-01-01

    Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance. PMID:25587284

  19. Efficient and Cost-Effective Alternative Treatment for Recurrent Urinary Tract Infections and Interstitial Cystitis in Women: A Two-Case Report

    PubMed Central

    Mansour, Anthony; Hariri, Essa; Shelh, Samar; Irani, Ralph; Mroueh, Mohamad

    2014-01-01

    Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance. PMID:25587284

  20. Distributional Cost-Effectiveness Analysis

    PubMed Central

    Asaria, Miqdad; Griffin, Susan; Cookson, Richard

    2015-01-01

    Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments. PMID:25908564

  1. Alternative time-dependent optimized effective potential

    NASA Astrophysics Data System (ADS)

    Nazarov, Vladimir

    2013-03-01

    The OEP is known as a single-particle potential minimizing the expectation value of a many-body Hamiltonian on the set of eigen-functions of a single-particle Hamiltonian. The time-dependent (TD) OEP can be constructed with the TD quantum stationary-action principle. Very useful conceptually in DFT and TDDFT, both OEPs are not practicable due to the complexity of their implementations. Here we report a TDOEP by minimizing the difference of LHS and RHS of the TD Schrödinger equation. If the orbitals are varied, then the TD Hartree-Fock equations are reproduced. Similarly, we now find the OEP. New OMP does not involve the inversion of the density-response function χs, which greatly facilitates implementations. Accordingly, the exchange-correlation kernel fxc involves of χs- 1 only, not its quadratic counterpart. To show the power of this method, we work out the fxch (q , ω) of the homogeneous electron gas to be used with the nearly-free electrons theory, where fxch is the main input. Partial support from National Science Council, Taiwan, Grant No. 100-2112-M-001-025-MY3 is acknowledged.

  2. Ion propulsion cost effectivity

    NASA Technical Reports Server (NTRS)

    Zafran, S.; Biess, J. J.

    1978-01-01

    Ion propulsion modules employing 8-cm thrusters and 30-cm thrusters were studied for Multimission Modular Spacecraft (MMS) applications. Recurring and nonrecurring cost elements were generated for these modules. As a result, ion propulsion cost drivers were identified to be Shuttle charges, solar array, power processing, and thruster costs. Cost effective design approaches included short length module configurations, array power sharing, operation at reduced thruster input power, simplified power processing units, and power processor output switching. The MMS mission model employed indicated that nonrecurring costs have to be shared with other programs unless the mission model grows. Extended performance missions exhibited the greatest benefits when compared with monopropellant hydrazine propulsion.

  3. Wireless data communication alternatives for small public safety agencies: how one community cost-effectively solved its expanding field data requirements

    NASA Astrophysics Data System (ADS)

    Canning, Ryan M.; Lefebvre, Eric

    2005-06-01

    A growing number of Public Safety agencies have begun leveraging wireless data communication technology to improve tactical response capabilities as well as overall productivity. For years police departments subscribed to CDPD (Cellular Digital Packet Data) services to provide officers with basic dispatch data and criminal database access. Now as cellular carriers have deactivated CDPD and shifted to 2.5G and 3G data services such as 1xRTT, GPRS and EDGE, police departments are scrambling to fill the void. Not surprisingly, the extraordinary investments cellular carriers made to upgrade their infrastructures have been transferred to the customer, with monthly fees running as high as $80 a month per user. It's no wonder public safety agencies have been reluctant to adopt these services. Lost in the fray are those smaller police departments which account for nearly 90% of the nation's total. This group has increasingly sought out alternative data communication solutions that are not predicated on budget-busting monthly access fees. One such example is the Marco Island Police Department (MIPD) in Southwestern Florida that received a Federal grant to augment its existing voice communications with data. After evaluating several different technologies and vendors, MIPD chose a 900 MHz ad hoc mesh network solution based on its ability to provide reliable, high-speed and secure IP-based data communications over extensive distances. This paper will discuss technical details of Marco Island's mobile mesh network implementation; including: coverage area with 900 MHz spread spectrum radios, strategic repeater tower placement, interference, throughput performance, and the necessity for application-persistence software.

  4. Alternate Assessments Based on Alternate Achievement Standards: Policy, Practice, and Potential

    ERIC Educational Resources Information Center

    Schafer, William D., Ed.; Lissitz, Robert W., Ed.

    2009-01-01

    What really works in alternate assessment based on alternate achievement standards? Every state is working to know the answer--both to comply with federal requirements for evaluating students with severe cognitive disabilities, and to ensure that all students reach their full potential. This comprehensive book is the first to gather today's best…

  5. Screening HIV-Infected Patients with Low CD4 Counts for Cryptococcal Antigenemia prior to Initiation of Antiretroviral Therapy: Cost Effectiveness of Alternative Screening Strategies in South Africa

    PubMed Central

    Rockers, Peter C.; Bonawitz, Rachael; Sriruttan, Charlotte; Glencross, Deborah K.; Cassim, Naseem; Coetzee, Lindi M.; Greene, Gregory S.; Chiller, Tom M.; Vallabhaneni, Snigdha; Long, Lawrence; van Rensburg, Craig; Govender, Nelesh P.

    2016-01-01

    countries with substantial numbers of people with untreated, advanced HIV disease such as South Africa, CrAg screening before initiation of ART has the potential to reduce cryptococcal meningitis and save lives. Reflex screening compared to provider-initiated screening saves more lives and is likely to be cost saving or have low additional costs per additional year of life saved. PMID:27390864

  6. The potential cost-effectiveness of the Diamondback 360® Coronary Orbital Atherectomy System for treating de novo, severely calcified coronary lesions: an economic modeling approach

    PubMed Central

    Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P.

    2015-01-01

    Background: Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360® Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. Methods and results: In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p < 0.001) lower, approximately US$2700. Estimated mean revascularization costs were lower by US$1240 in the base case. These cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings. Even in the low-value scenario, the use of the OAS is cost-effective with a cost per life-year gained of US$11,895. Conclusions: Based on economic modeling

  7. Exactly Solvable Quantum Mechanical Potentials: An Alternative Approach.

    ERIC Educational Resources Information Center

    Pronchik, Jeremy N.; Williams, Brian W.

    2003-01-01

    Describes an alternative approach to finding exactly solvable, one-dimensional quantum mechanical potentials. Differs from the usual approach in that instead of starting with a particular potential and seeking solutions to the related Schrodinger equations, it begins with known solutions to second-order ordinary differential equations and seeks to…

  8. The Potential Economic Benefits of Improved Postfracture Care: A Cost-Effectiveness Analysis of a Fracture Liaison Service in the US Health-Care System

    PubMed Central

    Solomon, Daniel H; Patrick, Amanda R; Schousboe, John; Losina, Elena

    2014-01-01

    Fractures related to osteoporosis are associated with $20 billion in cost in the United States, with the majority of cost born by federal health-care programs, such as Medicare and Medicaid. Despite the proven fracture reduction benefits of several osteoporosis treatments, less than one-quarter of patients older than 65 years of age who fracture receive such care. A postfracture liaison service (FLS) has been developed in many health systems but has not been widely implemented in the United States. We developed a Markov state-transition computer simulation model to assess the cost-effectiveness of an FLS using a health-care system perspective. Using the model, we projected the lifetime costs and benefits of FLS, with or without a bone mineral density test, in men and women who had experienced a hip fracture. We estimated the costs and benefits of an FLS, the probabilities of refracture while on osteoporosis treatment, as well as the utilities associated with various health states from published literature. We used multi-way sensitivity analyses to examine impact of uncertainty in input parameters on cost-effectiveness of FLS. The model estimates that an FLS would result in 153 fewer fractures (109 hip, 5 wrist, 21 spine, 17 other), 37.43 more quality-adjusted life years (QALYs), and save $66,879 compared with typical postfracture care per every 10,000 postfracture patients. Doubling the cost of the FLS resulted in an incremental cost-effectiveness ratio (ICER) of $22,993 per QALY. The sensitivity analyses showed that results were robust to plausible ranges of input parameters; assuming the least favorable values of each of the major input parameters results in an ICER of $112,877 per QALY. An FLS targeting patients post-hip fracture should result in cost savings and reduced fractures under most scenarios. PMID:24443384

  9. Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

    SciTech Connect

    Letschert, Virginie E.; Bojda, Nicholas; Ke, Jing; McNeil, Michael A.

    2012-07-01

    This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

  10. Cost-Effective Fuel Treatment Planning

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  11. Describing current and potential markets for alternative-fuel vehicles

    SciTech Connect

    1996-03-26

    Motor vehicles are a major source of greenhouse gases, and the rising numbers of motor vehicles and miles driven could lead to more harmful emissions that may ultimately affect the world`s climate. One approach to curtailing such emissions is to use, instead of gasoline, alternative fuels: LPG, compressed natural gas, or alcohol fuels. In addition to the greenhouse gases, pollutants can be harmful to human health: ozone, CO. The Clean Air Act Amendments of 1990 authorized EPA to set National Ambient Air Quality Standards to control this. The Energy Policy Act of 1992 (EPACT) was the first new law to emphasize strengthened energy security and decreased reliance on foreign oil since the oil shortages of the 1970`s. EPACT emphasized increasing the number of alternative-fuel vehicles (AFV`s) by mandating their incremental increase of use by Federal, state, and alternative fuel provider fleets over the new few years. Its goals are far from being met; alternative fuels` share remains trivial, about 0.3%, despite gains. This report describes current and potential markets for AFV`s; it begins by assessing the total vehicle stock, and then it focuses on current use of AFV`s in alternative fuel provider fleets and the potential for use of AFV`s in US households.

  12. Potential of trans fats policies to reduce socioeconomic inequalities in mortality from coronary heart disease in England: cost effectiveness modelling study

    PubMed Central

    Pearson-Stuttard, Jonathan; Hooton, William; Diggle, Peter; Capewell, Simon; O’Flaherty, Martin

    2015-01-01

    Objectives To determine health and equity benefits and cost effectiveness of policies to reduce or eliminate trans fatty acids from processed foods, compared with consumption remaining at most recent levels in England. Design Epidemiological modelling study. Setting Data from National Diet and Nutrition Survey, Low Income Diet and Nutrition Survey, Office of National Statistics, and health economic data from other published studies Participants Adults aged ≥25, stratified by fifths of socioeconomic circumstance. Interventions Total ban on trans fatty acids in processed foods; improved labelling of trans fatty acids; bans on trans fatty acids in restaurants and takeaways. Main outcome measures Deaths from coronary heart disease prevented or postponed; life years gained; quality adjusted life years gained. Policy costs to government and industry; policy savings from reductions in direct healthcare, informal care, and productivity loss. Results A total ban on trans fatty acids in processed foods might prevent or postpone about 7200 deaths (2.6%) from coronary heart disease from 2015-20 and reduce inequality in mortality from coronary heart disease by about 3000 deaths (15%). Policies to improve labelling or simply remove trans fatty acids from restaurants/fast food could save between 1800 (0.7%) and 3500 (1.3%) deaths from coronary heart disease and reduce inequalities by 600 (3%) to 1500 (7%) deaths, thus making them at best half as effective. A total ban would have the greatest net cost savings of about £265m (€361m, $415m) excluding reformulation costs, or £64m if substantial reformulation costs are incurred outside the normal cycle. Conclusions A regulatory policy to eliminate trans fatty acids from processed foods in England would be the most effective and equitable policy option. Intermediate policies would also be beneficial. Simply continuing to rely on industry to voluntary reformulate products, however, could have negative health and economic outcomes

  13. Effects of disputes and easement violations on the cost-effectiveness of land conservation

    PubMed Central

    Arcese, Peter

    2015-01-01

    Conservation initiatives to protect and restore valued species communities in human-dominated landscapes face challenges linked to their potential costs. Conservation easements on private land may represent a cost-effective alternative to land purchase, but long-term costs to monitor and enforce easements, or defend legal challenges, remain uncertain. We explored the cost-effectiveness of conservation easements, defined here as the fraction of the high-biodiversity landscape potentially protected via investment in easements versus land purchase. We show that easement violation and dispute rates substantially affect the estimated long-term cost-effectiveness of an easement versus land purchase strategy. Our results suggest that conservation easements can outperform land purchase as a strategy to protect biodiversity as long as the rate of disputes and legal challenges is low, pointing to a critical need for monitoring data to reduce costs and maximize the value of conservation investments. PMID:26413430

  14. Potential Alternatives Report for Validation of Alternatives to Aliphatic Isocyanate Polyurethanes

    NASA Technical Reports Server (NTRS)

    Lewis, pattie

    2011-01-01

    Identifying and selecting alternative materials and technologies that have the potential to reduce the identified HazMats and hazardous air pollutants (HAPs), while incorporating sound corrosion prevention and control technologies, is a complicated task due to the fast pace at which new technologies emerge and rules change. The alternatives are identified through literature searches, electronic database and Internet searches, surveys, and/or personal and professional contacts. Available test data was then compiled on the proposed alternatives to determine if the materials meet the test objectives or if further)laboratory or field-testing will be required. After reviewing technical information documented in the PAR, government representatives, technical representatives from the affected facilities, and other stakeholders involved in the process will select the list of viable alternative coatings for consideration and testing under the project's Joint Test Protocol entitled Joint Test Protocol for Validation of Alternatives to Aliphatic Isocyanate Polyurethanes and Field Test Plan entitled Field Evaluations Test Plan for Validation of Alternatives to Aliphatic Isocyanate Polyurethanes, both prepared by ITB. Test results will be reported in a Joint Test Report upon completion oftesting. The selection rationale and conclusions are documented in this PAR. A cost benefit analysis will be prepared to quantify the estimated capital and process costs of coating alternatives and cost savings relative to the current coating processes, however, some initial cost data has been included in this PAR. For this coatings project, isocyanates, as found in aliphatic isocyanate polyurethanes, were identified as the target HazMat to be eliminated. Table 1-1 lists the target HazMats, the related process and application, current specifications, and affected programs.

  15. Investigating polymorphisms by bioinformatics is a potential cost-effective method to screen for germline mutations in Chinese familial adenomatous polyposis patients

    PubMed Central

    YANG, JUN; LIU, WEI QING; LI, WEN LIANG; CHEN, CHENG; ZHU, ZHU; HONG, MIN; WANG, ZHI QIANG; DONG, JIAN

    2016-01-01

    The aim of this study was to investigate germline mutations of the APC, MUTYH and AXIN2 genes in Chinese patients with familial adenomatous polyposis (FAP), and further assess the value of bioinformatics in screening the pathogenic changes predisposing to FAP. APC genes from 11 unrelated FAP patients in Yunnan province in China were firstly examined by exon-specific DNA sequencing. For samples without already known pathogenic changes predisposing to FAP in the APC gene, whole-gene sequencing of MUTYH and AXIN2 was performed. Mutational analysis of each gene was performed by bioinformatics. Eleven different types of APC polymorphisms were observed in the cohort of families analyzed. Of these polymorphisms, four were missense substitutions (V1822D, V1173G, P1760H and K2057), one was a nonsense substitution (S1196X), and six were silent substitutions (Y486Y, T449T, T1493T, G1678G, S1756S and P1960P). One missense mutation (Q335H) and two intronic substitutions (c.264+11G>A and c.420+35A>G) were detected in the MUTYH gene, and four synonymous mutations (I144I, P455P, P462P and L688L) and three intonic mutations (c.1060–77G>T, c.1060–287A>G and c.1060–282 A>G) of the AXIN2 gene were observed. In addition to the already reported pathogenic mutations, by using function assessment tools and databases, the synonymous substitutions observed in the APC gene of our samples were predicted to affect splicing regulation in the translation of mRNA, while the missense mutations observed in the APC gene and MUTYH gene were predicted to be disease-related polymorphisms; however, no functional effect of the mutations was observed in the AXIN2 gene. Comprehensive screening for germline mutations in APC, MUTYH and AXIN2 genes followed by prediction of pathogenicity using bioinformatic tools contributes to a cost-effective way of screening germline mutations in Chinese familial adenomatous polyposis patients. PMID:27347161

  16. Potential alternative energy technologies on the Outer Continental Shelf.

    SciTech Connect

    Elcock, D.; Environmental Assessment

    2007-04-20

    This technical memorandum (TM) describes the technology requirements for three alternative energy technologies for which pilot and/or commercial projects on the U.S. Outer Continental Shelf (OCS) are likely to be proposed within the next five to seven years. For each of the alternative technologies--wind, wave, and ocean current--the TM first presents an overview. After each technology-specific overview, it describes the technology requirements for four development phases: site monitoring and testing, construction, operation, and decommissioning. For each phase, the report covers the following topics (where data are available): facility description, electricity generated, ocean area (surface and bottom) occupied, resource requirements, emissions and noise sources, hazardous materials stored or used, transportation requirements, and accident potential. Where appropriate, the TM distinguishes between pilot-scale (or demonstration-scale) facilities and commercial-scale facilities.

  17. Cost-effectiveness of zinc as adjunct therapy for acute childhood diarrhoea in developing countries.

    PubMed Central

    Robberstad, Bjarne; Strand, Tor; Black, Robert E.; Sommerfelt, Halvor

    2004-01-01

    OBJECTIVE: To analyse the incremental costs, effects and cost-effectiveness of zinc used as adjunct therapy to standard treatment of acute childhood diarrhoea, including dysentery, and to reassess the cost-effectiveness of standard case management with oral rehydration salt (ORS). METHODS: A decision tree was used to model expected clinical outcomes and expected costs under four alternative treatment strategies. The best available epidemiological, clinical and economic evidence was used in the calculations, and the United Republic of Tanzania was the reference setting. Probabilistic cost-effectiveness analysis was performed using a Monte-Carlo simulation technique and the potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. FINDINGS: ORS was found to be less cost-effective than previously thought. The use of zinc as adjunct therapy significantly improved the cost-effectiveness of standard management of diarrhoea for dysenteric as well as non-dysenteric illness. The results were particularly sensitive to mortality rates in non-dysenteric diarrhoea, but the alternative interventions can be defined as highly cost-effective even in pessimistic scenarios. CONCLUSION: There is sufficient evidence to recommend the inclusion of zinc into standard case management of both dysenteric and non-dysenteric acute diarrhoea.A direct transfer of our findings from the United Republic of Tanzania to other settings is not justified, but there are no indications of large geographical differences in the efficacy of zinc. It is therefore plausible that our findings are also applicable to other developing countries. PMID:15500284

  18. Heat-flow properties of systems with alternate masses or alternate on-site potentials

    NASA Astrophysics Data System (ADS)

    Pereira, Emmanuel; Santana, Leonardo M.; Ávila, Ricardo

    2011-07-01

    We address a central issue of phononics: the search of properties or mechanisms to manage the heat flow in reliable materials. We analytically study standard and simple systems modeling the heat flow in solids, namely, the harmonic, self-consistent harmonic and also anharmonic chains of oscillators, and we show an interesting insulating effect: While in the homogeneous models the heat flow decays as the inverse of the particle mass, in the chain with alternate masses it decays as the inverse of the square of the mass difference, that is, it decays essentially as the mass ratio (between the smaller and the larger one) for a large mass difference. A similar effect holds if we alternate on-site potentials instead of particle masses. The existence of such behavior in these different systems, including anharmonic models, indicates that it is a ubiquitous phenomenon with applications in the heat flow control.

  19. Fuels for urban transit buses: a cost-effectiveness analysis.

    PubMed

    Cohen, Joshua T; Hammitt, James K; Levy, Jonathan I

    2003-04-15

    Public transit agencies have begun to adopt alternative propulsion technologies to reduce urban transit bus emissions associated with conventional diesel (CD) engines. Among the most popular alternatives are emission controlled diesel buses (ECD), defined here to be buses with continuously regenerating diesel particle filters burning low-sulfur diesel fuel, and buses burning compressed natural gas (CNG). This study uses a series of simplifying assumptions to arrive at first-order estimates for the incremental cost-effectiveness (CE) of ECD and CNG relative to CD. The CE ratio numerator reflects acquisition and operating costs. The denominator reflects health losses (mortality and morbidity) due to primary particulate matter (PM), secondary PM, and ozone exposure, measured as quality adjusted life years (QALYs). We find that CNG provides larger health benefits than does ECD (nine vs six QALYs annually per 1000 buses) but that ECD is more cost-effective than CNG (dollar 270 000 per QALY for ECD vs dollar 1.7 million to dollar 2.4 million for CNG). These estimates are subject to much uncertainty. We identify assumptions that contribute most to this uncertainty and propose potential research directions to refine our estimates. PMID:12731827

  20. Alternative Fuels and Their Potential Impact on Aviation

    NASA Technical Reports Server (NTRS)

    Daggett, D.; Hendricks, R.; Walther, R.

    2006-01-01

    With a growing gap between the growth rate of petroleum production and demand, and with mounting environmental needs, the aircraft industry is investigating issues related to fuel availability, candidates for alternative fuels, and improved aircraft fuel efficiency. Bio-derived fuels, methanol, ethanol, liquid natural gas, liquid hydrogen, and synthetic fuels are considered in this study for their potential to replace or supplement conventional jet fuels. Most of these fuels present the airplane designers with safety, logistical, and performance challenges. Synthetic fuel made from coal, natural gas, or other hydrocarbon feedstock shows significant promise as a fuel that could be easily integrated into present and future aircraft with little or no modification to current aircraft designs. Alternatives, such as biofuel, and in the longer term hydrogen, have good potential but presently appear to be better suited for use in ground transportation. With the increased use of these fuels, a greater portion of a barrel of crude oil can be used for producing jet fuel because aircraft are not as fuel-flexible as ground vehicles.

  1. The Sunk Cost Effect in Pigeons and Humans

    ERIC Educational Resources Information Center

    Navarro, Anton D.; Fantino, Edmund

    2005-01-01

    The sunk cost effect is the increased tendency to persist in an endeavor once an investment of money, effort, or time has been made. To date, humans are the only animal in which this effect has been observed unambiguously. We developed a behavior-analytic model of the sunk cost effect to explore the potential for this behavior in pigeons as well…

  2. Glucocorticoid analogues: potential therapeutic alternatives for treating inflammatory muscle diseases.

    PubMed

    Reeves, Erica K M; Rayavarapu, Sree; Damsker, Jesse M; Nagaraju, Kanneboyina

    2012-03-01

    Glucocorticoids (GCs) have been prescribed to treat a variety of diseases, including inflammatory myopathies and Duchenne muscular dystrophy for over 50 years. However, their prescription remains controversial due to the significant side effects associated with the chronic treatment. It is a common belief that the clinical efficacy of GCs is due to their transrepression of pro-inflammatory genes through inhibition of inflammatory transcription factors (i.e. NF-κB, AP-1) whereas the adverse side effects are attributed to the glucocorticoid receptor (GR)-mediated transcription of target genes (transactivation). The past decade has seen an increased interest in the development of GR modulators that maintain the effective anti-inflammatory properties but lack the GR-dependent transcriptional response as a safe alternative to traditional GCs. Many of these analogues or "dissociative" compounds show potential promise in in vitro studies but fail to reach human clinical trials. In this review, we discuss molecular effects of currently prescribed GCs on skeletal muscle and also discuss the current state of development of GC analogues as alternative therapeutics for inflammatory muscle diseases. PMID:22214335

  3. Alternate corrections for estimating actual wetland evapotranspiration from potential evapotranspiration

    USGS Publications Warehouse

    Barclay, Shoemaker W.; Sumner, D.M.

    2006-01-01

    Corrections can be used to estimate actual wetland evapotranspiration (AET) from potential evapotranspiration (PET) as a means to define the hydrology of wetland areas. Many alternate parameterizations for correction coefficients for three PET equations are presented, covering a wide range of possible data-availability scenarios. At nine sites in the wetland Everglades of south Florida, USA, the relatively complex PET Penman equation was corrected to daily total AET with smaller standard errors than the PET simple and Priestley-Taylor equations. The simpler equations, however, required less data (and thus less funding for instrumentation), with the possibility of being corrected to AET with slightly larger, comparable, or even smaller standard errors. Air temperature generally corrected PET simple most effectively to wetland AET, while wetland stage and humidity generally corrected PET Priestley-Taylor and Penman most effectively to wetland AET. Stage was identified for PET Priestley-Taylor and Penman as the data type with the most correction ability at sites that are dry part of each year or dry part of some years. Finally, although surface water generally was readily available at each monitoring site, AET was not occurring at potential rates, as conceptually expected under well-watered conditions. Apparently, factors other than water availability, such as atmospheric and stomata resistances to vapor transport, also were limiting the PET rate. ?? 2006, The Society of Wetland Scientists.

  4. Distributional Cost-Effectiveness Analysis: A Tutorial.

    PubMed

    Asaria, Miqdad; Griffin, Susan; Cookson, Richard

    2016-01-01

    Distributional cost-effectiveness analysis (DCEA) is a framework for incorporating health inequality concerns into the economic evaluation of health sector interventions. In this tutorial, we describe the technical details of how to conduct DCEA, using an illustrative example comparing alternative ways of implementing the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). The 2 key stages in DCEA are 1) modeling social distributions of health associated with different interventions, and 2) evaluating social distributions of health with respect to the dual objectives of improving total population health and reducing unfair health inequality. As well as describing the technical methods used, we also identify the data requirements and the social value judgments that have to be made. Finally, we demonstrate the use of sensitivity analyses to explore the impacts of alternative modeling assumptions and social value judgments. PMID:25908564

  5. Cost-effective design of economic instruments in nutrition policy.

    PubMed

    Jensen, Jørgen D; Smed, Sinne

    2007-01-01

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10-30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn. PMID:17408494

  6. Sublingual Delivery of Frovatriptan: An Indication of Potential Alternative Route

    PubMed Central

    Verma, Surajpal; Prasad, Shyam Baboo

    2014-01-01

    Frovatriptan, a 5-HT1B and 5-HT1D receptor agonist, is used for the treatment of acute migraine attack. This molecule is classified into second line therapy because of its slow onset of action (peak response obtained after 4 hours of administration) and low bioavailability (25%). Moreover, its therapy is the most costly among all triptans. Attempt has been made in present work to suggest a way out to fasten its onset of action and to enhance its bioavailability. Prepared tablets were evaluated by physicochemical tests, in vitro permeation studies, ex vivo permeation studies, and histopathological studies. Suitable mathematical calculations were performed to calculate the minimum amount of bioavailability that could be enhanced. Tablets containing chitosan (5% w/w) were found to give optimum results. Prepared tablets can double the bioavailability of frovatriptan and can initiate its response within 10 minutes of its administration. Suggestive alternative has the potential to increase the efficacy of frovatriptan for treating acute migraine attack. PMID:27433492

  7. Potential Alternatives Report for Validation of Alternative Low-Emission Surface PreparationlDepainting Technologies for Structural Steel

    NASA Technical Reports Server (NTRS)

    Lewis, Pattie

    2006-01-01

    For this project, particulates and solvents used during the depainting process of steel structures were the identified hazardous material (HazMat) targeted for elimination or reduction. This Potential Alternatives Report (PAR) provides technical analyses of identified alternatives to the current coating removal processes, criteria used to select alternatives for further analysis, and a list of those alternatives recommended for testing. The initial coating removal alternatives list was compiled using literature searches and center participant recommendations. The involved project participants initially considered fifteen (15) alternatives. In late 2004, stakeholders down-selected the list and identified specific processes as potential alternatives to the current depainting methods. The selected alternatives were: 1. Plastic Blast Media 2. Hard Abrasive Media 3. Sponge Blast Media 4. Mechanical Removal with Vacuum Attachment 5. Liquid Nitrogen 6. Laser Coating Removal Available information about these processes was used to analyze the technical merits and the potential environmental, safety, and occupational health (ESOH) impacts of these methods. A preliminary cost benefit analysis will be performed to determine if implementation of alternative technologies is economically justified. NASA AP2

  8. Cost-effective conservation of an endangered frog under uncertainty.

    PubMed

    Rose, Lucy E; Heard, Geoffrey W; Chee, Yung En; Wintle, Brendan A

    2016-04-01

    How should managers choose among conservation options when resources are scarce and there is uncertainty regarding the effectiveness of actions? Well-developed tools exist for prioritizing areas for one-time and binary actions (e.g., protect vs. not protect), but methods for prioritizing incremental or ongoing actions (such as habitat creation and maintenance) remain uncommon. We devised an approach that combines metapopulation viability and cost-effectiveness analyses to select among alternative conservation actions while accounting for uncertainty. In our study, cost-effectiveness is the ratio between the benefit of an action and its economic cost, where benefit is the change in metapopulation viability. We applied the approach to the case of the endangered growling grass frog (Litoria raniformis), which is threatened by urban development. We extended a Bayesian model to predict metapopulation viability under 9 urbanization and management scenarios and incorporated the full probability distribution of possible outcomes for each scenario into the cost-effectiveness analysis. This allowed us to discern between cost-effective alternatives that were robust to uncertainty and those with a relatively high risk of failure. We found a relatively high risk of extinction following urbanization if the only action was reservation of core habitat; habitat creation actions performed better than enhancement actions; and cost-effectiveness ranking changed depending on the consideration of uncertainty. Our results suggest that creation and maintenance of wetlands dedicated to L. raniformis is the only cost-effective action likely to result in a sufficiently low risk of extinction. To our knowledge we are the first study to use Bayesian metapopulation viability analysis to explicitly incorporate parametric and demographic uncertainty into a cost-effective evaluation of conservation actions. The approach offers guidance to decision makers aiming to achieve cost-effective

  9. Cognitive-behavioral treatment for panic disorder with agoraphobia: a randomized, controlled trial and cost-effectiveness analysis.

    PubMed

    Roberge, Pasquale; Marchand, André; Reinharz, Daniel; Savard, Pierre

    2008-05-01

    A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement on standard symptom measures and quality of life from baseline to posttreatment and 3-month follow-up, with no significant differences between treatment conditions. Compared with standard CBT, brief and group CBT incurred lower treatment costs and had a superior cost-effectiveness ratio, suggesting the potential of these alternative treatment conditions in increasing access to effective treatment. PMID:18391051

  10. Cost effectiveness of sonic drilling

    SciTech Connect

    Masten, D.; Booth, S.R.

    1996-03-01

    Sonic drilling (combination of mechanical vibrations and rotary power) is an innovative environmental technology being developed in cooperation with DOE`s Arid-Site Volatile Organic Compounds Integrated Demonstration at Hanford and the Mixed Waste Landfill Integrated Demonstration at Sandia. This report studies the cost effectiveness of sonic drilling compared with cable-tool and mud rotary drilling. Benefit of sonic drilling is its ability to drill in all types of formations without introducing a circulating medium, thus producing little secondary waste at hazardous sites. Progress has been made in addressing the early problems of failures and downtime.

  11. Phytogenic Compounds as Alternatives to In-Feed Antibiotics: Potentials and Challenges in Application

    PubMed Central

    Yang, Chengbo; Chowdhury, M .A. Kabir; Hou, Yongqing; Gong, Joshua

    2015-01-01

    This article summarizes current experimental knowledge on the efficacy, possible mechanisms and feasibility in the application of phytogenic products as feed additives for food-producing animals. Phytogenic compounds comprise a wide range of plant-derived natural bioactive compounds and essential oils are a major group. Numerous studies have demonstrated that phytogenic compounds have a variety of functions, including antimicrobial/antiviral, antioxidative and anti-inflammation effects and improvement in the palatability of feed and gut development/health. However, the mechanisms underlying their functions are still largely unclear. In the past, there has been a lack of consistency in the results from both laboratory and field studies, largely due to the varied composition of products, dosages, purities and growing conditions of animals used. The minimal inhibitory concentration (MIC) of phytogenic compounds required for controlling enteric pathogens may not guarantee the best feed intake, balanced immunity of animals and cost-effectiveness in animal production. The lipophilic nature of photogenic compounds also presents a challenge in effective delivery to the animal gut and this can partially be resolved by microencapsulation and combination with other compounds (synergistic effect). Interestingly, the effects of photogenic compounds on anti-inflammation, gut chemosensing and possible disruption of bacterial quorum sensing could explain a certain number of studies with different animal species for the better production performance of animals that have received phytogenic feed additives. It is obvious that phytogenic compounds have good potential as an alternative to antibiotics in feed for food animal production and the combination of different phytogenic compounds appears to be an approach to improve the efficacy and safety of phytogenic compounds in the application. It is our expectation that the recent development of high-throughput and

  12. Differences in angiogenic potential of classically vs alternatively activated macrophages.

    PubMed

    Kodelja, V; Müller, C; Tenorio, S; Schebesch, C; Orfanos, C E; Goerdt, S

    1997-11-01

    Macrophages (M phi) are important for angiogenesis during inflammation, wound repair, and tumor growth. However, well-characterized M phi subsets such as IFN-gamma-induced, classically activated (ca) M phi or IL-4/glucocorticoid-induced, alternatively activated (aa) M phi have not been thoroughly examined for a positive or negative association with angiogenesis. While caM phi populate early inflammatory reactions and high-turnover granulomas, aaM phi occur in healing wounds and chronic inflammation. In contrast to caM phi-dominated lesions, aaM phi-rich lesions are highly vascularized. In order to determine their angiogenic potential in vitro, these M phi subsets as well as unstimulated control macrophages (coM phi) were analyzed by RT-PCR for mRNA expression of 10 angiogenic factors after 3 and 6 days of culture. Early during activation, caM phi and coM phi expressed equal levels of 8 of 10 angiogenic factors (PDGF-A, MK, TNF-alpha, TGF-beta 1, PDGF-B, HGF, TGF-alpha, IGF-1), while aaM phi showed expression of only 4 of these factors (TGF-beta 1, PDGF-B, HGF, GF-1). After maturation, TGF-alpha and IGF-1 showed a shift in mRNA expression from caM phi to aaM phi resulting in a considerably enhanced expression of these factors in day-6 aaM phi as compared to day-6 caM phi and coM phi while PDGF-A, MK, and TNF-alpha remained suppressed in day 6 aaM phi. In all M phi subsets including controls, mRNA expression of aFGF and bFGF was minimal or absent while TGFG-beta 1, HGF, and ODGF-B were constitutively expressed. In order to functionally integrate angiogenic factor mRNA expression profiles, mitogenic activity of M phi subsets towards microvascular endothelium was assessed by cocultivation. Coculture experiments revealed that endothelial proliferation induced by aaM phi was 3.0-3.5x higher than induced by caM phi. In conclusion, mature aaM phi are well equipped to play an important role in protracted M phi-associated angiogenic processes. Presumably due to expression of

  13. The Costs and Potential Benefits of Alternative Scholarly Publishing Models

    ERIC Educational Resources Information Center

    Houghton, John W.

    2011-01-01

    Introduction: This paper reports on a study undertaken for the UK Joint Information Systems Committee (JISC), which explored the economic implications of alternative scholarly publishing models. Rather than simply summarising the study's findings, this paper focuses on the approach and presents a step-by-step account of the research process,…

  14. Winter safflower, a potential alternative crop for the Pacific Northwest

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The dryland cropping system in the Pacific Northwest is dominated by a winter wheat-summer fallow cropping system that occupies more than 90% of the dryland hectares. Success in finding a viable alternative crop has been limited because the annual precipitation in this region varies from less than 1...

  15. Heterologously expressed Aspergillus aculeatus β-glucosidase in Saccharomyces cerevisiae is a cost-effective alternative to commercial supplementation of β-glucosidase in industrial ethanol production using Trichoderma reesei cellulases.

    PubMed

    Treebupachatsakul, Treesukon; Nakazawa, Hikaru; Shinbo, Hideaki; Fujikawa, Hiroki; Nagaiwa, Asami; Ochiai, Nobuhiro; Kawaguchi, Takashi; Nikaido, Mitsuru; Totani, Kazuhide; Shioya, Koki; Shida, Yosuke; Morikawa, Yasushi; Ogasawara, Wataru; Okada, Hirofumi

    2016-01-01

    Trichoderma reesei is a filamentous organism that secretes enzymes capable of degrading cellulose to cellobiose. The culture supernatant of T. reesei, however, lacks sufficient activity to convert cellobiose to glucose using β-glucosidase (BGL1). In this study, we identified a BGL (Cel3B) from T. reesei (TrCel3B) and compared it with the active β-glucosidases from Aspergillus aculeatus (AaBGL1). AaBGL1 showed higher stability and conversion of sugars to ethanol compared to TrCel3B, and therefore we chose to express this recombinant protein for use in fermentation processes. We expressed the recombinant protein in the yeast Saccharomyces cerevisiae, combined it with the superb T. reesei cellulase machinery and used the combination in a simultaneous saccharification and fermentation (SSF) process, with the hope that the recombinant would supplement the BGL activity. As the sugars were processed, the yeast immediately converted them to ethanol, thereby eliminating the problem posed by end product inhibition. Recombinant AaBGL1 activity was compared with Novozyme 188, a commercially available supplement for BGL activity. Our results show that the recombinant protein is as effective as the commercial supplement and can process sugars with equal efficiency. Expression of AaBGL1 in S. cerevisiae increased ethanol production effectively. Thus, heterologous expression of AaBGL1 in S. cerevisiae is a cost-effective and efficient process for the bioconversion of ethanol from lignocellulosic biomass. PMID:26073313

  16. Cost-Effectiveness of Payments for Ecosystem Services with Dual Goals of Environment and Poverty Alleviation

    NASA Astrophysics Data System (ADS)

    Gauvin, Crystal; Uchida, Emi; Rozelle, Scott; Xu, Jintao; Zhan, Jinyan

    2010-03-01

    The goal of this article is to understand strategies by which both the environmental and poverty alleviation objectives of PES programs can be achieved cost effectively. To meet this goal, we first create a conceptual framework to understand the implications of alternative targeting when policy makers have both environmental and poverty alleviation goals. We then use the Grain for Green program in China, the largest PES program in the developing world, as a case study. We also use a data set from a survey that we designed and implemented to evaluate the program. Using the data set we first evaluate what factors determined selection of program areas for the Grain for Green program. We then demonstrate the heterogeneity of parcels and households and examine the correlations across households and their parcels in terms of their potential environmental benefits, opportunity costs of participating, and the asset levels of households as an indicator of poverty. Finally, we compare five alternative targeting criteria and simulate their performance in terms of cost effectiveness in meeting both the environmental and poverty alleviation goals when given a fixed budget. Based on our simulations, we find that there is a substantial gain in the cost effectiveness of the program by targeting parcels based on the “gold standard,” i.e., targeting parcels with low opportunity cost and high environmental benefit managed by poorer households.

  17. Codeine and its alternates for pain and cough relief . 4. Potential alternates for cough relief.

    PubMed

    Eddy, N B; Friebel, H; Hahn, K J; Halbach, H

    1969-01-01

    In this report-the fourth of a series on codeine and its alternates for pain and cough relief-an attempt is made to evaluate, on the basis of experimental and clinical data, and wherever possible in comparison with codeine, the effectiveness of a number of antitussive substances currently in clinical use. In the discussion of the undesired side-effects particular attention is paid to the risk of dependence and abuse. PMID:4390406

  18. The AGS (alternating gradient synchrotron): Performance and potential

    SciTech Connect

    Ratner, L.G.

    1989-01-01

    This report discusses the following topics on the Brookhaven AGS: basic parameters, description of the accelerator complex and proton operation; operation with heavy ions and polarized protons; AGS upgrades and expanded potential. (LSP)

  19. Cost-Effectiveness of Proton Beam Therapy for Intraocular Melanoma

    PubMed Central

    Moriarty, James P.; Borah, Bijan J.; Foote, Robert L.; Pulido, Jose S.; Shah, Nilay D.

    2015-01-01

    Purpose Proton beam therapy is a commonly accepted treatment for intraocular melanomas, but the literature is lacking in descriptions of patient preferences of clinical outcomes and economic impact. In addition, no economic evaluations have been published regarding the incremental cost-effectiveness of proton beam therapy compared with enucleation or plaque brachytherapy, typical alternative treatments. We, therefore, conducted a cost-utility analysis of these three approaches for the treatment of intraocular melanomas. Materials and Methods A Markov model was constructed. Model parameters were identified from the published literature and publicly available data sources. Cost-effectiveness of each treatment was calculated in 2011 US Dollars per quality-adjusted life-year. Incremental cost-effectiveness ratios were calculated assuming enucleation as reference. One-way sensitivity analyses were conducted on all model parameters. A decision threshold of $50,000/quality-adjusted life-year was used to determine cost-effectiveness. Results Enucleation had the lowest costs and quality-adjusted life-years, and plaque brachytherapy had the highest costs and quality-adjusted life-years. Compared with enucleation, the base-case incremental cost-effectiveness ratios for plaque brachytherapy and proton beam therapy were $77,500/quality-adjusted life-year and $106,100/quality-adjusted life-year, respectively. Results were highly sensitive to multiple parameters. All three treatments were considered optimal, and even dominant, depending on the values used for sensitive parameters. Conclusion Base-case analysis results suggest enucleation to be optimal. However, the optimal choice was not robust to sensitivity analyses and, depending on the assumption, both plaque brachytherapy and proton beam therapy could be considered cost-effective. Future clinical studies should focus on generating further evidence with the greatest parameter uncertainty to inform future cost-effectiveness

  20. Cost-Effectiveness of Aspirin Adjuvant Therapy in Early Stage Colorectal Cancer in Older Patients

    PubMed Central

    Soon, Swee Sung; Chia, Whay-Kuang; Chan, Mun-ling Sarah; Ho, Gwo Fuang; Jian, Xiao; Deng, Yan Hong; Tan, Chuen-Seng; Sharma, Atul; Segelov, Eva; Mehta, Shaesta; Ali, Raghib; Toh, Han-Chong; Wee, Hwee-Lin

    2014-01-01

    Background & Aims Recent observational studies showed that post-operative aspirin use reduces cancer relapse and death in the earliest stages of colorectal cancer. We sought to evaluate the cost-effectiveness of aspirin as an adjuvant therapy in Stage I and II colorectal cancer patients aged 65 years and older. Methods Two five-state Markov models were constructed separately for Stage I and II colorectal cancer using TreeAge Pro 2014. Two hypothetical cohorts of 10,000 individuals at a starting age of 65 years and with colorectal cancer in remission were put through the models separately. Cost-effectiveness of aspirin was evaluated against no treatment (Stage I and II) and capecitabine (Stage II) over a 20-year period from the United States societal perspective. Extensive one-way sensitivity analyses and multivariable Probabilistic Sensitivity Analyses (PSA) were performed. Results In the base case analyses, aspirin was cheaper and more effective compared to other comparators in both stages. Sensitivity analyses showed that no treatment and capecitabine (Stage II only) can be cost-effective alternatives if the utility of taking aspirin is below 0.909, aspirin’s annual fatal adverse event probability exceeds 0.57%, aspirin’s relative risk of disease progression is 0.997 or more, or when capecitabine’s relative risk of disease progression is less than 0.228. Probabilistic Sensitivity Analyses (PSA) further showed that aspirin could be cost-effective 50% to 80% of the time when the willingness-to-pay threshold was varied from USD20,000 to USD100,000. Conclusion Even with a modest treatment benefit, aspirin is likely to be cost-effective in Stage I and II colorectal cancer, thus suggesting a potential unique role in secondary prevention in this group of patients. PMID:25250815

  1. Bioeconomic analysis of child-targeted subsidies for artemisinin combination therapies: a cost-effectiveness analysis

    PubMed Central

    Klein, Eili Y.; Smith, David L.; Cohen, Justin M.; Laxminarayan, Ramanan

    2015-01-01

    The Affordable Medicines Facility for malaria (AMFm) was conceived as a global market-based mechanism to increase access to effective malaria treatment and prolong effectiveness of artemisinin. Although results from a pilot implementation suggested that the subsidy was effective in increasing access to high-quality artemisinin combination therapies (ACTs), the Global Fund has converted AMFm into a country-driven mechanism whereby individual countries could choose to fund the subsidy from within their country envelopes. Because the initial costs of the subsidy in the pilot countries was higher than expected, countries are also exploring alternatives to a universal subsidy, such as subsidizing only child doses. We examined the incremental cost-effectiveness of a child-targeted policy using an age-structured bioeconomic model of malaria from the provider perspective. Because the vast majority of malaria deaths occur in children, targeting children could potentially improve the cost-effectiveness of the subsidy, though it would avert significantly fewer deaths. However, the benefits of a child-targeted subsidy (i.e. deaths averted) are eroded as leakage (i.e. older individuals taking young child-targeted doses) increases, with few of the benefits of a universal subsidy gained (i.e. reductions in overall prevalence). Although potentially more cost-effective, a child-targeted subsidy must contain measures to reduce the possibility of leakage. PMID:25994293

  2. Cost-effectiveness research in neurosurgery.

    PubMed

    Zygourakis, Corinna C; Kahn, James G

    2015-04-01

    Cost and value are increasingly important components of health care discussions. Despite a plethora of cost and cost-effectiveness analyses in many areas of medicine, there has been little of this type of research for neurosurgical procedures. This scarcity is vexing because this specialty represents one of the most expensive areas in medicine. This article discusses the general principles of cost-effectiveness analyses and reviews the cost- and cost-effectiveness-related research to date in neurosurgical subspecialties. The need for standardization of cost and cost-effectiveness measurement and reporting within neurosurgery is highlighted and a set of metrics for this purpose is defined. PMID:25771274

  3. Class Size Reduction or Rapid Formative Assessment?: A Comparison of Cost-Effectiveness

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2009-01-01

    The cost-effectiveness of class size reduction (CSR) was compared with the cost-effectiveness of rapid formative assessment, a promising alternative for raising student achievement. Drawing upon existing meta-analyses of the effects of student-teacher ratio, evaluations of CSR in Tennessee, California, and Wisconsin, and RAND cost estimates, CSR…

  4. Cost-Effectiveness Analysis. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.

    ERIC Educational Resources Information Center

    Buskirk, E. Drannon, Jr.

    Presented is the instructor's manual for a one-hour presentation on cost-effectiveness analysis. Topics covered are the scope of cost-effectiveness analysis, basic assessment procedures, and the role of citizens in the analysis of alternatives. A supplementary audiovisual program is available. These materials are part of the Working for Clean…

  5. The Cost-Effectiveness of Comprehensive School Reform and Rapid Assessment

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2008-01-01

    Analysis of the cost-effectiveness of 29 Comprehensive School Reform (CSR) models suggests that all 29 models are less cost-effective than an alternative approach for raising student achievement, involving rapid assessment systems that test students 2 to 5 times per week in math and reading and provide rapid feedback of the results to students and…

  6. The Sunk Cost Effect with Pigeons: Some Determinants of Decisions about Persistence

    ERIC Educational Resources Information Center

    Macaskill, Anne C.; Hackenberg, Timothy D.

    2012-01-01

    The sunk cost effect occurs when an individual persists following an initial investment, even when persisting is costly in the long run. The current study used a laboratory model of the sunk cost effect. Two response alternatives were available: Pigeons could persist by responding on a schedule key with mixed ratio requirements, or escape by…

  7. Cost-Effectiveness Analysis of the New South Wales Adult Drug Court Program

    ERIC Educational Resources Information Center

    Shanahan, Marian; Lancsar, Emily; Haas, Marion; Lind, Bronwyn; Weatherburn, Don; Chen, Shuling

    2004-01-01

    In New South Wales, Australia, a cost-effectiveness evaluation was conducted of an adult drug court (ADC) program as an alternative to jail for criminal offenders addicted to illicit drugs. This article describes the program, the cost-effectiveness analysis, and the results. The results of this study reveal that, for the 23-month period of the…

  8. A Departmental Cost-Effectiveness Model.

    ERIC Educational Resources Information Center

    Holleman, Thomas, Jr.

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

  9. In Search of Cost-Effective Schools.

    ERIC Educational Resources Information Center

    Raywid, Mary Anne; Shaheen, Thomas A.

    1994-01-01

    Examines major cost-effectiveness proposals, describing developments that highlight concerns over making schools cost effective. The article discusses ways to blend the concerns of educational quality, equity, and costs (district consolidations, shared service and facilities arrangements, new accountability strategies, new information systems,…

  10. Biomass alcohols as potential petroleum alternatives in the fuel and petrochemical industries: A generalized network model

    NASA Astrophysics Data System (ADS)

    Farina, R. F.

    A generalized network model called PETNET is developed to address this problem. The focus of the analysis presented is the role of biomass alcohols as potential alternatives to fossil hydrocarbons as raw materials in the petrochemical and oil industries. Illustrative scenarios for biomass-based alcohol replacements are investigated with PETNET by solving for alternative assumptions of price, capacity, resource availability and process technology.

  11. A Proposed Alternative Measure for Climate Change Potential

    NASA Astrophysics Data System (ADS)

    DeGroff, F. A.

    2015-12-01

    Background/Issue There currently exists no comprehensive metric to measure and value anthropogenic changes in carbon flux between geospheric carbon sinks. We propose that changes in carbon residence time within geospheres be used as a metric to assess anthropogenic changes in carbon flux, and the term 'carbon quality' (cq) be used to describe such changes. Carbon residence time represents the inverse of carbon flux; as carbon flux increases, the corresponding cq will decrease, and vice versa. Focusing on atmospheric carbon emissions as a measure of anthropogenic activity on the environment ignores the fungible characteristics of carbon that are crucial in both the biosphere and the worldwide economy. The ubiquitous carbon molecule enables the enormous diversity in the biosphere, as well as the widespread, strategic economic presence of carbon in the world economy. Focusing on a single form of inorganic carbon as a proxy metric for the plethora of anthropogenic activity and carbon compounds will prove inadequate, convoluted, and unmanageable. A broader, more basic metric is needed to capture the breath and scope of carbon activity. Results/Conclusions We propose a logarithmic vector scale for cq to measure anthropogenic carbon flux. The distance between vector points, e.g. the starting and ending residence times, would represent the change in cq. A base-10 logarithmic scale would allow the addition and subtraction of exponents to calculate changes in cq. As carbon moves between carbon reservoirs, the change in cq is measured as: cq = b ( log10 [mean carbon residence time] ) where b represents the carbon price coefficient for a particular country. For any country, cq measures the climate change potential for any organic carbon when converted to inorganic CO2, or to any lower residence time carbon state. The greater the carbon fees for a country, the larger the b coefficient would be, and the greater the import fees would be to achieve carbon parity on imports from

  12. Cost effectiveness of type 2 diabetes screening: A systematic review

    PubMed Central

    Najafi, Behzad; Farzadfar, Farshad; Ghaderi, Hossein; Hadian, Mohammad

    2016-01-01

    Background: Although studies reported diabetes mellitus screening cost effective, the mass screening for type2 diabetes remains controversial. In this study we reviewed the recently evidence about the cost effectiveness of mass screening systematically. Methods: We reviewed the MEDLINE, Scopus, Web of Science (WOS), and Cochrane library databases by MeSH terms to identify relevant studies from 2000 to 2013. We had 4 inclusion and 6 exclusion criteria and used the Drummond’s checklist for appraising the quality of studies. Results: The initial search yielded 358 potentially related studies from selected databases. 6 studies met our inclusion and exclusion criteria and included in final review. 3 and 2 of them were conducted in Europe and America and only one of them in Asia. Quality-adjusted life year (QALY) was the main outcome to appraise the effectiveness in the studies. Incremental cost effectiveness ratio (ICER) was computed in range from $516.33 to $126,238 per QALY in the studies. Conclusion: A review of previous diabetes screening cost effectiveness analysis showed that the studies varied in some aspects but reached similar conclusions. They concluded that the screening may be cost effective, however further studies is required to support the diabetes mass screening. PMID:27390696

  13. Direct estimation of the cost effectiveness of tornado shelters.

    PubMed

    Simmons, Kevin M; Sutter, Daniel

    2006-08-01

    This article estimates the cost effectiveness of tornado shelters using the annual probability of a tornado and new data on fatalities per building struck by a tornado. This approach differs from recent estimates of the cost effectiveness of tornado shelters in Reference 1 that use historical casualties. Historical casualties combine both tornado risk and resident action. If residents of tornado-prone states take greater precautions, observed fatalities might not be much higher than in states with lower risk. Estimation using the tornado probability avoids this potential bias. Despite the very different method used, the estimates are 68 million US dollars in permanent homes and 6.0 million US dollars in mobile homes in Oklahoma using a 3% real discount rate, within about 10% of estimates based on historical fatalities. The findings suggest that shelters provide cost-effective protection for mobile homes in the most tornado-prone states but not for permanent homes. PMID:16948687

  14. Cost-effectiveness of colorectal cancer screening – an overview

    PubMed Central

    Lansdorp-Vogelaar, Iris; Knudsen, Amy; Brenner, Hermann

    2010-01-01

    There are several modalities available for a colorectal cancer (CRC) screening program. When determining which CRC screening program to implement, the costs of such programs should be considered in comparison to the health benefits they are expected to provide. Cost-effectiveness analysis provides a tool to do this. In this paper we review the evidence on the cost-effectiveness of CRC screening. Published studies universally indicate that when compared with no CRC screening, all screening modalities provide additional years of life at a cost that is deemed acceptable by most industrialized nations. Many recent studies even find CRC screening to be cost-saving. However, when the alternative CRC screening strategies are compared against each other in an incremental cost-effectiveness analysis, no single optimal strategy emerges across the studies. There is consensus that the new technologies of stool DNA testing, computed tomographic colonography and capsule endoscopy are not yet cost-effective compared with the established CRC screening tests. PMID:20833348

  15. Geography of Existing and Potential Alternative Fuel Markets in the United States

    SciTech Connect

    Johnson, C.; Hettinger, D.

    2014-11-01

    When deploying alternative fuels, it is paramount to match the right fuel with the right location, in accordance with local market conditions. We used six market indicators to evaluate the existing and potential regional market health for each of the five most commonly deployed alternative fuels: electricity (used by plug-in electric vehicles), biodiesel (blends of B20 and higher), E85 ethanol, compressed natural gas (CNG), and propane. Each market indicator was mapped, combined, and evaluated by industry experts. This process revealed the weight the market indicators should be given, with the proximity of fueling stations being the most important indicator, followed by alternative fuel vehicle density, gasoline prices, state incentives, nearby resources, and finally, environmental benefit. Though markets vary among states, no state received 'weak' potential for all five fuels, indicating that all states have an opportunity to use at least one alternative fuel. California, Illinois, Indiana, Pennsylvania, and Washington appear to have the best potential markets for alternative fuels in general, with each sporting strong markets for four of the fuels. Wyoming showed the least potential, with weak markets for all alternative fuels except for CNG, for which it has a patchy market. Of all the fuels, CNG is promising in the greatest number of states--largely because freight traffic provides potential demand for many far-reaching corridor markets and because the sources of CNG are so widespread geographically.

  16. Cost-Effectiveness of Interventions to Prevent Disability in Leprosy: A Systematic Review

    PubMed Central

    van Veen, Natasja H. J.; McNamee, Paul; Richardus, Jan Hendrik; Smith, W. Cairns S.

    2009-01-01

    Background Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions. Methodology/Principal Findings We searched electronic databases (NHS EED, MEDLINE, EMBASE, and LILACS) and databases of ongoing trials (www.controlled-trials.com/mrct/, www.who.int/trialsearch). We checked reference lists and contacted experts for further relevant studies. We included studies that reported both cost and effectiveness outcomes of two or more alternative interventions to prevent disability in leprosy. We assessed the quality of the identified studies using a standard checklist for critical appraisal of economic evaluations of health care programmes. We found 66 citations to potentially relevant studies and three met our criteria. Two were randomised controlled trials (footwear, management of neuritis) and one was a generic model-based study (cost per DALY). Generally, the studies were small in size, reported inadequately all relevant costs, uncertainties in estimates, and issues of concern and were based on limited data sources. No cost-effectiveness data on self-care, which is a key strategy in POD, was found. Conclusion/Significance Evidence for cost-effectiveness of POD interventions for leprosy is scarce. High quality research is needed to identify POD interventions that offer value for money where resources are very scarce, and to develop strategies aimed at available, affordable and sustainable quality POD services for leprosy. The findings are relevant for

  17. Cost-Effective Stress Management Training.

    ERIC Educational Resources Information Center

    Shea, Gordon F.

    1980-01-01

    Stress management training can be a cost effective way to improve productivity and job performance. Among many relaxation techniques, the most effective in terms of teachability, participant motivation, and profitability are self-hypnosis, progressive relaxation, and transcendental meditation. (SK)

  18. Performance-Based Staff Development: The Cost-Effective Alternative.

    ERIC Educational Resources Information Center

    Boyer, Catherine M.

    1981-01-01

    Describes how to use the performance-based concept in developing staff. Discusses the identification of objectives based on performance expectations and the development of learning experiences that (1) emphasize application of knowledge; (2) integrate adult learning principles; and (3) make use of learning contracts, self-learning packages,…

  19. Are current cost-effectiveness thresholds for low- and middle-income countries useful? Examples from the world of vaccines.

    PubMed

    Newall, A T; Jit, M; Hutubessy, R

    2014-06-01

    The World Health Organization's CHOosing Interventions that are Cost Effective (WHO-CHOICE) thresholds for averting a disability-adjusted life-year of one to three times per capita income have been widely cited and used as a measure of cost effectiveness in evaluations of vaccination for low- and middle-income countries (LMICs). These thresholds were based upon criteria set out by the WHO Commission on Macroeconomics and Health, which reflected the potential economic returns of interventions. The CHOICE project sought to evaluate a variety of health interventions at a subregional level and classify them into broad categories to help assist decision makers, but the utility of the thresholds for within-country decision making for individual interventions (given budgetary constraints) has not been adequately explored. To examine whether the 'WHO-CHOICE thresholds' reflect funding decisions, we examined the results of two recent reviews of cost-effectiveness analyses of human papillomavirus and rotavirus vaccination in LMICs, and we assessed whether the results of these studies were reflected in funding decisions for these vaccination programmes. We found that in many cases, programmes that were deemed cost effective were not subsequently implemented in the country. We consider the implications of this finding, the advantages and disadvantages of alternative methods to estimate thresholds, and how cost perspectives and the funders of healthcare may impact on these choices. PMID:24791735

  20. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    SciTech Connect

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region.

  1. Development of cost-effective surfactant flooding technology. Quarterly report, April 1995--June 1995

    SciTech Connect

    Pope, G.A.; Sepehrnoori, K.; Jessen, F.W.

    1995-12-31

    The objective of this research is to develop cost-effective surfactant flooding technology by using surfactant simulation studies to evaluate and optimize alternative design strategies taking into account reservoir characteristics, process chemistry, and process design options such as horizontal wells. Task 1 is the development of an improved numerical method for our simulator that will enable us to solve a wider class of these difficult simulation problems, accurately and affordably. Task 2 is the application of this simulator to the optimization of surfactant flooding to reduce its risk and cost. The objective of Task 2 is to investigate and evaluate, through a systematic simulation study, surfactant flooding processes that are cost-effective. We previously have reported on low tension polymer flooding as an alternative to classical surfactant/polymer flooding. In this reporting period, we have studied the potential of improving the efficiency of surfactant/polymer flooding by coinjecting an alkali agent such as sodium carbonate under realistic reservoir conditions and process behavior. The alkaline/surfactant/polymer (ASP) flood attempts to take advantage of high pH fluids to reduce the amount of surfactant needed by the chemical reactions between injection fluid and formation fluid or formation rocks.

  2. Climate-change impact potentials as an alternative to global warming potentials

    NASA Astrophysics Data System (ADS)

    Kirschbaum, Miko U. F.

    2014-03-01

    For policy applications, such as for the Kyoto Protocol, the climate-change contributions of different greenhouse gases are usually quantified through their global warming potentials. They are calculated based on the cumulative radiative forcing resulting from a pulse emission of a gas over a specified time period. However, these calculations are not explicitly linked to an assessment of ultimate climate-change impacts. A new metric, the climate-change impact potential (CCIP), is presented here that is based on explicitly defining the climate-change perturbations that lead to three different kinds of climate-change impacts. These kinds of impacts are: (1) those related directly to temperature increases; (2) those related to the rate of warming; and (3) those related to cumulative warming. From those definitions, a quantitative assessment of the importance of pulse emissions of each gas is developed, with each kind of impact assigned equal weight for an overall impact assessment. Total impacts are calculated under the RCP6 concentration pathway as a base case. The relevant climate-change impact potentials are then calculated as the marginal increase of those impacts over 100 years through the emission of an additional unit of each gas in 2010. These calculations are demonstrated for CO2, methane and nitrous oxide. Compared with global warming potentials, climate-change impact potentials would increase the importance of pulse emissions of long-lived nitrous oxide and reduce the importance of short-lived methane.

  3. Designing to cost effectiveness - Enhancing quality

    NASA Astrophysics Data System (ADS)

    Brennan, James R.; Stracener, Jerrell T.

    The authors present a practical application of cost-effectiveness analysis techniques through the definition and solution of a representative design tradeoff study using cost-effectiveness as a figure of merit for quality. They also describe a decision process based on the results of tradeoff studies to provide a method of integrating the 'ilities' with design and manufacturing engineering to help accomplish integrated product development (IPD). While the approach is demonstrated in an aircraft application, the method is equally applicable in almost any product and any operational scenario, military or commercial.

  4. Selecting cost-effective areas for restoration of ecosystem services.

    PubMed

    Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

    2015-04-01

    Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. PMID:25199996

  5. AFM-assisted fabrication of thiol SAM pattern with alternating quantified surface potential

    PubMed Central

    2011-01-01

    Thiol self-assembled monolayers (SAMs) are widely used in many nano- and bio-technology applications. We report a new approach to create and characterize a thiol SAMs micropattern with alternating charges on a flat gold-coated substrate using atomic force microscopy (AFM) and Kelvin probe force microscopy (KPFM). We produced SAMs-patterns made of alternating positively charged, negatively charged, and hydrophobic-terminated thiols by an automated AFM-assisted manipulation, or nanografting. We show that these thiol patterns possess only small topographical differences as revealed by AFM, and distinguished differences in surface potential (20-50 mV), revealed by KPFM. The pattern can be helpful in the development of biosensor technologies, specifically for selective binding of biomolecules based on charge and hydrophobicity, and serve as a model for creating surfaces with quantified alternating surface potential distribution. PMID:21711703

  6. A Cost-Effective Model for Digital Forensic Investigations

    NASA Astrophysics Data System (ADS)

    Overill, Richard; Kwan, Michael; Chow, Kam-Pui; Lai, Pierre; Law, Frank

    Because of the way computers operate, every discrete event potentially leaves a digital trace. These digital traces must be retrieved during a digital forensic investigation to prove or refute an alleged crime. Given resource constraints, it is not always feasible (or necessary) for law enforcement to retrieve all the related digital traces and to conduct comprehensive investigations. This paper attempts to address the issue by proposing a model for conducting swift, practical and cost-effective digital forensic investigations.

  7. A cost effective data management subsystem for the LST

    NASA Technical Reports Server (NTRS)

    Dougherty, J. A.; Patterson, T. D.; Cole, A. E.

    1975-01-01

    The paper outlines the approach used in developing DMS (Data Management Subsystem) alternatives for the LST (Large Space Telescope) and in selecting the concept considered to be the most cost effective means of implementing the LST DMS requirements. Two candidate DMS concepts are discussed: a functionally integrated and a functionally separated one. For the single vehicle LST program, separation of the DMS functions best provides high reliability, operations flexibility, minimal interface complexity, and the least complex software development and verification task. The use of available hardware and NASA standard components is stressed.

  8. Key aspects of cost effective collector and solar field design

    NASA Astrophysics Data System (ADS)

    von Reeken, Finn; Nicodemo, Dario; Keck, Thomas; Weinrebe, Gerhard; Balz, Markus

    2016-05-01

    A study has been performed where different key parameters influencing solar field cost are varied. By using levelised cost of energy as figure of merit it is shown that parameters like GoToStow wind speed, heliostat stiffness or tower height should be adapted to respective site conditions from an economical point of view. The benchmark site Redstone (Northern Cape Province, South Africa) has been compared to an alternate site close to Phoenix (AZ, USA) regarding site conditions and their effect on cost-effective collector and solar field design.

  9. Cost-effective ceramics program in the United States

    SciTech Connect

    Schulz, R.B.; Johnson, D.R.

    1994-10-01

    The 5-year Cost-Effective Ceramics for Heat Engines program began in 1993. This effort reflects the realization that the problems with reliability of structural ceramics have been largely overcome, but the high cost of structural ceramics is limited their use in commercial applications. The technical causes of high cost were identified, and a technical plan developed. The work elements in the program include the following: economic cost modeling, ceramic machining, powder synthesis, alternative forming and densification processes, yield improvement, standards development, and low-expansion ceramics.

  10. Brain Games as a Potential Nonpharmaceutical Alternative for the Treatment of ADHD

    ERIC Educational Resources Information Center

    Wegrzyn, Stacy C.; Hearrington, Doug; Martin, Tim; Randolph, Adriane B.

    2013-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed childhood neurobehavioral disorder, affecting approximately 5.5 million children, of which approximately 66% take ADHD medication daily. This study investigated a potential nonpharmaceutical alternative to address the academic engagement of 5th through 11th grade…

  11. Alternative Delivery Systems: A Potential Partnership for Education and Public Broadcasting.

    ERIC Educational Resources Information Center

    Baltzer, Jan A.

    If educators and public broadcasters are to realize their potential for providing high quality educational and cultural material to the public, they must be aware of current and upcoming technologies and work in concert to achieve their goals. Several alternative delivery systems are currently available to help educators and broadcasters expand…

  12. Seasonal Influenza Vaccination for Children in Thailand: A Cost-Effectiveness Analysis

    PubMed Central

    Meeyai, Aronrag; Praditsitthikorn, Naiyana; Kotirum, Surachai; Kulpeng, Wantanee; Putthasri, Weerasak; Cooper, Ben S.; Teerawattananon, Yot

    2015-01-01

    Background Seasonal influenza is a major cause of mortality worldwide. Routine immunization of children has the potential to reduce this mortality through both direct and indirect protection, but has not been adopted by any low- or middle-income countries. We developed a framework to evaluate the cost-effectiveness of influenza vaccination policies in developing countries and used it to consider annual vaccination of school- and preschool-aged children with either trivalent inactivated influenza vaccine (TIV) or trivalent live-attenuated influenza vaccine (LAIV) in Thailand. We also compared these approaches with a policy of expanding TIV coverage in the elderly. Methods and Findings We developed an age-structured model to evaluate the cost-effectiveness of eight vaccination policies parameterized using country-level data from Thailand. For policies using LAIV, we considered five different age groups of children to vaccinate. We adopted a Bayesian evidence-synthesis framework, expressing uncertainty in parameters through probability distributions derived by fitting the model to prospectively collected laboratory-confirmed influenza data from 2005-2009, by meta-analysis of clinical trial data, and by using prior probability distributions derived from literature review and elicitation of expert opinion. We performed sensitivity analyses using alternative assumptions about prior immunity, contact patterns between age groups, the proportion of infections that are symptomatic, cost per unit vaccine, and vaccine effectiveness. Vaccination of children with LAIV was found to be highly cost-effective, with incremental cost-effectiveness ratios between about 2,000 and 5,000 international dollars per disability-adjusted life year averted, and was consistently preferred to TIV-based policies. These findings were robust to extensive sensitivity analyses. The optimal age group to vaccinate with LAIV, however, was sensitive both to the willingness to pay for health benefits and

  13. Cost-Effective School Nurse Practitioner Services.

    ERIC Educational Resources Information Center

    Sobolewski, Susan D.

    1981-01-01

    A broader utilization of school nurse practitioners by school districts represents a cost-effective approach in meeting educational goals. School nurse practitioners provide extended nursing services to high risk children, assist in coordinating health services between the school and the child's parents, participate in classroom presentations on…

  14. The "Cost-Effectiveness" of Sim One

    ERIC Educational Resources Information Center

    Hoffman, Kaaren I.; Abrahamson, Stephen

    1975-01-01

    Sim One is a computer-controlled patient, a sophisticated simulator developed by the University of Southern California School of Medicine. This article summarizes fifteen cost-effectiveness studies conducted over a 2-year period. Savings with the use of Sim One were found to justify the cost within a short period. (JT)

  15. Cost-Effectiveness of Interactive Courseware.

    ERIC Educational Resources Information Center

    Fletcher, J. D.

    What is known about the cost effectiveness of interactive courseware (ICW) is reviewed, and issues that remain are summarized. Effect size is used for reporting the effectiveness of ICW programs. Two ICW media are considered: computer-based instruction and interactive videodisc instruction. Effect sizes for computer-based instruction have been…

  16. Cost-Effectiveness Analysis of Combination Therapies for Visceral Leishmaniasis in the Indian Subcontinent

    PubMed Central

    Meheus, Filip; Balasegaram, Manica; Olliaro, Piero; Sundar, Shyam; Rijal, Suman; Faiz, Md. Abul; Boelaert, Marleen

    2010-01-01

    Background Visceral leishmaniasis is a systemic parasitic disease that is fatal unless treated. We assessed the cost and cost-effectiveness of alternative strategies for the treatment of visceral leishmaniasis in the Indian subcontinent. In particular we examined whether combination therapies are a cost-effective alternative compared to monotherapies. Methods and Findings We assessed the cost-effectiveness of all possible mono- and combination therapies for the treatment of visceral leishmaniasis in the Indian subcontinent (India, Nepal and Bangladesh) from a societal perspective using a decision analytical model based on a decision tree. Primary data collected in each country was combined with data from the literature and an expert poll (Delphi method). The cost per patient treated and average and incremental cost-effectiveness ratios expressed as cost per death averted were calculated. Extensive sensitivity analysis was done to evaluate the robustness of our estimations and conclusions. With a cost of US$92 per death averted, the combination miltefosine-paromomycin was the most cost-effective treatment strategy. The next best alternative was a combination of liposomal amphotericin B with paromomycin with an incremental cost-effectiveness of $652 per death averted. All other strategies were dominated with the exception of a single dose of 10mg per kg of liposomal amphotericin B. While strategies based on liposomal amphotericin B (AmBisome) were found to be the most effective, its current drug cost of US$20 per vial resulted in a higher average cost-effectiveness. Sensitivity analysis showed the conclusion to be robust to variations in the input parameters over their plausible range. Conclusions Combination treatments are a cost-effective alternative to current monotherapy for VL. Given their expected impact on the emergence of drug resistance, a switch to combination therapy should be considered once final results from clinical trials are available. PMID:20838649

  17. Notes on Cost-Effectiveness Evaluation of Schooling in Developing Countries.

    ERIC Educational Resources Information Center

    Jamison, Dean T.

    Within the parameter of a given level of expenditure on the educational system as a function of time, this cost-effectiveness analysis examines all feasible ways of providing schooling in developing nations to see what levels of output each alternative method entails. Both technological and conventional alternatives are considered: degree of…

  18. The potential of tissue engineering for developing alternatives to animal experiments: a systematic review.

    PubMed

    de Vries, Rob B M; Leenaars, Marlies; Tra, Joppe; Huijbregtse, Robbertjan; Bongers, Erik; Jansen, John A; Gordijn, Bert; Ritskes-Hoitinga, Merel

    2015-07-01

    An underexposed ethical issue raised by tissue engineering is the use of laboratory animals in tissue engineering research. Even though this research results in suffering and loss of life in animals, tissue engineering also has great potential for the development of alternatives to animal experiments. With the objective of promoting a joint effort of tissue engineers and alternative experts to fully realise this potential, this study provides the first comprehensive overview of the possibilities of using tissue-engineered constructs as a replacement of laboratory animals. Through searches in two large biomedical databases (PubMed, Embase) and several specialised 3R databases, 244 relevant primary scientific articles, published between 1991 and 2011, were identified. By far most articles reviewed related to the use of tissue-engineered skin/epidermis for toxicological applications such as testing for skin irritation. This review article demonstrates, however, that the potential for the development of alternatives also extends to other tissues such as other epithelia and the liver, as well as to other fields of application such as drug screening and basic physiology. This review discusses which impediments need to be overcome to maximise the contributions that the field of tissue engineering can make, through the development of alternative methods, to the reduction of the use and suffering of laboratory animals. PMID:23554402

  19. Cost-Effectiveness of Norovirus Vaccination in Children in Peru

    PubMed Central

    Mirelman, Andrew; Ballard, Sarah-Blythe; Saito, Mayuko; Kosek, Margaret; Gilman, Robert H.

    2015-01-01

    Background With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. Methods We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru’s routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Results Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. Conclusions The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence

  20. Cost-effectiveness of Different Diabetic Retinopathy Screening Modalities.

    PubMed

    Pasquel, Francisco J; Hendrick, Andrew M; Ryan, Martha; Cason, Emily; Ali, Mohammed K; Narayan, K M Venkat

    2016-03-01

    Current screening strategies aimed at detection of diabetic retinopathy (DR) historically have poor compliance, but advancements in technology can enable improved access to care. Nearly 80% of all persons with diabetes live in low- and middle-income countries (LMICs), highlighting the importance of a cost effective screening program. Establishing mechanisms to reach populations with geographic and financial barriers to access is essential to prevent visual disability. Teleretinal programs leverage technology to improve access and reduce cost. The quality of currently employed screening modalities depends on many variables including the instrument used, use of pupillary mydriasis, number of photographic fields, and the qualifications of the photographer and image interpreter. Recent telemedicine and newer technological approaches have been introduced, but data for these technologies is yet limited. We present results of a systematic review of studies evaluating cost-effectiveness of DR screening, and discuss potential relevance for LMICs. PMID:26719134

  1. Cost-effectiveness of integrated collaborative care for comorbid major depression in patients with cancer☆

    PubMed Central

    Duarte, A.; Walker, J.; Walker, S.; Richardson, G.; Holm Hansen, C.; Martin, P.; Murray, G.; Sculpher, M.; Sharpe, M.

    2015-01-01

    Objectives Comorbid major depression is associated with reduced quality of life and greater use of healthcare resources. A recent randomised trial (SMaRT, Symptom Management Research Trials, Oncology-2) found that a collaborative care treatment programme (Depression Care for People with Cancer, DCPC) was highly effective in treating depression in patients with cancer. This study aims to estimate the cost-effectiveness of DCPC compared with usual care from a health service perspective. Methods Costs were estimated using UK national unit cost estimates and health outcomes measured using quality-adjusted life-years (QALYs). Incremental cost-effectiveness of DCPC compared with usual care was calculated and scenario analyses performed to test alternative assumptions on costs and missing data. Uncertainty was characterised using cost-effectiveness acceptability curves. The probability of DCPC being cost-effective was determined using the UK National Institute for Health and Care Excellence's (NICE) cost-effectiveness threshold range of £20,000 to £30,000 per QALY gained. Results DCPC cost on average £631 more than usual care per patient, and resulted in a mean gain of 0.066 QALYs, yielding an incremental cost-effectiveness ratio of £9549 per QALY. The probability of DCPC being cost-effective was 0.9 or greater at cost-effectiveness thresholds above £20,000 per QALY for the base case and scenario analyses. Conclusions Compared with usual care, DCPC is likely to be cost-effective at the current thresholds used by NICE. This study adds to the weight of evidence that collaborative care treatment models are cost-effective for depression, and provides new evidence regarding their use in specialist medical settings. PMID:26652589

  2. Cost-effectiveness of monitoring free flaps.

    PubMed

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

    2016-06-01

    Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. PMID:27015730

  3. Ensuring cost effectiveness in the TAP process

    SciTech Connect

    Trego, A.L.

    1992-06-16

    The Training Accredition Program (TAP) at the Waste Isolation Division (WID) is discussed by the general manager. Cost effectiveness in the TAP process is made possible by saving through sharing which refers to the exchange and co-development of information and technology among Westinghouse Government owned-contractor operators and with other organizations. In 1990 a comprehensive management and supervisor training (MAST) program plan was devised and a MAST certification program of 31 self-paced written moduler was developed. This program has proven to be inexpensive to develop and implement when compared to classroom training. In addition, total quality is used as a tool to continuously improve work process. Continuous improvement requires continued evaluation of work process, such as TAP analysis and development in summary to make training at DOE facilities the most cost-effective training anywhere, we need to share, challenge conventional wisdom, and seek to continuously improve.

  4. Program Planning and the Cost-Effectiveness Analysis of Instructional Technologies: A Case Study in Planning Continuing Education Services.

    ERIC Educational Resources Information Center

    Lent, Richard M.

    This report provides a description of the conceptualization and methods required to perform a cost effectiveness analysis in the field of instructional technology. The case study discussed involves a cost effectiveness comparison of four alternative systems for delivering continuing education instruction in management to several geographically…

  5. High-throughput and Cost-effective Chicken Genotyping Using Next-Generation Sequencing

    PubMed Central

    Pértille, Fábio; Guerrero-Bosagna, Carlos; Silva, Vinicius Henrique da; Boschiero, Clarissa; Nunes, José de Ribamar da Silva; Ledur, Mônica Corrêa; Jensen, Per; Coutinho, Luiz Lehmann

    2016-01-01

    Chicken genotyping is becoming common practice in conventional animal breeding improvement. Despite the power of high-throughput methods for genotyping, their high cost limits large scale use in animal breeding and selection. In the present paper we optimized the CornellGBS, an efficient and cost-effective genotyping by sequence approach developed in plants, for its application in chickens. Here we describe the successful genotyping of a large number of chickens (462) using CornellGBS approach. Genomic DNA was cleaved with the PstI enzyme, ligated to adapters with barcodes identifying individual animals, and then sequenced on Illumina platform. After filtering parameters were applied, 134,528 SNPs were identified in our experimental population of chickens. Of these SNPs, 67,096 had a minimum taxon call rate of 90% and were considered ‘unique tags’. Interestingly, 20.7% of these unique tags have not been previously reported in the dbSNP. Moreover, 92.6% of these SNPs were concordant with a previous Whole Chicken-genome re-sequencing dataset used for validation purposes. The application of CornellGBS in chickens showed high performance to infer SNPs, particularly in exonic regions and microchromosomes. This approach represents a cost-effective (~US$50/sample) and powerful alternative to current genotyping methods, which has the potential to improve whole-genome selection (WGS), and genome-wide association studies (GWAS) in chicken production. PMID:27220827

  6. High-throughput and Cost-effective Chicken Genotyping Using Next-Generation Sequencing.

    PubMed

    Pértille, Fábio; Guerrero-Bosagna, Carlos; Silva, Vinicius Henrique da; Boschiero, Clarissa; Nunes, José de Ribamar da Silva; Ledur, Mônica Corrêa; Jensen, Per; Coutinho, Luiz Lehmann

    2016-01-01

    Chicken genotyping is becoming common practice in conventional animal breeding improvement. Despite the power of high-throughput methods for genotyping, their high cost limits large scale use in animal breeding and selection. In the present paper we optimized the CornellGBS, an efficient and cost-effective genotyping by sequence approach developed in plants, for its application in chickens. Here we describe the successful genotyping of a large number of chickens (462) using CornellGBS approach. Genomic DNA was cleaved with the PstI enzyme, ligated to adapters with barcodes identifying individual animals, and then sequenced on Illumina platform. After filtering parameters were applied, 134,528 SNPs were identified in our experimental population of chickens. Of these SNPs, 67,096 had a minimum taxon call rate of 90% and were considered 'unique tags'. Interestingly, 20.7% of these unique tags have not been previously reported in the dbSNP. Moreover, 92.6% of these SNPs were concordant with a previous Whole Chicken-genome re-sequencing dataset used for validation purposes. The application of CornellGBS in chickens showed high performance to infer SNPs, particularly in exonic regions and microchromosomes. This approach represents a cost-effective (~US$50/sample) and powerful alternative to current genotyping methods, which has the potential to improve whole-genome selection (WGS), and genome-wide association studies (GWAS) in chicken production. PMID:27220827

  7. Cost-effectiveness analysis and innovation.

    PubMed

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency. PMID:18619695

  8. Theater SBI cost-effectiveness ratios

    SciTech Connect

    Canavan, G.H.

    1993-11-01

    To address M missiles spaced at intervals longer than the constillation reconstitution time t, the defense needs at the absentee ratio N{sub a} of SBIs to fill the belt plus the M SBIs needed for the intercepts; the resulting cost effectiveness scales as M/(M + N{sub a}). N{sub a} is large and CER small for small ranges and numbers of missiles. For several-hundred missile threats, CERs are greater than unity for ranges of interest.

  9. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

    The development of a model for the cost-effective management of space venture risks is discussed. The risk assessment and control program of insurance companies is examined. A simplified system development cycle which consists of a conceptual design phase, a preliminary design phase, a final design phase, a construction phase, and a system operations and maintenance phase is described. The model incorporates insurance safety risk methods and reliability engineering, and testing practices used in the development of large aerospace and defense systems.

  10. A review of potential alternatives for air cleaning at the Hanford Waste Vitrification Plant

    SciTech Connect

    Sehmel, G.A.

    1990-07-01

    Pacific Northwest Laboratory conducted this review in support of the Hanford Waste Vitrification Plant (HWVP) being designed by Fluor Daniel Inc. for the US Department of Energy (DOE). The literature on air cleaning systems is reviewed to identify potential air cleaning alternatives that might be included in the design of HWVP. An overview of advantages/disadvantages of the various air cleaning technologies follows. Information and references are presented for the following potential air cleaning alternatives: deep-bed glass-fiber filters (DBGF), high-efficiency particulate air filters (HEPA), remote modular filter systems, high-efficiency mist eliminators (HEME), electrostatic precipitators, and the sand filter. Selected information is summarized for systems in the United States, Belgium, Japan, and West Germany. This review addresses high-capacity air cleaning systems currently used in the nuclear industry and emphasizes recent developments. 10 refs., 9 figs., 3 tabs.

  11. Potential end-to-end imaging information rate advantages of various alternative communication systems

    NASA Technical Reports Server (NTRS)

    Rice, R. F.

    1978-01-01

    Various communication systems were considered which are required to transmit both imaging and a typically error sensitive, class of data called general science/engineering (gse) over a Gaussian channel. The approach jointly treats the imaging and gse transmission problems, allowing comparisons of systems which include various channel coding and data compression alternatives. Actual system comparisons include an Advanced Imaging Communication System (AICS) which exhibits the rather significant potential advantages of sophisticated data compression coupled with powerful yet practical channel coding.

  12. Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation.

    PubMed Central

    Crossan, Catriona; Tsochatzis, Emmanuel A; Longworth, Louise; Gurusamy, Kurinchi; Davidson, Brian; Rodríguez-Perálvarez, Manuel; Mantzoukis, Konstantinos; O'Brien, Julia; Thalassinos, Evangelos; Papastergiou, Vassilios; Burroughs, Andrew

    2015-01-01

    BACKGROUND Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. OBJECTIVE To assess the diagnostic accuracy and cost-effectiveness of NILTs in patients with chronic liver disease. DATA SOURCES We searched various databases from 1998 to April 2012, recent conference proceedings and reference lists. METHODS We included studies that assessed the diagnostic accuracy of NILTs using liver biopsy as the reference standard. Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was conducted using the bivariate random-effects model with correlation between sensitivity and specificity (whenever possible). Decision models were used to evaluate the cost-effectiveness of the NILTs. Expected costs were estimated using a NHS perspective and health outcomes were measured as quality-adjusted life-years (QALYs). Markov models were developed to estimate long-term costs and QALYs following testing, and antiviral treatment where indicated, for chronic hepatitis B (HBV) and chronic hepatitis C (HCV). NILTs were compared with each other, sequential testing strategies, biopsy and strategies including no testing. For alcoholic liver disease (ALD), we assessed the cost-effectiveness of NILTs in the context of potentially increasing abstinence from alcohol. Owing to a lack of data and treatments specifically for fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), the analysis was limited to an incremental cost per correct diagnosis. An analysis of NILTs to identify patients with cirrhosis for increased monitoring was also conducted. RESULTS Given a cost-effectiveness threshold of £20,000 per QALY, treating everyone with HCV without prior testing was cost-effective

  13. Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis

    PubMed Central

    2013-01-01

    Background The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32+0 weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection. Methods Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective. In addition, two separate measures of effectiveness were utilized: cases of cerebral palsy (CP) averted and quality-adjusted life years (QALYs). Results From a health system and a societal perspective, respectively, a savings of $2,242 and $112,602 is obtained for each QALY gained and a savings of $30,942 and $1,554,198 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is imminent. From a health system perspective and a societal perspective, respectively, a cost of $2,083 is incurred and a savings of $108,277 is obtained for each QALY gained and a cost of $28,755 is incurred and a savings of $1,494,500 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is threatened. Conclusions Administration of magnesium sulphate to patients in whom preterm birth is imminent is a dominant (i.e. cost-effective) strategy, no matter what cost perspective or measure of effectiveness is used. Administration of magnesium sulphate to patients in whom preterm birth is threatened is a dominant strategy from a societal perspective and is very likely to be cost-effective from a health system perspective. PMID:24350635

  14. Cost-effectiveness of hepatitis B vaccination in adults with diagnosed diabetes.

    PubMed

    Hoerger, Thomas J; Schillie, Sarah; Wittenborn, John S; Bradley, Christina L; Zhou, Fangjun; Byrd, Kathy; Murphy, Trudy V

    2013-01-01

    OBJECTIVE To examine the cost-effectiveness of a hepatitis B vaccination program for unvaccinated adults with diagnosed diabetes in the U.S. RESEARCH DESIGN AND METHODS We used a cost-effectiveness simulation model to estimate the cost-effectiveness of vaccinating adults 20-59 years of age with diagnosed diabetes not previously vaccinated for or infected by hepatitis B virus (HBV). The model estimated acute and chronic HBV infections, complications, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and vaccine prices. RESULTS With a 10% uptake rate, the intervention will vaccinate 528,047 people and prevent 4,271 acute and 256 chronic hepatitis B infections. Net health care costs will increase by $91.4 million, and 1,218 QALYs will be gained, producing a cost-effectiveness ratio of $75,094 per QALY gained. Results are most sensitive to age, the discount rate, the hepatitis B incidence ratio for people with diabetes, and hepatitis B infection rates. Cost-effectiveness ratios rise with age at vaccination; an alternative intervention that vaccinates adults with diabetes 60 years of age or older had a cost-effectiveness ratio of $2.7 million per QALY. CONCLUSIONS Hepatitis B vaccination for adults with diabetes 20-59 years of age is modestly cost-effective. Vaccinating older adults with diabetes is not cost-effective. The study did not consider hepatitis outbreak investigation costs, and limited information exists on hepatitis progression among older adults with diabetes. Partly based on these results, the Advisory Committee on Immunization Practices recently recommended hepatitis B vaccination for people 20-59 years of age with diagnosed diabetes. PMID:22933435

  15. Alternatives to potentially inappropriate medications for use in e-prescribing software: triggers and treatment algorithms

    PubMed Central

    Hume, Anne L; Quilliam, Brian J; Goldman, Roberta; Eaton, Charles

    2011-01-01

    Objective To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults. Design Literature review, expert panel and focus group. Setting Primary care with access to e-prescribing systems. Participants Primary care physicians using e-prescribing systems receiving medication history. Interventions Standardised treatment algorithms for clinicians attempting to prescribe PIMs for older patients. Main outcome measure Development of 15 treatment algorithms suggesting alternative therapies. Results Evidence-based treatment algorithms were well received by primary care physicians. Providing alternatives to PIMs would make it easier for physicians to change decisions at the point of prescribing. Conclusion Prospectively identifying older persons receiving PIMs or with adherence issues and providing feasible interventions may prevent adverse drug events. PMID:21719560

  16. Cost-effectiveness of simvastatin versus cholestyramine: results for Sweden.

    PubMed

    Hjalte, K; Lindgren, B; Persson, U

    1992-03-01

    Cost-effectiveness ratios were estimated for each of 2 plasma cholesterol-lowering drug therapies, the HMG-CoA reductase inhibitor simvastatin and the well established cholestyramine, in comparison with a nonpreventive drug treatment alternative. The study was confined to Swedish men (aged 37 to 64 years at start of therapy) with total serum cholesterol levels above 6.2 mmol/L who were free of coronary artery disease (CAD). Costs included expected direct costs of plasma cholesterol-lowering treatment less expected savings resulting from preventing CAD. Effects were defined as changes in life expectancy. A discount rate of 5% and Swedish kronor (SEK) 1988 prices were used. The impact on CAD risks was calculated using multivariate logistic risk estimates from the Framingham Heart Study; Swedish estimates were used to calculate intervention costs and changes in healthcare costs. Over the range of cholesterol levels examined (6.2 to 9.8 mmol/L), simvastatin was consistently more cost-effective than cholestyramine. PMID:10147032

  17. Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness

    PubMed Central

    van der Woude, J. A. D.; Nair, S. C.; Custers, R. J. H.; van Laar, J. M.; Kuchuck, N. O.; Lafeber, F. P. J. G.; Welsing, P. M. J.

    2016-01-01

    Objective In end-stage knee osteoarthritis the treatment of choice is total knee arthroplasty (TKA). An alternative treatment is knee joint distraction (KJD), suggested to postpone TKA. Several studies reported significant and prolonged clinical improvement of KJD. To make an appropriate decision regarding the position of this treatment, a cost-effectiveness and cost-utility analysis from healthcare perspective for different age and gender categories was performed. Methods A treatment strategy starting with TKA and a strategy starting with KJD for patients of different age and gender was simulated. To extrapolate outcomes to long-term health and economic outcomes a Markov (Health state) model was used. The number of surgeries, QALYs, and treatment costs per strategy were calculated. Costs-effectiveness is expressed using the cost-effectiveness plane and cost-effectiveness acceptability curves. Results Starting with KJD the number of knee replacing procedures could be reduced, most clearly in the younger age categories; especially revision surgery. This resulted in the KJD strategy being dominant (more effective with cost-savings) in about 80% of simulations (with only inferiority in about 1%) in these age categories when compared to TKA. At a willingness to pay of 20.000 Euro per QALY gained, the probability of starting with KJD to be cost-effective compared to starting with a TKA was already found to be over 75% for all age categories and over 90–95% for the younger age categories. Conclusion A treatment strategy starting with knee joint distraction for knee osteoarthritis has a large potential for being a cost-effective intervention, especially for the relatively young patient. PMID:27171268

  18. Alternative derivation of an exchange-only density-functional optimized effective potential

    SciTech Connect

    Joubert, D. P.

    2007-10-15

    An alternative derivation of the exchange-only density-functional optimized effective potential equation is given. It is shown that the localized Hartree-Fock-common energy denominator Green's function approximation (LHF-CEDA) for the density-functional exchange potential proposed independently by Della Sala and Goerling [J. Chem. Phys. 115, 5718 (2001)] and Gritsenko and Baerends [Phys. Rev. A 64, 42506 (2001)] can be derived as an approximation to the OEP exchange potential in a similar way that the KLI approximation [Phys. Rev. A 45, 5453 (1992)] was derived. An exact expression for the correction term to the LHF-CEDA approximation can thus be found. The correction term can be expressed in terms of the first-order perturbation-theory many-electron wave function shift when the Kohn-Sham Hamiltonian is subjected to a perturbation equal to the difference between the density-functional exchange potential and the Hartree-Fock nonlocal potential, expressed in terms of the Kohn-Sham orbitals. An explicit calculation shows that the density weighted mean of the correction term is zero, confirming that the LHF-CEDA approximation can be interpreted as a mean-field approximation. The corrected LHF-CEDA equation and the optimized effective potential equation are shown to be identical, with information distributed differently between terms in the equations. For a finite system the correction term falls off at least as fast as 1/r{sup 4} for large r.

  19. Evaluating the Cost-Effectiveness of Lifestyle Modification versus Metformin Therapy for the Prevention of Diabetes in Singapore

    PubMed Central

    Png, May Ee; Yoong, Joanne Su-Yin

    2014-01-01

    Background In Singapore, as diabetes is an increasingly important public health issue, the cost-effectiveness of pursuing lifestyle modification programs and/or alternative prevention strategies is of critical importance for policymakers. While the US Diabetes Prevention Program (DPP) compared weight loss through lifestyle modification with oral treatment of diabetes drug metformin to prevent/delay the onset of type 2 diabetes in pre-diabetic subjects, no data on either the actual or potential cost effectiveness of such a program is available for East or South-east Asian populations. This study estimates the 3-year cost-effectiveness of lifestyle modification and metformin among pre-diabetic subjects from a Singapore health system and societal perspective. Methodology Cost effectiveness was analysed from 2010–2012 using a decision-based model to estimate the rates of getting diabetes, healthcare costs and health-related quality of life. Cost per quality-adjusted life year (QALY) was estimated using costs relevant to the time horizon of the study from Singapore. All costs are expressed in 2012 US dollars. Principal Findings The total economic cost for non-diabetic subjects from the societal perspective was US$25,867, US$28,108 and US$26,177 for placebo, lifestyle modification and metformin intervention respectively. For diabetic patients, the total economic cost from the societal perspective was US$32,921, US$35,163 and US$33,232 for placebo, lifestyle modification and metformin intervention respectively. Lifestyle modification relative to placebo is likely to be associated with an incremental cost per QALY gained at US$36,663 while that of metformin intervention is likely to be US$6,367 from a societal perspective. Conclusion Based on adaptation of the DPP data to local conditions, both lifestyle modification and metformin intervention are likely to be cost-effective and worth implementing in Singapore to prevent or delay the onset of type 2 diabetes. However

  20. Potential use of California lignite and other alternate fuel for enhanced oil recovery. Phase I and II. Final report. [As alternative fuels for steam generation in thermal EOR

    SciTech Connect

    Shelton, R.; Shimizu, A.; Briggs, A.

    1980-02-01

    The Nation's continued reliance on liquid fossil fuels and decreasing reserves of light oils gives increased impetus to improving the recovery of heavy oil. Thermal enhanced oil recovery EOR techniques, such as steam injection, have generally been the most effective for increasing heavy oil production. However, conventional steam generation consumes a large fraction of the produced oil. The substitution of alternate (solid) fuels would release much of this consumed oil to market. This two-part report focuses on two solid fuels available in California, the site of most thermal EOR - petroleum coke and lignite. Phase I, entitled Economic Analysis, shows detailed cost comparisons between the two candidate fuels and also with Western coal. The analysis includes fuels characterizations, process designs for several combustion systems, and a thorough evaluation of the technical and economic uncertainties. In Phase II, many technical parameters of petroleum coke combustion were measured in a pilot-plant fluidized bed. The results of the study showed that petroleum coke combustion for EOR is feasible and cost effective in a fluidized bed combustor.

  1. Cost effectiveness of stream-gaging program in Michigan

    USGS Publications Warehouse

    Holtschlag, D.J.

    1985-01-01

    Data uses and funding sources were identified for the 129 continuous gaging stations being operated in Michigan as of 1984. One gaging station was identified as having insufficient reason to continue its operation. Several stations were identified for reactivation, should funds become available, because of insufficiencies in the data network. Alternative methods of developing streamflow information based on routing and regression analyses were investigated for 10 stations. However, no station records were reproduced with sufficient accuracy to replace conventional gaging practices. A cost-effectiveness analysis of the data collection procedure for the ice-free season was conducted using a Kalman-filter analysis. To define missing record characteristics, cross-correlation coefficients and coefficients of variation were computed at stations on the basis of daily mean discharge. Discharge measurement data were used to describe the gage/discharge rating stability at each station. The results of the cost-effectiveness analysis for a 9-month ice-free season show that the current policy of visiting most stations on a fixed servicing schedule once every 6 weeks results in an average standard error of 12.1% for the current $718,100 budget. By adopting a flexible servicing schedule, the average standard error could be reduced to 11.1%. Alternatively, the budget could be reduced to $700,200 while maintaining the current level of accuracy. A minimum budget of $680,200 is needed to operate the 129-gaging-station program; a budget less than this would not permit proper service and maintenance of stations. At the minimum budget, the average standard error would be 14.4%. A budget of $789,900 (the maximum analyzed) would result in a decrease in the average standard error to 9.07%. Owing to continual changes in the composition of the network and the changes in the uncertainties of streamflow accuracy at individual stations, the cost-effectiveness analysis will need to be updated

  2. Celery-based topical repellents as a potential natural alternative for personal protection against mosquitoes.

    PubMed

    Tuetun, B; Choochote, W; Pongpaibul, Y; Junkum, A; Kanjanapothi, D; Chaithong, U; Jitpakdi, A; Riyong, D; Pitasawat, B

    2008-12-01

    Celery-based products were investigated for chemical composition, skin irritation, and mosquito repellency in comparison to commercial repellents and the standard chemical, N,N-diethyl-3-methylbenzamide (DEET), with a goal to develop a natural alternative to synthetic repellents for protection against mosquitoes. Chemical identification by gas chromatography coupled with mass spectrometry discovered that the major constituents of Apium graveolens hexane extract (AHE) were 3-n-butyl-tetrahydrophthalide (92.48%), followed by 5.10% beta-selinene and 0.68% gamma-selinene. Evaluation of skin irritation in 27 human volunteers revealed no irritant potential from 25% ethanolic AHE solution. Laboratory investigated repellent against female Aedes aegypti mosquitoes demonstrated that G10 formula, the best AHE-developed product, provided remarkable repellency with a median protection time of 4.5 h (4.5-5 h), which was greater than that of ethanolic DEET solution (25% DEET, 3.5 h) and comparable to that of the best commercial repellent, Insect Block 28 (28.5% DEET, 4.5 h). According to significantly promising results, including highly effective repellency and no potential skin irritation or other side effects, the G10 formula is a worthwhile product that has the promise of being developed for commercialized registration. This developed AHE product could be an acceptable and affordable alternative to conventional synthetic chemicals in preventing mosquito bites, and in turn, helping to interrupt mosquito-borne disease transmission. PMID:18766378

  3. Alternative antimicrobial compounds to control potential Lactobacillus contamination in bioethanol fermentations.

    PubMed

    Limayem, Alya; Hanning, Irene B; Muthaiyan, Arunachalam; Illeghems, Koen; Kim, Jin-Woo; Crandall, Philip G; O'Bryan, Corliss A; Ricke, Steven C

    2011-01-01

    Antibiotics are commonly used to control microbial contaminants in yeast-based bioethanol fermentation. Given the increase in antibiotic-resistant bacteria, alternative natural antimicrobials were evaluated against the potential contaminant, Lactobacillus. The effects of nisin, ϵ-polylysine, chitosan (CS) and lysozyme were screened against 5 Lactobacillus strains. A standard broth- microdilution method was used in 96-well plates to assess the minimal inhibitory concentration (MIC). L. delbrueckii subsp lactis ATCC479 exhibited maximal MICs with CS, ϵ-polylysine and nisin (1.87, 0.3125 and 0.05 mg/mL, respectively). Nisin reduced most Lactobacillus strains by 6 log CFU/mL after 48 hours with the exception of L. casei. Synergism occurred when ethylenediaminetetraacetic acid (EDTA) was added with nisin. An MIC of 0.4 mg/mL of nisin combined with the EDTA at an MIC of 1 mg/ml markedly suppressed L .casei by 6 log CFU/mL. In conclusion, alternative antimicrobials proved to be a potential candidate for controlling bacterial contamination in the fermentation process. Synergistic effect of nisin with EDTA successfully inhibited the nisin-resistant contaminant, L. casei. PMID:21879832

  4. Pharmacoinformatics approach for investigation of alternative potential hepatitis C virus nonstructural protein 5B inhibitors

    PubMed Central

    Mirza, Muhammad Usman; Ghori, Noor-Ul-Huda; Ikram, Nazia; Adil, Abdur Rehman; Manzoor, Sadia

    2015-01-01

    Hepatitis C virus (HCV) is one of the major viruses affecting the world today. It is a highly variable virus, having a rapid reproduction and evolution rate. The variability of genomes is due to hasty replication catalyzed by nonstructural protein 5B (NS5B) which is also a potential target site for the development of anti-HCV agents. Recently, the US Food and Drug Administration approved sofosbuvir as a novel oral NS5B inhibitor for the treatment of HCV. Unfortunately, it is much highlighted for its pricing issues. Hence, there is an urgent need to scrutinize alternate therapies against HCV that are available at affordable price and do not have associated side effects. Such a need is crucial especially in underdeveloped countries. The search for various new bioactive compounds from plants is a key part of pharmaceutical research. In the current study, we applied a pharmacoinformatics-based approach for the identification of active plant-derived compounds against NS5B. The results were compared to docking results of sofosbuvir. The lead compounds with high-binding ligands were further analyzed for pharmacokinetic and pharmacodynamic parameters based on in silico absorption, distribution, metabolism, excretion, and toxicity (ADMET) profile. The results showed the potential alternative lead compounds that can be developed into commercial drugs having high binding energy and promising ADMET properties. PMID:25848219

  5. Social network bridging potential and the use of complementary and alternative medicine in later life.

    PubMed

    Goldman, Alyssa W; Cornwell, Benjamin

    2015-09-01

    The use of complementary/alternative medicine (CAM) is typically modeled as a function of individual health beliefs, including changes in perceptions of conventional medicine, an orientation toward more holistic care, and increasing patient involvement in health care decision-making. Expanding on research that shows that health-related behavior is shaped by social networks, this paper examines the possibility that CAM usage is partly a function of individuals' social network structure. We argue that people are more likely to adopt CAM when they function as bridges between network members who are otherwise not (or poorly) connected to each other. This circumstance not only provides individuals with access to a wider range of information about treatment options, it also reduces the risk of sanctioning by network members if one deviates from conventional forms of treatment. We test this idea using data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative study of older Americans. Analyses of egocentric social network data show that older adults with bridging potential in their networks are significantly more likely to engage in a greater number of types of CAM. We close by discussing alternative explanations of these findings and their potential implications for research on CAM usage. PMID:26207353

  6. Cost effectiveness and delivery study for future HIV vaccines.

    PubMed

    Barth-Jones, D C; Cheng, H; Kang, L Y; Kenya, Patrick R; Odera, D; Mosqueira, N R; Mendoza, W; Portela, M C; Brito, C; Tangcharoensathien, V; Akaleephan, C; Supantamart, S; Patcharanarumol, W; de Macedo Brigido, L F; Fonseca, M G P; Sanchez, M; Chang, M-L; Osmanov, S; Avrett, S; Esparza, J; Griffiths, U

    2005-09-01

    Research teams from five countries, Brazil, China, Kenya, Peru and Thailand, have initiated a policy-maker survey on vaccine delivery, cost studies for future HIV vaccination programmes, and associated simulation modeling exercises analysing the relative cost-effectiveness of potential HIV vaccination strategies. The survey assesses challenges and opportunities for future country-level HIV vaccination strategies, providing data on the vaccine characteristics (e.g. vaccine efficacies for susceptibility, infectiousness and disease progression) and vaccination programme strategies to be considered in the cost-effectiveness modeling analyses. The study will provide decision-makers with modeling data on vaccination policy considerations that will assist in developing country-level capacities for future HIV vaccine policy adoption and effective delivery systems, and will help delineate the long-term financial requirements for sustainable HIV vaccination programmes. The WHO-UNAIDS HIV Vaccine Initiative and the collaborating researchers welcome comments or questions from policy makers, health professionals and other stakeholders in the public and private sectors about this effort to help advance policy and capacity related to future potential HIV vaccines. PMID:16103763

  7. Cost-effective ultrasound PACS solution

    NASA Astrophysics Data System (ADS)

    Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

    1995-05-01

    Picture archiving and communication systems (PACS) have been quite successful at the University of Florida in the areas of CT, MR, and nuclear medicine. In each case, although we have not always been able to provide the optimal level of performance, we have been able to solve a problem and the systems are used extensively. Ultrasound images are required in a number of locations and the multiformat camera print capability was no longer adequate for the growing volume in the ultrasound section. Although we were certain we could successfully implement PACS for ultrasound, new forces in health care dictate that we justify our system in terms of cost. We analyzed the feasibility of a PACS solution for ultrasound and designed a system that meets our needs and is cost effective. We evaluated the ultrasound operation in terms of image acquisition patterns and throughput requirements. An inventory of existing and PACS equipment was made to determine the feasibility of interfacing the two systems. Commercial systems were evaluated for functionality and cost and a system was designed to meet our needs. The only way to achieve our goal of installing a cost effective ultrasound PACS was to eliminate film and use the cost savings to offset the cost of new equipment and development. We designed a system that could be produced using inexpensive components and existing hardware and software to meet our needs. A commercial vendor was chosen to provide the ultrasound acquisition. The Radiology Information System interface used at the University provides the necessary data to build a DICOM header, and an existing DICOM server routes the images to the appropriate workstations, archives, and printers. Additional storage is added to an existing archive to accommodate the ultrasound images and two existing workstations are evaluated for use in ultrasound.

  8. Cost-effective applications of photovoltaics

    SciTech Connect

    Thornton, J.P.

    1996-05-01

    When photovoltaic (PV) cells were first developed at Bell Laboratories in the mid-1950s, their inventors envisioned widespread terrestrial use. However, PV cells were rapidly adopted for space applications, not only because of their reliability, but because they were generally the most cost- effective power sources for satellites in spite of their high cost. Concern over oil supply and price during the 1970s once again turned people`s thoughts toward the use of PV cells and other renewable energy technologies to help meet the nation`s energy demands. A partnership was developed between the federal government and private industry to drive the cost of PV technologies down to where they could compete in commercial markets. This partnership, which continues today, has been highly successful in achieving its goal. Today`s photovoltaic modules-more efficient and reliable than ever-have dropped to about 1/100th of their 1972 prices. From $500 or more per peak watt in those early days, module prices have dropped to about $5 per peak watt. Figure 1 illustrates the expansion of PV into commercial 2 effective markets as cost (and price) decreases. Once cost only in space, military, or consumer (primarily calculators and watches) applications, PV has now penetrated into both international and domestic markets. Currently cost-effective domestic uses, which are the primary subject of this paper, include applications in the residential, municipal, remote, and utility market sectors. The price of an installed PV system now ranges from $7 per watt to as high as $15 or $20 per watt, depending on factors such as the quantity purchased, size of the unit, amount of storage, and whether output is a.c. or d.c. This translates to a life-cycle energy cost of about 25 cents to 40 cents per kilowatt hour (kWh). Even at these seemingly high prices, PV technologies are gaining significant penetration into many U.S. markets.

  9. Mythology in the Making: Is the Open University Really Cost-Effective?

    ERIC Educational Resources Information Center

    Mace, John

    1978-01-01

    An alternative technique, cost-effectiveness analysis, is proposed as a more appropriate way of evaluating the Open University. A rudimentary application of the technique to the cost structure of OU indicates that it could result in a substantial reduction in OU's costs. (Author/LBH)

  10. Using Pair Counseling to Improve the Cost-Effectiveness of College Career Counseling

    ERIC Educational Resources Information Center

    McClain, Mary-Catherine; Sampson, James P.

    2013-01-01

    As the demand for career counseling services grows, the need for accountability rises, and the availability of funding decreases, it becomes more critical that practitioners utilize cost-effective interventions and alternative forms of treatment. One option for improving access to all clients while concurrently reducing costs involves using…

  11. A Guide to the Selection of Cost-Effective Wastewater Treatment Systems. Technical Report.

    ERIC Educational Resources Information Center

    Van Note, Robert H.; And Others

    The data within this publication provide guidelines for planners, engineers and decision-makers at all governmental levels to evaluate cost-effectiveness of alternative wastewater treatment proposals. The processes described include conventional and advanced treatment units as well as most sludge handling and processing units. Flow sheets, cost…

  12. Assembly of a Cost-Effective Anode Using Palladium Nanoparticles for Alkaline Fuel Cell Applications

    ERIC Educational Resources Information Center

    Feliciano-Ramos, Ileana; Casan~as-Montes, Barbara; García-Maldonado, María M.; Menendez, Christian L.; Mayol, Ana R.; Díaz-Vazquez, Liz M.; Cabrera, Carlos R.

    2015-01-01

    Nanotechnology allows the synthesis of nanoscale catalysts, which offer an efficient alternative for fuel cell applications. In this laboratory experiment, the student selects a cost-effective anode for fuel cells by comparing three different working electrodes. These are commercially available palladium (Pd) and glassy carbon (GC) electrodes, and…

  13. Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer

    PubMed Central

    Hashemi-Meshkini, Amir; Keshavarz, Khosro; Gharibnaseri, Zahra; Kheirandish, Mehrnaz; Kebriaeezadeh, Abbas

    2013-01-01

    Introduction Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives. Material and methods To evaluate the efficacy of exemestane, a systematic review was conducted by searching electronic databases. The outcomes of interest were “clinical benefit”, “overall response” and “disease-free survival rate”. To evaluate the cost of treatments, costs of both domestic generic and imported brand medicines were taken into account, and the incremental cost-effectiveness ratio (ICER) was calculated for each comparison. Results Regarding primary breast cancer, based upon available evidence, exemestane could not be considered as a cost-effective medicine either in generic or brand form compared with placebo (ICER: 119,100 and 215,525), with tamoxifen after 2-3 years of therapy (ICER: 35,150 and 82,400) and with sequential treatment by tamoxifen and exemestane (dominated because of lower effectiveness and higher cost). In metastatic breast cancer, exemestane was not considered a cost-effective treatment compared with both anastrozole and megestrol acetate (dominated) and was highly cost-effective compared with tamoxifen (ICERs: 2,208 and 4,326 dollars per one more patient with an overall response for generic and brand medicines) although even in this case it was not cost-effective in terms of the 1-year survival rates (dominated). Conclusions Regarding current evidence and related costs in terms of Iranian pharmaceutical market prices, exemestane could not be considered a cost-effective treatment in primary and advanced breast cancer compared with available alternatives. However, more evidence is still needed for more certain decisions. PMID:23847669

  14. Cost-effectiveness of minimally invasive sacroiliac joint fusion

    PubMed Central

    Cher, Daniel J; Frasco, Melissa A; Arnold, Renée JG; Polly, David W

    2016-01-01

    Background Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085). SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion Compared to traditional non-surgical treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption. PMID:26719717

  15. Cost-effectiveness of continuous erythropoietin receptor activator in anemia

    PubMed Central

    Schmid, Holger

    2014-01-01

    Background Erythropoiesis-stimulating agents (ESAs) are the mainstay of anemia therapy. Continuous erythropoietin receptor activator (CERA) is a highly effective, long-acting ESA developed for once-monthly dosing. A multitude of clinical studies has evaluated the safety and efficiency of this treatment option for patients with renal anemia. In times of permanent financial pressure on health care systems, the cost-effectiveness of CERA should be of particular importance for payers and clinicians. Objective To critically analyze, from the nephrologists’ point of view, the published literature focusing on the cost-effectiveness of CERA for anemia treatment. Methods The detailed literature search covered electronic databases including MEDLINE, PubMed, and Embase, as well as international conference abstract databases. Results Peer-reviewed literature analyzing the definite cost-effectiveness of CERA is scarce, and most of the available data originate from conference abstracts. Identified data are restricted to the treatment of anemia due to chronic kidney disease. Although the majority of studies suggest a considerable cost advantage for CERA, the published literature cannot easily be compared. While time and motion studies clearly indicate that a switch to CERA could minimize health care staff time in dialysis units, the results of studies comparing direct costs are more ambivalent, potentially reflecting the differences between health care systems and variability between centers. Conclusion Analyzed data are predominantly insufficient; they miss clear evidence and have to thus be interpreted with great caution. In this day and age of financial restraints, results from well-designed, head-to-head studies with clearly defined endpoints have to prove whether CERA therapy can achieve cost savings without compromising anemia management. PMID:25050070

  16. Cost-Effectiveness of Pharmacotherapy to Reduce Obesity

    PubMed Central

    Veerman, J. Lennert; Barendregt, Jan J.; Forster, Megan; Vos, Theo

    2011-01-01

    Aims Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. Methods We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs) below A$50 000 per Disability Adjusted Life Year (DALY) averted are considered good value for money. Results The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000–180 000) for sibutramine and A$230 000/DALY (170 000–340 000) for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. Conclusions Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden. PMID:22046255

  17. Using Cost-Effectiveness Tests to Design CHP Incentive Programs

    SciTech Connect

    Tidball, Rick

    2014-11-01

    This paper examines the structure of cost-effectiveness tests to illustrate how they can accurately reflect the costs and benefits of CHP systems. This paper begins with a general background discussion on cost-effectiveness analysis of DER and then describes how cost-effectiveness tests can be applied to CHP. Cost-effectiveness results are then calculated and analyzed for CHP projects in five states: Arkansas, Colorado, Iowa, Maryland, and North Carolina. Based on the results obtained for these five states, this paper offers four considerations to inform regulators in the application of cost-effectiveness tests in developing CHP programs.

  18. Antimicrobial Peptides as Potential Alternatives to Antibiotics in Food Animal Industry.

    PubMed

    Wang, Shuai; Zeng, Xiangfang; Yang, Qing; Qiao, Shiyan

    2016-01-01

    Over the last decade, the rapid emergence of multidrug-resistant pathogens has become a global concern, which has prompted the search for alternative antibacterial agents for use in food animals. Antimicrobial peptides (AMPs), produced by bacteria, insects, amphibians and mammals, as well as by chemical synthesis, are possible candidates for the design of new antimicrobial agents because of their natural antimicrobial properties and a low propensity for development of resistance by microorganisms. This manuscript reviews the current knowledge of the basic biology of AMPs and their applications in non-ruminant nutrition. Antimicrobial peptides not only have broad-spectrum activity against bacteria, fungi, and viruses but also have the ability to bypass the common resistance mechanisms that are placing standard antibiotics in jeopardy. In addition, AMPs have beneficial effects on growth performance, nutrient digestibility, intestinal morphology and gut microbiota in pigs and broilers. Therefore, AMPs have good potential as suitable alternatives to conventional antibiotics used in swine and poultry industries. PMID:27153059

  19. An assessment of potential impact of alternative fluorocarbons on tropospheric ozone

    NASA Technical Reports Server (NTRS)

    Niki, Hiromi

    1990-01-01

    While the chlorofuorocarbons (CFCs) such as CFC-11 (CFCl3) and CFC-12 (CF2Cl2) are chemically inert in the troposphere, the hydrogen-containing halocarbons being considered as their replacements can, to a large extent, be removed in the troposphere by the HO radical. These alternative halocarbons include the hydrochlorofluorocarbons (HCFCs) 123 (CF3CHCl2), 141b (CFCl2CH3), 142b (CF2ClCH3), 22 (CHF2Cl), and 124 (CF3CHFCl) and the hydrofluorocarbons (HCFs) 134a (CF3CH2F), 152a (CHF2CH3) and 125 (CF3CHF2). Listed are the rate constants (k) for the HO radical reaction of these compounds and their estimated chemical lifetimes in the troposphere. In this table, values of the lifetimes of these selected HCFCs and HCFs are seen to vary by more than a factor of more than ten ranging from 1.6 years for HFC 152a and HCFC 125 to as long as 28 years for HFC 125. Clearly, from the standpoint of avoiding or minimizing impact on stratospheric O3, those halocarbons with short tropospheric lifetimes are the desirable alternates. However, potential environmental consequences of their degradation in the troposphere should be assessed and taken into account in the selection process.

  20. Potential impacts on air quality of the use of ethanol as an alternative fuel. Final report

    SciTech Connect

    Gaffney, J.S.; Marley, N.A.

    1994-09-01

    The use of ethanol/gasoline mixtures in motor vehicles has been proposed as an alternative fuel strategy that might improve air quality while minimizing US dependence on foreign oil. New enzymatic production methodologies are being explored to develop ethanol as a viable, economic fuel. In an attempt to reduce urban carbon monoxide (CO) and ozone levels, a number of cities are currently mandating the use of ethanol/gasoline blends. However, it is not at all clear that these blended fuels will help to abate urban pollution. In fact, the use of these fuels may lead to increased levels of other air pollutants, specifically aldehydes and peroxyacyl nitrates. Although these pollutants are not currently regulated, their potential health and environmental impacts must be considered when assessing the impacts of alternative fuels on air quality. Indeed, formaldehyde has been identified as an important air pollutant that is currently being considered for control strategies by the State of California. This report focuses on measurements taken in Albuquerque, New Mexico during the summer of 1993 and the winter of 1994 as an initial attempt to evaluate the air quality effects of ethanol/gasoline mixtures. The results of this study have direct implications for the use of such fuel mixtures as a means to reduce CO emissions and ozone in a number of major cities and to bring these urban centers into compliance with the Clean Air Act.

  1. Antimicrobial Peptides as Potential Alternatives to Antibiotics in Food Animal Industry

    PubMed Central

    Wang, Shuai; Zeng, Xiangfang; Yang, Qing; Qiao, Shiyan

    2016-01-01

    Over the last decade, the rapid emergence of multidrug-resistant pathogens has become a global concern, which has prompted the search for alternative antibacterial agents for use in food animals. Antimicrobial peptides (AMPs), produced by bacteria, insects, amphibians and mammals, as well as by chemical synthesis, are possible candidates for the design of new antimicrobial agents because of their natural antimicrobial properties and a low propensity for development of resistance by microorganisms. This manuscript reviews the current knowledge of the basic biology of AMPs and their applications in non-ruminant nutrition. Antimicrobial peptides not only have broad-spectrum activity against bacteria, fungi, and viruses but also have the ability to bypass the common resistance mechanisms that are placing standard antibiotics in jeopardy. In addition, AMPs have beneficial effects on growth performance, nutrient digestibility, intestinal morphology and gut microbiota in pigs and broilers. Therefore, AMPs have good potential as suitable alternatives to conventional antibiotics used in swine and poultry industries. PMID:27153059

  2. Cost-effective bifacial dye-sensitized solar cells with transparent iron selenide counter electrodes. An avenue of enhancing rear-side electricity generation capability

    NASA Astrophysics Data System (ADS)

    Liu, Juan; Tang, Qunwei; He, Benlin; Yu, Liangmin

    2015-02-01

    Alloy materials have established themselves as alternative electrocatalysts for electrochemical devices because of their cost-effectiveness, high conductivity, good electrocatalytic activity, and reasonable stability. Aiming at reducing fabrication cost without sacrificing power conversion efficiency of dye-sensitized solar cells (DSSCs), we report the feasibility of designing transparent and cost-effective Fe-Se alloy counter electrodes for bifacial DSSCs. Due to the rapid charge transfer ability and electrocatalytic activity, maximum front and rear efficiencies of 7.64% and 4.95% are measured for the DSSC with FeSe alloy electrode in comparison with 6.97% and 3.56% from Pt-based solar cell. The impressive results along with simple synthesis highlight the potential application of Fe-Se alloys in robust bifacial DSSCs.

  3. Analysis of Burnup and Economic Potential of Alternative Fuel Materials in Thermal Reactors

    SciTech Connect

    Oggianu, Stella Maris; No, Hee Cheon; Kazimi, Mujid S.

    2003-09-15

    A strategy is proposed for the assessment of nuclear fuel material economic potential use in future light water reactors (LWRs). In this methodology, both the required enrichment and the fuel performance limits are considered. In order to select the best fuel candidate, the optimal burnup that produces the lowest annual fuel cost within the burnup potential for a given fuel material and smear density ratio is determined.Several nuclear materials are presented as examples of the application of the methodology proposed in this paper. The alternative fuels considered include uranium dioxide (UO{sub 2}), uranium carbide (UC), uranium nitride (UN), metallic uranium (U-Zr alloy), combined thorium and uranium oxides (ThO{sub 2}/UO{sub 2}), and combined thorium and uranium metals (U/Th). For these examples, a typical LWR lattice geometry in a zirconium-based cladding was assumed. The uncertainties in the results presented are large due to the scarcity of experimental data regarding the behavior of the considered materials at high burnups. Also, chemical compatibility issues are to be considered separately.The same methodology can be applied in the future to evaluate the economic potential of other nuclear fuel materials including different cladding designs, dispersions of ceramics into ceramics, dispersions of ceramics into metals, and also for geometries other than the traditional circular fuel pin.

  4. A simple separation method with a microfluidic channel based on alternating current potential modulation.

    PubMed

    Noh, Hui-Bog; Chandra, Pranjal; Kim, You-Jeong; Shim, Yoon-Bo

    2012-11-20

    A simple separation and detection system based on an electrochemical potential modulated microchannel (EPMM) device was developed for the first time. The application of alternating current (AC) potential to the microfluidic separation channel walls, which were composed of screen printed carbon electrodes, resulted in the oscillation and fluctuation of analytes and in the formation of a perfect flat flow front. These events resulted in an increase in the effective concentration and in the fine separation of samples. The performance of the EPMM device was examined through the analysis of endocrine disruptors (EDs) and heavy metal ions (HMIs) as model compounds. The analytical parameters that affected the separation and detection of EDs and HMIs were studied in terms of AC amplitude, AC frequency, flow rate, buffer concentration, pH, detection potential, and temperature. The separation efficiency was evaluated through measurements of the theoretical plate number (N), the retention time, and the half-peak width. Linear calibration plots for the detection of EDs and HMIs were obtained between 0.15 and 250.0 nM (detection limit 86.4 ± 2.9 pM) and between 0.01 and 10.0 nM (detection limit 9.5 ± 0.3 pM), respectively. The new device was successfully demonstrated with authentic and real samples. PMID:23075295

  5. Nanostructured systems containing babassu (Orbignya speciosa) oil as a potential alternative therapy for benign prostatic hyperplasia

    PubMed Central

    de Sousa, Valeria Pereira; Crean, Joanne; de Almeida Borges, Vinícius Raphael; Rodrigues, Carlos Rangel; Tajber, Lidia; Boylan, Fabio; Cabral, Lucio Mendes

    2013-01-01

    The oil of babassu tree nuts (Orbignya speciosa) is a potential alternative for treatment and prophylaxis of benign prostatic hyperplasia. Improved results can be obtained by drug vectorization to the hyperplastic tissue. The main objective of this work was the preparation and characterization of poly(lactic-co-glycolic acid) (PLGA) nanoparticle and clay nanosystems containing babassu oil (BBS). BBS was extracted from the kernels of babassu tree nuts and characterized by gas chromatography-mass spectrometry as well as 1H and 13C nuclear magnetic resonance. BBS-clay nanosystems were obtained by adding polyvinylpyrrolidone, Viscogel B8®, and BBS at a 2:1:1 mass ratio and characterized by X-ray diffraction, thermogravimetric analysis, infrared spectroscopy, and laser diffraction. The PLGA-BBS nanoparticles were prepared by the precipitation-solvent evaporation method. Mean diameter, polydispersity, zeta potential, and scanning electron microscopic images of the nanosystems were analyzed. Thermogravimetric analysis showed successful formation of the nanocomposite. PLGA nanoparticles containing BBS were obtained, with a suitable size that was confirmed by scanning electron microscopy. Both nanostructured systems showed active incorporation yields exceeding 90%. The two systems obtained represent a new and potentially efficient therapy for benign prostatic hyperplasia. PMID:23990721

  6. Can Aging in Place Be Cost Effective? A Systematic Review

    PubMed Central

    Graybill, Erin M.; McMeekin, Peter; Wildman, John

    2014-01-01

    Purpose of the Study To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to ‘age in place’ and highlight what further research is needed to inform decisions regarding aging in place. Design People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Methods Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Results Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. Implications The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn. PMID:25058505

  7. The Value of Heterogeneity for Cost-Effectiveness Subgroup Analysis

    PubMed Central

    Manca, Andrea; Claxton, Karl; Sculpher, Mark J.

    2014-01-01

    This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy. PMID:24944196

  8. Osthole: A Review on Its Bioactivities, Pharmacological Properties, and Potential as Alternative Medicine

    PubMed Central

    Zhang, Zhong-Rong; Leung, Wing Nang; Cheung, Ho Yee; Chan, Chun Wai

    2015-01-01

    This paper reviews the latest understanding of biological and pharmacological properties of osthole (7-methoxy-8-(3-methyl-2-butenyl)-2H-1-benzopyran-2-one), a natural product found in several medicinal plants such as Cnidium monnieri and Angelica pubescens. In vitro and in vivo experimental results have revealed that osthole demonstrates multiple pharmacological actions including neuroprotective, osteogenic, immunomodulatory, anticancer, hepatoprotective, cardiovascular protective, and antimicrobial activities. In addition, pharmacokinetic studies showed osthole uptake and utilization are fast and efficient in body. Moreover, the mechanisms of multiple pharmacological activities of osthole are very likely related to the modulatory effect on cyclic adenosine monophosphate (cAMP) and cyclic adenosine monophosphate (cGMP) level, though some mechanisms remain unclear. This review aims to summarize the pharmacological properties of osthole and give an overview of the underlying mechanisms, which showcase its potential as a multitarget alternative medicine. PMID:26246843

  9. Use of alternative assays to identify and prioritize organophosphorus flame retardants for potential developmental and neurotoxicity.

    PubMed

    Behl, Mamta; Hsieh, Jui-Hua; Shafer, Timothy J; Mundy, William R; Rice, Julie R; Boyd, Windy A; Freedman, Jonathan H; Hunter, E Sidney; Jarema, Kimberly A; Padilla, Stephanie; Tice, Raymond R

    2015-01-01

    Due to their toxicity and persistence in the environment, brominated flame retardants (BFRs) are being phased out of commercial use, leading to the increased use of alternative chemicals such as the organophosphorus flame retardants (OPFRs). There is, however, limited information on the potential health effects of OPFRs. Due to the structural similarity of the OPFRs to organophosphorus insecticides, there is concern regarding developmental toxicity and neurotoxicity. In response, we evaluated a set of OPFRs (triphenyl phosphate [TPHP]), isopropylated phenyl phosphate [IPP], 2-ethylhexyl diphenyl phosphate [EHDP], tert-butylated phenyl diphenyl phosphate [BPDP], trimethyl phenyl phosphate [TMPP], isodecyl diphenyl phosphate [IDDP], (tris(1,3-dichloroisopropyl) phosphate [TDCIPP], and tris(2-chloroethyl)phosphate [TCEP]) in a battery of cell-based in vitro assays and alternative model organisms and compared the results to those obtained for two classical BFRs (3,3',5,5'-tetrabromobisphenol A [TBBPA] and 2,2'4,4'-brominated diphenyl ether [BDE-47]). The assays used evaluated the effects of chemicals on the differentiation of mouse embryonic stem cells, the proliferation and growth of human neural stem cells, rat neuronal growth and network activity, and development of nematode (Caenorhabditis elegans) and zebrafish (Danio rerio). All assays were performed in a concentration-response format, allowing for the determination of the point of departure (POD: the lowest concentration where a chemically-induced response exceeds background noise). The majority of OPFRs (8/9) were active in multiple assays in the range of 1-10 μM, most of which had comparable activity to the BFRs TBBPA and BDE-47. TCEP was negative in all assays. The results indicate that the replacement OPFRs, with the exception of TCEP, showed comparable activity to the two BFRs in the assays tested. Based on these results, more comprehensive studies are warranted to further characterize the potential hazard

  10. Cost effectiveness of recycling: a systems model.

    PubMed

    Tonjes, David J; Mallikarjun, Sreekanth

    2013-11-01

    Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets. PMID:23816311

  11. ROV's: The key is cost effectiveness

    SciTech Connect

    Saunders, E.

    1986-10-01

    Although diver-support activities will continue to be required in terms of monitoring and assistance, low-cost, remotely operated vehicles (ROV's) will have an increasing presence in the oil industry and other fields provided there is ongoing improvement in management, preparation, and execution of work. Beyond the safety aspect, the key is cost effectiveness. It is the company's intention wherever possible, and within realistic constraints, to take the man out of the water either by direct ROV replacement of the diver or by assisting him. Shell's exploration and production operations are based in three main areas: the southern, central, and northern North Sea. These developed fields, which consist of 26 various structures (interconnected), are connected to the mainland by over 1,100 km of submarine pipeline. Maintenance and underwater engineering costs in northern operations alone exceed pounds40 million/year (about $60 million/year) where typical support is an estimated 700 ROV days/year. The utilization analysis indicates a major use in ''eyeball'' vehicles for diver monitoring, and a large percentage for pipeline survey with only a limited amount on structural work and other special applications. The ''Bondi initiative'' in the late 1970s was intended to remove the diver from the water by ROV replacement, but due to lack of development, the capability in many areas has not evolved.

  12. Cost effectiveness of recycling: A systems model

    SciTech Connect

    Tonjes, David J.; Mallikarjun, Sreekanth

    2013-11-15

    Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.

  13. Cost-effectiveness of Antivenoms for Snakebite Envenoming in Nigeria

    PubMed Central

    Habib, Abdulrazaq G.; Lamorde, Mohammed; Dalhat, Mahmood M.; Habib, Zaiyad G.; Kuznik, Andreas

    2015-01-01

    Background Snakebite envenoming is a major public health problem throughout the rural tropics. Antivenom is effective in reducing mortality and remains the mainstay of therapy. This study aimed to determine the cost-effectiveness of using effective antivenoms for Snakebite envenoming in Nigeria. Methodology Economic analysis was conducted from a public healthcare system perspective. Estimates of model inputs were obtained from the literature. Incremental Cost Effectiveness Ratios (ICERs) were quantified as deaths and Disability-Adjusted-Life-Years (DALY) averted from antivenom therapy. A decision analytic model was developed and analyzed with the following model base-case parameter estimates: type of snakes causing bites, antivenom effectiveness to prevent death, untreated mortality, risk of Early Adverse Reactions (EAR), mortality risk from EAR, mean age at bite and remaining life expectancy, and disability risk (amputation). End-user costs applied included: costs of diagnosing and monitoring envenoming, antivenom drug cost, supportive care, shipping/freezing antivenom, transportation to-and-from hospital and feeding costs while on admission, management of antivenom EAR and free alternative snakebite care for ineffective antivenom. Principal Findings We calculated a cost/death averted of ($2330.16) and cost/DALY averted of $99.61 discounted and $56.88 undiscounted. Varying antivenom effectiveness through the 95% confidence interval from 55% to 86% yield a cost/DALY averted of $137.02 to $86.61 respectively. Similarly, varying the prevalence of envenoming caused by carpet viper from 0% to 96% yield a cost/DALY averted of $254.18 to $78.25 respectively. More effective antivenoms and carpet viper envenoming rather than non-carpet viper envenoming were associated with lower cost/DALY averted. Conclusions/Significance Treatment of snakebite envenoming in Nigeria is cost-effective with a cost/death averted of $2330.16 and cost/DALY averted of $99.61 discounted, lower

  14. Cost Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    SciTech Connect

    Fairey, Philip

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous United States. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  15. Microbial Peptidyl-Prolyl cis/trans Isomerases (PPIases): Virulence Factors and Potential Alternative Drug Targets

    PubMed Central

    2014-01-01

    SUMMARY Initially discovered in the context of immunomodulation, peptidyl-prolyl cis/trans isomerases (PPIases) were soon identified as enzymes catalyzing the rate-limiting protein folding step at peptidyl bonds preceding proline residues. Intense searches revealed that PPIases are a superfamily of proteins consisting of three structurally distinguishable families with representatives in every described species of prokaryote and eukaryote and, recently, even in some giant viruses. Despite the clear-cut enzymatic activity and ubiquitous distribution of PPIases, reports on solely PPIase-dependent biological roles remain scarce. Nevertheless, they have been found to be involved in a plethora of biological processes, such as gene expression, signal transduction, protein secretion, development, and tissue regeneration, underscoring their general importance. Hence, it is not surprising that PPIases have also been identified as virulence-associated proteins. The extent of contribution to virulence is highly variable and dependent on the pleiotropic roles of a single PPIase in the respective pathogen. The main objective of this review is to discuss this variety in virulence-related bacterial and protozoan PPIases as well as the involvement of host PPIases in infectious processes. Moreover, a special focus is given to Legionella pneumophila macrophage infectivity potentiator (Mip) and Mip-like PPIases of other pathogens, as the best-characterized virulence-related representatives of this family. Finally, the potential of PPIases as alternative drug targets and first tangible results are highlighted. PMID:25184565

  16. Chlorella zofingiensis as an Alternative Microalgal Producer of Astaxanthin: Biology and Industrial Potential

    PubMed Central

    Liu, Jin; Sun, Zheng; Gerken, Henri; Liu, Zheng; Jiang, Yue; Chen, Feng

    2014-01-01

    Astaxanthin (3,3′-dihydroxy-β,β-carotene-4,4′-dione), a high-value ketocarotenoid with a broad range of applications in food, feed, nutraceutical, and pharmaceutical industries, has been gaining great attention from science and the public in recent years. The green microalgae Haematococcus pluvialis and Chlorella zofingiensis represent the most promising producers of natural astaxanthin. Although H. pluvialis possesses the highest intracellular astaxanthin content and is now believed to be a good producer of astaxanthin, it has intrinsic shortcomings such as slow growth rate, low biomass yield, and a high light requirement. In contrast, C. zofingiensis grows fast phototrophically, heterotrophically and mixtrophically, is easy to be cultured and scaled up both indoors and outdoors, and can achieve ultrahigh cell densities. These robust biotechnological traits provide C. zofingiensis with high potential to be a better organism than H. pluvialis for mass astaxanthin production. This review aims to provide an overview of the biology and industrial potential of C. zofingiensis as an alternative astaxanthin producer. The path forward for further expansion of the astaxanthin production from C. zofingiensis with respect to both challenges and opportunities is also discussed. PMID:24918452

  17. Alternative future analysis for assessing the potential impact of climate change on urban landscape dynamics.

    PubMed

    He, Chunyang; Zhao, Yuanyuan; Huang, Qingxu; Zhang, Qiaofeng; Zhang, Da

    2015-11-01

    Assessing the impact of climate change on urban landscape dynamics (ULD) is the foundation for adapting to climate change and maintaining urban landscape sustainability. This paper demonstrates an alternative future analysis by coupling a system dynamics (SD) and a cellular automata (CA) model. The potential impact of different climate change scenarios on ULD from 2009 to 2030 was simulated and evaluated in the Beijing-Tianjin-Tangshan megalopolis cluster area (BTT-MCA). The results suggested that the integrated model, which combines the advantages of the SD and CA model, has the strengths of spatial quantification and flexibility. Meanwhile, the results showed that the influence of climate change would become more severe over time. In 2030, the potential urban area affected by climate change will be 343.60-1260.66 km(2) (5.55 -20.37 % of the total urban area, projected by the no-climate-change-effect scenario). Therefore, the effects of climate change should not be neglected when designing and managing urban landscape. PMID:26057724

  18. Chlorella zofingiensis as an alternative microalgal producer of astaxanthin: biology and industrial potential.

    PubMed

    Liu, Jin; Sun, Zheng; Gerken, Henri; Liu, Zheng; Jiang, Yue; Chen, Feng

    2014-06-01

    Astaxanthin (3,3'-dihydroxy-β,β-carotene-4,4'-dione), a high-value ketocarotenoid with a broad range of applications in food, feed, nutraceutical, and pharmaceutical industries, has been gaining great attention from science and the public in recent years. The green microalgae Haematococcus pluvialis and Chlorella zofingiensis represent the most promising producers of natural astaxanthin. Although H. pluvialis possesses the highest intracellular astaxanthin content and is now believed to be a good producer of astaxanthin, it has intrinsic shortcomings such as slow growth rate, low biomass yield, and a high light requirement. In contrast, C. zofingiensis grows fast phototrophically, heterotrophically and mixtrophically, is easy to be cultured and scaled up both indoors and outdoors, and can achieve ultrahigh cell densities. These robust biotechnological traits provide C. zofingiensis with high potential to be a better organism than H. pluvialis for mass astaxanthin production. This review aims to provide an overview of the biology and industrial potential of C. zofingiensis as an alternative astaxanthin producer. The path forward for further expansion of the astaxanthin production from C. zofingiensis with respect to both challenges and opportunities is also discussed. PMID:24918452

  19. [The health economics of attention deficit hyperactivity disorder in Germany. Part 2: Therapeutic options and their cost-effectiveness].

    PubMed

    Schlander, M; Trott, G-E; Schwarz, O

    2010-03-01

    Attention deficit hyperactivity disorder (ADHD) has been associated with a continuous increase of health care utilization and thus expenditures. This raises the issue of cost-effectiveness of health care provided for patients with ADHD. Comparative health economic evaluations generate relevant insights and typically report incremental cost-effectiveness ratios (ICERs) of alternatives versus an established standard. Typically, results of cost-effectiveness analyses (CEAs) are reported in terms of incremental cost-effectiveness ratios (ICERs). International evaluations, as well specific adaptations to Germany, indicate an acceptable to attractive cost-effectiveness--according to currently used international benchmarks--of an intense medication management strategy based on stimulants, primarily methylphenidate, with ICERs ranging from 20,000 EUR to 37,000 EUR per quality-adjusted life year (QALY) gained. Economic modeling studies also suggest cost-effectiveness of long-acting modified-release preparations of methylphenidate, owing to improved treatment compliance associated with simplified once daily administration schemes. Atomoxetine, in contrast, appears economically inferior compared to long-acting stimulants, given its higher acquisition costs and at best equal clinical effectiveness. There are currently no data supporting the cost-effectiveness of psychotherapeutic or behavioral interventions. Economic evaluations, which have been published to date, are generally limited by time horizons of up to 1 year and by their prevailing focus on ADHD core symptom improvement only. Therefore, further research into the cost-effectiveness of ADHD treatment strategies seems warranted. PMID:19936695

  20. Cost-Effectiveness in Individual Development Accounts

    ERIC Educational Resources Information Center

    Schreiner, Mark; Ng, Guat Tin; Sherraden, Michael

    2006-01-01

    Because resources are limited, the benefits and costs of social-work interventions--like all interventions--must be compared with the benefits and costs of alternatives. Evidence-based practice should ask, What works? How well does it work? And what does it cost? This article analyzes the provision of Individual Development Accounts (IDAs) with a…

  1. Assessing Zambia's industrial fortification options: getting beyond changes in prevalence and cost-effectiveness.

    PubMed

    Fiedler, John L; Lividini, Keith; Kabaghe, Gladys; Zulu, Rodah; Tehinse, John; Bermudez, Odilia I; Jallier, Vincent; Guyondet, Christophe

    2013-12-01

    Background. Since fortification of sugar with vitamin A was mandated in 1998, Zambia's fortification program has not changed, while the country remains plagued by high rates ofmicronutrient deficiencies. Objective. To provide evidence-based fortification options with the hope of reinvigorating the Zambian fortification program. Methods. Zambia's 2006 Living Conditions Monitoring Survey is used to estimate the apparent intakes of vitamin A, iron, and zinc, as well as the apparent consumption levels and coverage of four fortification vehicles. Fourteen alternativefoodfortification portfolios are modeled, and their costs, impacts, average cost-effectiveness, and incremental cost-effectiveness are calculated using three alternative impact measures. Results. Alternative impact measures result in different rank orderings of the portfolios. The most cost-effective portfolio is vegetable oil, which has a cost per disability-adjusted life-year (DALY) saved ranging from 12% to 25% of that of sugar, depending on the impact measure used. The public health impact of fortified vegetable oil, however, is relatively modest. Additional criteria beyond cost-effectiveness are introduced and used to rank order the portfolios. The size of the public health impact, the total cost, and the incremental cost-effectiveness of phasing in multiple vehicle portfolios over time are analyzed. Conclusions. Assessing fortification portfolios by measuring changes in the prevalence of inadequate intakes underestimates impact. A more sensitive measure, which also takes into account change in the Estimated Average Requirement (EAR) gap, is provided by a dose-response-based approach to estimating the number ofDALYs saved. There exist highly cost-effective fortification intervention portfolios with substantial public health impacts and variable price tags that could help improve Zambians' nutrition status. PMID:24605698

  2. Over-Reporting in Handwashing Self-Reports: Potential Explanatory Factors and Alternative Measurements

    PubMed Central

    Contzen, Nadja; De Pasquale, Sandra; Mosler, Hans-Joachim

    2015-01-01

    Handwashing interventions are a priority in development and emergency aid programs. Evaluation of these interventions is essential to assess the effectiveness of programs; however, measuring handwashing is quite difficult. Although observations are considered valid, they are time-consuming and cost-ineffective; self-reports are highly efficient but considered invalid because desirable behaviour tends to be over-reported. Socially desirable responding has been claimed to be the main cause of inflated self-reports, but its underlying factors and mechanisms are understudied. The present study investigated socially desirable responding and additional potential explanatory factors for over-reported handwashing to identify indications for measures which mitigate over-reporting. Additionally, a script-based covert recall, an alternative interview question intended to mitigate recall errors and socially desirable responding, was developed and tested. Cross-sectional data collection was conducted in the Borena Zone, Ethiopia, through 2.5-hour observations and 1-hour interviews with the primary caregivers in households. A total sample of N = 554 was surveyed. Data were analysed with correlation and multiple regression analyses and dependent t-tests. Over-reporting of handwashing was associated with factors assumed to be involved in (1) socially desirable responding, (2) encoding and recall of information, and (3) dissonance processes. The latter two factor groups explained over-reported handwashing beyond socially desirable responding. The alternative interview question—script-based covert recall—reduced over-reporting compared to conventional self-reports. Although the difficulties involved in measuring handwashing by self-reports and observations are widely known, the present study is the first to investigate the factors which explain over-reporting of handwashing. This research contributes to the limited evidence base on a highly important subject: how to evaluate

  3. Plant oils as feedstock alternatives to petroleum - A short survey of potential oil crop platforms.

    PubMed

    Carlsson, Anders S

    2009-06-01

    Our society is highly depending on petroleum for its activities. About 90% is used as an energy source for transportation and for generation of heat and electricity and the remaining as feedstocks in the chemical industry. However, petroleum is a finite source as well as causing several environmental problems such as rising carbon dioxide levels in the atmosphere. Petroleum therefore needs to be replaced by alternative and sustainable sources. Plant oils and oleochemicals derived from them represent such alternative sources, which can deliver a substantial part of what is needed to replace the petroleum used as feedstocks. Plant derived feedstock oils can be provided by two types of oil qualities, multi-purpose and technical oils. Multi-purpose oils represent oil qualities that contain common fatty acids and that can be used for both food and feedstock applications. Technical oil qualities contain unusual fatty acids with special properties gained from their unique molecular structure and these types of oils should only be used for feedstock applications. As a risk mitigation strategy in the selection of crops, technical oil qualities should therefore preferably be produced by oil crop platforms dedicated for industrial usage. This review presents a short survey of oil crop platforms to be considered for either multi-purpose or technical oils production. Included among the former platforms are some of the major oil crops in cultivation such as oil palm, soybean and rapeseed. Among the later are those that could be developed into dedicated industrial platforms such as crambe, flax, cotton and Brassica carinata. The survey finishes off by highlighting the potential of substantial increase in plant oil production by developing metabolic flux platforms, which are starch crops converted into oil crops. PMID:19375482

  4. The cost effectiveness of levalbuterol versus racemic albuterol.

    PubMed

    Quinn, Campion

    2004-07-01

    Albuterol is a selective beta2-agonist that is widely used in the prevention and treatment of reactive airway disease. It is formulated as a racemic mixture containing equal parts of the R- and S-isomers. The therapeutic activity of albuterol is due entirely to the R-isomer, whereas the S-isomer may actually have detrimental effects. Because the slowly metabolized S-isomer tends to accumulate in the body, there has been concern that chronic use of racemic albuterol might lead to loss of effectiveness and clinical deterioration, with potentially serious health and cost consequences. Levalbuterol is a formulation containing only the R-isomer of albuterol, and clinical trials have demonstrated that it offers therapeutic advantages over racemic albuterol. The cost effectiveness of levalbuterol derives mainly from reduced need for acute medical care and hospitalization. PMID:15354680

  5. Methods of cost-effectiveness analysis in the evaluation of new antipsychotics: implications for schizophrenia treatment.

    PubMed

    Neumann, P J

    1999-01-01

    Because health care payers are increasingly interested in learning whether new treatments offer value for money, there has been an abundance of research into the cost-effectiveness of pharmacologic therapies in the United States. In the past few years, a number of studies comparing the cost-effectiveness of the conventional neuroleptics with that of the atypical antipsychotics have been published. Cost-effectiveness analyses show the relationship between the resources used (costs) and the health benefits achieved (effects) for a health or medical intervention compared with an alternative strategy. Ideally, the analyses can help decision makers improve the health of the population by better allocating society's limited health care resources. However, the extent to which cost-effectiveness data are actually used in decision making is unclear. The analyses are sometimes viewed with skepticism, in part because studies differ in their methodological approaches. Recently, the U.S. Panel on Cost-Effectiveness in Health and Medicine offered recommendations for standard methodological practices, which may help improve the quality of studies and the acceptability of the approach in the future. The issue is particularly important in light of new legislation governing how the Food and Drug Administration will regulate promotional claims made by drug companies regarding health economic information. PMID:10073371

  6. Cost effectiveness of therapies for atrial fibrillation. A review.

    PubMed

    Teng, M P; Catherwood, L E; Melby, D P

    2000-10-01

    Atrial fibrillation is the most common supraventricular tachyarrhythmia encountered in clinical practice, affecting over 5% of persons over the age of 65 years. A common pathophysiological mechanism for arrhythmia development is atrial distention and fibrosis induced by hypertension, coronary artery disease or ventricular dysfunction. Less frequently, atrial fibrillation is caused by mitral stenosis or other provocative factors such as thyrotoxicosis, pericarditis or alcohol intoxication. Depending on the extent of associated cardiovascular disease, atrial fibrillation may produce haemodynamic compromise, or symptoms such as palpitations, fatigue, chest pain or dyspnoea. Arrhythmia-induced atrial stasis can precipitate clot formation and the potential for subsequent thromboembolism. Comprehensive management of atrial fibrillation requires a multifaceted approach directed at controlling symptoms, protecting the patient from ischaemic stroke or peripheral embolism and possible conversion to or maintenance of sinus rhythm. Numerous randomised trials have demonstrated the efficacy of warfarin--and less so aspirin (acetylsalicylic acid)--in reducing the risk of embolic events. Furthermore, therapeutic strategies exist that can favourably modify symptoms by restoring and maintaining sinus rhythm with cardioversion and antiarrhythmic prophylaxis. However, the risks and benefits of various treatments is highly dependent on patient-specific features, emphasising the need for an individualised approach. This article reviews the findings of cost-effectiveness studies published over the past decade that have evaluated different components of treatment strategies for atrial fibrillation. These studies demonstrate the economic attractiveness of acute management options, long term warfarin prophylaxis, telemetry-guided initiation of antiarrhythmic therapy, approaches to restore and maintain sinus rhythm, and the potential role of transoesophageal echocardiographic screening for

  7. How to develop renewable power in China? A cost-effective perspective.

    PubMed

    Cong, Rong-Gang; Shen, Shaochuan

    2014-01-01

    To address the problems of climate change and energy security, Chinese government strived to develop renewable power as an important alternative of conventional electricity. In this paper, the learning curve model is employed to describe the decreasing unit investment cost due to accumulated installed capacity; the technology diffusion model is used to analyze the potential of renewable power. Combined with the investment cost, the technology potential, and scenario analysis of China social development in the future, we develop the Renewable Power Optimization Model (RPOM) to analyze the optimal development paths of three sources of renewable power from 2009 to 2020 in a cost-effective way. Results show that (1) the optimal accumulated installed capacities of wind power, solar power, and biomass power will reach 169000, 20000, and 30000 MW in 2020; (2) the developments of renewable power show the intermittent feature; (3) the unit investment costs of wind power, solar power, and biomass power will be 4500, 11500, and 5700 Yuan/KW in 2020; (4) the discounting effect dominates the learning curve effect for solar and biomass powers; (5) the rise of on-grid ratio of renewable power will first promote the development of wind power and then solar power and biomass power. PMID:24578672

  8. How to Develop Renewable Power in China? A Cost-Effective Perspective

    PubMed Central

    2014-01-01

    To address the problems of climate change and energy security, Chinese government strived to develop renewable power as an important alternative of conventional electricity. In this paper, the learning curve model is employed to describe the decreasing unit investment cost due to accumulated installed capacity; the technology diffusion model is used to analyze the potential of renewable power. Combined with the investment cost, the technology potential, and scenario analysis of China social development in the future, we develop the Renewable Power Optimization Model (RPOM) to analyze the optimal development paths of three sources of renewable power from 2009 to 2020 in a cost-effective way. Results show that (1) the optimal accumulated installed capacities of wind power, solar power, and biomass power will reach 169000, 20000, and 30000 MW in 2020; (2) the developments of renewable power show the intermittent feature; (3) the unit investment costs of wind power, solar power, and biomass power will be 4500, 11500, and 5700 Yuan/KW in 2020; (4) the discounting effect dominates the learning curve effect for solar and biomass powers; (5) the rise of on-grid ratio of renewable power will first promote the development of wind power and then solar power and biomass power. PMID:24578672

  9. Evaluation of the odour reduction potential of alternative cover materials at a commercial landfill.

    PubMed

    Solan, P J; Dodd, V A; Curran, T P

    2010-02-01

    The availability of virgin soils and traditional landfill covers are not only costly and increasingly becoming scarce, but they also reduce the storage capacity of landfill. The problem can be overcome by the utilisation of certain suitable waste streams as alternative landfill covers. The objective of this study was to assess the suitability of Construction & Demolition fines (C&D), Commercial & Industrial fines (C&I) and woodchip (WC) as potential landfill cover materials in terms of odour control. Background odour analysis was conducted to determine if any residual odour was emitted from the cover types. It was deemed negligible for the three materials. The odour reduction performance of each of the materials was also examined on an area of an active landfill site. A range of intermediate cover compositions were also studied to assess their performance. Odour emissions were sampled using a Jiang hood and analysed. Results indicate that the 200 mm deep combination layer of C&D and wood chip used on-site is adequate for odour abatement. The application of daily cover was found to result in effective reduction allowing for the background odour of woodchip. PMID:19786346

  10. Therapeutic potential of choline magnesium trisalicylate as an alternative to aspirin for patients with bleeding tendencies.

    PubMed

    Danesh, B J; Saniabadi, A R; Russell, R I; Lowe, G D

    1987-12-01

    We have compared the effects of acetyl salicylic acid (ASA, aspirin) and choline magnesium trisalicylate (CMT), a non-acetylated salicylate product, on platelet aggregation in human whole blood ex-vivo. Using a whole blood platelet counter, platelet aggregation was quantified by measuring the fall in the number of single platelets at peak aggregation in response to collagen, arachidonic acid (AA), as well as spontaneous aggregation. In double blind and random order, 12 healthy volunteers received, on two separate occasions 10 days apart, a single oral dose of 652 mg ASA or 655 mg CMT. Despite a comparable absorption of salicylic acid from the two drugs, ingestion of ASA resulted in a marked inhibition of platelet aggregation induced by collagen (p less than 0.005), AA (p less than 0.01) and spontaneous aggregation (p less than 0.01), whereas such effects were not observed after CMT ingestion. We suggest that CMT may have therapeutic potential as an alternative to aspirin when inhibition of platelet aggregation can induce bleeding complications. PMID:3329766

  11. Oleoylethanolamide: A Novel Potential Pharmacological Alternative to Cannabinoid Antagonists for the Control of Appetite

    PubMed Central

    Romano, Adele; Coccurello, Roberto; Giacovazzo, Giacomo; Bedse, Gaurav; Moles, Anna; Gaetani, Silvana

    2014-01-01

    The initial pharmaceutical interest for the endocannabinoid system as a target for antiobesity therapies has been restricted by the severe adverse effects of the CB1 antagonist rimonabant. This study points at oleoylethanolamide (OEA), a monounsaturated analogue, and functional antagonist of anandamide, as a potential and safer antiobesity alternative to CB1 antagonism. Mice treated with equal doses (5 or 10 mg/kg, i.p.) of OEA or rimonabant were analyzed for the progressive expression of spontaneous behaviors (eating, grooming, rearing, locomotion, and resting) occurring during the development of satiety, according to the paradigm called behavioral satiety sequence (BSS). Both drugs reduced food (wet mash) intake to a similar extent. OEA treatment decreased eating activity within the first 30 min and caused a temporary increase of resting time that was not accompanied by any decline of horizontal, vertical and total motor activity. Besides decreasing eating activity, rimonabant caused a marked increase of the time spent grooming and decreased horizontal motor activity, alterations that might be indicative of aversive nonmotivational effects on feeding. These results support the idea that OEA suppresses appetite by stimulating satiety and that its profile of action might be predictive of safer effects in humans as a novel antiobesity treatment. PMID:24800213

  12. The Potential of the Internet for Alternative Caring Practices for Health

    PubMed Central

    Atkinson, Sarah; Ayers, Andrew

    2013-01-01

    The practices of health care in late modernity are informed by competing visions of the ideal human and the nature of care. Western societies typically characterise the ideal human as independent and self-reliant. The resultant welfare systems provide temporary havens away from the everyday, competitive spaces of capitalist societies, termed here the enclave model. Social scientists problematise this model on several grounds: the construction of pathologised and medicalised body forms; the neglect of caring practices that are gendered, invisible and primarily private; the de-politicisation of caring practices. Policy calls reject reference to care and its associations with dependency, make visible and value informal care work or invoke a caring citizenship as a policy goal not just a means. Into this field of contested notions of care enters a well-documented rise in access to, and consultation through, the internet in everyday lives for a vast range of issues. Health care encountered on-line reflects a similar range in form as that encountered off-line and much that is innovative, whilst clearly of benefit, does nothing to challenge the existing dominance of the enclave model of social care. However, certain groups of sites create spaces through which participants can both express and extract caring relationships that are otherwise unforthcoming. The paper argues that these sites afford potential to develop an alternative model of caring, to reframe questions of how to care about distant others and to demonstrate the centrality of caring relations to human life. PMID:20419518

  13. Oleoylethanolamide: a novel potential pharmacological alternative to cannabinoid antagonists for the control of appetite.

    PubMed

    Romano, Adele; Coccurello, Roberto; Giacovazzo, Giacomo; Bedse, Gaurav; Moles, Anna; Gaetani, Silvana

    2014-01-01

    The initial pharmaceutical interest for the endocannabinoid system as a target for antiobesity therapies has been restricted by the severe adverse effects of the CB1 antagonist rimonabant. This study points at oleoylethanolamide (OEA), a monounsaturated analogue, and functional antagonist of anandamide, as a potential and safer antiobesity alternative to CB1 antagonism. Mice treated with equal doses (5 or 10 mg/kg, i.p.) of OEA or rimonabant were analyzed for the progressive expression of spontaneous behaviors (eating, grooming, rearing, locomotion, and resting) occurring during the development of satiety, according to the paradigm called behavioral satiety sequence (BSS). Both drugs reduced food (wet mash) intake to a similar extent. OEA treatment decreased eating activity within the first 30 min and caused a temporary increase of resting time that was not accompanied by any decline of horizontal, vertical and total motor activity. Besides decreasing eating activity, rimonabant caused a marked increase of the time spent grooming and decreased horizontal motor activity, alterations that might be indicative of aversive nonmotivational effects on feeding. These results support the idea that OEA suppresses appetite by stimulating satiety and that its profile of action might be predictive of safer effects in humans as a novel antiobesity treatment. PMID:24800213

  14. Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation

    PubMed Central

    Dorian, Paul; Kongnakorn, Thitima; Phatak, Hemant; Rublee, Dale A.; Kuznik, Andreas; Lanitis, Tereza; Liu, Larry Z.; Iloeje, Uchenna; Hernandez, Luis; Lip, Gregory Y.H.

    2014-01-01

    Aims Warfarin, a vitamin K antagonist (VKA), has been the standard of care for stroke prevention in patients with atrial fibrillation (AF). Aspirin is recommended for low-risk patients and those unsuitable for warfarin. Apixaban is an oral anticoagulant that has demonstrated better efficacy than warfarin and aspirin in the ARISTOTLE and AVERROES studies, respectively, and causes less bleeding than warfarin. We evaluated the potential cost-effectiveness of apixaban against warfarin and aspirin from the perspective of the UK payer perspective. Results and methods A lifetime Markov model was developed to evaluate the pharmacoeconomic impact of apixaban compared with warfarin and aspirin in VKA suitable and VKA unsuitable patients, respectively. Clinical events considered in the model include ischaemic stroke, haemorrhagic stroke, intracranial haemorrhage, other major bleed, clinically relevant non-major bleed, myocardial infarction, cardiovascular hospitalization and treatment discontinuations; data from the ARISTOTLE and AVERROES trials and published mortality rates and event-related utility rates were used in the model. Apixaban was projected to increase life expectancy and quality-adjusted life years (QALYs) compared with warfarin and aspirin. These gains were expected to be achieved at a drug acquisition-related cost increase over lifetime. The estimated incremental cost-effectiveness ratio was £11 909 and £7196 per QALY gained with apixaban compared with warfarin and aspirin, respectively. Sensitivity analyses indicated that results were robust to a wide range of inputs. Conclusions Based on randomized trial data, apixaban is a cost-effective alternative to warfarin and aspirin, in VKA suitable and VKA unsuitable patients with AF, respectively. PMID:24513791

  15. Release of Lungworm Larvae from Snails in the Environment: Potential for Alternative Transmission Pathways

    PubMed Central

    Giannelli, Alessio; Colella, Vito; Abramo, Francesca; do Nascimento Ramos, Rafael Antonio; Falsone, Luigi; Brianti, Emanuele; Varcasia, Antonio; Dantas-Torres, Filipe; Knaus, Martin; Fox, Mark T.; Otranto, Domenico

    2015-01-01

    Background Gastropod-borne parasites may cause debilitating clinical conditions in animals and humans following the consumption of infected intermediate or paratenic hosts. However, the ingestion of fresh vegetables contaminated by snail mucus and/or water has also been proposed as a source of the infection for some zoonotic metastrongyloids (e.g., Angiostrongylus cantonensis). In the meantime, the feline lungworms Aelurostrongylus abstrusus and Troglostrongylus brevior are increasingly spreading among cat populations, along with their gastropod intermediate hosts. The aim of this study was to assess the potential of alternative transmission pathways for A. abstrusus and T. brevior L3 via the mucus of infected Helix aspersa snails and the water where gastropods died. In addition, the histological examination of snail specimens provided information on the larval localization and inflammatory reactions in the intermediate host. Methodology/Principal Findings Twenty-four specimens of H. aspersa received ~500 L1 of A. abstrusus and T. brevior, and were assigned to six study groups. Snails were subjected to different mechanical and chemical stimuli throughout 20 days in order to elicit the production of mucus. At the end of the study, gastropods were submerged in tap water and the sediment was observed for lungworm larvae for three consecutive days. Finally, snails were artificially digested and recovered larvae were counted and morphologically and molecularly identified. The anatomical localization of A. abstrusus and T. brevior larvae within snail tissues was investigated by histology. L3 were detected in the snail mucus (i.e., 37 A. abstrusus and 19 T. brevior) and in the sediment of submerged specimens (172 A. abstrusus and 39 T. brevior). Following the artificial digestion of H. aspersa snails, a mean number of 127.8 A. abstrusus and 60.3 T. brevior larvae were recovered. The number of snail sections positive for A. abstrusus was higher than those for T. brevior

  16. Cost effectiveness of pharmacogenomics: a critical and systematic review.

    PubMed

    Wong, William B; Carlson, Josh J; Thariani, Rahber; Veenstra, David L

    2010-01-01

    The use of pharmacogenetic testing in clinical practice is limited thus far. A potential barrier to the widespread implementation of pharmacogenetic testing is the lack of evidence on whether testing provides good value for money. The objective of this review was to provide a systematic and critical review of economic evaluations of pharmacogenetic testing. A literature search using publically available databases was performed for articles published up to October 2009. To be included, studies had to meet the definition of being a pharmacogenomic study (defined as use of information on human genetic variation to target drug therapy) and an economic evaluation (defined as an evaluation of both costs and clinical outcomes). Articles that met these criteria were subsequently reviewed and graded using the Quality of Health Economic Studies (QHES) instrument. Lastly, the evidence for biomarker validity and utility were qualitatively assessed using expert opinion. A total of 34 articles were identified using our defined criteria. The most common disease category was thromboembolic-related diseases (26%), while the most common biomarkers were thiopurine methyltransferase and cytochrome P450 2C9 (18% each). Almost all studies were published after 2004 (91%). Two types of studies were identified: cost-effectiveness studies and cost-utility studies, with roughly half of the overall studies being cost-utility studies (53%) and a majority of these published within the last 3 years. The average quality score was 77 (range 29-99). Of the biomarkers reviewed, it was estimated that most had demonstrated clinical validity, but only two had demonstrated clinical utility. Despite a recent increase in the number of economic evaluations of pharmacogenetic applications, further studies examining the clinical validity and utility of these biomarkers are needed to support cost-effectiveness assessments. PMID:20936884

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

    PubMed

    Krull, Cheryl R; Stanley, Margaret C; Burns, Bruce R; Choquenot, David; Etherington, Thomas R

    2016-01-01

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

  18. Reducing Wildlife Damage with Cost-Effective Management Programmes

    PubMed Central

    Krull, Cheryl R.; Stanley, Margaret C.; Burns, Bruce R.; Choquenot, David; Etherington, Thomas R.

    2016-01-01

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

  19. Cost effective ER data acquisition using a dynamic characterization strategy

    SciTech Connect

    Skinner, Kenneth M.; Salpas, Peter A.

    2007-07-01

    The important first step in remediating contaminated sites is completing characterization. The process for characterization of natural environmental media (i.e., soil, sediment, surface water, groundwater) involves three basic steps: (1) develop a plan, (2) implement the plan by collecting information necessary to define the nature and extent of contaminants in the natural media, and (3) integrate, interpret and report the results. Because of budgetary constraints, these three steps are typically applied linearly with the expectation that by the end of one application of the process the site will be characterized with sufficient resolution to make decisions about remedial actions. Our experience over the past 13 years at a complex site in Tennessee has shown that this linear approach to characterization does not produce the desired resolution. Because characterization is typically a process of defining unknowns the inflexible nature of the linear approach makes it impractical to react as the conceptual understanding of site contaminants changes in response to the acquisition of new data. An alternative, flexible approach to characterization has been developed based on lessons learned. Over the past 3 years the flexible approach has cost-effectively produced the information needed for decision making. (authors)

  20. Cost effectiveness of the stream-gaging program in Louisiana

    USGS Publications Warehouse

    Herbert, R.A.; Carlson, D.D.

    1985-01-01

    This report documents the results of a study of the cost effectiveness of the stream-gaging program in Louisiana. Data uses and funding sources were identified for the 68 continuous-record stream gages currently (1984) in operation with a budget of $408,700. Three stream gages have uses specific to a short-term study with no need for continued data collection beyond the study. The remaining 65 stations should be maintained in the program for the foreseeable future. In addition to the current operation of continuous-record stations, a number of wells, flood-profile gages, crest-stage gages, and stage stations, are serviced on the continuous-record station routes; thus, increasing the current budget to $423,000. The average standard error of estimate for data collected at the stations is 34.6%. Standard errors computed in this study are one measure of streamflow errors, and can be used as guidelines in comparing the effectiveness of alternative networks. By using the routes and number of measurements prescribed by the ' Traveling Hydrographer Program, ' the standard error could be reduced to 31.5% with the current budget of $423,000. If the gaging resources are redistributed, the 34.6% overall level of accuracy at the 68 continuous-record sites and the servicing of the additional wells or gages could be maintained with a budget of approximately $410,000. (USGS)

  1. Chapter 15: Public health policy and cost-effectiveness analysis.

    PubMed

    Goldie, Sue J

    2003-01-01

    Recent scientific advances are providing an opportunity to revisit strategies for cervical cancer prevention. How to invest health resources wisely, such that public health benefits are maximized-and opportunity costs are minimized-is a critical question in the setting of enhanced cytologic screening methods, human papillomavirus DNA testing, and vaccine development. Developing sound clinical guidelines and public health policy will require careful consideration of the incremental benefits, harms, and costs associated with new interventions compared with existing interventions, at both an individual and a population level. In addition to an intervention's effectiveness, public health decision making requires the consideration of its feasibility, sustainability, and affordability. No clinical trial or single cohort study will be able to simultaneously consider all of these components. Cost-effectiveness analysis and disease-simulation modeling, capitalizing on data from multiple sources, can serve as a valuable tool to extend the time horizon of clinical trials, to evaluate more strategies than possible in a single clinical trial, and to assess the relative costs and benefits of alternative policies to reduce mortality from cervical cancer. PMID:12807953

  2. Cost-Effective Hyperspectral Transmissometers for Oceanographic Applications: Performance Analysis

    PubMed Central

    Ramírez-Pérez, Marta; Röttgers, Rüdiger; Torrecilla, Elena; Piera, Jaume

    2015-01-01

    The recent development of inexpensive, compact hyperspectral transmissometers broadens the research capabilities of oceanographic applications. These developments have been achieved by incorporating technologies such as micro-spectrometers as detectors as well as light emitting diodes (LEDs) as light sources. In this study, we evaluate the performance of the new commercial LED-based hyperspectral transmissometer VIPER (TriOS GmbH, Rastede, Germany), which combines different LEDs to emulate the visible light spectrum, aiming at the determination of attenuation coefficients in coastal environments. For this purpose, experimental uncertainties related to the instrument stability, the effect of ambient light and derived temperature, and salinity correction factors are analyzed. Our results identify some issues related to the thermal management of the LEDs and the contamination of ambient light. Furthermore, the performance of VIPER is validated against other transmissometers through simultaneous field measurements. It is demonstrated that VIPER provides a compact and cost-effective alternative for beam attenuation measurements in coastal waters, but it requires the consideration of several optimizations. PMID:26343652

  3. Metronomic Chemotherapy in Anaplastic Thyroid Carcinoma: A Potentially Feasible Alternative to Therapeutic Nihilism

    PubMed Central

    Revannasiddaiah, Swaroop; Madabhavi, Irappa; Bodh, Anita; Thakur, Priyanka; Sharma, Mukesh

    2015-01-01

    Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT), and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC. PMID:26009682

  4. Metronomic chemotherapy in anaplastic thyroid carcinoma: a potentially feasible alternative to therapeutic nihilism.

    PubMed

    Revannasiddaiah, Swaroop; Madabhavi, Irappa; Bodh, Anita; Thakur, Priyanka; Sharma, Mukesh

    2015-01-01

    Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT), and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC. PMID:26009682

  5. The Cost Effectiveness of 22 Approaches for Raising Student Achievement

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2010-01-01

    Review of cost-effectiveness studies suggests that rapid assessment is more cost effective with regard to student achievement than comprehensive school reform (CSR), cross-age tutoring, computer-assisted instruction, a longer school day, increases in teacher education, teacher experience or teacher salaries, summer school, more rigorous math…

  6. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... found cost effective for a State transportation department or county to undertake a federally financed... 23 Highways 1 2010-04-01 2010-04-01 false Finding of cost effectiveness. 635.205 Section 635.205 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC...

  7. 49 CFR 639.21 - Determination of cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21 Section 639.21 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of...

  8. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Finding of cost effectiveness. 635.205 Section 635.205 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may...

  9. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., the State must assess cost-effectiveness on a case-by-case basis. (d) Reports on family coverage. A State with a waiver under this section must include in its annual report pursuant to § 457.750, the cost... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this...

  10. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Presuming cost-effectiveness results. 436.13 Section 436.13 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for...

  11. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Presuming cost-effectiveness results. 436.13 Section 436.13 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for...

  12. Cost Effectiveness for Gifted and Talented Educational Programs.

    ERIC Educational Resources Information Center

    Storms, Walt W.

    Presented is a systematic approach for analyzing cost effectiveness of gifted and talented educational programs in terms of categorizing funds, prorating expenditures, designing a data collection form, determining cost effectiveness, and considering multiple variable implications. All costs are reported to be subsumed under six major categories:…

  13. The Social Value Of Vaccination Programs: Beyond Cost-Effectiveness.

    PubMed

    Luyten, Jeroen; Beutels, Philippe

    2016-02-01

    In the current global environment of increased strain on health care budgets, all medical interventions have to compete for funding. Cost-effectiveness analysis has become a standard method to use in estimating how much value an intervention offers relative to its costs, and it has become an influential element in decision making. However, the application of cost-effectiveness analysis to vaccination programs fails to capture the full contribution such a program offers to the community. Recent literature has highlighted how cost-effectiveness analysis can neglect the broader economic impact of vaccines. In this article we also argue that socioethical contributions such as effects on health equity, sustaining the public good of herd immunity, and social integration of minority groups are neglected in cost-effectiveness analysis. Evaluations of vaccination programs require broad and multidimensional perspectives that can account for their social, ethical, and economic impact as well as their cost-effectiveness. PMID:26858372

  14. On the potential for alternative greenhouse gas equivalence metrics to influence sectoral mitigation patterns

    NASA Astrophysics Data System (ADS)

    Brennan, Mark E.; Zaitchik, Benjamin F.

    2013-03-01

    Equivalence metrics used to quantify the relative climate impacts of different atmospheric forcers serve an essential function in policy and economic discussions about global climate change. The 100-year global warming potential (GWP-100), the most established greenhouse gas (GHG) equivalence metric, is used within the Kyoto Protocol, and in most emissions inventory, trading and offset mechanisms, to assign the mitigation value of non-carbon dioxide greenhouse gases relative to carbon dioxide. In recent literature the GWP-100 and alternative metrics have been used to compare various anthropogenic climate forcers with respect to a wide range of environmental and economic goals. Building on this work, we examine how 16 different static and time-varying CO2-equivalence schemes might influence GHG mitigation across sectors and gases in a perfect and fluid global mitigation regime. This mitigation regime is guided by achieving a global mean radiative forcing (RF) of 5.7 Wm-2 in 2100 from 1765 levels through a mitigation policy of prescribed emissions reductions in each decade. It was found that static metrics defined on 20- instead of 100-year time horizons favor mitigation strategies that maximize the abatement of short-lived gases (e.g. methane), on average resulting in an RF from methane in 2100 of 0.5 Wm-2 instead of 1.1 Wm-2 from 100-year metrics. Similarly, metrics that consider integrated rather than end-point climate impacts imply mitigation strategies that maximize mitigation of shorter-lived GHGs, resulting in higher abatement of agriculture and waste emissions. Comparing extreme scenarios, these mitigation shifts across gases and sectors result in a nearly 30% difference in the representation of methane in global cumulative emissions reductions. This shift across gases and sectors to mitigate shorter-lived GHGs, in lieu of longer-lived GHGs like carbon dioxide, has implications for the long-term warming commitment due to 21st century emissions.

  15. Weak Polygyny in California Sea Lions and the Potential for Alternative Mating Tactics

    PubMed Central

    Flatz, Ramona; González-Suárez, Manuela; Young, Julie K.; Hernández-Camacho, Claudia J.; Immel, Aaron J.; Gerber, Leah R.

    2012-01-01

    Female aggregation and male territoriality are considered to be hallmarks of polygynous mating systems. The development of genetic parentage assignment has called into question the accuracy of behavioral traits in predicting true mating systems. In this study we use 14 microsatellite markers to explore the mating system of one of the most behaviorally polygynous species, the California sea lion (Zalophus californianus). We sampled a total of 158 female-pup pairs and 99 territorial males across two breeding rookeries (San Jorge and Los Islotes) in the Gulf of California, Mexico. Fathers could be identified for 30% of pups sampled at San Jorge across three breeding seasons and 15% of sampled pups at Los Islotes across two breeding seasons. Analysis of paternal relatedness between the pups for which no fathers were identified (sampled over four breeding seasons at San Jorge and two at Los Islotes) revealed that few pups were likely to share a father. Thirty-one percent of the sampled males on San Jorge and 15% of the sampled males on Los Islotes were assigned at least one paternity. With one exception, no male was identified as the father of more than two pups. Furthermore, at Los Islotes rookery there were significantly fewer pups assigned paternity than expected given the pool of sampled males (p<0.0001). Overall, we found considerably lower variation in male reproductive success than expected in a species that exhibits behavior associated with strongly polygynous mating. Low variation in male reproductive success may result from heightened mobility among receptive females in the Gulf of California, which reduces the ability of males to monopolize groups of females. Our results raise important questions regarding the adaptive role of territoriality and the potential for alternative mating tactics in this species. PMID:22432039

  16. Cost-Effectiveness of Cetuximab for Advanced Esophageal Squamous Cell Carcinoma

    PubMed Central

    Bruno, Marco J.; Polinder, Suzanne; Lorenzen, Sylvie; Lordick, Florian; Peppelenbosch, Maikel P.; Spaander, Manon C. W.

    2016-01-01

    Background Costly biologicals in palliative oncology are emerging at a rapid pace. For example, in patients with advanced esophageal squamous cell carcinoma addition of cetuximab to a palliative chemotherapy regimen appears to improve survival. However, it simultaneously results in higher costs. We aimed to determine the incremental cost-effectiveness ratio of adding cetuximab to first-line chemotherapeutic treatment of patients with advanced esophageal squamous cell carcinoma, based on data from a randomized controlled phase II trial. Methods A cost effectiveness analysis model was applied based on individual patient data. It included only direct medical costs from the health-care perspective. Quality-adjusted life-years and incremental cost-effectiveness ratios were calculated. Sensitivity analysis was performed by a Monte Carlo analysis. Results Adding cetuximab to a cisplatin-5-fluorouracil first-line regimen for advanced esophageal squamous cell carcinoma resulted in an the incremental cost-effectiveness ratio of €252,203 per quality-adjusted life-year. Sensitivity analysis shows that there is a chance of less than 0.001 that the incremental cost-effectiveness ratio will be less than a maximum willingness to pay threshold of €40,000 per quality-adjusted life-year, which is representative for the threshold used in The Netherlands and other developed countries. Conclusions Addition of cetuximab to a cisplatin-5-fluorouracil first-line regimen for advanced esophageal squamous cell carcinoma is not cost-effective when appraised according to currently accepted criteria. Cost-effectiveness analyses using outcome data from early clinical trials (i.c. a phase II trial) enable pharmaceutical companies and policy makers to gain early insight into whether a new drug meets the current eligibility standards for reimbursement and thereby potential admittance for use in regular clinical practice. PMID:27100871

  17. Potential radiological impacts of upper-bound operational accidents during proposed waste disposal alternatives for Hanford defense waste

    SciTech Connect

    Mishima, J.; Sutter, S.L.; Hawley, K.A.; Jenkins, C.E.; Napier, B.A.

    1986-02-01

    The Geologic Disposal Alternative, the In-Place Stabilization and Disposal Alternative, and the Reference Disposal Alternative are being evaluated for disposal of Hanford defense high-level, transuranic, and tank wastes. Environmental impacts associated with disposal of these wastes according to the alternatives listed above include potential doses to the downwind population from operation during the application of the handling and processing techniques comprising each disposal alternative. Scenarios for operational accident and abnormal operational events are postulated, on the basis of the currently available information, for the application of the techniques employed for each waste class for each disposal alternative. From these scenarios, an upper-bound airborne release of radioactive material was postulated for each waste class and disposal alternative. Potential downwind radiologic impacts were calculated from these upper-bound events. In all three alternatives, the single postulated event with the largest calculated radiologic impact for any waste class is an explosion of a mixture of ferri/ferro cyanide precipitates during the mechanical retrieval or microwave drying of the salt cake in single shell waste tanks. The anticipated downwind dose (70-year dose commitment) to the maximally exposed individual is 3 rem with a total population dose of 7000 man-rem. The same individual would receive 7 rem from natural background radiation during the same time period, and the same population would receive 3,000,000 man-rem. Radiological impacts to the public from all other postulated accidents would be less than that from this accident; furthermore, the radiological impacts resulting from this accident would be less than one-half that from the natural background radiation dose.

  18. Cost-effectiveness of conservation payment schemes for species with different range sizes.

    PubMed

    Drechsler, Martin; Smith, Henrik G; Sturm, Astrid; Wätzold, Frank

    2016-08-01

    Payments to compensate landowners for carrying out costly land-use measures that benefit endangered biodiversity have become an important policy instrument. When designing such payments, it is important to take into account that spatially connected habitats are more valuable for many species than isolated ones. One way to incentivize provision of connected habitats is to offer landowners an agglomeration bonus, that is, a bonus on top of payments they are receiving to conserve land if the land is spatially connected. Researchers have compared the cost-effectiveness of the agglomeration bonus with 2 alternatives: an all-or-nothing, agglomeration payment, where landowners receive a payment only if the conserved land parcels have a certain level of spatial connectivity, and a spatially homogeneous payment, where landowners receive a payment for conserved land parcels irrespective of their location. Their results show the agglomeration bonus is rarely the most cost-effective option, and when it is, it is only slightly better than one of the alternatives. This suggests that the agglomeration bonus should not be given priority as a policy design option. However, this finding is based on consideration of only 1 species. We examined whether the same applied to 2 species, one for which the homogeneous payment is best and the other for which the agglomeration payment is most cost-effective. We modified a published conceptual model so that we were able to assess the cost-effectiveness of payment schemes for 2 species and applied it to a grassland bird and a grassland butterfly in Germany that require the same habitat but have different spatial-connectivity needs. When conserving both species, the agglomeration bonus was more cost-effective than the agglomeration and the homogeneous payment; thus, we showed that as a policy the agglomeration bonus is a useful conservation-payment option. PMID:26918707

  19. Cost-effectiveness of the stream-gaging program in Missouri

    USGS Publications Warehouse

    Waite, L.A.

    1987-01-01

    This report documents the results of an evaluation of the cost effectiveness of the 1986 stream-gaging program in Missouri. Alternative methods of developing streamflow information and cost-effective resource allocation were used to evaluate the Missouri program. Alternative methods were considered statewide, but the cost effective resource allocation study was restricted to the area covered by the Rolla field headquarters. The average standard error of estimate for records of instantaneous discharge was 17 percent; assuming the 1986 budget and operating schedule, it was shown that this overall degree of accuracy could be improved to 16 percent by altering the 1986 schedule of station visitations. A minimum budget of $203,870, with a corresponding average standard error of estimate 17 percent, is required to operate the 1986 program for the Rolla field headquarters; a budget of less than this would not permit proper service and maintenance of the stations or adequate definition of stage-discharge relations. The maximum budget analyzed was $418,870, which resulted in an average standard error of estimate of 14 percent. Improved instrumentation can have a positive effect on streamflow uncertainties by decreasing lost records. An earlier study of data uses found that data uses were sufficient to justify continued operation of all stations. One of the stations investigated, Current River at Doniphan (07068000) was suitable for the application of alternative methods for simulating discharge records. However, the station was continued because of data use requirements. (Author 's abstract)

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

    PubMed

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

    2016-09-01

    Water scarcity has become a critical problem in many semiarid and arid regions. The single largest water use in such regions is for crop irrigation, which typically relies on groundwater and surface water sources. With increasing stress on these traditional water sources, it is important to consider alternative irrigation sources for areas with limited freshwater resources. One potential irrigation water resource is treated wastewater for agricultural fields located near urban centers. In addition, treated wastewater can contribute an appreciable amount of necessary nutrients for plants. The suitability of reclaimed water for specific applications depends on water quality and usage requirements. The main factors that determine the suitability of recycled water for agricultural irrigation are salinity, heavy metals, and pathogens, which cause adverse effects on human, plants, and soils. In this paper, we develop a regional water reuse decision-support model (RWRM) using the general algebraic modeling system to analyze the cost-effectiveness of alternative treatment trains to generate irrigation water from reclaimed wastewater, with the irrigation water designed to meet crop requirements as well as California's wastewater reuse regulations (Title 22). Using a cost-minimization framework, least-cost solutions consisting of treatment processes and their intensities (blending ratios) are identified to produce alternative irrigation sources for citrus and turfgrass. Our analysis illustrates the benefits of employing an optimization framework and flexible treatment design to identify cost-effective blending opportunities that may produce high-quality irrigation water for a wide range of end uses. PMID:27499353

  1. Applicability of Learning Potential Measurement with Spanish-Speaking Youth as an Alternative to IQ. Final Report.

    ERIC Educational Resources Information Center

    Gimon, Alexander T.; And Others

    The learning potential (LP) procedure represents an alternative method of measuring ability of Spanish-speaking students who tend to score low on traditional IQ tests. This study sought to determine the relative predictive power of LP and IQ measures on achievement of 188 first through sixth grade Spanish-speaking students. Subjects participated…

  2. Teaching and Technology Transfer as Alternative Revenue Streams: A Primer on the Potential Legal Implications for UK Universities

    ERIC Educational Resources Information Center

    Van Hoorebeek, Mark; Marson, James

    2005-01-01

    Purpose: The purpose of this paper is to assess the financial and intellectual issues facing the university sector as many institutions in the UK pursue alternative revenue streams. As a consequence to the increasing financial pressures, university departments are increasingly exposed to new forms of potential litigation and also face the risk to…

  3. Cost-effective solar heating system

    SciTech Connect

    Kyrias, G.M.

    1981-09-08

    The collector includes two planar panels separated by a thin spacer. The spacer includes a closed border within the edge of the collector and a number of separate strips within the border. The strips are disposed parallel to each other and are spaced in from the border, the spaces between the border and adjacent ends of successive strips alternating between a larger space and a smaller space, so that the path of least resistance through the collector is a serpentine passage. The smaller spaces prevent air and water from being trapped when the panel is filled and drained. A flow-restricting orifice is coupled to each collector to permit the collectors to be supplied at high pressure but without excessive flow. The supply pressure is much greater than the hydrostatic pressure head differences between the collectors so that when the collectors are connected in parallel in an open system, differences in flow rate due to elevation differences between the panels are minimized. The panels used in the collector are composed of glass cloth included in a cured polyester resin or epoxy resin. The strips and border of the separator are composed of a polyester resin or epoxy resin filled with silica particles and applied to the panels through a template.

  4. Cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry meat food supply.

    PubMed

    Lake, Robin J; Horn, Beverley J; Dunn, Alex H; Parris, Ruth; Green, F Terri; McNickle, Don C

    2013-07-01

    An analysis of the cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry supply examined a series of interventions. Effectiveness was evaluated in terms of reduced health burden measured by disability-adjusted life years (DALYs). Costs of implementation were estimated from the value of cost elements, determined by discussions with industry. Benefits were estimated by changing the inputs to a poultry food chain quantitative risk model. Proportional reductions in the number of predicted Campylobacter infections were converted into reductions in the burden of disease measured in DALYs. Cost-effectiveness ratios were calculated for each intervention, as cost per DALY reduction and the ratios compared. The results suggest that the most cost-effective interventions (lowest ratios) are at the primary processing stage. Potential phage-based controls in broiler houses were also highly cost-effective. This study is limited by the ability to quantify costs of implementation and assumptions required to estimate health benefits, but it supports the implementation of interventions at the primary processing stage as providing the greatest quantum of benefit and lowest cost-effectiveness ratios. PMID:23834790

  5. Applying a Simple Model of Cost Effectiveness Study of HPV Vaccine for Iran

    PubMed Central

    Khatibi, Mohsen; Rasekh, Hamid Reza

    2015-01-01

    HPV vaccine has been recently added to the Iran Drug List, so decision makers need information beyond that available from RCTs to recommend funding for this vaccination. Modeling and economic studies have addressed some of those information needs. We reviewed cost effectiveness studies to find a suitable model for Iranian population to determine the potential cost effectiveness of HPV vaccine program based on domestic available epidemiologic data. Articles were obtained from an extensive literature search to determine the cost effectiveness of implementing an HPV vaccination program with routine cervical cancer screening. A total of 64 studies were included in this review. Although the studies used different model structures, baseline parameters and assumptions (either a Markov, Hybrid, or Dynamic model). Most of the proposed cost effectiveness models need to model the probability of HPV acquisition, the possible progression from HPV infection to CIN I, CIN II, CIN III and cervical cancer, the probability of HPV transmission which are not available in Iranian epidemiologic data. Based on the available epidemiologic data in Iran, the simplified and it requires substantially fewer assumptions than the other more complex Markov and hybrid models, therefore we decided to use this model for the evaluation of cost effectiveness of HPV vaccine in Iran. PMID:25901173

  6. How cost-effective would a vaccine be against schistosomiasis?

    PubMed

    1996-08-01

    An estimated 20 million people suffer severe disease or disability from schistosomiasis and about 50,000 die from the disease annually. While the inexpensive and effective drug praziquantel exists, there is a high risk of reinfection following treatment, necessitating long-term annual retreatment. Vaccine research has identified several antigens in Schistosoma mansoni, one of the worm species which causes human disease. However, tests of 6 of these antigens in animals for their protective potential as vaccines or vaccine components have yielded only inconsistent and largely disappointing results. The antigens are nonetheless capable of producing immune responses indicative of protection in people living in endemic areas and therefore have potential. A schistosomiasis vaccine administered to at least 80% of children in a schistosomiasis-endemic area of a low-income country, and providing protection for at least 90% of those receiving the full dose, would cost US$64-405 per healthy year of life saved. The vaccine, however, must provide protection for at least 10 years, cost no more than US$5 per completely vaccinated child, including delivery, and be delivered through the EPI system. Such a schistosomiasis vaccine would be relatively cost-effective compared with mass chemotherapy with praziquantel for children aged 6-15 years. PMID:12321483

  7. Tungsten carbides as potential alternative direct methanol fuel cell anode electrocatalysts

    NASA Astrophysics Data System (ADS)

    Zellner, Michael

    The reduction of precious metal loading and the improvement of sluggish kinetics at the anode electrocatalyst are two primary concerns for economical development of direct methanol fuel cells (DMFC). The purpose of this research is to examine the feasibility of using tungsten carbides as alternative fuel cell anode electrocatalysts. The anodic chemistry of the direct methanol fuel cell requires the oxidation of methanol and the decomposition of water to produce protons, electrons, and gas-phase CO2. Currently, the most effective anode electrocatalyst for DMFC is the Pt/Ru bimetallic catalyst, which efficiently oxidizes methanol, as well as decomposes water for the oxidation and removal of adsorbed CO species. Although the Pt/Ru bimetallic system exhibits desirable electrochemical activities, both Pt and Ru are expensive due to limited supplies. In addition, strong chemisorption of CO on Pt and Ru makes the electrocatalyst susceptible to CO poisoning, blocking the active sites for methanol oxidation. This work began by examining the reactions of methanol, water, and CO on carbide-modified tungsten (C/W) single crystal surfaces, with and without submonolayer coverages of Pt. These fundamental surface science results demonstrated the potential for tungsten carbides to be used as anode catalysts in DMFC, exhibiting decomposition of both methanol and water along with significantly lowered CO desorption temperatures. Additionally, submonolayer Pt-modification of the C/W surfaces resulted in a synergistic effect, eliminating the undesired reaction pathway on the C/W surface that produced gas-phase CH4. To bridge the materials gap between model single crystal surfaces and the more realistic thin film electrocatalysts, polycrystalline tungsten carbide thin films were created via physical vapor deposition (PVD) and carburization of polycrystalline tungsten foil. Fundamental surface science techniques were applied to the PVD films to examine the reaction pathways of DMFC

  8. Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

    PubMed Central

    2011-01-01

    Background Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies showed inconsistent results for these vaccines because of lack of consensus on the impact. We aimed to investigate which factors had a major impact on cost-effectiveness and were primarily responsible for the large differences in previously estimated cost-effectiveness ratios. Methods Based on updated data on health outcomes and cost estimates, we re-assessed the cost-effectiveness of routine paediatric rotavirus vaccination within the National Immunization Program for the Netherlands. Two consensus meetings were organised with national and international experts in the field to achieve consensus and resolve potential controversies. Results It was estimated that rotavirus vaccination in the Netherlands could avert 34,214 cases of rotavirus gastroenteritis in children aged less than 5 years. Notably, 2,779 hospitalisations were averted of which 315 were extensions of existing hospital stays due to nosocomial rotavirus infection. With a threshold varying from 20K€ - 50K€ per QALY and according to the base-case scenario, the full vaccination costs per child leading to cost-effectiveness was €57.76 -€77.71. Results were sensitive to the inclusion of potential vaccine induced herd protection, QALY losses and number of deaths associated with rotavirus gastroenteritis. Conclusions Our economic analysis indicates that inclusion of rotavirus vaccination in the Dutch National Immunization Program might be cost-effective depending on the cost of the vaccine and the impact of rotavirus gastroenteritis on children's quality of life. PMID:21663620

  9. Cost-Effectiveness of Surveillance for Bloodstream Infections for Sepsis Management in Low-Resource Settings.

    PubMed

    Penno, Erin C; Baird, Sarah J; Crump, John A

    2015-10-01

    Bacterial sepsis is a leading cause of mortality among febrile patients in low- and middle-income countries, but blood culture services are not widely available. Consequently, empiric antimicrobial management of suspected bloodstream infection is based on generic guidelines that are rarely informed by local data on etiology and patterns of antimicrobial resistance. To evaluate the cost-effectiveness of surveillance for bloodstream infections to inform empiric management of suspected sepsis in low-resource areas, we compared costs and outcomes of generic antimicrobial management with management informed by local data on etiology and patterns of antimicrobial resistance. We applied a decision tree model to a hypothetical population of febrile patients presenting at the district hospital level in Africa. We found that the evidence-based regimen saved 534 more lives per 100,000 patients at an additional cost of $25.35 per patient, resulting in an incremental cost-effectiveness ratio of $4,739. This ratio compares favorably to standard cost-effectiveness thresholds, but should ultimately be compared with other policy-relevant alternatives to determine whether routine surveillance for bloodstream infections is a cost-effective strategy in the African context. PMID:26175032

  10. Cost-effectiveness of Collagen Crosslinking for Progressive Keratoconus in the UK NHS

    PubMed Central

    Salmon, Andrew; Chalk, Daniel; Stein, Ken; Frost, Andrew

    2015-01-01

    Background Keratoconus is a progressive degenerative corneal disorder of children and young adults that is traditionally managed by refractive error correction, with corneal transplantation reserved for the most severe cases. UVA collagen crosslinking is a novel procedure that aims to prevent disease progression, which is currently being considered for use in the UK NHS. We assess whether it might be a cost-effective alternative to standard management for patients with progressive keratoconus. Methods We constructed a Markov model in which we estimated disease progression from prospective follow-up studies, derived costs derived from the NHS National Tariff, and calculated utilities from linear regression models of visual acuity in the better-seeing eye. We performed deterministic and probabilistic sensitivity analyses to assess the impact of possible variations in the model parameters. Results Collagen crosslinking is cost-effective compared to standard management at an incremental cost of £3,174 per QALY in the base case. Deterministic sensitivity analysis shows that this could rise above £33,263 per QALY if the duration of treatment efficacy is limited to 5 years. Other model parameters are not decision significant. Collagen crosslinking is cost effective in 85% of simulations at a willingness to pay threshold of £30,000 per QALY. Conclusion UVA collagen crosslinking is very likely to be cost-effective, compared to standard management, for the treatment of progressive keratoconus. However, further research to explore its efficacy beyond five years is desirable. PMID:26315704