Science.gov

Sample records for abundant dynamic cost-effective

  1. Cost effective dynamic design and test requirements for Shuttle payloads

    NASA Technical Reports Server (NTRS)

    Stahle, C. V.; Gongloff, H. R.; Bangs, W. F.

    1975-01-01

    The results of a study examining current spacecraft dynamic design and test requirements for the cost effective design and development of Shuttle payloads are presented. Dynamic environments, payload configurations, design/test requirements, test levels, assembly level of testing, simulation methods, prototype role, load limiting, test facilities, and flight measurements are discussed as they relate to the development of a cost effective design and test philosophy for Shuttle Spacelab payloads. It is concluded that changes to current design/test practices will minimize long range payload costs. However, changes to current practices need be quantitatively evaluated before an orderly progression to more cost effective methods can be achieved without undue risk of mission failures. Of major importance is optimization of test levels and plans for payloads and payload subsystems which will result in minimum project costs.

  2. Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.

    PubMed

    Freiesleben de Blasio, Birgitte; Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at

  3. Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.

    PubMed

    Freiesleben de Blasio, Birgitte; Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at

  4. Stocking of hatchery-reared striped bass in the Patuxent River, Maryland: survival, relative abundance, and cost-effectiveness

    USGS Publications Warehouse

    Dorazio, R.M.; Florence, B.M.; Wooley, C.M.

    1991-01-01

    Hatchery-reared fingerlings of striped bass Morone saxatilis were tagged, stocked, and recovered in the Patuxent River, Maryland, to estimate their survival and abundance relative to wild young of the year and to compare the costs and benefits of stocking phase-I (35–50 mm, total length) and phase-II (150–200 mm) fish. About 100,000 phase-I fingerlings were tagged and released each year during midsummer 1988 and 1989. Both tagged and untagged (wild) young of the year were recovered by alongshore seining in the river through 80 d poststocking. Mortality rates of wild and hatchery-reared young of the year were not significantly different-about 3%/d. Wild young of the year were more abundant in 1989 than in 1988. In 1988, phase-I fingerlings composed 56% of all young-of-the-year striped bass in the river. In 1989 wild young-of-the-year striped bass outnumbered hatchery-reared fingerlings by about 11 to 1. Whether phase-I or phase-II stocking was more cost-effective depended on the relative magnitudes of fingerling survival and on hatchery production costs. The range of phase-II survival (5–50%) observed among different hatcheries and years of production was too broad to support generalizations about cost-effectiveness, given the fivefold difference in the unit costs of phase-I and phase-II production.

  5. Cost-effectiveness of influenza control measures: a dynamic transmission model-based analysis.

    PubMed

    Chen, S-C; Liao, C-M

    2013-12-01

    We investigated the cost-effectiveness of different influenza control strategies in a school setting in Taiwan. A susceptible-exposure-infected-recovery (SEIR) model was used to simulate influenza transmission and we used a basic reproduction number (R 0)-asymptomatic proportion (θ) control scheme to develop a cost-effectiveness model. Based on our dynamic transmission model and economic evaluation, this study indicated that the optimal cost-effective strategy for all modelling scenarios was a combination of natural ventilation and respiratory masking. The estimated costs were US$10/year per person in winter for one kindergarten student. The cost for hand washing was estimated to be US$32/year per person, which was much lower than that of isolation (US$55/year per person) and vaccination (US$86/year per person) in containing seasonal influenza. Transmission model-based, cost-effectiveness analysis can be a useful tool for providing insight into the impacts of economic factors and health benefits on certain strategies for controlling seasonal influenza.

  6. Cost-effectiveness of influenza control measures: a dynamic transmission model-based analysis.

    PubMed

    Chen, S-C; Liao, C-M

    2013-12-01

    We investigated the cost-effectiveness of different influenza control strategies in a school setting in Taiwan. A susceptible-exposure-infected-recovery (SEIR) model was used to simulate influenza transmission and we used a basic reproduction number (R 0)-asymptomatic proportion (θ) control scheme to develop a cost-effectiveness model. Based on our dynamic transmission model and economic evaluation, this study indicated that the optimal cost-effective strategy for all modelling scenarios was a combination of natural ventilation and respiratory masking. The estimated costs were US$10/year per person in winter for one kindergarten student. The cost for hand washing was estimated to be US$32/year per person, which was much lower than that of isolation (US$55/year per person) and vaccination (US$86/year per person) in containing seasonal influenza. Transmission model-based, cost-effectiveness analysis can be a useful tool for providing insight into the impacts of economic factors and health benefits on certain strategies for controlling seasonal influenza. PMID:23481024

  7. Species Abundance Patterns in Complex Evolutionary Dynamics

    NASA Astrophysics Data System (ADS)

    Tokita, Kei

    2004-10-01

    An analytic theory of species abundance patterns (SAPs) in biological networks is presented. The theory is based on multispecies replicator dynamics equivalent to the Lotka-Volterra equation, with diverse interspecies interactions. Various SAPs observed in nature are derived from a single parameter. The abundance distribution is formed like a widely observed left-skewed lognormal distribution. As the model has a general form, the result can be applied to similar patterns in other complex biological networks, e.g., gene expression.

  8. Predicting the Dynamics of Protein Abundance

    PubMed Central

    Mehdi, Ahmed M.; Patrick, Ralph; Bailey, Timothy L.; Bodén, Mikael

    2014-01-01

    Protein synthesis is finely regulated across all organisms, from bacteria to humans, and its integrity underpins many important processes. Emerging evidence suggests that the dynamic range of protein abundance is greater than that observed at the transcript level. Technological breakthroughs now mean that sequencing-based measurement of mRNA levels is routine, but protocols for measuring protein abundance remain both complex and expensive. This paper introduces a Bayesian network that integrates transcriptomic and proteomic data to predict protein abundance and to model the effects of its determinants. We aim to use this model to follow a molecular response over time, from condition-specific data, in order to understand adaptation during processes such as the cell cycle. With microarray data now available for many conditions, the general utility of a protein abundance predictor is broad. Whereas most quantitative proteomics studies have focused on higher organisms, we developed a predictive model of protein abundance for both Saccharomyces cerevisiae and Schizosaccharomyces pombe to explore the latitude at the protein level. Our predictor primarily relies on mRNA level, mRNA–protein interaction, mRNA folding energy and half-life, and tRNA adaptation. The combination of key features, allowing for the low certainty and uneven coverage of experimental observations, gives comparatively minor but robust prediction accuracy. The model substantially improved the analysis of protein regulation during the cell cycle: predicted protein abundance identified twice as many cell-cycle-associated proteins as experimental mRNA levels. Predicted protein abundance was more dynamic than observed mRNA expression, agreeing with experimental protein abundance from a human cell line. We illustrate how the same model can be used to predict the folding energy of mRNA when protein abundance is available, lending credence to the emerging view that mRNA folding affects translation

  9. Cost-effective multi-camera array for high quality video with very high dynamic range

    NASA Astrophysics Data System (ADS)

    Keinert, Joachim; Wetzel, Marcus; Schöberl, Michael; Schäfer, Peter; Zilly, Frederik; Bätz, Michel; Fößel, Siegfried; Kaup, André

    2014-03-01

    Temporal bracketing can create images with higher dynamic range than the underlying sensor. Unfortunately, moving objects cause disturbing artifacts. Moreover, the combination with high frame rates is almost unachiev­ able since a single video frame requires multiple sensor readouts. The combination of multiple synchronized side-by-side cameras equipped with different attenuation filters promises a remedy, since all exposures can be performed at the same time with the same duration using the playout video frame rate. However, a disparity correction is needed to compensate the spatial displacement of the cameras. Unfortunately, the requirements for a high quality disparity correction contradict the goal to increase dynamic range. When using two cameras, disparity correction needs objects to be properly exposed in both cameras. In contrast, a dynamic range in­crease needs the cameras to capture different luminance ranges. As this contradiction has not been addressed in literature so far, this paper proposes a novel solution based on a three camera setup. It enables accurate de­ termination of the disparities and an increase of the dynamic range by nearly a factor of two while still limiting costs. Compared to a two camera solution, the mean opinion score (MOS) is improved by 13.47 units in average for the Middleburry images.

  10. Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation

    PubMed Central

    Sirintrapun, Sahussapont J.; Cimic, Adela

    2012-01-01

    Context: Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Aims: Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Settings and Design: Both the consulting “sending” pathologist and consultant “receiving” pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Materials and Methods: Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Results: Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. Conclusions: The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced. PMID:23024887

  11. Cost-Effective Large-Scale Occupancy–Abundance Monitoring of Invasive Brushtail Possums (Trichosurus Vulpecula) on New Zealand’s Public Conservation Land

    PubMed Central

    Gormley, Andrew M.; Forsyth, David M.; Wright, Elaine F.; Lyall, John; Elliott, Mike; Martini, Mark; Kappers, Benno; Perry, Mike; McKay, Meredith

    2015-01-01

    There is interest in large-scale and unbiased monitoring of biodiversity status and trend, but there are few published examples of such monitoring being implemented. The New Zealand Department of Conservation is implementing a monitoring program that involves sampling selected biota at the vertices of an 8-km grid superimposed over the 8.6 million hectares of public conservation land that it manages. The introduced brushtail possum (Trichosurus Vulpecula) is a major threat to some biota and is one taxon that they wish to monitor and report on. A pilot study revealed that the traditional method of monitoring possums using leg-hold traps set for two nights, termed the Trap Catch Index, was a constraint on the cost and logistical feasibility of the monitoring program. A phased implementation of the monitoring program was therefore conducted to collect data for evaluating the trade-off between possum occupancy–abundance estimates and the costs of sampling for one night rather than two nights. Reducing trapping effort from two nights to one night along four trap-lines reduced the estimated costs of monitoring by 5.8% due to savings in labour, food and allowances; it had a negligible effect on estimated national possum occupancy but resulted in slightly higher and less precise estimates of relative possum abundance. Monitoring possums for one night rather than two nights would provide an annual saving of NZ$72,400, with 271 fewer field days required for sampling. Possums occupied 60% (95% credible interval; 53–68) of sampling locations on New Zealand’s public conservation land, with a mean relative abundance (Trap Catch Index) of 2.7% (2.0–3.5). Possum occupancy and abundance were higher in forest than in non-forest habitats. Our case study illustrates the need to evaluate relationships between sampling design, cost, and occupancy–abundance estimates when designing and implementing large-scale occupancy–abundance monitoring programs. PMID:26029890

  12. Cost-Effective Large-Scale Occupancy-Abundance Monitoring of Invasive Brushtail Possums (Trichosurus Vulpecula) on New Zealand's Public Conservation Land.

    PubMed

    Gormley, Andrew M; Forsyth, David M; Wright, Elaine F; Lyall, John; Elliott, Mike; Martini, Mark; Kappers, Benno; Perry, Mike; McKay, Meredith

    2015-01-01

    There is interest in large-scale and unbiased monitoring of biodiversity status and trend, but there are few published examples of such monitoring being implemented. The New Zealand Department of Conservation is implementing a monitoring program that involves sampling selected biota at the vertices of an 8-km grid superimposed over the 8.6 million hectares of public conservation land that it manages. The introduced brushtail possum (Trichosurus Vulpecula) is a major threat to some biota and is one taxon that they wish to monitor and report on. A pilot study revealed that the traditional method of monitoring possums using leg-hold traps set for two nights, termed the Trap Catch Index, was a constraint on the cost and logistical feasibility of the monitoring program. A phased implementation of the monitoring program was therefore conducted to collect data for evaluating the trade-off between possum occupancy-abundance estimates and the costs of sampling for one night rather than two nights. Reducing trapping effort from two nights to one night along four trap-lines reduced the estimated costs of monitoring by 5.8% due to savings in labour, food and allowances; it had a negligible effect on estimated national possum occupancy but resulted in slightly higher and less precise estimates of relative possum abundance. Monitoring possums for one night rather than two nights would provide an annual saving of NZ$72,400, with 271 fewer field days required for sampling. Possums occupied 60% (95% credible interval; 53-68) of sampling locations on New Zealand's public conservation land, with a mean relative abundance (Trap Catch Index) of 2.7% (2.0-3.5). Possum occupancy and abundance were higher in forest than in non-forest habitats. Our case study illustrates the need to evaluate relationships between sampling design, cost, and occupancy-abundance estimates when designing and implementing large-scale occupancy-abundance monitoring programs.

  13. Temperature-associated dynamics of songbird winter distributions and abundances.

    PubMed

    Butler, J Russell; MacMynowski, Dena P; Laurent, Chad; Root, Terry L

    2007-12-01

    Using Christmas Bird Count data, we analyze the annual spatio-temporal abundances of six passerine species in the upper Great Plains, US (1960-1990). This study provides new insight into how global warming could cause separation of species within present-day communities. We find that winter relative abundances of similarly-sized songbirds are differentially affected by ambient winter temperature. As such, average annual winter temperature fluctuations (i.e., severity of winter) are significantly (P < 0.05) correlated with the relative abundances of three species while the other three are not. Our conditional probability-of-occurrence analysis indicates that the abundances of the three temperature-associated species declined markedly below -4 degrees C while the abundances of the other three species fluctuated little from 8 degrees C to -16 degrees C. We conclude that even in colder climates i) the winter distributions of some, but not all, songbirds are directly or indirectly limited by temperature; and ii) these birds have dynamic abundances that can quickly respond to temperature changes.

  14. Identifying the factors affecting phytoplankton abundance dynamics in Shihmen Reservoir, Taiwan

    NASA Astrophysics Data System (ADS)

    Kuo, Yi-Ming; Chuang, Illy; Chu, Hone-Jay; Wu, Jiunn-Tzong; Jang, Cheng-Shin

    2013-04-01

    Investigations of multiple temporal distributions of phytoplankton dynamics through environmental variables in water bodies over extensive areas remain relatively scarce. This study focused on the determination of the key factors regulating temporal and spatial variations of phytoplankton abundance at three monitoring sites in Shihmen Reservoir within five years (2006-2010). Dynamic factor analysis (DFA), a dimension-reduction technique, was designed to identify the underlying latent effects in multiple time series and interactions between explanatory variables (i.e., environmental variables) and the response variable (phytoplankton abundance). The optimal DFA model successfully described the dynamics of phytoplankton abundance in the Shihmen Reservoir. The results demonstrated that water temperature, water level, COD, BOD, and DO considerably affected phytoplankton abundance at most of the monitoring sites. Among them, water temperature, water level, and COD significantly affected phytoplankton abundance at all three sites, indicating that these variables contributed more to the long-term dynamics of phytoplankton abundance than other variables at the surface water of Shihmen Reservoir. The influx and efflux of Reservoir altering hydrological conditions in Shihmen Reservoir may attenuate the nutrients effects on phytoplankton abundance. In this study, BOD and DO are the other crucial water quality factors that control variations of phytoplankton. The explanatory variables mainly explain the dynamics of phytoplankton abundance than common trends do. In the future, the water manager may consider these variables to propose strategies to manage water quality in Shihmen Reservoir.

  15. Dynamical evolution and molecular abundances of interstellar clouds

    NASA Technical Reports Server (NTRS)

    Prasad, Sheo S.; Heere, Karen R.; Tarafdar, Shankar P.

    1991-01-01

    Dynamical models are presented that start with interstellar gas in an initial diffuse state and consider their gravitational collapse and the formation of dense cores. Frozen-in tangled magnetic fields are included to mimic forces that might oppose gravitational contraction and whose effectiveness may increase with increasing core densities. Results suggest the possibility that dense cloud cores may be dynamically evolving ephemeral objects, such that their lifespan at a given core density decreases as that density increases.

  16. Seasonal temperature and precipitation regulate brook trout young-of-the-year abundance and population dynamics

    USGS Publications Warehouse

    Kanno, Yoichiro; Pregler, Kasey C.; Hitt, Nathaniel P.; Letcher, Benjamin H.; Hocking, Daniel; Wofford, John E.B.

    2015-01-01

    Our results indicate that YOY abundance is a key driver of brook trout population dynamics that is mediated by seasonal weather patterns. A reliable assessment of climate change impacts on brook trout needs to account for how alternations in seasonal weather patterns impact YOY abundance and how such relationships may differ across the range of brook trout distribution.

  17. Rank abundance relations in evolutionary dynamics of random replicators

    NASA Astrophysics Data System (ADS)

    Yoshino, Yoshimi; Galla, Tobias; Tokita, Kei

    2008-09-01

    We present a nonequilibrium statistical mechanics description of rank abundance relations (RAR) in random community models of ecology. Specifically, we study a multispecies replicator system with quenched random interaction matrices. We here consider symmetric interactions as well as asymmetric and antisymmetric cases. RARs are obtained analytically via a generating functional analysis, describing fixed-point states of the system in terms of a small set of order parameters, and in dependence on the symmetry or otherwise of interactions and on the productivity of the community. Our work is an extension of Tokita [Phys. Rev. Lett. 93, 178102 (2004)], where the case of symmetric interactions was considered within an equilibrium setup. The species abundance distribution in our model come out as truncated normal distributions or transformations thereof and, in some case, are similar to left-skewed distributions observed in ecology. We also discuss the interaction structure of the resulting food-web of stable species at stationarity, cases of heterogeneous cooperation pressures as well as effects of finite system size and of higher-order interactions.

  18. Rank abundance relations in evolutionary dynamics of random replicators.

    PubMed

    Yoshino, Yoshimi; Galla, Tobias; Tokita, Kei

    2008-09-01

    We present a nonequilibrium statistical mechanics description of rank abundance relations (RAR) in random community models of ecology. Specifically, we study a multispecies replicator system with quenched random interaction matrices. We here consider symmetric interactions as well as asymmetric and antisymmetric cases. RARs are obtained analytically via a generating functional analysis, describing fixed-point states of the system in terms of a small set of order parameters, and in dependence on the symmetry or otherwise of interactions and on the productivity of the community. Our work is an extension of Tokita [Phys. Rev. Lett. 93, 178102 (2004)], where the case of symmetric interactions was considered within an equilibrium setup. The species abundance distribution in our model come out as truncated normal distributions or transformations thereof and, in some case, are similar to left-skewed distributions observed in ecology. We also discuss the interaction structure of the resulting food-web of stable species at stationarity, cases of heterogeneous cooperation pressures as well as effects of finite system size and of higher-order interactions.

  19. Fish and Phytoplankton Exhibit Contrasting Temporal Species Abundance Patterns in a Dynamic North Temperate Lake

    PubMed Central

    Hansen, Gretchen J. A.; Carey, Cayelan C.

    2015-01-01

    Temporal patterns of species abundance, although less well-studied than spatial patterns, provide valuable insight to the processes governing community assembly. We compared temporal abundance distributions of two communities, phytoplankton and fish, in a north temperate lake. We used both 17 years of observed relative abundance data as well as resampled data from Monte Carlo simulations to account for the possible effects of non-detection of rare species. Similar to what has been found in other communities, phytoplankton and fish species that appeared more frequently were generally more abundant than rare species. However, neither community exhibited two distinct groups of “core” (common occurrence and high abundance) and “occasional” (rare occurrence and low abundance) species. Both observed and resampled data show that the phytoplankton community was dominated by occasional species appearing in only one year that exhibited large variation in their abundances, while the fish community was dominated by core species occurring in all 17 years at high abundances. We hypothesize that the life-history traits that enable phytoplankton to persist in highly dynamic environments may result in communities dominated by occasional species capable of reaching high abundances when conditions allow. Conversely, longer turnover times and broad environmental tolerances of fish may result in communities dominated by core species structured primarily by competitive interactions. PMID:25651399

  20. Fish and phytoplankton exhibit contrasting temporal species abundance patterns in a dynamic north temperate lake.

    PubMed

    Hansen, Gretchen J A; Carey, Cayelan C

    2015-01-01

    Temporal patterns of species abundance, although less well-studied than spatial patterns, provide valuable insight to the processes governing community assembly. We compared temporal abundance distributions of two communities, phytoplankton and fish, in a north temperate lake. We used both 17 years of observed relative abundance data as well as resampled data from Monte Carlo simulations to account for the possible effects of non-detection of rare species. Similar to what has been found in other communities, phytoplankton and fish species that appeared more frequently were generally more abundant than rare species. However, neither community exhibited two distinct groups of "core" (common occurrence and high abundance) and "occasional" (rare occurrence and low abundance) species. Both observed and resampled data show that the phytoplankton community was dominated by occasional species appearing in only one year that exhibited large variation in their abundances, while the fish community was dominated by core species occurring in all 17 years at high abundances. We hypothesize that the life-history traits that enable phytoplankton to persist in highly dynamic environments may result in communities dominated by occasional species capable of reaching high abundances when conditions allow. Conversely, longer turnover times and broad environmental tolerances of fish may result in communities dominated by core species structured primarily by competitive interactions. PMID:25651399

  1. Dynamic regulation of partner abundance mediates response of reef coral symbioses to environmental change.

    PubMed

    Cunning, R; Vaughan, N; Gillette, P; Capo, T R; Matté, J L; Baker, A C

    2015-05-01

    Regulating partner abunclance may allow symmotic organisms to mediate interaction outcomes, facilitating adaptive responses to environmental change. To explore the capacity for-adaptive regulation in an ecologically important endosymbiosis, we studied the population dynamics of symbiotic algae in reef-building corals under different abiotic contexts. We found high natural variability in symbiont abundance in corals across reefs, but this variability converged to different symbiont-specific abundances when colonies were maintained under constant conditions. When conditions changed seasonally, symbiont abundance readjusted to new equilibria. We explain these patterns using an a priori model of symbiotic costs and benefits to the coral host, which shows that the observed changes in symbiont abundance are consistent with the maximization of interaction benefit under different environmental conditions. These results indicate that, while regulating symbiont abundance helps hosts sustain maximum benefit in a dynamic environment, spatiotemporal variation in abiotic factors creates a broad range of symbiont abundances (and interaction outcomes) among corals that may account for observed natural variability in performance (e.g., growth rate) and stress tolerance (e.g., bleaching susceptibility). This cost or benefit framework provides a new perspective on the dynamic regulation of reef coral symbioses and illustrates that the dependence of interaction outcomes on biotic and abiotic contexts may be important in understanding how diverse mutualisms respond to environmental change.

  2. Dynamic regulation of partner abundance mediates response of reef coral symbioses to environmental change.

    PubMed

    Cunning, R; Vaughan, N; Gillette, P; Capo, T R; Matté, J L; Baker, A C

    2015-05-01

    Regulating partner abunclance may allow symmotic organisms to mediate interaction outcomes, facilitating adaptive responses to environmental change. To explore the capacity for-adaptive regulation in an ecologically important endosymbiosis, we studied the population dynamics of symbiotic algae in reef-building corals under different abiotic contexts. We found high natural variability in symbiont abundance in corals across reefs, but this variability converged to different symbiont-specific abundances when colonies were maintained under constant conditions. When conditions changed seasonally, symbiont abundance readjusted to new equilibria. We explain these patterns using an a priori model of symbiotic costs and benefits to the coral host, which shows that the observed changes in symbiont abundance are consistent with the maximization of interaction benefit under different environmental conditions. These results indicate that, while regulating symbiont abundance helps hosts sustain maximum benefit in a dynamic environment, spatiotemporal variation in abiotic factors creates a broad range of symbiont abundances (and interaction outcomes) among corals that may account for observed natural variability in performance (e.g., growth rate) and stress tolerance (e.g., bleaching susceptibility). This cost or benefit framework provides a new perspective on the dynamic regulation of reef coral symbioses and illustrates that the dependence of interaction outcomes on biotic and abiotic contexts may be important in understanding how diverse mutualisms respond to environmental change. PMID:26236853

  3. Modelling community dynamics based on species-level abundance models from detection/nondetection data

    USGS Publications Warehouse

    Yamaura, Yuichi; Royle, J. Andrew; Kuboi, Kouji; Tada, Tsuneo; Ikeno, Susumu; Makino, Shun'ichi

    2011-01-01

    1. In large-scale field surveys, a binary recording of each species' detection or nondetection has been increasingly adopted for its simplicity and low cost. Because of the importance of abundance in many studies, it is desirable to obtain inferences about abundance at species-, functional group-, and community-levels from such binary data. 2. We developed a novel hierarchical multi-species abundance model based on species-level detection/nondetection data. The model accounts for the existence of undetected species, and variability in abundance and detectability among species. Species-level detection/nondetection is linked to species- level abundance via a detection model that accommodates the expectation that probability of detection (at least one individuals is detected) increases with local abundance of the species. We applied this model to a 9-year dataset composed of the detection/nondetection of forest birds, at a single post-fire site (from 7 to 15 years after fire) in a montane area of central Japan. The model allocated undetected species into one of the predefined functional groups by assuming a prior distribution on individual group membership. 3. The results suggest that 15–20 species were missed in each year, and that species richness of communities and functional groups did not change with post-fire forest succession. Overall abundance of birds and abundance of functional groups tended to increase over time, although only in the winter, while decreases in detectabilities were observed in several species. 4. Synthesis and applications. Understanding and prediction of large-scale biodiversity dynamics partly hinge on how we can use data effectively. Our hierarchical model for detection/nondetection data estimates abundance in space/time at species-, functional group-, and community-levels while accounting for undetected individuals and species. It also permits comparison of multiple communities by many types of abundance-based diversity and similarity

  4. Using spatiotemporal statistical models to estimate animal abundance and infer ecological dynamics from survey counts

    USGS Publications Warehouse

    Conn, Paul B.; Johnson, Devin S.; Ver Hoef, Jay M.; Hooten, Mevin B.; London, Joshua M.; Boveng, Peter L.

    2015-01-01

    Ecologists often fit models to survey data to estimate and explain variation in animal abundance. Such models typically require that animal density remains constant across the landscape where sampling is being conducted, a potentially problematic assumption for animals inhabiting dynamic landscapes or otherwise exhibiting considerable spatiotemporal variation in density. We review several concepts from the burgeoning literature on spatiotemporal statistical models, including the nature of the temporal structure (i.e., descriptive or dynamical) and strategies for dimension reduction to promote computational tractability. We also review several features as they specifically relate to abundance estimation, including boundary conditions, population closure, choice of link function, and extrapolation of predicted relationships to unsampled areas. We then compare a suite of novel and existing spatiotemporal hierarchical models for animal count data that permit animal density to vary over space and time, including formulations motivated by resource selection and allowing for closed populations. We gauge the relative performance (bias, precision, computational demands) of alternative spatiotemporal models when confronted with simulated and real data sets from dynamic animal populations. For the latter, we analyze spotted seal (Phoca largha) counts from an aerial survey of the Bering Sea where the quantity and quality of suitable habitat (sea ice) changed dramatically while surveys were being conducted. Simulation analyses suggested that multiple types of spatiotemporal models provide reasonable inference (low positive bias, high precision) about animal abundance, but have potential for overestimating precision. Analysis of spotted seal data indicated that several model formulations, including those based on a log-Gaussian Cox process, had a tendency to overestimate abundance. By contrast, a model that included a population closure assumption and a scale prior on total

  5. Species composition, abundance, and seasonal dynamics of stink bugs (Hemiptera: Pentatomidae) in Minnesota soybean fields.

    PubMed

    Koch, Robert L; Pahs, Tiffany

    2014-08-01

    Stink bugs (Hemiptera: Pentatomidae) have historically not been pests of soybean in Minnesota. In response to the invasion of Halyomorpha halys (Stål) and reports of increasing abundance of species native to North America, a state-wide survey of soybean was conducted over 3 yr in Minnesota to determine species composition, abundance, and seasonal dynamics of Pentatomidae associated with soybean. Fourteen species of Pentatomidae (12 herbivorous and two predatory) were collected from soybean. H. halys was not detected in this survey. Among the herbivorous species found, adults of Euschistus variolarius (Palisot de Beauvois) had the greatest relative abundance (60.51%) and frequency of detection (18.44%), followed by Euschistus servus euschistoides (Say) (19.37 and 3.04%, respectively) and Chinavia hilaris (Say) (5.50 and 1.69%, respectively). Abundance of herbivorous nymphs and adults exceeded an economic threshold (20 nymphs and adults per 100 sweeps) in 0.82% of fields in 2012 but not in 2011 or 2013. The frequency of detection of herbivorous species and ratio of nymphs to adults increased with increasing reproductive growth stage of soybean. In two of three years, herbivorous adults were more abundant in the edge compared with interior of fields. Two predatory Pentatomidae, Podisus maculiventris (Say) and Podisus placidus Uhler, comprised 5.95 and 1.62% of the pentatomid adults. Though the species composition of Pentatomidae in Minnesota soybean differs from that in eastern and southern states, the spatial (i.e., greater abundance near field edge) and seasonal dynamics (i.e., increasing abundance and reproduction with increasing reproductive maturity of soybean) in soybean appear similar.

  6. Using a Dynamic Hydrology Model To Predict Mosquito Abundances in Flood and Swamp Water

    PubMed Central

    Stieglitz, Marc; Stark, Colin; Le Blancq, Sylvie; Cane, Mark

    2002-01-01

    We modeled surface wetness at high resolution, using a dynamic hydrology model, to predict flood and swamp water mosquito abundances. Historical meteorologic data, as well as topographic, soil, and vegetation data, were used to model surface wetness and identify potential fresh and swamp water breeding habitats in two northern New Jersey watersheds. Surface wetness was positively associated with the subsequent abundance of the dominant floodwater mosquito species, Aedes vexans, and the swamp water species, Anopheles walkeri. The subsequent abundance of Culex pipiens, a species that breeds in polluted, eutrophic waters, was negatively correlated with local modeled surface wetness. These associations permit real-time monitoring and forecasting of these floodwater and nonfloodwater species at high spatial and temporal resolution. These predictions will enable public health agencies to institute control measures before the mosquitoes emerge as adults, when their role as transmitters of disease comes into play. PMID:11749741

  7. Using a dynamic hydrology model to predict mosquito abundances in flood and swamp water.

    PubMed

    Shaman, Jeffrey; Stieglitz, Marc; Stark, Colin; Le Blancq, Sylvie; Cane, Mark

    2002-01-01

    We modeled surface wetness at high resolution, using a dynamic hydrology model, to predict flood and swamp water mosquito abundances. Historical meteorologic data, as well as topographic, soil, and vegetation data, were used to model surface wetness and identify potential fresh and swamp water breeding habitats in two northern New Jersey watersheds. Surface wetness was positively associated with the subsequent abundance of the dominant floodwater mosquito species, Aedes vexans, and the swamp water species, Anopheles walkeri. The subsequent abundance of Culex pipiens, a species that breeds in polluted, eutrophic waters, was negatively correlated with local modeled surface wetness. These associations permit real-time monitoring and forecasting of these floodwater and nonfloodwater species at high spatial and temporal resolution. These predictions will enable public health agencies to institute control measures before the mosquitoes emerge as adults, when their role as transmitters of disease comes into play.

  8. Occupancy and abundance of wintering birds in a dynamic agricultural landscape

    USGS Publications Warehouse

    Miller, M.W.; Pearlstine, E.V.; Dorazio, R.M.; Mazzotti, F.J.

    2011-01-01

    Assessing wildlife management action requires monitoring populations, and abundance often is the parameter monitored. Recent methodological advances have enabled estimation of mean abundance within a habitat using presence-absence or count data obtained via repeated visits to a sample of sites. These methods assume populations are closed and intuitively assume habitats within sites change little during a field season. However, many habitats are highly variable over short periods. We developed a variation of existing occupancy and abundance models that allows for extreme spatio-temporal differences in habitat, and resulting changes in wildlife abundance, among sites and among visits to a site within a field season. We conducted our study in sugarcane habitat within the Everglades Agricultural Area southeast of Lake Okeechobee in south Florida. We counted wintering birds, primarily passerines, within 245 sites usually 5 times at each site during December 2006-March 2007. We estimated occupancy and mean abundance of birds in 6 vegetation states during the sugarcane harvest and allowed these parameters to vary temporally or spatially within a vegetation state. Occupancy and mean abundance of the common yellowthroat (Geothlypis trichas) was affected by structure of sugarcane and uncultivated edge vegetation (occupancy = 1.00 [95%C?? = 0.96-1.00] and mean abundance = 7.9 [95%C?? = 3.2-19.5] in tall sugarcane with tall edge vegetation versus 0.20 [95%C?? = 0.04-0.71] and 0.22 [95%C?? = 0.04-1.2], respectively, in short sugarcane with short edge vegetation in one half of the study area). Occupancy and mean abundance of palm warblers (Dendroica palmarum) were constant (occupancy = 1.00, 95%C?? = 0.69-1.00; mean abundance = 18, 95%C?? = 1-270). Our model may enable wildlife managers to assess rigorously effects of future edge habitat management on avian distribution and abundance within agricultural landscapes during winter or the breeding season. The model may also help

  9. Occupancy and abundance of wintering birds in a dynamic agricultural landscape

    USGS Publications Warehouse

    Miller, Mark W.; Pearlstine, Elise V.; Dorazio, Robert M.; Mazzotti, Frank J.

    2011-01-01

    Assessing wildlife management action requires monitoring populations, and abundance often is the parameter monitored. Recent methodological advances have enabled estimation of mean abundance within a habitat using presence–absence or count data obtained via repeated visits to a sample of sites. These methods assume populations are closed and intuitively assume habitats within sites change little during a field season. However, many habitats are highly variable over short periods. We developed a variation of existing occupancy and abundance models that allows for extreme spatio-temporal differences in habitat, and resulting changes in wildlife abundance, among sites and among visits to a site within a field season. We conducted our study in sugarcane habitat within the Everglades Agricultural Area southeast of Lake Okeechobee in south Florida. We counted wintering birds, primarily passerines, within 245 sites usually 5 times at each site during December 2006–March 2007. We estimated occupancy and mean abundance of birds in 6 vegetation states during the sugarcane harvest and allowed these parameters to vary temporally or spatially within a vegetation state. Occupancy and mean abundance of the common yellowthroat (Geothlypis trichas) was affected by structure of sugarcane and uncultivated edge vegetation (occupancy=1.00 [95%CĪ=0.96–1.00] and mean abundance=7.9 [95%CĪ=3.2–19.5] in tall sugarcane with tall edge vegetation versus 0.20 [95%CĪ=0.04–0.71] and 0.22 [95%CĪ=0.04–1.2], respectively, in short sugarcane with short edge vegetation in one half of the study area). Occupancy and mean abundance of palm warblers (Dendroica palmarum) were constant (occupancy=1.00, 95%CĪ=0.69–1.00; mean abundance=18, 95%CĪ=1–270). Our model may enable wildlife managers to assess rigorously effects of future edge habitat management on avian distribution and abundance within agricultural landscapes during winter or the breeding season. The model may also help

  10. Abundance and dynamics of antibiotic resistance genes and integrons in lake sediment microcosms.

    PubMed

    Berglund, Björn; Khan, Ghazanfar Ali; Lindberg, Richard; Fick, Jerker; Lindgren, Per-Eric

    2014-01-01

    Antibiotic resistance in bacteria causing disease is an ever growing threat to the world. Recently, environmental bacteria have become established as important both as sources of antibiotic resistance genes and in disseminating resistance genes. Low levels of antibiotics and other pharmaceuticals are regularly released into water environments via wastewater, and the concern is that such environmental contamination may serve to create hotspots for antibiotic resistance gene selection and dissemination. In this study, microcosms were created from water and sediments gathered from a lake in Sweden only lightly affected by human activities. The microcosms were exposed to a mixture of antibiotics of varying environmentally relevant concentrations (i.e., concentrations commonly encountered in wastewaters) in order to investigate the effect of low levels of antibiotics on antibiotic resistance gene abundances and dynamics in a previously uncontaminated environment. Antibiotic concentrations were measured using liquid chromatography-tandem mass spectrometry. Abundances of seven antibiotic resistance genes and the class 1 integron integrase gene, intI1, were quantified using real-time PCR. Resistance genes sulI and ermB were quantified in the microcosm sediments with mean abundances 5 and 15 gene copies/10(6) 16S rRNA gene copies, respectively. Class 1 integrons were determined in the sediments with a mean concentration of 3.8 × 10(4) copies/106 16S rRNA gene copies. The antibiotic treatment had no observable effect on antibiotic resistance gene or integron abundances. PMID:25247418

  11. Suprapopulation dynamics of Bothriocephalus acheilognathi in a North Carolina reservoir: abundance, dispersion, and prevalence

    SciTech Connect

    Riggs, M.R.; Esch, G.W.

    1987-10-01

    A 2 1/2-year study (September 1980-March 1983) of abundance, dispersion, and prevalence of the pseudophyllidean cestode, Bothriocephalus acheilognathi, in 3 species of fish (Gambusia affinis, Notropis lutrensis, and Pimephales promelas) was conducted in 3 ecologically distinct areas of a North Carolina cooling pond. Mean infrapopulation density and prevalence differed by site, season, and species and size of hosts. Degree of aggregation and abundance and prevalence of gravid worms differed by species of host. Abundance of gravid worms was significantly lower in metapopulations from localities that received power plant effluents. The differences in infrapopulation density, prevalence, and aggregation appeared to be related to predator-prey interactions, which varied with season and local community structure. Differences in abundance of gravid worms, on the other hand, were probably caused by differential suitability of hosts and by local variation in selenium concentration in the water column. Thus, it appears that both biotic and abiotic components of the host community determined the suprapopulation dynamics of B. acheilognathi in Belews Lake.

  12. Species abundance distribution and population dynamics in a two-community model of neutral ecology

    NASA Astrophysics Data System (ADS)

    Vallade, M.; Houchmandzadeh, B.

    2006-11-01

    Explicit formulas for the steady-state distribution of species in two interconnected communities of arbitrary sizes are derived in the framework of Hubbell’s neutral model of biodiversity. Migrations of seeds from both communities as well as mutations in both of them are taken into account. These results generalize those previously obtained for the “island-continent” model and they allow an analysis of the influence of the ratio of the sizes of the two communities on the dominance/diversity equilibrium. Exact expressions for species abundance distributions are deduced from a master equation for the joint probability distribution of species in the two communities. Moreover, an approximate self-consistent solution is derived. It corresponds to a generalization of previous results and it proves to be accurate over a broad range of parameters. The dynamical correlations between the abundances of a species in both communities are also discussed.

  13. Measuring and predicting abundance and dynamics of habitat for piping plovers on a large reservoir

    USGS Publications Warehouse

    Anteau, Michael J.; Wiltermuth, Mark T.; Sherfy, Mark H.; Shaffer, Terry L.

    2014-01-01

    Measuring habitat and understanding habitat dynamics have become increasingly important for wildlife conservation. Using remotely-sensed data, we developed procedures to measure breeding habitat abundance for the federally listed piping plover (Charadrius melodus) at Lake Sakakawea, North Dakota, USA. We also developed a model to predict habitat abundance based on past and projected water levels, vegetation colonization rates, and topography. Previous studies define plover habitat as flat areas (30% bare-substrate obstruction) were 76% correct and omission and commission errors were equal. Due to water level fluctuations, habitat abundance varied markedly among years (1986–2009) ranging from 9 to 5195 ha. The proportion bare substrate declined with the number of years since a contour was inundated until 5 years (β = -0.65, SE = 0.05), then it stabilized near zero, and the decline varied by shoreline segment (5, 50, and 95 percentile were β = -0.19, SE = 0.05, β = -0.63, SE = 0.05, and β = -0.91, SE = 0.05, respectively). Years since inundated predicted habitat abundance well at shoreline segments (R2 = 0.77), but it predicted better for the whole lake (R2 = 0.86). The vastness and dynamics of plover habitat on Lake Sakakawea suggest that this is a key area for conservation of this species. Model-based habitat predictions can benefit resource conservation because they can (1) form the basis for a sampling stratification, (2) help allocate monitoring efforts among areas, and (3) help inform management through simulations or what-if scenarios.

  14. Seasonal and interannual dynamics of microzooplankton abundances in the Gulf of Trieste (Northern Adriatic Sea, Italy)

    NASA Astrophysics Data System (ADS)

    Monti, Marina; Minocci, Marco; Milani, Luisella; Fonda Umani, Serena

    2012-12-01

    Abundance and composition of microzooplankton were studied over a 15 years period (from March 1986 to December 1990 and from July 1998 to December 2010) in the Gulf of Trieste (Adriatic Sea, NE Mediterranean Sea). Sampling was conducted biweekly-monthly at the surface at the historical station C1, 200 m offshore (bottom depth 17.5 m). Aloricate ciliates dominated in both periods (median 117 and 243 ind. L-1 in the first and second period respectively) while tintinnids were more abundant in the first period (median 55 ind. L-1vs 16 ind. L-1). For heterotrophic dinoflagellates there are no data during the first period and in the second one they represented the second major group. Micrometazoans remained almost constant over time. In the first period all microzooplankton groups showed a maximum in April, while in the last period the peak has shifted to September. This is particularly evident for both aloricate ciliates and micrometazoans. Tintinnids, that in the past had the absolute maximum in spring, in the second period maintained the only, lower peak in October. Tintinnids in the first period were constituted by 27 species and dominated by the genera Tintinnopsis, Stenosemella and Salpingella. In the last 10 years we registered a dramatic decrease in abundance, paralleling an increase in species (40) with some "new entries" as well as the almost complete disappearance of genera Helicostomella, Favella, Coxiella and Steenstrupiella. The observed changes of the seasonal dynamics of microzooplankton abundance, as well as of the tintinnids composition over the long period considered in our study, might suggest a climatic forcing together with the known anthropogenic oligotrophication of the entire North Adriatic.

  15. Dynamics of the abundance of some bivalve species in Russian waters of the Sea of Japan and its prognosis

    NASA Astrophysics Data System (ADS)

    Gabaev, D. D.

    2009-04-01

    The abundance dynamics of several species of bivalve mollusks spats were studied on scallop collectors situated in Minonosok bay of Pos’eta Gulf for 27 years and for 4 years in Kit bay of the Sea of Japan (Russia). A significant positive relation was found between the species having similar thermopathy: the Japanese scallop Mizuhopecten yessoensis and Swift’s scallop Swiftopecten swifti, as well as between the wrinkled rock borer Hiatella arctica and Swift’s scallop Swiftopecten swifti. A significant reverse relation was found between the bay mussel Mytilus trossulus and the Northern Pacific seastar Asterias amurensis. Some of the studied mollusks of Minonosok bay and the remote Kit bay display a significant reversed interrelation in their abundance dynamics caused by the precipitation regime. The one-way dispersion analysis a revealed significant influence of the water temperature in June and the precipitation abundance in the summer on Swift’s scallop’s dynamic abundance. The two-way dispersion analysis showed a significant influence of the ice period duration and the solar activity expressed in Wolf’s numbers on the Japanese scallop abundance dynamics. The uneven years in the period from 1977 to 1984 were usually productive for M. yessoensis and S. swifti spat. After 1985, the even years became more productive (there was asynchronicity in the abundance dynamics compared with 1977-1984). Such asynchronicity appeared with the advent of the new 22-year solar cycle, which caused a change in the magnet polarity in 1986.

  16. Effects of Chemical Abundances on the Structure and Dynamics of the Solar Atmosphere

    NASA Astrophysics Data System (ADS)

    Demarque, Pierre; Basu, S.; Robinson, F.; Hunter, C.; Kallinger, T.

    2008-05-01

    This paper presents a comparison between two three-dimensional radiative hydrodynamical (3D RHD) simulations of the solar outer layers using the Grevesse & Sauval (1998; GS98) and the Asplund, Grevesse & Sauval (2005; AGS05) mixtures, respectively. The AGS05 mixture is a revision of the solar abundance mixture using a model atmosphere based on the stratification and dynamics of a solar 3D RHD simulation performed with the GS98 mixture, using the code of Stein & Nordlund (1989, 1998). Our simulations use the same code, and physically realistic treatment of radiative opacities and equation of state as Robinson et al. (2003). A comparison between our GS98 and AGS05 3D simulations shows differences both in the mean vertical temperature gradient and in the turbulent velocity field in the line forming region of the solar atmosphere. The whole superadiabatic layer (SAL) in the AGS05 simulation, including its peak, is shifted outward with respect to the GS98 SAL. Turbulent velocities, critical for absorption line profile calculations, are larger in the AGS05 simulation by about 10%. Since opacities for the AGS05 mixture are lower than those for the GS98 mixture, the T-τ relations derived from the two simulations are different. At 5000K, τ obtained from the GS98 simulation is about 30% larger than that obtained from the AGS05 simulation. These results show the importance of preserving self consistency in the chemical abundances between the model atmosphere and the 3D HRD simulation. When deriving the solar abundances, one must iterate the chemical composition in the model atmosphere, and hence in the 3D simulation on which the atmosphere is based. This research was supported in part by NASA/ATP grant NAG5-13299 (PD and FR) and NSF grant ATM 0348837 to SB.

  17. Statistical analysis of polychaete population density: dynamics of dominant species and scaling properties in relative abundance fluctuations

    NASA Astrophysics Data System (ADS)

    Quiroz-Martinez, B.; Schmitt, F. G.; Dauvin, J.-C.

    2012-01-01

    We consider here the dynamics of two polychaete populations based on a 20 yr temporal benthic survey of two muddy fine sand communities in the Bay of Morlaix, Western English Channel. These populations display high temporal variability, which is analyzed here using scaling approaches. We find that population densities have heavy tailed probability density functions. We analyze the dynamics of relative species abundance in two different communities of polychaetes by estimating in a novel way a "mean square drift" coefficient which characterizes their fluctuations in relative abundance over time. We show the usefulness of using new tools to approach and model such highly variable population dynamics in marine ecosystems.

  18. Abundance, diversity and seasonal dynamics of predatory bacteria in aquaculture zero discharge systems.

    PubMed

    Kandel, Prem P; Pasternak, Zohar; van Rijn, Jaap; Nahum, Ortal; Jurkevitch, Edouard

    2014-07-01

    Standard aquaculture generates large-scale pollution and strains water resources. In aquaculture using zero discharge systems (ZDS), highly efficient fish growth and water recycling are combined. The wastewater stream is directed through compartments in which beneficial microbial activities induced by creating suitable environmental conditions remove biological and chemical pollutants, alleviating both problems. Bacterial predators, preying on bacterial populations in the ZDS, may affect their diversity, composition and functional redundancy, yet in-depth understanding of this phenomenon is lacking. The dynamics of populations belonging to the obligate predators Bdellovibrio and like organisms (BALOs) were analyzed in freshwater and saline ZDS over a 7-month period using QPCR targeting the Bdellovibrionaceae, and the Bacteriovorax and Bacteriolyticum genera in the Bacteriovoracaeae. Both families co-existed in ZDS compartments, constituting 0.13-1.4% of total Bacteria. Relative predator abundance varied according to the environmental conditions prevailing in different compartments, most notably salinity. Strikingly, the Bdellovibrionaceae, hitherto only retrieved from freshwater and soil, also populated the saline system. In addition to the detected BALOs, other potential predators were highly abundant, especially from the Myxococcales. Among the general bacterial population, Flavobacteria, Bacteroidetes, Fusobacteriaceae and unclassified Bacteria dominated a well mixed but seasonally fluctuating diverse community of up to 238 operational taxonomic units, as revealed by 16S rRNA gene sequencing.

  19. Abundance, diversity and seasonal dynamics of predatory bacteria in aquaculture zero discharge systems.

    PubMed

    Kandel, Prem P; Pasternak, Zohar; van Rijn, Jaap; Nahum, Ortal; Jurkevitch, Edouard

    2014-07-01

    Standard aquaculture generates large-scale pollution and strains water resources. In aquaculture using zero discharge systems (ZDS), highly efficient fish growth and water recycling are combined. The wastewater stream is directed through compartments in which beneficial microbial activities induced by creating suitable environmental conditions remove biological and chemical pollutants, alleviating both problems. Bacterial predators, preying on bacterial populations in the ZDS, may affect their diversity, composition and functional redundancy, yet in-depth understanding of this phenomenon is lacking. The dynamics of populations belonging to the obligate predators Bdellovibrio and like organisms (BALOs) were analyzed in freshwater and saline ZDS over a 7-month period using QPCR targeting the Bdellovibrionaceae, and the Bacteriovorax and Bacteriolyticum genera in the Bacteriovoracaeae. Both families co-existed in ZDS compartments, constituting 0.13-1.4% of total Bacteria. Relative predator abundance varied according to the environmental conditions prevailing in different compartments, most notably salinity. Strikingly, the Bdellovibrionaceae, hitherto only retrieved from freshwater and soil, also populated the saline system. In addition to the detected BALOs, other potential predators were highly abundant, especially from the Myxococcales. Among the general bacterial population, Flavobacteria, Bacteroidetes, Fusobacteriaceae and unclassified Bacteria dominated a well mixed but seasonally fluctuating diverse community of up to 238 operational taxonomic units, as revealed by 16S rRNA gene sequencing. PMID:24749684

  20. [Dynamics of abundance of antifungal strains of Pseudomonas in the rhizosphere of hydroponic cucumbers grown on greenhouse mineral substrate].

    PubMed

    Kravchenko, L V; Shaposhnikov, A I; Makarova, N M; Azarova, T S; Tikhonovich, I A

    2006-01-01

    Data were obtained on the dynamics of the abundance of the biocontrol strains of Pseudomonas chlororaphis SPB1217 and Pseudomonas fluorescens SPB2137 with antifungal activity. These strains are able to develop in the rhizosphere of cucumbers grown on mineral substrate under hydroponic conditions in industrial greenhouses. After four weeks of vegetation of plants, the abundance of the inoculated strains was 19-28% of the total bacterial numbers determined by inoculation onto solid medium. The investigated strains spread together with the young, actively growing and exudating roots; they reached a stable level of abundance in deep layers of the greenhouse substrate. A significant difference in the abundance of fungi in the tested variants was observed after 20 days of vegetation: the abundance of fungi in the control was two times higher than in the variant inoculated with strain SPB2137.

  1. Probing surface hydrogen bonding and dynamics by natural abundance, multidimensional, 17O DNP-NMR spectroscopy

    DOE PAGES

    Perras, Frederic A.; Chaudhary, Umesh; Slowing, Igor I.; Pruski, Marek

    2016-05-06

    Dynamic nuclear polarization (DNP)-enhanced solid-state nuclear magnetic resonance (SSNMR) spectroscopy is increasingly being used as a tool for the atomic-level characterization of surface sites. DNP surface-enhanced SSNMR spectroscopy of materials has, however, been limited to studying relatively receptive nuclei, and the particularly rare 17O nuclide, which is of great interest for materials science, has not been utilized. We demonstrate that advanced 17O SSNMR experiments can be performed on surface species at natural isotopic abundance using DNP. We use 17O DNP surface-enhanced 2D SSNMR to measure 17O{1H} HETCOR spectra as well as dipolar oscillations on a series of thermally treatedmore » mesoporous silica nanoparticle samples having different pore diameters. These experiments allow for a nonintrusive and unambiguous characterization of hydrogen bonding and dynamics at the surface of the material; no other single experiment can give such details about the interactions at the surface. Lastly, our data show that, upon drying, strongly hydrogen-bonded surface silanols, whose motions are greatly restricted by the interaction when compared to lone silanols, are selectively dehydroxylated.« less

  2. Cost effective energy conservation measures

    SciTech Connect

    Mashburn, W.H.

    1997-06-01

    Determining the cost effectiveness of energy conservation measures (ECM`s) consists of more than determining simple payback or life cycle costing. If strategic energy planning is involved, then establishment of an energy management program is of major importance. Training incorporated into the energy auditing process enhances the audit by involving knowledgeable employees, as well an increasing the chance of implementation of measures identified and reported. Involving employees in the process gives them ownership, and greatly improves the implementation rate. Once a company gets turned on to saving energy, it spreads like wildfire through the plant. Consultants who incorporate training as part of their audit will enhance their marketability. This paper discusses training techniques as a part of the auditing process, and lists major potential ECM`s that the author has found to have a high priority.

  3. Dynamics of Vibrio cholerae abundance in Austrian saline lakes, assessed with quantitative solid-phase cytometry.

    PubMed

    Schauer, Sonja; Jakwerth, Stefan; Bliem, Rupert; Baudart, Julia; Lebaron, Philippe; Huhulescu, Steliana; Kundi, Michael; Herzig, Alois; Farnleitner, Andreas H; Sommer, Regina; Kirschner, Alexander

    2015-11-01

    In order to elucidate the main predictors of Vibrio cholerae dynamics and to estimate the risk of Vibrio cholera-related diseases, a recently developed direct detection approach based on fluorescence in situ hybridization and solid-phase cytometry (CARD-FISH/SPC) was applied in comparison to cultivation for water samples from the lake Neusiedler See, Austria and three shallow alkaline lakes over a period of 20 months. Vibrio cholerae attached to crustacean zooplankton was quantified via FISH and epifluorescence microscopy. Concentrations obtained by CARD-FISH/SPC were significantly higher than those obtained by culture in 2011, but were mostly of similar magnitude in 2012. Maximum cell numbers were 1.26 × 10(6) V. cholerae per L in Neusiedler See and 7.59 × 10(7) V. cholerae per L in the shallow alkaline lakes. Only on a few occasions during summer was the crustacean zooplankton the preferred habitat for V. cholerae. In winter, V. cholerae was not culturable but could be quantified at all sites with CARD-FISH/SPC. Beside temperature, suspended solids, zooplankton and ammonium were the main predictors of V. cholerae abundance in Neusiedler See, while in the shallow alkaline lakes it was organic carbon, conductivity and phosphorus. Based on the obtained concentrations a first estimation of the health risk for visitors of the lake could be performed.

  4. [Cost-effectiveness analysis of professional oral hygiene].

    PubMed

    Olesov, E E; Shaĭmieva, N I; Kononenko, V I; Bersanov, R U; Monakova, N E

    2014-01-01

    Periodontal status and oral hygiene indexes were studied in 125 young employee of Kurchatov Institute. Oral hygiene values dynamic was assessed after professional oral hygiene in persons with unsatisfactory oral hygiene at baseline examination. When compared with the same values in the absence of professional oral hygiene procedures the results allowed calculating cost-effectiveness rate for biannual professional oral hygiene.

  5. Rodent Abundance Dynamics and Leptospirosis Carriage in an Area of Hyper-Endemicity in New Caledonia

    PubMed Central

    Perez, Julie; Brescia, Fabrice; Becam, Jérôme; Mauron, Carine; Goarant, Cyrille

    2011-01-01

    Background Widespread but particularly incident in the tropics, leptospirosis is transmitted to humans directly or indirectly by virtually any Mammal species. However, rodents are recognized as the most important reservoir. In endemic regions, seasonal outbreaks are observed during hot rainy periods. In such regions, hot spots can be evidenced, where leptospirosis is “hyper-endemic”, its incidence reaching 500 annual cases per 100,000. A better knowledge of how rodent populations and their Leptospira prevalence respond to seasonal and meteorological fluctuations might help implement relevant control measures. Methodology/Principal Findings In two tribes in New Caledonia with hyper-endemic leptospirosis, rodent abundance and Leptospira prevalence was studied twice a year, in hot and cool seasons for two consecutive years. Highly contrasted meteorological situations, particularly rainfall intensities, were noted between the two hot seasons studied. Our results show that during a hot and rainy period, both the rodent populations and their Leptospira carriage were higher. This pattern was more salient in commensal rodents than in the sylvatic rats. Conclusions/Significance The dynamics of rodents and their Leptospira carriage changed during the survey, probably under the influence of meteorology. Rodents were both more numerous and more frequently carrying (therefore disseminating) leptospires during a hot rainy period, also corresponding to a flooding period with higher risks of human exposure to waters and watered soils. The outbreaks of leptospirosis in hyper-endemic areas could arise from meteorological conditions leading to both an increased risk of exposure of humans and an increased volume of the rodent reservoir. Rodent control measures would therefore be most effective during cool and dry seasons, when rodent populations and leptospirosis incidence are low. PMID:22039557

  6. Population dynamics in a cyclic environment: consequences of cyclic food abundance on tawny owl reproduction and survival.

    PubMed

    Karell, Patrik; Ahola, Kari; Karstinen, Teuvo; Zolei, Aniko; Brommer, Jon E

    2009-09-01

    1. Understanding which factors regulate population dynamics may help us to understand how a population would respond to environmental change, and why some populations are declining. 2. In southern Finland, vole abundance shows a three-phased cycle of low, increase and decrease phases, but these have been fading out in recent years. During five such cycles (1981-1995), all tawny owls Strix aluco were censused in a 250-km(2) study area, and their reproduction and survival were monitored. 3. Males and females showed similar dynamics, but experienced breeders recruited more offspring and had higher survival than first breeders. Offspring recruitment, but not survival of breeding individuals varied in accordance with vole abundance. 4. The population's numerical response to prey abundance was primarily due to first-breeding individuals entering the population in the increase phase when immigration was the highest. First-breeding birds were younger, but experienced breeders were older in more favourable vole years. 5. A stage-specific matrix population model integrating survival and fecundity showed that, despite obvious variation in fecundity between vole cycle phases, this variation had limited importance for overall tawny owl population dynamics, but that the survival of experienced breeders during the low phase is most important for population growth. 6. Model and data agreed that the vole cycle drives the dynamics of this avian predator by limiting the recruitment of new breeders during the low phase. Population dynamics hence differ not only from the classic example of the species in a more temperate region in the UK where the number of territories is stable across years, but also from the dynamics of other avian vole predators in Fennoscandia where the recurring crash in vole abundance drastically lowers adult survival thereby creating vacancies. PMID:19493132

  7. Controls of picophytoplankton abundance and composition in a highly dynamic marine system, the Northern Alboran Sea (Western Mediterranean)

    NASA Astrophysics Data System (ADS)

    Amorim, Ana L.; León, Pablo; Mercado, Jesús M.; Cortés, Dolores; Gómez, Francisco; Putzeys, Sebastien; Salles, Soluna; Yebra, Lidia

    2016-06-01

    The Alboran Sea is a highly dynamic basin which exhibits a high spatio-temporal variability of hydrographic structures (e.g. fronts, gyres, coastal upwellings). This work compares the abundance and composition of picophytoplankton observed across the northern Alboran Sea among eleven cruises between 2008 and 2012 using flow cytometry. We evaluate the seasonal and longitudinal variability of picophytoplankton on the basis of the circulation regimes at a regional scale and explore the presence of cyanobacteria ecotypes in the basin. The maximal abundances obtained for Prochlorococcus, Synechococcus and picoeukaryotes (12.7 × 104, 13.9 × 104 and 8.6 × 104 cells mL- 1 respectively) were consistent with those reported for other adjacent marine areas. Seasonal changes in the abundance of the three picophytoplankton groups were highly significant although they did not match the patterns described for other coastal waters. Higher abundances of Prochlorococcus were obtained in autumn-winter while Synechococcus and picoeukaryotes exhibited a different seasonal abundance pattern depending on the sector (e.g. Synechococcus showed higher abundance in summer in the west sector and during winter in the eastern study area). Additionally, conspicuous longitudinal gradients were observed for Prochlorococcus and Synechococcus, with Prochlorococcus decreasing from west to east and Synechococcus following the opposite pattern. The analysis of environmental variables (i.e. temperature, salinity and inorganic nutrients) and cell abundances indicates that Prochlorococcus preferred high salinity and nitrate to phosphate ratio. On the contrary, temperature did not seem to play a role in Prochlorococcus distribution as it was numerically important during the whole seasonal cycle. Variability in Synechococcus abundance could not be explained by changes in any environmental variable suggesting that different ecotypes were sampled during the surveys. In particular, our data would indicate

  8. Abundance and size distribution dynamics of abyssal epibenthic megafauna in the northeast Pacific.

    PubMed

    Ruhl, Henry A

    2007-05-01

    The importance of interannual variation in deep-sea abundances is now becoming recognized. There is, however, relatively little known about what processes dominate the observed fluctuations. The abundance and size distribution of the megabenthos have been examined here using a towed camera system at a deep-sea station in the northeast Pacific (Station M) from 1989 to 2004. This 16-year study included 52 roughly seasonal transects averaging 1.2 km in length with over 35600 photographic frames analyzed. Mobile epibenthic megafauna at 4100 m depth have exhibited interannual scale changes in abundance from one to three orders of magnitude. Increases in abundance have now been significantly linked to decreases in mean body size, suggesting that accruals in abundance probably result from the recruitment of young individuals. Examinations of size-frequency histograms indicate several possible recruitment events. Shifts in size-frequency distributions were also used to make basic estimations of individual growth rates from 1 to 6 mm/month, depending on the taxon. Regional intensification in reproduction followed by recruitment within the study area could explain the majority of observed accruals in abundance. Although some adult migration is certainly probable in accounting for local variation in abundances, the slow movements of benthic life stages restrict regional migrations for most taxa. Negative competitive interactions and survivorship may explain the precipitous declines of some taxa. This and other studies have shown that abundances from protozoans to large benthic invertebrates and fishes all have undergone significant fluctuations in abundance at Station M over periods of weeks to years. PMID:17536411

  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. Impact of climate and mosquito vector abundance on sylvatic arbovirus circulation dynamics in Senegal.

    PubMed

    Althouse, Benjamin M; Hanley, Kathryn A; Diallo, Mawlouth; Sall, Amadou A; Ba, Yamar; Faye, Ousmane; Diallo, Diawo; Watts, Douglas M; Weaver, Scott C; Cummings, Derek A T

    2015-01-01

    Sylvatic arboviruses have been isolated in Senegal over the last 50 years. The ecological drivers of the pattern and frequency of virus infection in these species are largely unknown. We used time series analysis and Bayesian hierarchical count modeling on a long-term arbovirus dataset to test associations between mosquito abundance, weather variables, and the frequency of isolation of dengue, yellow fever, chikungunya, and Zika viruses. We found little correlation between mosquito abundance and viral isolations. Rainfall was a negative predictor of dengue virus (DENV) isolation but a positive predictor of Zika virus isolation. Temperature was a positive predictor of yellow fever virus (YFV) isolations but a negative predictor of DENV isolations. We found slight interference between viruses, with DENV negatively associated with concurrent YFV isolation and YFV negatively associated with concurrent isolation of chikungunya virus. These findings begin to characterize some of the ecological associations of sylvatic arboviruses with each other and climate and mosquito abundance.

  11. Impact of Climate and Mosquito Vector Abundance on Sylvatic Arbovirus Circulation Dynamics in Senegal

    PubMed Central

    Althouse, Benjamin M.; Hanley, Kathryn A.; Diallo, Mawlouth; Sall, Amadou A.; Ba, Yamar; Faye, Ousmane; Diallo, Diawo; Watts, Douglas M.; Weaver, Scott C.; Cummings, Derek A. T.

    2015-01-01

    Sylvatic arboviruses have been isolated in Senegal over the last 50 years. The ecological drivers of the pattern and frequency of virus infection in these species are largely unknown. We used time series analysis and Bayesian hierarchical count modeling on a long-term arbovirus dataset to test associations between mosquito abundance, weather variables, and the frequency of isolation of dengue, yellow fever, chikungunya, and Zika viruses. We found little correlation between mosquito abundance and viral isolations. Rainfall was a negative predictor of dengue virus (DENV) isolation but a positive predictor of Zika virus isolation. Temperature was a positive predictor of yellow fever virus (YFV) isolations but a negative predictor of DENV isolations. We found slight interference between viruses, with DENV negatively associated with concurrent YFV isolation and YFV negatively associated with concurrent isolation of chikungunya virus. These findings begin to characterize some of the ecological associations of sylvatic arboviruses with each other and climate and mosquito abundance. PMID:25404071

  12. [Effects of macro-jellyfish abundance dynamics on fishery resource structure in the Yangtze River estuary and its adjacent waters].

    PubMed

    Shan, Xiu-Juan; Zhuang, Zhi-Meng; Jin, Xian-Shi; Dai, Fang-Qun

    2011-12-01

    Based on the bottom trawl survey data in May 2007 and May and June 2008, this paper analyzed the effects of the abundance dynamics of macro-jellyfish on the species composition, distribution, and abundance of fishery resource in the Yangtze River estuary and its adjacent waters. From May 2007 to June 2008, the average catch per haul and the top catch per haul of macro-jellyfish increased, up to 222.2 kg x h(-1) and 1800 kg x h(-1) in June 2008, respectively. The macro-jellyfish were mainly distributed in the areas around 50 m isobath, and not beyond 100 m isobath where was the joint front of the coastal waters of East China Sea, Yangtze River runoff, and Taiwan Warm Current. The main distribution area of macro-jellyfish in June migrated northward, as compared with that in May, and the highest catches of macro-jellyfish in May 2007 and May 2008 were found in the same sampling station (122.5 degrees E, 28.5 degrees N). In the sampling stations with higher abundance of macro-jellyfish, the fishery abundance was low, and the fishery species also changed greatly, mainly composed by small-sized species (Trachurus japonicus, Harpadon nehereus, and Acropoma japonicum) and pelagic species (Psenopsis anomala, Octopus variabilis) and Trichiurus japonicus, and P. anomala accounted for 23.7% of the total catch in June 2008. Larimichthys polyactis also occupied higher proportion of the total catch in sampling stations with higher macro-jellyfish abundance, but the demersal species Lophius litulon was not found, and a few crustaceans were collected. This study showed that macro-jellyfish had definite negative effects on the fishery community structure and abundance in the Yangtze River estuary fishery ecosystem, and further, changed the energy flow patterns of the ecosystem through cascading trophic interactions. Therefore, macro-jellyfish was strongly suggested to be an independent ecological group when the corresponding fishery management measures were considered.

  13. Diversity, abundance, and evolutionary dynamics of Pong-like transposable elements in Triticeae.

    PubMed

    Markova, Dragomira N; Mason-Gamer, Roberta J

    2015-12-01

    Pong-like elements are members of the PIF/Harbinger superfamily of DNA transposons that has been described in many plants, animals, and fungi. Most Pong elements contain two open reading frames (ORFs). One encodes a transposase (ORF2) that catalyzes transposition of Pong and related non-autonomous elements, while the function of the second is unknown. Little is known about the evolutionary history of Pong elements in flowering plants. In this work, we present the first comprehensive analysis of the diversity, abundance, and evolution of the Pong-like transposase gene in the genomes of 21 diploid species from the wheat tribe, Triticeae, and we present the first convincing evidence of horizontal transfer of nuclear-encoded Pong elements in any organism. A phylogenetic analysis of nearly 300 Pong sequences based on a conserved region of the transposase domain revealed a complex evolutionary history of Pong elements that can be best explained by ancestral polymorphism, followed by differential evolutionary success of some transposase lineages, and by occasional horizontal transfer between phylogenetically distant genera. In addition, we used transposon display to estimate the abundance of the transposase gene within Triticeae genomes, and our results revealed varying levels of Pong proliferation, with numbers of transposase copies ranging from 22 to 92. Comparisons of Pong transposase abundance to flow cytometry estimates of genome size revealed that larger Triticeae genome size was not correlated with transposase abundance. PMID:26206730

  14. Chemical Abundances in NGC 5053: A Very Metal-poor and Dynamically Complex Globular Cluster

    NASA Astrophysics Data System (ADS)

    Boberg, Owen M.; Friel, Eileen D.; Vesperini, Enrico

    2015-05-01

    NGC 5053 provides a rich environment to test our understanding of the complex evolution of globular clusters (GCs). Recent studies have found that this cluster has interesting morphological features beyond the typical spherical distribution of GCs, suggesting that external tidal effects have played an important role in its evolution and current properties. Additionally, simulations have shown that NGC 5053 could be a likely candidate to belong to the Sagittarius dwarf galaxy (Sgr dSph) stream. Using the Wisconsin-Indiana-Yale-NOAO-Hydra multi-object spectrograph, we have collected high quality (signal-to-noise ratio ˜ 75-90), medium-resolution spectra for red giant branch stars in NGC 5053. Using these spectra we have measured the Fe, Ca, Ti, Ni, Ba, Na, and O abundances in the cluster. We measure an average cluster [Fe/H] abundance of -2.45 with a standard deviation of 0.04 dex, making NGC 5053 one of the most metal-poor GCs in the Milky Way (MW). The [Ca/Fe], [Ti/Fe], and [Ba/Fe] we measure are consistent with the abundances of MW halo stars at a similar metallicity, with alpha-enhanced ratios and slightly depleted [Ba/Fe]. The Na and O abundances show the Na-O anti-correlation found in most GCs. From our abundance analysis it appears that NGC 5053 is at least chemically similar to other GCs found in the MW. This does not, however, rule out NGC 5053 being associated with the Sgr dSph stream.

  15. Spatial-Temporal Survey and Occupancy-Abundance Modeling To Predict Bacterial Community Dynamics in the Drinking Water Microbiome

    PubMed Central

    Pinto, Ameet J.; Schroeder, Joanna; Lunn, Mary; Sloan, William

    2014-01-01

    ABSTRACT Bacterial communities migrate continuously from the drinking water treatment plant through the drinking water distribution system and into our built environment. Understanding bacterial dynamics in the distribution system is critical to ensuring that safe drinking water is being supplied to customers. We present a 15-month survey of bacterial community dynamics in the drinking water system of Ann Arbor, MI. By sampling the water leaving the treatment plant and at nine points in the distribution system, we show that the bacterial community spatial dynamics of distance decay and dispersivity conform to the layout of the drinking water distribution system. However, the patterns in spatial dynamics were weaker than those for the temporal trends, which exhibited seasonal cycling correlating with temperature and source water use patterns and also demonstrated reproducibility on an annual time scale. The temporal trends were driven by two seasonal bacterial clusters consisting of multiple taxa with different networks of association within the larger drinking water bacterial community. Finally, we show that the Ann Arbor data set robustly conforms to previously described interspecific occupancy abundance models that link the relative abundance of a taxon to the frequency of its detection. Relying on these insights, we propose a predictive framework for microbial management in drinking water systems. Further, we recommend that long-term microbial observatories that collect high-resolution, spatially distributed, multiyear time series of community composition and environmental variables be established to enable the development and testing of the predictive framework. PMID:24865557

  16. The role of water mass dynamics in controlling bacterial abundance and production in the middle Adriatic Sea.

    PubMed

    Solić, M; Krstulović, N; Vilibić, I; Kuspilić, G; Sestanović, S; Santić, D; Ordulj, M

    2008-06-01

    Month-to-month fluctuations in the abundance of bacteria and heterotrophic nanoflagellates (HNF) and bacterial production, as well as various chemical (nutrients, oxygen) and physical (salinity, temperature) parameters were analysed at a station located in the open middle Adriatic Sea during one decade (1997-2006). Being influenced by both coastal waters and open Adriatic circulation in the surface layer, and by the deep Adriatic water masses in the deep layers (100 m), this station is quite suitable for detecting the environmental changes occurring in the open Adriatic Sea with respect to the circulation of its water masses and their long-term changes and anomalies. Multivariate methods were used to identify seasonal and inter-annual changes of the investigated parameters, associating observed changes to the changes in Adriatic water masses and circulation regimes. The analyses showed that bacterial abundance and production were controlled by different water mass dynamics during 1997-2001 compared to 2002-2006 period, particularly noticeable in different seasonal patterns of biological parameters. The interplay between North Adriatic Dense Water (NAdDW) and Levantine Intermediate Water (LIW) resulted in a change in the available nutrients (NAdDW is poor in orthophosphates), and as a consequence different bacterial abundance and production. A few periods were examined in detail, such as 2004, when LIW inflow was particularly strong and was accompanied by an increase of bacterial and HNF abundances, as well as of bacterial production.

  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. Cost-Effectiveness and Educational Policy.

    ERIC Educational Resources Information Center

    Levin, Henry M.

    1988-01-01

    Techniques of cost-effectiveness analysis and their applications to educational policy are discussed. Recommendations are made to increase the capacity of evaluators, policy analysts, and decision makers to use these tools appropriately for resource allocation. (SLD)

  19. Spatial and seasonal dynamic of abundance and distribution of guanaco and livestock: insights from using density surface and null models.

    PubMed

    Schroeder, Natalia M; Matteucci, Silvia D; Moreno, Pablo G; Gregorio, Pablo; Ovejero, Ramiro; Taraborelli, Paula; Carmanchahi, Pablo D

    2014-01-01

    Monitoring species abundance and distribution is a prerequisite when assessing species status and population viability, a difficult task to achieve for large herbivores at ecologically meaningful scales. Co-occurrence patterns can be used to infer mechanisms of community organization (such as biotic interactions), although it has been traditionally applied to binary presence/absence data. Here, we combine density surface and null models of abundance data as a novel approach to analyze the spatial and seasonal dynamics of abundance and distribution of guanacos (Lama guanicoe) and domestic herbivores in northern Patagonia, in order to visually and analytically compare the dispersion and co-occurrence pattern of ungulates. We found a marked seasonal pattern in abundance and spatial distribution of L. guanicoe. The guanaco population reached its maximum annual size and spatial dispersion in spring-summer, decreasing up to 6.5 times in size and occupying few sites of the study area in fall-winter. These results are evidence of the seasonal migration process of guanaco populations, an increasingly rare event for terrestrial mammals worldwide. The maximum number of guanacos estimated for spring (25,951) is higher than the total population size (10,000) 20 years ago, probably due to both counting methodology and population growth. Livestock were mostly distributed near human settlements, as expected by the sedentary management practiced by local people. Herbivore distribution was non-random; i.e., guanaco and livestock abundances co-varied negatively in all seasons, more than expected by chance. Segregation degree of guanaco and small-livestock (goats and sheep) was comparatively stronger than that of guanaco and large-livestock, suggesting a competition mechanism between ecologically similar herbivores, although various environmental factors could also contribute to habitat segregation. The new and compelling combination of methods used here is highly useful for

  20. Spatial and Seasonal Dynamic of Abundance and Distribution of Guanaco and Livestock: Insights from Using Density Surface and Null Models

    PubMed Central

    Schroeder, Natalia M.; Matteucci, Silvia D.; Moreno, Pablo G.; Gregorio, Pablo; Ovejero, Ramiro; Taraborelli, Paula; Carmanchahi, Pablo D.

    2014-01-01

    Monitoring species abundance and distribution is a prerequisite when assessing species status and population viability, a difficult task to achieve for large herbivores at ecologically meaningful scales. Co-occurrence patterns can be used to infer mechanisms of community organization (such as biotic interactions), although it has been traditionally applied to binary presence/absence data. Here, we combine density surface and null models of abundance data as a novel approach to analyze the spatial and seasonal dynamics of abundance and distribution of guanacos (Lama guanicoe) and domestic herbivores in northern Patagonia, in order to visually and analytically compare the dispersion and co-occurrence pattern of ungulates. We found a marked seasonal pattern in abundance and spatial distribution of L. guanicoe. The guanaco population reached its maximum annual size and spatial dispersion in spring-summer, decreasing up to 6.5 times in size and occupying few sites of the study area in fall-winter. These results are evidence of the seasonal migration process of guanaco populations, an increasingly rare event for terrestrial mammals worldwide. The maximum number of guanacos estimated for spring (25951) is higher than the total population size (10000) 20 years ago, probably due to both counting methodology and population growth. Livestock were mostly distributed near human settlements, as expected by the sedentary management practiced by local people. Herbivore distribution was non-random; i.e., guanaco and livestock abundances co-varied negatively in all seasons, more than expected by chance. Segregation degree of guanaco and small-livestock (goats and sheep) was comparatively stronger than that of guanaco and large-livestock, suggesting a competition mechanism between ecologically similar herbivores, although various environmental factors could also contribute to habitat segregation. The new and compelling combination of methods used here is highly useful for researchers

  1. Population dynamics of some Pakistan mosquitoes: changes in adult relative abundance over time and space.

    PubMed

    Reisen, W K; Milby, M M

    1986-02-01

    Time series and spatial changes in the relative abundance of 14 mosquito species were described from weekly or biweekly collections at nine localities in Punjab province, Pakistan, from January 1976 to June 1980. Comparisons between indoor aspirator catches and outdoor mechanical sweeper collections enabled mosquito resting habits to be classified as: (1) endophilic (Anopheles culicifacies, An. fluviatilis, An. stephensi, An. subpictus); (2) partially exophilic (An. annularis, An. pulcherrimus, An. nigerrimus, Culex bitaeniorhynchus, Cx, pseudovishnui, Cx, quinquefasciatus, Cx. tritaeniorhynchus), or exophilic (Cx. fuscocephala, Aedes caspius, Mansonia uniformis). Temporal abundance patterns were grouped by seasonality, overwintering strategies and the magnitude of fluctuation. Seasonal patterns were: (1) unimodal-spring (Cx. quinquefasciatus, Ae. capius); (2) unimodal-monsoon (An. nigerrimus, An. subpictus, Cx. bitaeniorhynchus, Cx. fuscocephala); (3) bimodal-spring dominant (An. annularis, An. culcifacies, An. stephensi), and (4) bimodal-monsoon/post-monsoon dominant (An. fluviatilis, An. pulcherrimus, Cx. pseudovishnui, Cx. tritaeniorhynchus, Ma. uniformis). Mosquito overwintering strategies included: (1) adults with slowed reproductive activity (An. annularis, An. culicifacies, An. fluviatilis, An. pulcherrimus, An. stephensi, Cx. quinquefasciatus); (2) females with interrupted reproductive activity (An. nigerrimus, Cx. fuscocephala, Cx. pseudovishnui, Cx. tritaeniorhynchus); (3) immature stages (Ae. caspius, Ma. uniformis) and (4) annual extinction and re-introduction (An. subpictus). The magnitude of seasonal change was classified by the number of standard deviations from the overall mean exhibited by the annual maxima or minima: (1) stationary, less than 1 standard deviation (An. culicifacies, An. fluviatilis, Cx. bitaeniorhynchus, Ae. caspius), (2) fluctuating moderately, one to two standard deviations (An. annularis, An. nigerrimus, An. pulcherrimus, An

  2. Evolutionary dynamics of selfish DNA explains the abundance distribution of genomic subsequences.

    PubMed

    Sheinman, Michael; Ramisch, Anna; Massip, Florian; Arndt, Peter F

    2016-01-01

    Since the sequencing of large genomes, many statistical features of their sequences have been found. One intriguing feature is that certain subsequences are much more abundant than others. In fact, abundances of subsequences of a given length are distributed with a scale-free power-law tail, resembling properties of human texts, such as Zipf's law. Despite recent efforts, the understanding of this phenomenon is still lacking. Here we find that selfish DNA elements, such as those belonging to the Alu family of repeats, dominate the power-law tail. Interestingly, for the Alu elements the power-law exponent increases with the length of the considered subsequences. Motivated by these observations, we develop a model of selfish DNA expansion. The predictions of this model qualitatively and quantitatively agree with the empirical observations. This allows us to estimate parameters for the process of selfish DNA spreading in a genome during its evolution. The obtained results shed light on how evolution of selfish DNA elements shapes non-trivial statistical properties of genomes. PMID:27488939

  3. Functional traits predict relationship between plant abundance dynamic and long-term climate warming.

    PubMed

    Soudzilovskaia, Nadejda A; Elumeeva, Tatiana G; Onipchenko, Vladimir G; Shidakov, Islam I; Salpagarova, Fatima S; Khubiev, Anzor B; Tekeev, Dzhamal K; Cornelissen, Johannes H C

    2013-11-01

    Predicting climate change impact on ecosystem structure and services is one of the most important challenges in ecology. Until now, plant species response to climate change has been described at the level of fixed plant functional types, an approach limited by its inflexibility as there is much interspecific functional variation within plant functional types. Considering a plant species as a set of functional traits greatly increases our possibilities for analysis of ecosystem functioning and carbon and nutrient fluxes associated therewith. Moreover, recently assembled large-scale databases hold comprehensive per-species data on plant functional traits, allowing a detailed functional description of many plant communities on Earth. Here, we show that plant functional traits can be used as predictors of vegetation response to climate warming, accounting in our test ecosystem (the species-rich alpine belt of Caucasus mountains, Russia) for 59% of variability in the per-species abundance relation to temperature. In this mountain belt, traits that promote conservative leaf water economy (higher leaf mass per area, thicker leaves) and large investments in belowground reserves to support next year's shoot buds (root carbon content) were the best predictors of the species increase in abundance along with temperature increase. This finding demonstrates that plant functional traits constitute a highly useful concept for forecasting changes in plant communities, and their associated ecosystem services, in response to climate change. PMID:24145400

  4. Plasma Membrane Abundance of Human Aquaporin 5 Is Dynamically Regulated by Multiple Pathways.

    PubMed

    Kitchen, Philip; Öberg, Fredrik; Sjöhamn, Jennie; Hedfalk, Kristina; Bill, Roslyn M; Conner, Alex C; Conner, Matthew T; Törnroth-Horsefield, Susanna

    2015-01-01

    Aquaporin membrane protein channels mediate cellular water flow. Human aquaporin 5 (AQP5) is highly expressed in the respiratory system and secretory glands where it facilitates the osmotically-driven generation of pulmonary secretions, saliva, sweat and tears. Dysfunctional trafficking of AQP5 has been implicated in several human disease states, including Sjögren's syndrome, bronchitis and cystic fibrosis. In order to investigate how the plasma membrane expression levels of AQP5 are regulated, we studied real-time translocation of GFP-tagged AQP5 in HEK293 cells. We show that AQP5 plasma membrane abundance in transfected HEK293 cells is rapidly and reversibly regulated by at least three independent mechanisms involving phosphorylation at Ser156, protein kinase A activity and extracellular tonicity. The crystal structure of a Ser156 phosphomimetic mutant indicates that its involvement in regulating AQP5 membrane abundance is not mediated by a conformational change of the carboxy-terminus. We suggest that together these pathways regulate cellular water flow. PMID:26569106

  5. Evolutionary dynamics of selfish DNA explains the abundance distribution of genomic subsequences

    PubMed Central

    Sheinman, Michael; Ramisch, Anna; Massip, Florian; Arndt, Peter F.

    2016-01-01

    Since the sequencing of large genomes, many statistical features of their sequences have been found. One intriguing feature is that certain subsequences are much more abundant than others. In fact, abundances of subsequences of a given length are distributed with a scale-free power-law tail, resembling properties of human texts, such as Zipf’s law. Despite recent efforts, the understanding of this phenomenon is still lacking. Here we find that selfish DNA elements, such as those belonging to the Alu family of repeats, dominate the power-law tail. Interestingly, for the Alu elements the power-law exponent increases with the length of the considered subsequences. Motivated by these observations, we develop a model of selfish DNA expansion. The predictions of this model qualitatively and quantitatively agree with the empirical observations. This allows us to estimate parameters for the process of selfish DNA spreading in a genome during its evolution. The obtained results shed light on how evolution of selfish DNA elements shapes non-trivial statistical properties of genomes. PMID:27488939

  6. Plasma Membrane Abundance of Human Aquaporin 5 Is Dynamically Regulated by Multiple Pathways

    PubMed Central

    Kitchen, Philip; Öberg, Fredrik; Sjöhamn, Jennie; Hedfalk, Kristina; Bill, Roslyn M.; Conner, Alex C.; Conner, Matthew T.; Törnroth-Horsefield, Susanna

    2015-01-01

    Aquaporin membrane protein channels mediate cellular water flow. Human aquaporin 5 (AQP5) is highly expressed in the respiratory system and secretory glands where it facilitates the osmotically-driven generation of pulmonary secretions, saliva, sweat and tears. Dysfunctional trafficking of AQP5 has been implicated in several human disease states, including Sjögren’s syndrome, bronchitis and cystic fibrosis. In order to investigate how the plasma membrane expression levels of AQP5 are regulated, we studied real-time translocation of GFP-tagged AQP5 in HEK293 cells. We show that AQP5 plasma membrane abundance in transfected HEK293 cells is rapidly and reversibly regulated by at least three independent mechanisms involving phosphorylation at Ser156, protein kinase A activity and extracellular tonicity. The crystal structure of a Ser156 phosphomimetic mutant indicates that its involvement in regulating AQP5 membrane abundance is not mediated by a conformational change of the carboxy-terminus. We suggest that together these pathways regulate cellular water flow. PMID:26569106

  7. Functional traits predict relationship between plant abundance dynamic and long-term climate warming

    PubMed Central

    Soudzilovskaia, Nadejda A.; Elumeeva, Tatiana G.; Onipchenko, Vladimir G.; Shidakov, Islam I.; Salpagarova, Fatima S.; Khubiev, Anzor B.; Tekeev, Dzhamal K.; Cornelissen, Johannes H. C.

    2013-01-01

    Predicting climate change impact on ecosystem structure and services is one of the most important challenges in ecology. Until now, plant species response to climate change has been described at the level of fixed plant functional types, an approach limited by its inflexibility as there is much interspecific functional variation within plant functional types. Considering a plant species as a set of functional traits greatly increases our possibilities for analysis of ecosystem functioning and carbon and nutrient fluxes associated therewith. Moreover, recently assembled large-scale databases hold comprehensive per-species data on plant functional traits, allowing a detailed functional description of many plant communities on Earth. Here, we show that plant functional traits can be used as predictors of vegetation response to climate warming, accounting in our test ecosystem (the species-rich alpine belt of Caucasus mountains, Russia) for 59% of variability in the per-species abundance relation to temperature. In this mountain belt, traits that promote conservative leaf water economy (higher leaf mass per area, thicker leaves) and large investments in belowground reserves to support next year’s shoot buds (root carbon content) were the best predictors of the species increase in abundance along with temperature increase. This finding demonstrates that plant functional traits constitute a highly useful concept for forecasting changes in plant communities, and their associated ecosystem services, in response to climate change. PMID:24145400

  8. Functional traits predict relationship between plant abundance dynamic and long-term climate warming.

    PubMed

    Soudzilovskaia, Nadejda A; Elumeeva, Tatiana G; Onipchenko, Vladimir G; Shidakov, Islam I; Salpagarova, Fatima S; Khubiev, Anzor B; Tekeev, Dzhamal K; Cornelissen, Johannes H C

    2013-11-01

    Predicting climate change impact on ecosystem structure and services is one of the most important challenges in ecology. Until now, plant species response to climate change has been described at the level of fixed plant functional types, an approach limited by its inflexibility as there is much interspecific functional variation within plant functional types. Considering a plant species as a set of functional traits greatly increases our possibilities for analysis of ecosystem functioning and carbon and nutrient fluxes associated therewith. Moreover, recently assembled large-scale databases hold comprehensive per-species data on plant functional traits, allowing a detailed functional description of many plant communities on Earth. Here, we show that plant functional traits can be used as predictors of vegetation response to climate warming, accounting in our test ecosystem (the species-rich alpine belt of Caucasus mountains, Russia) for 59% of variability in the per-species abundance relation to temperature. In this mountain belt, traits that promote conservative leaf water economy (higher leaf mass per area, thicker leaves) and large investments in belowground reserves to support next year's shoot buds (root carbon content) were the best predictors of the species increase in abundance along with temperature increase. This finding demonstrates that plant functional traits constitute a highly useful concept for forecasting changes in plant communities, and their associated ecosystem services, in response to climate change.

  9. Dynamics of Viral Abundance and Diversity in a Sphagnum-Dominated Peatland: Temporal Fluctuations Prevail Over Habitat.

    PubMed

    Ballaud, Flore; Dufresne, Alexis; Francez, André-Jean; Colombet, Jonathan; Sime-Ngando, Télesphore; Quaiser, Achim

    2015-01-01

    Viruses impact microbial activity and carbon cycling in various environments, but their diversity and ecological importance in Sphagnum-peatlands are unknown. Abundances of viral particles and prokaryotes were monitored bi-monthly at a fen and a bog at two different layers of the peat surface. Viral particle abundance ranged from 1.7 x 10(6) to 5.6 x 10(8) particles mL(-1), and did not differ between fen and bog but showed seasonal fluctuations. These fluctuations were positively correlated with prokaryote abundance and dissolved organic carbon, and negatively correlated with water-table height and dissolved oxygen. Using shotgun metagenomics we observed a shift in viral diversity between winter/spring and summer/autumn, indicating a seasonal succession of viral communities, mainly driven by weather-related environmental changes. Based on the seasonal asynchrony between viral and microbial diversity, we hypothesize a seasonal shift in the active microbial communities associated with a shift from lysogenic to lytic lifestyles. Our results suggest that temporal variations of environmental conditions rather than current habitat differences control the dynamics of virus-host interactions in Sphagnum-dominated peatlands. PMID:26779149

  10. Dynamics of Viral Abundance and Diversity in a Sphagnum-Dominated Peatland: Temporal Fluctuations Prevail Over Habitat

    PubMed Central

    Ballaud, Flore; Dufresne, Alexis; Francez, André-Jean; Colombet, Jonathan; Sime-Ngando, Télesphore; Quaiser, Achim

    2016-01-01

    Viruses impact microbial activity and carbon cycling in various environments, but their diversity and ecological importance in Sphagnum-peatlands are unknown. Abundances of viral particles and prokaryotes were monitored bi-monthly at a fen and a bog at two different layers of the peat surface. Viral particle abundance ranged from 1.7 x 106 to 5.6 x 108 particles mL-1, and did not differ between fen and bog but showed seasonal fluctuations. These fluctuations were positively correlated with prokaryote abundance and dissolved organic carbon, and negatively correlated with water-table height and dissolved oxygen. Using shotgun metagenomics we observed a shift in viral diversity between winter/spring and summer/autumn, indicating a seasonal succession of viral communities, mainly driven by weather-related environmental changes. Based on the seasonal asynchrony between viral and microbial diversity, we hypothesize a seasonal shift in the active microbial communities associated with a shift from lysogenic to lytic lifestyles. Our results suggest that temporal variations of environmental conditions rather than current habitat differences control the dynamics of virus-host interactions in Sphagnum-dominated peatlands. PMID:26779149

  11. The Dynamics of Transcript Abundance during Cellularization of Developing Barley Endosperm1[OPEN

    PubMed Central

    Zhang, Runxuan; Burton, Rachel A; Shirley, Neil J.; Little, Alan; Morris, Jenny; Milne, Linda

    2016-01-01

    Within the cereal grain, the endosperm and its nutrient reserves are critical for successful germination and in the context of grain utilization. The identification of molecular determinants of early endosperm development, particularly regulators of cell division and cell wall deposition, would help predict end-use properties such as yield, quality, and nutritional value. Custom microarray data have been generated using RNA isolated from developing barley grain endosperm 3 d to 8 d after pollination (DAP). Comparisons of transcript abundance over time revealed 47 gene expression modules that can be clustered into 10 broad groups. Superimposing these modules upon cytological data allowed patterns of transcript abundance to be linked with key stages of early grain development. Here, attention was focused on how the datasets could be mined to explore and define the processes of cell wall biosynthesis, remodeling, and degradation. Using a combination of spatial molecular network and gene ontology enrichment analyses, it is shown that genes involved in cell wall metabolism are found in multiple modules, but cluster into two main groups that exhibit peak expression at 3 DAP to 4 DAP and 5 DAP to 8 DAP. The presence of transcription factor genes in these modules allowed candidate genes for the control of wall metabolism during early barley grain development to be identified. The data are publicly available through a dedicated web interface (https://ics.hutton.ac.uk/barseed/), where they can be used to interrogate co- and differential expression for any other genes, groups of genes, or transcription factors expressed during early endosperm development. PMID:26754666

  12. 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.

  13. Constraining the Thermal Structure, Abundances, and Dynamics of the Exoplanet HD 209458b

    NASA Astrophysics Data System (ADS)

    Zellem, Robert; Griffith, Caitlin A.; Lewis, Nikole K.; Swain, Mark R.; Knutson, Heather A.

    2014-11-01

    HD 209458b has been extensively studied from the UV to IR as it is one of the brightest of the transiting exoplanets and has a large planet-to-star contrast. However its thermal profile and abundances remain constrained to at best 3 orders of magnitude (Line et al. 2014), largely due to a lack of spectral coverage. We expand HD 209458b’s wavelength coverage with ground and space observations. Our ground H, K, and L-band secondary eclipse spectroscopy, which explores HD 209458b’s emission mechanisms, is motivated by multiple detections of bright 3.3 μm emission on HD 189733b, resembling the CH4 ν3 band and potentially non-LTE fluorescence (Swain et al. 2010; Waldmann et al. 2012). CH4 fluorescence has previously been observed on Titan (Kim et al. 2000), Saturn, and Jupiter (Drossart et al. 1999; Brown et al. 2003), thereby likening exoplanets to their Solar System counterparts. We find that the hotter HD 209458b lacks to ~3σ a bright 3.3 μm feature as seen on HD 189733b, which is consistent with thermochemical equilibrium predictions (Moses et al. 2011). We measure HD 209458b’s longitudinally-varying thermal structure with Spitzer/IRAC full-orbit phase curve observations, and revise a previous 4.5 μm emission measurement downward by ˜35%. This change is significant because the high 4.5 and 5.8 μm brightness temperatures were interpreted as a thermal inversion (e.g., Line et al. 2014). While our 4.5 μm photometric emission point does not require an inversion, the shape of the phase curve, particularly the location and brightness temperature of the hot spot, suggests that HD 209458b has a dayside inversion. However the nightside is much cooler than predicted by a GCM. This discrepancy is potentially due to the GCM lacking quenching where vertical mixing outpaces reaction rates, causing increased CO and CH4 abundances at higher altitudes. We explore evidence for CH4 quenching with IRAC 3.6 micron data, which overlap the wings of the CH4 ν3 band, allowing

  14. Constraining the Thermal Structure, Abundances, and Dynamics of the Exoplanet HD 209458b

    NASA Astrophysics Data System (ADS)

    Zellem, Robert; Griffith, Caitlin Ann; Lewis, Nikole; Swain, Mark R.; Knutson, Heather

    2015-01-01

    HD 209458b has been extensively studied from the UV to IR as it is one of the brightest of the transiting exoplanets and has a large planet-to-star contrast. However its thermal profile and abundances remain constrained to at best 3 orders of magnitude (Line et al. 2014), largely due to a lack of spectral coverage. We expand HD 209458b's wavelength coverage with ground and space observations. Our ground H, K, and L-band secondary eclipse spectroscopy, which explores HD 209458b's emission mechanisms, is motivated by multiple detections of bright 3.3 μm emission on HD 189733b, resembling the CH4 ν3 band and potentially non-LTE fluorescence (Swain et al. 2010; Waldmann et al. 2012). CH4 fluorescence has previously been observed on Titan (Kim et al. 2000), Saturn, and Jupiter (Drossart et al. 1999; Brown et al. 2003), thereby likening exoplanets to their Solar System counterparts. We find that the hotter HD 209458b lacks to ~3σ a bright 3.3 μm feature as seen on HD 189733b, which is consistent with thermochemical equilibrium predictions (Moses et al. 2011). We measure HD 209458b's longitudinally-varying thermal structure with Spitzer/IRAC full-orbit phase curve observations, and revise a previous 4.5 μm emission measurement downward by ˜35%. This change is significant because the high 4.5 and 5.8 μm brightness temperatures were interpreted as a thermal inversion (e.g., Line et al. 2014). While our 4.5 μm photometric emission point does not require an inversion, the shape of the phase curve, particularly the location and brightness temperature of the hot spot, suggests that HD 209458b has a dayside inversion. However the nightside is much cooler than predicted by a GCM. This discrepancy is potentially due to the GCM lacking quenching where vertical mixing outpaces reaction rates, causing increased CO and CH4 abundances at higher altitudes. We explore evidence for CH4 quenching with IRAC 3.6 micron data, which overlap the wings of the CH4 ν3 band, allowing us to

  15. Spatio-temporal Dynamic Heterogeneity of Nematode Abundance in a Desert Ecosystem

    PubMed Central

    Pen-Mouratov, S.; Steinberger, Y.

    2005-01-01

    The abundance and distribution of natural populations of soil organisms can be influenced greatly by the types and arrangement of habitat patchiness within a landscape. Most animal populations inhabit a variety of different habitats, even within a relatively small geographic region. The aim of our research was to determine how abiotic and biotic environmental factors, including small shrub canopy, influence patchiness and the alteration of nematode populations inhabiting a small plot in a desert ecosystem. The results of our investigation showed that the aggregation of total number of nematodes, trophic groups, and nematode species in an arid region with low soil moisture content may be significantly different (P < 0.01), even in 10-m-square areas. Ecological indices such as λ, H', J', and SR were defined as useful for detecting changes in spatial patterns of nematodes. Only the H' index identified a difference in temporal and spatial patterns (P < 0.01). We conclude that the influence of different factors such as temperature, organic content, and vegetation on small plots with extreme habitat conditions was not dominant. Factors such as inter- and intra-species competition appear to play the main role in the creation of the mosaic of small plots. PMID:19262840

  16. 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…

  17. 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…

  18. Cost-Effectiveness of Online Teacher Training

    ERIC Educational Resources Information Center

    Jung, Insung

    2005-01-01

    This study aims to compare the cost-effectiveness of an online teacher training method with a face-to-face training method in teaching "ICT integration in the school curriculum". In addition, the study explores the possibilities of a school-based voluntary training method in supporting other approaches to ICT teacher training. The analyses of…

  19. Cost Effectiveness of CBI in Defense Training.

    ERIC Educational Resources Information Center

    Fletcher, J. D.; Orlansky, Jesse

    This presentation provides an in-process review of researching efforts at the U.S. Army Research Institute and the Institute for Defense Analysis to update their earlier studies of Computer Based Instruction (CBI) cost-effectiveness. In the presentation five topics are addressed: (1) the differences between education and training, and why they…

  20. Cost-Effective Analysis of Teletraining.

    ERIC Educational Resources Information Center

    Shatzer, Linda

    1987-01-01

    Presents case study on personal computer teleconferencing to compare its cost effectiveness with that of on-site training. A model is described that uses a checklist for decision making in three areas: (1) initial considerations, (2) planning considerations, i.e., design elements, and (3) technical considerations, i.e., review and selection…

  1. The cost-effectiveness of harm reduction.

    PubMed

    Wilson, David P; Donald, Braedon; Shattock, Andrew J; Wilson, David; Fraser-Hurt, Nicole

    2015-02-01

    HIV prevalence worldwide among people who inject drugs (PWID) is around 19%. Harm reduction for PWID includes needle-syringe programs (NSPs) and opioid substitution therapy (OST) but often coupled with antiretroviral therapy (ART) for people living with HIV. Numerous studies have examined the effectiveness of each harm reduction strategy. This commentary discusses the evidence of effectiveness of the packages of harm reduction services and their cost-effectiveness with respect to HIV-related outcomes as well as estimate resources required to meet global and regional coverage targets. NSPs have been shown to be safe and very effective in reducing HIV transmission in diverse settings; there are many historical and very recent examples in diverse settings where the absence of, or reduction in, NSPs have resulted in exploding HIV epidemics compared to controlled epidemics with NSP implementation. NSPs are relatively inexpensive to implement and highly cost-effective according to commonly used willingness-to-pay thresholds. There is strong evidence that substitution therapy is effective, reducing the risk of HIV acquisition by 54% on average among PWID. OST is relatively expensive to implement when only HIV outcomes are considered; other societal benefits substantially improve the cost-effectiveness ratios to be highly favourable. Many studies have shown that ART is cost-effective for keeping people alive but there is only weak supportive, but growing evidence, of the additional effectiveness and cost-effectiveness of ART as prevention among PWID. Packages of combined harm reduction approaches are highly likely to be more effective and cost-effective than partial approaches. The coverage of harm reduction programs remains extremely low across the world. The total annual costs of scaling up each of the harm reduction strategies from current coverage levels, by region, to meet WHO guideline coverage targets are high with ART greatest, followed by OST and then NSPs. But

  2. Population Dynamics of Aphthona whitfieldi (Coleoptera: Chrysomelidae), Pest of Jatropha curcas, and Environmental Factors Favoring Its Abundance in Burkina Faso.

    PubMed

    Sawadogo, Alizèta; Nagalo, Estérer; Nacro, Souleymane; Rouamba, Mathurin; Kenis, Marc

    2015-01-01

    The flea beetle Aphthona whitfieldi Bryant (Coleoptera: Chrysomelidae) is the main pest of the bioenergy crop Jatropha curcas L. (Euphorbiaceae) in Burkina Faso and several other West African countries. Adults severely defoliate plants, resulting in seedling mortality, poor growth, and low yields. To study the population dynamics of the pest in the Sissili Province of Burkina Faso, 12 sites were monitored weekly during a year and 31 sites were inspected for damage at the peak period of insect abundance. The effect of cropping systems (hedge, intercropping, and monoculture) and surrounding vegetation on population densities of A. whitfieldi was assessed. Beetles were rarely found in the dry season and peaked in the second half of the rainy season. The cropping system did not significantly influence the abundance and attack level. In contrast, the close vicinity of fallow lands seems to increase damage levels. Many aspects of the biology and ecology of A. whitfieldi remain to be investigated before sustainable control methods can be developed. However, this study already allows us to propose recommendations for further research on management. PMID:26206896

  3. Consumers limit the abundance and dynamics of a perennial shrub with a seed bank

    USGS Publications Warehouse

    Kauffman, M.J.; Maron, J.L.

    2006-01-01

    For nearly 30 years, ecologists have argued that predators of seeds and seedlings seldom have population-level effects on plants with persistent seed banks and density-dependent seedling survival. We parameterized stage-based population models that incorporated density dependence and seed dormancy with data from a 5.5-year experiment that quantified how granivorous mice and herbivorous voles influence bush lupine (Lupinus arboreus) demography. We asked how seed dormancy and density-dependent seedling survival mediate the impacts of these consumers in dune and grassland habitats. In dune habitat, mice reduced analytical ?? (the intrinsic rate of population growth) by 39%, the equilibrium number of above-ground plants by 90%, and the seed bank by 98%; voles had minimal effects. In adjacent grasslands, mice had minimal effects, but seedling herbivory by voles reduced analytical ?? by 15% and reduced both the equilibrium number of aboveground plants and dormant seeds by 63%. A bootstrap analysis demonstrated that these consumer effects were robust to parameter uncertainty. Our results demonstrate that the quantitative strengths of seed dormancy and density-dependent seedling survival-not their mere existence-critically mediate consumer effects. This study suggests that plant population dynamics and distribution may be more strongly influenced by consumers of seeds and seedlings than is currently recognized. ?? 2006 by The University of Chicago.

  4. Consumers limit the abundance and dynamics of a perennial shrub with a seed bank.

    PubMed

    Kauffman, Matthew J; Maron, John L

    2006-10-01

    For nearly 30 years, ecologists have argued that predators of seeds and seedlings seldom have population-level effects on plants with persistent seed banks and density-dependent seedling survival. We parameterized stage-based population models that incorporated density dependence and seed dormancy with data from a 5.5-year experiment that quantified how granivorous mice and herbivorous voles influence bush lupine (Lupinus arboreus) demography. We asked how seed dormancy and density-dependent seedling survival mediate the impacts of these consumers in dune and grassland habitats. In dune habitat, mice reduced analytical lambda (the intrinsic rate of population growth) by 39%, the equilibrium number of aboveground plants by 90%, and the seed bank by 98%; voles had minimal effects. In adjacent grasslands, mice had minimal effects, but seedling herbivory by voles reduced analytical lambda by 15% and reduced both the equilibrium number of aboveground plants and dormant seeds by 63%. A bootstrap analysis demonstrated that these consumer effects were robust to parameter uncertainty. Our results demonstrate that the quantitative strengths of seed dormancy and density-dependent seedling survival--not their mere existence--critically mediate consumer effects. This study suggests that plant population dynamics and distribution may be more strongly influenced by consumers of seeds and seedlings than is currently recognized. PMID:17004218

  5. Impact of land use practices on faunal abundance, nutrient dynamics and biochemical properties of desert pedoecosystem.

    PubMed

    Tripathi, G; Sharma, B M

    2005-11-01

    Increased dependence of resource-poor rural communities on soils of low inherent fertility are the major problem of desert agroecosystem. Agrisilviculture practices may help to conserve the soil biota for maintaining essential soil properties and processes in harsh climate. Therefore, the impacts of different land use systems on faunal density, nutrient dynamics and biochemical properties of soil were studied in agrisilviculture system of Indian desert. The selected fields had trees (Zizyphus mauritiana, Prosopis cineraria, Acacia nilotica) and crops (Cuminum cyminum, Brassica nigra, Triticum aestivum) in different combinations. Populations of Acari, Myriapoda, Coleoptera, Collembola, other soil arthropods and total soil fauna showed significant changes with respect to different land use practices and tree species, indicating a strong relation between above and below ground biodiversity. The Coleoptera exhibited greatest association with all agrisilviculture fields. The Z. mauritiana system indicated highest facilitative effects (RTE value) on all groups of soil fauna. Soil temperature, moisture, organic carbon, nitrate- and ammonical-nitrogen, available phosphorus, soil respiration and dehydrogenase activity were greater under tree than that of tree plus cropping system. It showed accumulation of nitrate-nitrogen in tree field and more utilization by crops in cultivated lands. Positive and significant correlation among organic carbon, nitrate- and ammonical-nitrogen, phosphorus, soil respiration and dehydrogenase activity clearly reflects increase in soil nutrients with the increase in microbial and other biotic activity. P. cineraria field was the best pedoecosystem, while C. cyminum was the best winter crop for cultivation in desert agroforestry system for soil biological health and soil sustainability. The increase in organic carbon, soil nutrients and microbial activity is associated with the increase in soil faunal population which reflect role of soil fauna

  6. Impact of land use practices on faunal abundance, nutrient dynamics and biochemical properties of desert pedoecosystem.

    PubMed

    Tripathi, G; Sharma, B M

    2005-11-01

    Increased dependence of resource-poor rural communities on soils of low inherent fertility are the major problem of desert agroecosystem. Agrisilviculture practices may help to conserve the soil biota for maintaining essential soil properties and processes in harsh climate. Therefore, the impacts of different land use systems on faunal density, nutrient dynamics and biochemical properties of soil were studied in agrisilviculture system of Indian desert. The selected fields had trees (Zizyphus mauritiana, Prosopis cineraria, Acacia nilotica) and crops (Cuminum cyminum, Brassica nigra, Triticum aestivum) in different combinations. Populations of Acari, Myriapoda, Coleoptera, Collembola, other soil arthropods and total soil fauna showed significant changes with respect to different land use practices and tree species, indicating a strong relation between above and below ground biodiversity. The Coleoptera exhibited greatest association with all agrisilviculture fields. The Z. mauritiana system indicated highest facilitative effects (RTE value) on all groups of soil fauna. Soil temperature, moisture, organic carbon, nitrate- and ammonical-nitrogen, available phosphorus, soil respiration and dehydrogenase activity were greater under tree than that of tree plus cropping system. It showed accumulation of nitrate-nitrogen in tree field and more utilization by crops in cultivated lands. Positive and significant correlation among organic carbon, nitrate- and ammonical-nitrogen, phosphorus, soil respiration and dehydrogenase activity clearly reflects increase in soil nutrients with the increase in microbial and other biotic activity. P. cineraria field was the best pedoecosystem, while C. cyminum was the best winter crop for cultivation in desert agroforestry system for soil biological health and soil sustainability. The increase in organic carbon, soil nutrients and microbial activity is associated with the increase in soil faunal population which reflect role of soil fauna

  7. Cost effectiveness of a medical digital library.

    PubMed

    Roussel, F; Darmoni, S J; Thirion, B

    2001-01-01

    The rapid increase in the price of electronic journals has made the optimization of collection management an urgent task. As there is currently no standard procedure for the evaluation of this problem, we applied the Reading Factor (RF), an electronically computed indicator used for consultation of individual articles. The aim of our study was to assess the cost effective impact of modifications in our digital library (i.e. change of access from the Intranet to the Internet or change in editorial policy). The digital OVID library at Rouen University Hospital continues to be cost-effective in comparison with the interlibrary loan costs. Moreover, when electronic versions are offered alongside a limited amount of interlibrary loans, a reduction in library costs was observed.

  8. Future costs in cost effectiveness analysis.

    PubMed

    Lee, Robert H

    2008-07-01

    This paper resolves several controversies in CEA. Generalizing [Garber, A.M., Phelps, C.E., 1997. Economic foundations of cost-effectiveness analysis. Journal of Health Economics 16 (1), 1-31], the paper shows accounting for unrelated future costs distorts decision making. After replicating [Meltzer, D., 1997. Accounting for future costs in medical cost-effectiveness analysis. Journal of Health Economics 16 (1), 33-64] quite different conclusion that unrelated future costs should be included in CEA, the paper shows that Meltzer's findings result from modeling the budget constraint as an annuity, which is problematic. The paper also shows that related costs should be included in CEA. This holds for a variety of models, including a health maximization model. CEA should treat costs in the manner recommended by Garber and Phelps.

  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. 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.

  11. [Cost effectiveness and health sector reform].

    PubMed

    Musgrove, P

    1995-01-01

    The cost-effectiveness of a health intervention is an estimate of the relation between what it costs to be provided, and the improvement in health which results from such intervention. Health may improve because the incidence of illness or injury is reduced, because death is avoided or delayed, or because the duration or severity of disability is limited. The calculation of this health benefit combines objective factors, such as the age at incidence and whether or not the outcome is death, with subjective factors such as the severity of disability, the judgement as to the value of life lived at different ages, and the rate at which the future is discounted. The construction and interpretation of the estimate are explained. Also, the paper examines whether the concept of cost-effectiveness is consistent with ethical norms such as equity, and concludes that they are not in conflict. Finally, it addresses the question of how to incorporate cost-effectiveness into a health sector reform, and possible ways to implement it.

  12. River Temperature Dynamics and Habitat Characteristics as Predictors of Salmonid Abundance using Fiber-Optic Distributed Temperature Sensing

    NASA Astrophysics Data System (ADS)

    Gryczkowski, L.; Gallion, D.; Haeseker, S.; Bower, R.; Collier, M.; Selker, J. S.; Scherberg, J.; Henry, R.

    2011-12-01

    Salmonids require cool water for all life stages, including spawning and growth. Excessive water temperature causes reduced growth and increased disease and mortality. During the summer, salmonids seek local zones of cooler water as a refuge from elevated temperatures. They also prefer specific habitat features such as boulders and overhanging vegetation. The purpose of this study is to determine whether temperature dynamics or commonly measured fish habitat metrics best explain salmonid abundance. The study site was a 2-kilometer reach of the Walla Walla River near Milton-Freewater, OR, USA, which provides habitat for the salmonids chinook salmon (Oncorhynchus tshawytscha), steelhead/rainbow trout (Oncorhynchus mykiss), mountain whitefish (Prosopium williamsoni), and the endangered bull trout (Salvelinus confluentus). The Walla Walla River is listed as an impaired water body under section 303(d) of the Clean Water Act due to temperature. The associated total maximum daily load (TMDL) calls for temperatures to be below 18 °C at all times for salmonid rearing and migration; however, river temperatures surpassed 24 °C in parts of the study reach in 2009. The two largest factors contributing to the warmer water are reduced riparian vegetation, which decreases shading and increases direct solar radiation, and decreased summer flows caused by diversions and irrigation for agriculture. Fiber-optic distributed temperature sensing has emerged as a unique and powerful tool for ecological applications because of its high spatial and temporal resolution. In this study, meter-scale temperature measurements were obtained at 15-minute intervals along the length of the study reach, allowing for the detection and quantification of cold water inflows during the summer of 2009. The cold water inflows were classified as groundwater or hyporheic sources based on the diurnal temperature patterns. Snorkel surveys were conducted in mid-July and mid-August, 2009 to enumerate salmonid

  13. 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

  14. 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

  15. 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.

  16. The cost-effectiveness of pentavalent rotavirus vaccination in England and Wales.

    PubMed

    Atkins, Katherine E; Shim, Eunha; Carroll, Stuart; Quilici, Sibilia; Galvani, Alison P

    2012-11-01

    Rotavirus vaccines have shown great potential for reducing the disease burden of the major cause of severe childhood gastroenteritis. The decision regarding whether rotavirus vaccination will be introduced into the national immunization program is currently being reviewed. The conclusions of previous evaluations of rotavirus vaccination cost-effectiveness contradict each other. This is the first analysis to incorporate a dynamic transmission model to assess the cost-effectiveness of rotavirus vaccination in England and Wales. Most previously reported models do not include herd protection, and thus may underestimate the cost-effectiveness of vaccination against rotavirus. We incorporate a dynamic model of rotavirus transmission in England and Wales into a cost-effectiveness analysis to determine the probability that the pentavalent rotavirus vaccination will be cost-effective over a range of full-course vaccine prices. This novel approach allows the cost-effectiveness analysis to include a feasible level of herd protection provided by a vaccination program. Our base case model predicts that pentavalent rotavirus vaccination is likely to be cost-effective in England and Wales at £ 60 per course. In some scenarios the vaccination is predicted to be not only cost-effective but also cost-saving. These savings could be generated within ten years after vaccine introduction. Our budget impact analysis demonstrates that for the realistic base case scenarios, 58-96% of the cost outlay for vaccination will be recouped within the first four years of a program. Our results indicate that rotavirus vaccination would be beneficial to public health and could be economically sound. Since rotavirus vaccination is not presently on the immunization schedule for England and Wales but is currently under review, this study can inform policymakers of the cost-effectiveness and budget impact of implementing a mass rotavirus vaccine strategy.

  17. Cost-effectiveness as a price control.

    PubMed

    Jena, Anupam B; Philipson, Tomas

    2007-01-01

    After a technology is developed, cost-effectiveness analysis can offer an economically sound approach to adoption decisions. Little attention has been paid, however, to the incentives these criteria induce for getting technologies to market in the first place. We argue that technology adoption procedures more fully take into account the key trade-off inherent in research and development: the decreased welfare of current patients as a result of higher prices versus the increased welfare of future patients as a result of the incentives for innovation that such prices provide. Empirical evidence from a case study of HIV/AIDS provides an illustration of our conclusions.

  18. Dynamics of V ibrio cholerae abundance in Austrian saline lakes, assessed with quantitative solid‐phase cytometry

    PubMed Central

    Schauer, Sonja; Jakwerth, Stefan; Bliem, Rupert; Baudart, Julia; Lebaron, Philippe; Huhulescu, Steliana; Kundi, Michael; Herzig, Alois; Farnleitner, Andreas H.; Sommer, Regina

    2015-01-01

    Summary In order to elucidate the main predictors of V ibrio cholerae dynamics and to estimate the risk of V ibrio cholera‐related diseases, a recently developed direct detection approach based on fluorescence in situ hybridization and solid‐phase cytometry (CARD‐FISH/SPC) was applied in comparison to cultivation for water samples from the lake Neusiedler See, Austria and three shallow alkaline lakes over a period of 20 months. V ibrio cholerae attached to crustacean zooplankton was quantified via FISH and epifluorescence microscopy. Concentrations obtained by CARD‐FISH/SPC were significantly higher than those obtained by culture in 2011, but were mostly of similar magnitude in 2012. Maximum cell numbers were 1.26 × 106 V . cholerae per L in Neusiedler See and 7.59 × 107 V . cholerae per L in the shallow alkaline lakes. Only on a few occasions during summer was the crustacean zooplankton the preferred habitat for V . cholerae. In winter, V . cholerae was not culturable but could be quantified at all sites with CARD‐FISH/SPC. Beside temperature, suspended solids, zooplankton and ammonium were the main predictors of V . cholerae abundance in Neusiedler See, while in the shallow alkaline lakes it was organic carbon, conductivity and phosphorus. Based on the obtained concentrations a first estimation of the health risk for visitors of the lake could be performed. PMID:25847810

  19. Competing pressures on populations: long-term dynamics of food availability, food quality, disease, stress and animal abundance.

    PubMed

    Chapman, Colin A; Schoof, Valérie A M; Bonnell, Tyler R; Gogarten, Jan F; Calmé, Sophie

    2015-05-26

    Despite strong links between sociality and fitness that ultimately affect the size of animal populations, the particular social and ecological factors that lead to endangerment are not well understood. Here, we synthesize approximately 25 years of data and present new analyses that highlight dynamics in forest composition, food availability, the nutritional quality of food, disease, physiological stress and population size of endangered folivorous red colobus monkeys (Procolobus rufomitratus). There is a decline in the quality of leaves 15 and 30 years following two previous studies in an undisturbed area of forest. The consumption of a low-quality diet in one month was associated with higher glucocorticoid levels in the subsequent month and stress levels in groups living in degraded forest fragments where diet was poor was more than twice those in forest groups. In contrast, forest composition has changed and when red colobus food availability was weighted by the protein-to-fibre ratio, which we have shown positively predicts folivore biomass, there was an increase in the availability of high-quality trees. Despite these changing social and ecological factors, the abundance of red colobus has remained stable, possibly through a combination of increasing group size and behavioural flexibility.

  20. Competing pressures on populations: long-term dynamics of food availability, food quality, disease, stress and animal abundance.

    PubMed

    Chapman, Colin A; Schoof, Valérie A M; Bonnell, Tyler R; Gogarten, Jan F; Calmé, Sophie

    2015-05-26

    Despite strong links between sociality and fitness that ultimately affect the size of animal populations, the particular social and ecological factors that lead to endangerment are not well understood. Here, we synthesize approximately 25 years of data and present new analyses that highlight dynamics in forest composition, food availability, the nutritional quality of food, disease, physiological stress and population size of endangered folivorous red colobus monkeys (Procolobus rufomitratus). There is a decline in the quality of leaves 15 and 30 years following two previous studies in an undisturbed area of forest. The consumption of a low-quality diet in one month was associated with higher glucocorticoid levels in the subsequent month and stress levels in groups living in degraded forest fragments where diet was poor was more than twice those in forest groups. In contrast, forest composition has changed and when red colobus food availability was weighted by the protein-to-fibre ratio, which we have shown positively predicts folivore biomass, there was an increase in the availability of high-quality trees. Despite these changing social and ecological factors, the abundance of red colobus has remained stable, possibly through a combination of increasing group size and behavioural flexibility. PMID:25870398

  1. Competing pressures on populations: long-term dynamics of food availability, food quality, disease, stress and animal abundance

    PubMed Central

    Chapman, Colin A.; Schoof, Valérie A. M.; Bonnell, Tyler R.; Gogarten, Jan F.; Calmé, Sophie

    2015-01-01

    Despite strong links between sociality and fitness that ultimately affect the size of animal populations, the particular social and ecological factors that lead to endangerment are not well understood. Here, we synthesize approximately 25 years of data and present new analyses that highlight dynamics in forest composition, food availability, the nutritional quality of food, disease, physiological stress and population size of endangered folivorous red colobus monkeys (Procolobus rufomitratus). There is a decline in the quality of leaves 15 and 30 years following two previous studies in an undisturbed area of forest. The consumption of a low-quality diet in one month was associated with higher glucocorticoid levels in the subsequent month and stress levels in groups living in degraded forest fragments where diet was poor was more than twice those in forest groups. In contrast, forest composition has changed and when red colobus food availability was weighted by the protein-to-fibre ratio, which we have shown positively predicts folivore biomass, there was an increase in the availability of high-quality trees. Despite these changing social and ecological factors, the abundance of red colobus has remained stable, possibly through a combination of increasing group size and behavioural flexibility. PMID:25870398

  2. Cost effective data acquisition for small developments

    SciTech Connect

    Johnson, J.D.

    1987-01-01

    A cost effective method for obtaining reservoir fata to define the depletion mechanism in the small Odin gas field is described. The addition of a simple work program to the drilling plan for the first development well provided basic reservoir and aquifer data, and the well completion scheme provided for continuing reservoir surveillance. Cost effective methods for reservoir data acquisition are particularly relevant for marginal developments. This discussion should be of interest for operators of gas fields where the depletion mechanism is not defined, and where early acquisition of additional data can provide an indication of the mechanism. A brief development history of Odin field illustrates the need for good reservoir data. Initially there was some uncertainty surrounding the amount of bottom water influx into the Odin gas sand and the resulting reservoir depletion mechanism. Conclusions about the expected type of reservoir depletion mechanism were drawn from data including conventional cores analysis, measured pressure gradients, fluid saturation logs, and production well tests. Production history is shown which confirms the conclusions made from the initial data acquisition.

  3. 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.

  4. 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

  5. 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

  6. Chemical heat pump cost effectiveness evaluation

    NASA Astrophysics Data System (ADS)

    Standley, W. R.

    1982-02-01

    The cost-effectiveness and energy-effectiveness of existing chemical heat pump (CHP) concepts is compared with a baseline of conventional energy technologies and a group of near-term emerging energy technologies with which CHPs are expected to compete. The analysis is structured to evaluate these systems functioning as the primary space conditioning unit of both a 'standard' single-family detached home and a 'representative' commercial building. Each HVAC system and application is analyzed in each of two locations in the United States, the southwest (Albuquerque, NM) and the northeast (Boston, MA). In addition, the CHPs are evaluated in a 'representative' industrial waste heat upgrading application, and compared to potentially-competitive technologies for industrial 'heat pumping'.

  7. Paralemmin, a Prenyl-Palmitoyl–anchored Phosphoprotein Abundant in Neurons and Implicated in Plasma Membrane Dynamics and Cell Process Formation

    PubMed Central

    Kutzleb, Christian; Sanders, Gabriele; Yamamoto, Raina; Wang, Xiaolu; Lichte, Beate; Petrasch-Parwez, Elisabeth; Kilimann, Manfred W.

    1998-01-01

    We report the identification and initial characterization of paralemmin, a putative new morphoregulatory protein associated with the plasma membrane. Paralemmin is highly expressed in the brain but also less abundantly in many other tissues and cell types. cDNAs from chicken, human, and mouse predict acidic proteins of 42 kD that display a pattern of sequence cassettes with high inter-species conservation separated by poorly conserved linker sequences. Prenylation and palmitoylation of a COOH-terminal cluster of three cysteine residues confers hydrophobicity and membrane association to paralemmin. Paralemmin is also phosphorylated, and its mRNA is differentially spliced in a tissue-specific and developmentally regulated manner. Differential splicing, lipidation, and phosphorylation contribute to electrophoretic heterogeneity that results in an array of multiple bands on Western blots, most notably in brain. Paralemmin is associated with the cytoplasmic face of the plasma membranes of postsynaptic specializations, axonal and dendritic processes and perikarya, and also appears to be associated with an intracellular vesicle pool. It does not line the neuronal plasmalemma continuously but in clusters and patches. Its molecular and morphological properties are reminiscent of GAP-43, CAP-23, and MARCKS, proteins implicated in plasma membrane dynamics. Overexpression in several cell lines shows that paralemmin concentrates at sites of plasma membrane activity such as filopodia and microspikes, and induces cell expansion and process formation. The lipidation motif is essential for this morphogenic activity. We propose a function for paralemmin in the control of cell shape, e.g., through an involvement in membrane flow or in membrane–cytoskeleton interaction. PMID:9813098

  8. 23 CFR 635.205 - Finding of cost effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Finding of cost effectiveness. 635.205 Section 635.205... CONSTRUCTION AND MAINTENANCE Force Account Construction § 635.205 Finding of cost effectiveness. (a) It may be found cost effective for a State transportation department or county to undertake a federally...

  9. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.63 Cost-effectiveness testing. (a... paragraph (a) of this section, if the State plan requires the cost effectiveness of an energy...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. Mesozooplankton abundance in relation to the chlorophyll maximum in the Neuse River Estuary, North Carolina, USA: Implications for trophic dynamics

    NASA Astrophysics Data System (ADS)

    Kimmel, David G.; McGlaughon, Benjamin D.; Leonard, Jeremy; Paerl, Hans W.; Taylor, J. Christopher; Cira, Emily K.; Wetz, Michael S.

    2015-05-01

    Estuaries often have distinct zones of high chlorophyll a concentrations, known as chlorophyll maximum (CMAX). The persistence of these features is often attributed to physical (mixing and light availability) and chemical (nutrient availability) features, but the role of mesozooplankton grazing is rarely explored. We measured the spatial and temporal variability of the CMAX and mesozooplankton community in the eutrophic Neuse River Estuary, North Carolina. We also conducted grazing experiments to determine the relative impact of mesozooplankton grazing on the CMAX during the phytoplankton growing season (spring through late summer). The CMAX was consistently located upriver of the zone of maximum zooplankton abundance, with an average spatial separation of 18 km. Grazing experiments in the CMAX region revealed negligible effect of mesozooplankton on chlorophyll a during March, and no effect during June or August. These results suggest that the spatial separation of the peak in chlorophyll a concentration and mesozooplankton abundance results in minimal impact of mesozooplankton grazing, contributing to persistence of the CMAX for prolonged time periods. In the Neuse River Estuary, the low mesozooplankton abundance in the CMAX region is attributed to lack of a low salinity tolerant species, predation by the ctenophore Mnemiopsis leidyi, and/or physiologic impacts on mesozooplankton growth rates due to temperature (in the case of low wintertime abundances). The consequences of this lack of overlap result in exacerbation of the effects of eutrophication; namely a lack of trophic transfer to mesozooplankton in this region and the sinking of phytodetritus to the benthos that fuels hypoxia.

  16. Cost-effective x-ray lithography

    NASA Astrophysics Data System (ADS)

    Roltsch, Tom J.

    1991-08-01

    The push towards faster, denser VLSI device structures and eventually to ULSI devices means ever-decreasing design rules for IC manufacturers. In order to define patterns on silicon and gallium arsenide substrates with feature sizes of 0.25 microns, lithography, metallization, and electronic materials processing techniques will be pushed beyond current limitations. Of these technologies, lithography in the sub-0.5 micron region appears to be the main obstacle yet to be overcome. As deep-UV optical systems become more expensive and the useful field sized decrease in the attempt to achieve finer resolutions, the question of whether to switch to an alternate lithographic method becomes imminent. X-ray lithography is the leading candidate. In this paper, the question of whether x-ray lithography is economically superior to optical lithography and the cost-effectiveness of x-ray lithography are addressed. Also, the question of how x-ray lithography can be performed in a production environment is considered. First shown is that more elaborate optical systems are simply not going to match x-ray proximity system in terms of resolution because of the need to use exotic lens materials or complicated and ever finer reflection systems, none of which can correct for diffraction effects, yet must be corrected for every other aberration. The economic superiority of a synchrotron-based x- ray lithography beamline is demonstrated in a production facility using a processing-cost model based on Shinji Okazaki's cost-per-bit model. Considered, as well, is the strong possibility that exists for the use of an optically based production line which would use an anode or plasma x-ray stepper to define only the smallest geometries, such as the gate level on a DRAM chip. It is shown that it is unlikely, even pushing the limits of materials and optics, that deep-UV systems will be able to define patterns below 0.35 microns in a production environment. X-ray lithography systems could define 0

  17. Dynamic relationships between body size, species richness, abundance, and energy use in a shallow marine epibenthic faunal community

    PubMed Central

    Labra, Fabio A; Hernández-Miranda, Eduardo; Quiñones, Renato A

    2015-01-01

    We study the temporal variation in the empirical relationships among body size (S), species richness (R), and abundance (A) in a shallow marine epibenthic faunal community in Coliumo Bay, Chile. We also extend previous analyses by calculating individual energy use (E) and test whether its bivariate and trivariate relationships with S and R are in agreement with expectations derived from the energetic equivalence rule. Carnivorous and scavenger species representing over 95% of sample abundance and biomass were studied. For each individual, body size (g) was measured and E was estimated following published allometric relationships. Data for each sample were tabulated into exponential body size bins, comparing species-averaged values with individual-based estimates which allow species to potentially occupy multiple size classes. For individual-based data, both the number of individuals and species across body size classes are fit by a Weibull function rather than by a power law scaling. Species richness is also a power law of the number of individuals. Energy use shows a piecewise scaling relationship with body size, with energetic equivalence holding true only for size classes above the modal abundance class. Species-based data showed either weak linear or no significant patterns, likely due to the decrease in the number of data points across body size classes. Hence, for individual-based size spectra, the SRA relationship seems to be general despite seasonal forcing and strong disturbances in Coliumo Bay. The unimodal abundance distribution results in a piecewise energy scaling relationship, with small individuals showing a positive scaling and large individuals showing energetic equivalence. Hence, strict energetic equivalence should not be expected for unimodal abundance distributions. On the other hand, while species-based data do not show unimodal SRA relationships, energy use across body size classes did not show significant trends, supporting energetic

  18. Dynamic relationships between body size, species richness, abundance, and energy use in a shallow marine epibenthic faunal community.

    PubMed

    Labra, Fabio A; Hernández-Miranda, Eduardo; Quiñones, Renato A

    2015-01-01

    We study the temporal variation in the empirical relationships among body size (S), species richness (R), and abundance (A) in a shallow marine epibenthic faunal community in Coliumo Bay, Chile. We also extend previous analyses by calculating individual energy use (E) and test whether its bivariate and trivariate relationships with S and R are in agreement with expectations derived from the energetic equivalence rule. Carnivorous and scavenger species representing over 95% of sample abundance and biomass were studied. For each individual, body size (g) was measured and E was estimated following published allometric relationships. Data for each sample were tabulated into exponential body size bins, comparing species-averaged values with individual-based estimates which allow species to potentially occupy multiple size classes. For individual-based data, both the number of individuals and species across body size classes are fit by a Weibull function rather than by a power law scaling. Species richness is also a power law of the number of individuals. Energy use shows a piecewise scaling relationship with body size, with energetic equivalence holding true only for size classes above the modal abundance class. Species-based data showed either weak linear or no significant patterns, likely due to the decrease in the number of data points across body size classes. Hence, for individual-based size spectra, the SRA relationship seems to be general despite seasonal forcing and strong disturbances in Coliumo Bay. The unimodal abundance distribution results in a piecewise energy scaling relationship, with small individuals showing a positive scaling and large individuals showing energetic equivalence. Hence, strict energetic equivalence should not be expected for unimodal abundance distributions. On the other hand, while species-based data do not show unimodal SRA relationships, energy use across body size classes did not show significant trends, supporting energetic

  19. Dynamic relationships between body size, species richness, abundance, and energy use in a shallow marine epibenthic faunal community.

    PubMed

    Labra, Fabio A; Hernández-Miranda, Eduardo; Quiñones, Renato A

    2015-01-01

    We study the temporal variation in the empirical relationships among body size (S), species richness (R), and abundance (A) in a shallow marine epibenthic faunal community in Coliumo Bay, Chile. We also extend previous analyses by calculating individual energy use (E) and test whether its bivariate and trivariate relationships with S and R are in agreement with expectations derived from the energetic equivalence rule. Carnivorous and scavenger species representing over 95% of sample abundance and biomass were studied. For each individual, body size (g) was measured and E was estimated following published allometric relationships. Data for each sample were tabulated into exponential body size bins, comparing species-averaged values with individual-based estimates which allow species to potentially occupy multiple size classes. For individual-based data, both the number of individuals and species across body size classes are fit by a Weibull function rather than by a power law scaling. Species richness is also a power law of the number of individuals. Energy use shows a piecewise scaling relationship with body size, with energetic equivalence holding true only for size classes above the modal abundance class. Species-based data showed either weak linear or no significant patterns, likely due to the decrease in the number of data points across body size classes. Hence, for individual-based size spectra, the SRA relationship seems to be general despite seasonal forcing and strong disturbances in Coliumo Bay. The unimodal abundance distribution results in a piecewise energy scaling relationship, with small individuals showing a positive scaling and large individuals showing energetic equivalence. Hence, strict energetic equivalence should not be expected for unimodal abundance distributions. On the other hand, while species-based data do not show unimodal SRA relationships, energy use across body size classes did not show significant trends, supporting energetic

  20. 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

  1. Costs and cost-effectiveness of periviable care.

    PubMed

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

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

  2. Cost-effectiveness of vaccination against herpes zoster.

    PubMed

    de Boer, Pieter T; Wilschut, Jan C; Postma, Maarten J

    2014-01-01

    Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN.

  3. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If... life cycle cost-effective without further analysis. (b) A Federal agency may presume that an investment in an energy or water conservation measure retrofit to an existing Federal building is not life...

  4. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart, “cost-effective” means that the State's cost of purchasing family coverage that includes coverage...

  5. 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…

  6. 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…

  7. Abundance, diversity, and seasonal population dynamics of aquatic Coleoptera and Heteroptera in rice fields: effects of direct seeding management.

    PubMed

    Watanabe, Kohei; Koji, Shinsaku; Hidaka, Kazumasa; Nakamura, Koji

    2013-10-01

    Recent introduction of modern drainage systems has produced intensely dry conditions in rice farmlands and has degraded habitats for aquatic animals. In this study, we compared water beetle (Coleoptera) and water bug (Heteroptera) communities within rice fields cultivated under different management regimes: V-furrow no-till direct-seeding (DS) and conventional regimes. In DS fields, rice is sown in well-drained fields, and flooding is performed a month later than in conventional rice fields. DS fields are then continuously flooded until harvesting; unlike in conventional fields, where midseason drainage is performed in summer. We observed that DS fields supported higher densities of water beetles and water bugs than conventional fields, probably because of the high compatibility between the flooding period and the reproductive season of the insects. The species richness of water beetles was higher in DS fields than in conventional fields. Overall, DS fields showed higher water beetle and water bug abundance, but the effect was variable for individual species: seven species were more abundant in DS than in conventional fields, whereas two species showed opposite tendencies. Considering the differential responses among species to the management regimes, a mosaic of DS and conventional fields is preferable to either field alone for the conservation of aquatic insects in rice agroecosystems.

  8. Natural 15N- and 13C-abundance as indicators of forest nitrogen status and soil carbon dynamics

    SciTech Connect

    Garten Jr, Charles T; Hanson, Paul J; Todd Jr, Donald E; Lu, Benwhea Bonnie; Brice, Deanne Jane

    2007-09-01

    This book highlights new and emerging uses of stable isotope analysis in a variety of ecological disciplines. While the use of natural abundance isotopes in ecological research is now relatively standard, new techniques and ways of interpreting patterns are developing rapidly. The second edition of this book provides a thorough, up-to-date examination of these methods of research. As part of the Ecological Methods and Concepts series which provides the latest information on experimental techniques in ecology, this book looks at a wide range of techniques that use natural abundance isotopes to: {sm_bullet} follow whole ecosystem element cycling {sm_bullet} understand processes of soil organic matter formation {sm_bullet} follow the movement of water in whole watersheds {sm_bullet} understand the effects of pollution in both terrestrial and aquatic environments {sm_bullet} study extreme systems such as hydrothermal vents {sm_bullet}follow migrating organisms In each case, the book explains the background to the methodology, looks at the underlying principles and assumptions, and outlines the potential limitations and pitfalls. Stable Isotopes in Ecology and Environmental Science is an ideal resource for both ecologists who are new to isotopic analysis, and more experienced isotope ecologists interested in innovative techniques and pioneering new uses.

  9. Abundance, diversity, and seasonal population dynamics of aquatic Coleoptera and Heteroptera in rice fields: effects of direct seeding management.

    PubMed

    Watanabe, Kohei; Koji, Shinsaku; Hidaka, Kazumasa; Nakamura, Koji

    2013-10-01

    Recent introduction of modern drainage systems has produced intensely dry conditions in rice farmlands and has degraded habitats for aquatic animals. In this study, we compared water beetle (Coleoptera) and water bug (Heteroptera) communities within rice fields cultivated under different management regimes: V-furrow no-till direct-seeding (DS) and conventional regimes. In DS fields, rice is sown in well-drained fields, and flooding is performed a month later than in conventional rice fields. DS fields are then continuously flooded until harvesting; unlike in conventional fields, where midseason drainage is performed in summer. We observed that DS fields supported higher densities of water beetles and water bugs than conventional fields, probably because of the high compatibility between the flooding period and the reproductive season of the insects. The species richness of water beetles was higher in DS fields than in conventional fields. Overall, DS fields showed higher water beetle and water bug abundance, but the effect was variable for individual species: seven species were more abundant in DS than in conventional fields, whereas two species showed opposite tendencies. Considering the differential responses among species to the management regimes, a mosaic of DS and conventional fields is preferable to either field alone for the conservation of aquatic insects in rice agroecosystems. PMID:24073897

  10. Cost-effectiveness of a Primary Care Depression Intervention

    PubMed Central

    Pyne, Jeffrey M; Rost, Kathryn M; Zhang, Mingliang; Williams, D Keith; Smith, Jeffrey; Fortney, John

    2003-01-01

    OBJECTIVE To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. SETTING Primary care practices located in 10 states across the United States. PATIENTS/PARTICIPANTS Two hundred eleven patients beginning a new treatment episode for major depression. INTERVENTIONS Training the primary care team to assess, educate, and monitor depressed patients during the acute and continuation stages of their depression treatment episode over 1 year. MEASUREMENTS AND MAIN RESULTS Cost-effectiveness was measured by calculating incremental (enhanced minus usual care) costs and quality-adjusted life years (QALYs) derived from SF-36 data. The mean incremental cost-effectiveness ratio in the main analysis was $15,463 per QALY. The mean incremental cost-effectiveness ratios for the sensitivity analyses ranged from $11,341 (using geographic block variables to control for pre-intervention service utilization) to $19,976 (increasing the cost estimates by 50%) per QALY. CONCLUSIONS This quality improvement depression intervention was cost-effective relative to usual care compared to cost-effectiveness ratios for common primary care interventions and commonly cited cost-effectiveness ratio thresholds for intervention implementation. PMID:12823650

  11. 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.

  12. The Potential Cost-Effectiveness of Amblyopia Screening Programs

    PubMed Central

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

    2013-01-01

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

  13. Short-term occupancy and abundance dynamics of the Oregon spotted frog (Rana pretiosa) across its core range

    USGS Publications Warehouse

    Adams, Michael J.; Pearl, Christopher A.; Mccreary, Brome; Galvan, Stephanie

    2014-01-01

    The Oregon spotted frog (Rana pretiosa) occupies only a fraction of its original range and is listed as Threatened under the Endangered Species Act. We surveyed 93 sites in a rotating frame design (2010–13) in the Klamath and Deschutes Basins, Oregon, which encompass most of the species’ core extant range. Oregon spotted frogs are declining in abundance and probability of site occupancy. We did not find an association between the probability that Oregon spotted frogs disappear from a site (local extinction) and any of the variables hypothesized to affect Oregon spotted frog occupancy. This 4-year study provides baseline data, but the 4-year period was too short to draw firm conclusions. Further study is essential to understand how habitat changes and management practices relate to the status and trends of this species.

  14. Applications of Cost Effectiveness to Counseling Center Retention Programs.

    ERIC Educational Resources Information Center

    Weiss, Steven J.; Giddan, Norman S.

    1986-01-01

    Provides a framework for considering cost-benefit analysis and cost-effectiveness analysis of college counseling centers and retention activities. Results indicated that careful evaluation techniques can improve the efficiency and effectiveness of student retention programs. (Author/BL)

  15. Cost-effectiveness of colorectal cancer screening - an overview.

    PubMed

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

    2010-08-01

    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.

  16. 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

  17. 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

  18. Antimicrobial stewardship programs - cost-minimizing or cost-effective?

    PubMed

    You, Joyce

    2015-02-01

    Antimicrobial stewardship programs (ASPs) are aimed to improve patient care and health care outcomes. It is encouraging to find ASP interventions to be cost-saving in many cost-minimization analyses in literature. Nevertheless, the cost-effectiveness of ASP interventions, measured in cost per quality-adjusted life-years, is less well-established. This Editorial aims to explore the barriers in assessing clinical effectiveness of ASPs and provide suggestions to conduct cost-effectiveness analysis of ASPs. PMID:25331093

  19. Cost-effectiveness analysis of using antiretroviral drug resistance testing.

    PubMed

    Lauria, Francesco Nicola; Angeletti, Claudio

    2003-01-01

    Human immunodeficiency virus (HIV)-infected patients failing highly active antiretroviral therapy (HAART) have a substantially lower chance of clinical success than naive patients given their first antiretroviral therapy. This suggests that HAART failure is a determinant for an increase in the cost of treatment. A review of the literature regarding cost and impact of antiretroviral drug-resistance testing was performed. Examination of existing methods to execute a cost-effectiveness analysis on the use of these tests in clinical practice was also undertaken. The cost of treatment failure in HIV-infected patients has been quantified in several retrospective studies. The cost of care for patients with virological suppression was significantly lower than those with a single virological failure. Moreover, the latter group had lower costs than patients with multiple failures. The result of the cost-effective analysis based on a specific model application using genotypic resistance assays to guide the choice of a subsequent therapy in HIV disease, is cost-effective under a wide range of assumptions regarding effectiveness and costs. The available studies on the cost-effective evaluation of genotypic tests are limited, and the respective studies supply important indications on cost-effective evaluations. Despite its demonstrated benefits, antiretroviral drug resistance testing presents features and limitations that also restrict the cost-effectiveness analysis. PMID:15000585

  20. Nitrate dynamics in natural plants: insights based on the concentration and natural isotope abundances of tissue nitrate

    PubMed Central

    Liu, Xue-Yan; Koba, Keisuke; Makabe, Akiko; Liu, Cong-Qiang

    2014-01-01

    The dynamics of nitrate (NO−3), a major nitrogen (N) source for natural plants, has been studied mostly through experimental N addition, enzymatic assay, isotope labeling, and genetic expression. However, artificial N supply may not reasonably reflect the N strategies in natural plants because NO−3 uptake and reduction may vary with external N availability. Due to abrupt application and short operation time, field N addition, and isotopic labeling hinder the elucidation of in situ NO−3-use mechanisms. The concentration and natural isotopes of tissue NO−3 can offer insights into the plant NO−3 sources and dynamics in a natural context. Furthermore, they facilitate the exploration of plant NO−3 utilization and its interaction with N pollution and ecosystem N cycles without disturbing the N pools. The present study was conducted to review the application of the denitrifier method for concentration and isotope analyses of NO−3 in plants. Moreover, this study highlights the utility and advantages of these parameters in interpreting NO−3 sources and dynamics in natural plants. We summarize the major sources and reduction processes of NO−3 in plants, and discuss the implications of NO−3 concentration in plant tissues based on existing data. Particular emphasis was laid on the regulation of soil NO−3 and plant ecophysiological functions in interspecific and intra-plant NO−3 variations. We introduce N and O isotope systematics of NO−3 in plants and discuss the principles and feasibilities of using isotopic enrichment and fractionation factors; the correlation between concentration and isotopes (N and O isotopes: δ18O and Δ17O); and isotope mass-balance calculations to constrain sources and reduction of NO−3 in possible scenarios for natural plants are deliberated. Finally, we offer a preliminary framework of intraplant δ18O-NO−3 variation, and summarize the uncertainties in using tissue NO−3 parameters to interpret plant NO−3 utilization

  1. Synergistic Effects of Marine Reserves and Harvest Controls on the Abundance and Catch Dynamics of a Coral Reef Fishery.

    PubMed

    Hopf, Jess K; Jones, Geoffrey P; Williamson, David H; Connolly, Sean R

    2016-06-20

    Marine no-take reserves, where fishing and other extractive activities are prohibited, have well-established conservation benefits [1], yet their impacts on fisheries remains contentious [2-4]. For fishery species, reserves are often implemented alongside more conventional harvest strategies, including catch and size limits [2, 5]. However, catch and fish abundances observed post-intervention are often attributed to reserves, without explicitly estimating the potential contribution of concurrent management interventions [2, 3, 6-9]. Here we test a metapopulation model against observed fishery [10] and population [11] data for an important coral reef fishery (coral trout; Plectropomus spp.) in Australia's Great Barrier Reef Marine Park (GBRMP) to evaluate how the combined increase in reserve area [12] and reduction in fishing effort [13, 14] in 2004 influenced changes in fish stocks and the commercial fishery. We found that declines in catch, increases in catch rates, and increases in biomass since 2004 were substantially attributable to the integration of direct effort controls with the rezoning, rather than the rezoning alone. The combined management approach was estimated to have been more productive for fish and fisheries than if the rezoning had occurred alone and comparable to what would have been obtained with effort controls alone. Sensitivity analyses indicate that the direct effort controls prevented initial decreases in catch per unit effort that would have otherwise occurred with the rezoning. Our findings demonstrate that by concurrently restructuring the fishery, the conservation benefits of reserves were enhanced and the fishery cost of rezoning the reserve network was socialized, mitigating negative impacts on individual fishers. PMID:27185553

  2. Synergistic Effects of Marine Reserves and Harvest Controls on the Abundance and Catch Dynamics of a Coral Reef Fishery.

    PubMed

    Hopf, Jess K; Jones, Geoffrey P; Williamson, David H; Connolly, Sean R

    2016-06-20

    Marine no-take reserves, where fishing and other extractive activities are prohibited, have well-established conservation benefits [1], yet their impacts on fisheries remains contentious [2-4]. For fishery species, reserves are often implemented alongside more conventional harvest strategies, including catch and size limits [2, 5]. However, catch and fish abundances observed post-intervention are often attributed to reserves, without explicitly estimating the potential contribution of concurrent management interventions [2, 3, 6-9]. Here we test a metapopulation model against observed fishery [10] and population [11] data for an important coral reef fishery (coral trout; Plectropomus spp.) in Australia's Great Barrier Reef Marine Park (GBRMP) to evaluate how the combined increase in reserve area [12] and reduction in fishing effort [13, 14] in 2004 influenced changes in fish stocks and the commercial fishery. We found that declines in catch, increases in catch rates, and increases in biomass since 2004 were substantially attributable to the integration of direct effort controls with the rezoning, rather than the rezoning alone. The combined management approach was estimated to have been more productive for fish and fisheries than if the rezoning had occurred alone and comparable to what would have been obtained with effort controls alone. Sensitivity analyses indicate that the direct effort controls prevented initial decreases in catch per unit effort that would have otherwise occurred with the rezoning. Our findings demonstrate that by concurrently restructuring the fishery, the conservation benefits of reserves were enhanced and the fishery cost of rezoning the reserve network was socialized, mitigating negative impacts on individual fishers.

  3. Early-stage changes in natural (13)C and (15)N abundance and nutrient dynamics during different litter decomposition.

    PubMed

    Gautam, Mukesh Kumar; Lee, Kwang-Sik; Song, Byeong-Yeol; Lee, Dongho; Bong, Yeon-Sik

    2016-05-01

    Decomposition, nutrient, and isotopic (δ(13)C and δ(15)N) dynamics during 1 year were studied for leaf and twig litters of Pinus densiflora, Castanea crenata, Erigeron annuus, and Miscanthus sinensis growing on a highly weathered soil with constrained nutrient supply using litterbags in a cool temperate region of South Korea. Decay constant (k/year) ranged from 0.58 to 1.29/year, and mass loss ranged from 22.36 to 58.43 % among litter types. The results demonstrate that mass loss and nutrient dynamics of decomposing litter were influenced by the seasonality of mineralization and immobilization processes. In general, most nutrients exhibited alternate phases of rapid mineralization followed by gradual immobilization, except K, which was released throughout the field incubation. At the end of study, among all the nutrients only N and P showed net immobilization. Mobility of different nutrients from decomposing litter as the percentage of initial litter nutrient concentration was in the order of K > Mg > Ca > N ≈ P. The δ(13)C (0.32-6.70 ‰) and δ(15)N (0.74-3.90 ‰) values of residual litters showed nonlinear increase and decrease, respectively compared to initial isotopic values during decomposition. Litter of different functional types and chemical quality converged toward a conservative nutrient use strategy through mechanisms of slow decomposition and slow nutrient mobilization. Our results indicate that litter quality and season, are the most important regulators of litter decomposition in these forests. The results revealed significant relationships between litter decomposition rates and N, C:N ratio and P, and seasonality (temperature). These results and the convergence of different litters towards conservative nutrient use in these nutrient constrained ecosystems imply optimization of litter management because litter removal can have cascading effects on litter decomposition and nutrient availability in these systems. PMID:26915037

  4. Early-stage changes in natural (13)C and (15)N abundance and nutrient dynamics during different litter decomposition.

    PubMed

    Gautam, Mukesh Kumar; Lee, Kwang-Sik; Song, Byeong-Yeol; Lee, Dongho; Bong, Yeon-Sik

    2016-05-01

    Decomposition, nutrient, and isotopic (δ(13)C and δ(15)N) dynamics during 1 year were studied for leaf and twig litters of Pinus densiflora, Castanea crenata, Erigeron annuus, and Miscanthus sinensis growing on a highly weathered soil with constrained nutrient supply using litterbags in a cool temperate region of South Korea. Decay constant (k/year) ranged from 0.58 to 1.29/year, and mass loss ranged from 22.36 to 58.43 % among litter types. The results demonstrate that mass loss and nutrient dynamics of decomposing litter were influenced by the seasonality of mineralization and immobilization processes. In general, most nutrients exhibited alternate phases of rapid mineralization followed by gradual immobilization, except K, which was released throughout the field incubation. At the end of study, among all the nutrients only N and P showed net immobilization. Mobility of different nutrients from decomposing litter as the percentage of initial litter nutrient concentration was in the order of K > Mg > Ca > N ≈ P. The δ(13)C (0.32-6.70 ‰) and δ(15)N (0.74-3.90 ‰) values of residual litters showed nonlinear increase and decrease, respectively compared to initial isotopic values during decomposition. Litter of different functional types and chemical quality converged toward a conservative nutrient use strategy through mechanisms of slow decomposition and slow nutrient mobilization. Our results indicate that litter quality and season, are the most important regulators of litter decomposition in these forests. The results revealed significant relationships between litter decomposition rates and N, C:N ratio and P, and seasonality (temperature). These results and the convergence of different litters towards conservative nutrient use in these nutrient constrained ecosystems imply optimization of litter management because litter removal can have cascading effects on litter decomposition and nutrient availability in these systems.

  5. Screening strategies for active tuberculosis: focus on cost-effectiveness

    PubMed Central

    Dobler, Claudia Caroline

    2016-01-01

    In recent years, there has been renewed interest in screening for active tuberculosis (TB), also called active case-finding (ACF), as a possible means to achieve control of the global TB epidemic. ACF aims to increase the detection of TB, in order to diagnose and treat patients with TB earlier than if they had been diagnosed and treated only at the time when they sought health care because of symptoms. This will reduce or avoid secondary transmission of TB to other people, with the long-term goal of reducing the incidence of TB. Here, the history of screening for active TB, current screening practices, and the role of TB-diagnostic tools are summarized and the literature on cost-effectiveness of screening for active TB reviewed. Cost-effectiveness analyses indicate that community-wide ACF can be cost-effective in settings with a high incidence of TB. ACF among close TB contacts is cost-effective in settings with a low as well as a high incidence of TB. The evidence for cost-effectiveness of screening among HIV-infected persons is not as strong as for TB contacts, but the reviewed studies suggest that the intervention can be cost-effective depending on the background prevalence of TB and test volume. None of the cost-effectiveness analyses were informed by data from randomized controlled trials. As the results of randomized controlled trials evaluating different ACF strategies will become available in future, we will hopefully gain a better understanding of the role that ACF can play in achieving global TB control. PMID:27418848

  6. Cost effectiveness of ramipril treatment for cardiovascular risk reduction

    PubMed Central

    Malik, I; Bhatia, V; Kooner, J

    2001-01-01

    OBJECTIVE—To assess the cost effectiveness of ramipril treatment in patients at low, medium, and high risk of cardiovascular death.
DESIGN—Population based cost effectiveness analysis from the perspective of the health care provider in the UK. Effectiveness was modelled using data from the HOPE (heart outcome prevention evaluation) trial. The life table method was used to predict mortality in a medium risk cohort, as in the HOPE trial (2.44% annual mortality), and in low and high risk groups (1% and 4.5% annual mortality, respectively).
SETTING—UK population using 1998 government actuary department data.
MAIN OUTCOME MEASURE—Cost per life year gained at five years and lifetime treatment with ramipril.
RESULTS—Cost effectiveness was £36 600, £13 600, and £4000 per life year gained at five years and £5300, £1900, and £100 per life year gained at 20 years (lifetime treatment) in low, medium, and high risk groups, respectively. Cost effectiveness at 20 years remained well below that of haemodialysis (£25 000 per life year gained) over a range of potential drug costs and savings. Treatment of the HOPE population would cost the UK National Health Service (NHS) an additional £360 million but would prevent 12 000 deaths per annum.
CONCLUSIONS—Ramipril is cost effective treatment for cardiovascular risk reduction in patients at medium, high, and low pretreatment risk, with a cost effectiveness comparable with the use of statins. Implementation of ramipril treatment in a medium risk population would result in a major reduction in cardiovascular deaths but would increase annual NHS spending by £360 million.


Keywords: angiotensin converting enzyme inhibitor; cardiovascular risk; cost effectiveness; ramipril PMID:11303006

  7. 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.

  8. Analyses of Blood Bank Efficiency, Cost-Effectiveness and Quality

    NASA Astrophysics Data System (ADS)

    Lam, Hwai-Tai Chen

    In view of the increasing costs of hospital care, it is essential to investigate methods to improve the labor efficiency and the cost-effectiveness of the hospital technical core in order to control costs while maintaining the quality of care. This study was conducted to develop indices to measure efficiency, cost-effectiveness, and the quality of blood banks; to identify factors associated with efficiency, cost-effectiveness, and quality; and to generate strategies to improve blood bank labor efficiency and cost-effectiveness. Indices developed in this study for labor efficiency and cost-effectiveness were not affected by patient case mix and illness severity. Factors that were associated with labor efficiency were identified as managerial styles, and organizational designs that balance workload and labor resources. Medical directors' managerial involvement was not associated with labor efficiency, but their continuing education and specialty in blood bank were found to reduce the performance of unnecessary tests. Surprisingly, performing unnecessary tests had no association with labor efficiency. This suggested the existence of labor slack in blood banks. Cost -effectiveness was associated with workers' benefits, wages, and the production of high-end transfusion products by hospital-based donor rooms. Quality indices used in this study included autologous transfusion rates, platelet transfusion rates, and the check points available in an error-control system. Because the autologous transfusion rate was related to patient case mix, severity of illness, and possible inappropriate transfusion, it was not recommended to be used for quality index. Platelet-pheresis transfusion rates were associated with the transfusion preferences of the blood bank medical directors. The total number of check points in an error -control system was negatively associated with government ownership and workers' experience. Recommendations for improving labor efficiency and cost-effectiveness

  9. The cost-effectiveness of exercise referral schemes

    PubMed Central

    2011-01-01

    Background Exercise referral schemes (ERS) aim to identify inactive adults in the primary care setting. The primary care professional refers the patient to a third party service, with this service taking responsibility for prescribing and monitoring an exercise programme tailored to the needs of the patient. This paper examines the cost-effectiveness of ERS in promoting physical activity compared with usual care in primary care setting. Methods A decision analytic model was developed to estimate the cost-effectiveness of ERS from a UK NHS perspective. The costs and outcomes of ERS were modelled over the patient's lifetime. Data were derived from a systematic review of the literature on the clinical and cost-effectiveness of ERS, and on parameter inputs in the modelling framework. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses investigated the impact of varying ERS cost and effectiveness assumptions. Sub-group analyses explored the cost-effectiveness of ERS in sedentary people with an underlying condition. Results Compared with usual care, the mean incremental lifetime cost per patient for ERS was £169 and the mean incremental QALY was 0.008, generating a base-case incremental cost-effectiveness ratio (ICER) for ERS at £20,876 per QALY in sedentary individuals without a diagnosed medical condition. There was a 51% probability that ERS was cost-effective at £20,000 per QALY and 88% probability that ERS was cost-effective at £30,000 per QALY. In sub-group analyses, cost per QALY for ERS in sedentary obese individuals was £14,618, and in sedentary hypertensives and sedentary individuals with depression the estimated cost per QALY was £12,834 and £8,414 respectively. Incremental lifetime costs and benefits associated with ERS were small, reflecting the preventative public health context of the intervention, with this resulting in estimates of cost-effectiveness that are

  10. Calibrating abundance indices with population size estimators of red back salamanders (Plethodon cinereus) in a New England forest

    PubMed Central

    Ellison, Aaron M.; Jackson, Scott

    2015-01-01

    Herpetologists and conservation biologists frequently use convenient and cost-effective, but less accurate, abundance indices (e.g., number of individuals collected under artificial cover boards or during natural objects surveys) in lieu of more accurate, but costly and destructive, population size estimators to detect and monitor size, state, and trends of amphibian populations. Although there are advantages and disadvantages to each approach, reliable use of abundance indices requires that they be calibrated with accurate population estimators. Such calibrations, however, are rare. The red back salamander, Plethodon cinereus, is an ecologically useful indicator species of forest dynamics, and accurate calibration of indices of salamander abundance could increase the reliability of abundance indices used in monitoring programs. We calibrated abundance indices derived from surveys of P. cinereus under artificial cover boards or natural objects with a more accurate estimator of their population size in a New England forest. Average densities/m2 and capture probabilities of P. cinereus under natural objects or cover boards in independent, replicate sites at the Harvard Forest (Petersham, Massachusetts, USA) were similar in stands dominated by Tsuga canadensis (eastern hemlock) and deciduous hardwood species (predominantly Quercus rubra [red oak] and Acer rubrum [red maple]). The abundance index based on salamanders surveyed under natural objects was significantly associated with density estimates of P. cinereus derived from depletion (removal) surveys, but underestimated true density by 50%. In contrast, the abundance index based on cover-board surveys overestimated true density by a factor of 8 and the association between the cover-board index and the density estimates was not statistically significant. We conclude that when calibrated and used appropriately, some abundance indices may provide cost-effective and reliable measures of P. cinereus abundance that could

  11. Calibrating abundance indices with population size estimators of red back salamanders (Plethodon cinereus) in a New England forest.

    PubMed

    Siddig, Ahmed A; Ellison, Aaron M; Jackson, Scott

    2015-01-01

    Herpetologists and conservation biologists frequently use convenient and cost-effective, but less accurate, abundance indices (e.g., number of individuals collected under artificial cover boards or during natural objects surveys) in lieu of more accurate, but costly and destructive, population size estimators to detect and monitor size, state, and trends of amphibian populations. Although there are advantages and disadvantages to each approach, reliable use of abundance indices requires that they be calibrated with accurate population estimators. Such calibrations, however, are rare. The red back salamander, Plethodon cinereus, is an ecologically useful indicator species of forest dynamics, and accurate calibration of indices of salamander abundance could increase the reliability of abundance indices used in monitoring programs. We calibrated abundance indices derived from surveys of P. cinereus under artificial cover boards or natural objects with a more accurate estimator of their population size in a New England forest. Average densities/m(2) and capture probabilities of P. cinereus under natural objects or cover boards in independent, replicate sites at the Harvard Forest (Petersham, Massachusetts, USA) were similar in stands dominated by Tsuga canadensis (eastern hemlock) and deciduous hardwood species (predominantly Quercus rubra [red oak] and Acer rubrum [red maple]). The abundance index based on salamanders surveyed under natural objects was significantly associated with density estimates of P. cinereus derived from depletion (removal) surveys, but underestimated true density by 50%. In contrast, the abundance index based on cover-board surveys overestimated true density by a factor of 8 and the association between the cover-board index and the density estimates was not statistically significant. We conclude that when calibrated and used appropriately, some abundance indices may provide cost-effective and reliable measures of P. cinereus abundance that

  12. Cost-effectiveness and Pricing of Antibacterial Drugs

    PubMed Central

    Verhoef, Talitha I; Morris, Stephen

    2015-01-01

    Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of ‘value’, which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. PMID:25521641

  13. 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

  14. Groundwater remediation and the cost effectiveness of phytoremediation.

    PubMed

    Compernolle, T; Van Passel, S; Weyens, N; Vangronsveld, J; Lebbe, L; Thewys, T

    2012-10-01

    In 1999, phytoremediation was applied at the site of a Belgian car factory to contain two BTEX plumes. This case study evaluates the cost effectiveness of phytoremediation compared to other remediation options, applying a tailored approach for economic evaluation. Generally, when phytoremediation is addressed as being cost effective, the cost effectiveness is only determined on an average basis. This study however, demonstrates that an incremental analysis may provide a more nuanced conclusion. When the cost effectiveness is calculated on an average basis, in this particular case, the no containment strategy (natural attenuation) has the lowest cost per unit mass removed and hence, should be preferred. However, when the cost effectiveness is determined incrementally, no containment should only be preferred if the value of removing an extra gram of contaminant mass is lower than 320 euros. Otherwise, a permeable reactive barrier should be adopted. A similar analysis is provided for the effect determined on the basis of remediation time. Phytoremediation is preferred compared to 'no containment' if reaching the objective one year earlier is worth 7 000 euros.

  15. Climate influences on the cost-effectiveness of vector-based interventions against malaria in elimination scenarios.

    PubMed

    Parham, Paul E; Hughes, Dyfrig A

    2015-04-01

    Despite the dependence of mosquito population dynamics on environmental conditions, the associated impact of climate and climate change on present and future malaria remains an area of ongoing debate and uncertainty. Here, we develop a novel integration of mosquito, transmission and economic modelling to assess whether the cost-effectiveness of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) against Plasmodium falciparum transmission by Anopheles gambiae s.s. mosquitoes depends on climatic conditions in low endemicity scenarios. We find that although temperature and rainfall affect the cost-effectiveness of IRS and/or LLIN scale-up, whether this is sufficient to influence policy depends on local endemicity, existing interventions, host immune response to infection and the emergence rate of insecticide resistance. For the scenarios considered, IRS is found to be more cost-effective than LLINs for the same level of scale-up, and both are more cost-effective at lower mean precipitation and higher variability in precipitation and temperature. We also find that the dependence of peak transmission on mean temperature translates into optimal temperatures for vector-based intervention cost-effectiveness. Further cost-effectiveness analysis that accounts for country-specific epidemiological and environmental heterogeneities is required to assess optimal intervention scale-up for elimination and better understand future transmission trends under climate change. PMID:25688017

  16. Climate influences on the cost-effectiveness of vector-based interventions against malaria in elimination scenarios

    PubMed Central

    Parham, Paul E.; Hughes, Dyfrig A.

    2015-01-01

    Despite the dependence of mosquito population dynamics on environmental conditions, the associated impact of climate and climate change on present and future malaria remains an area of ongoing debate and uncertainty. Here, we develop a novel integration of mosquito, transmission and economic modelling to assess whether the cost-effectiveness of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) against Plasmodium falciparum transmission by Anopheles gambiae s.s. mosquitoes depends on climatic conditions in low endemicity scenarios. We find that although temperature and rainfall affect the cost-effectiveness of IRS and/or LLIN scale-up, whether this is sufficient to influence policy depends on local endemicity, existing interventions, host immune response to infection and the emergence rate of insecticide resistance. For the scenarios considered, IRS is found to be more cost-effective than LLINs for the same level of scale-up, and both are more cost-effective at lower mean precipitation and higher variability in precipitation and temperature. We also find that the dependence of peak transmission on mean temperature translates into optimal temperatures for vector-based intervention cost-effectiveness. Further cost-effectiveness analysis that accounts for country-specific epidemiological and environmental heterogeneities is required to assess optimal intervention scale-up for elimination and better understand future transmission trends under climate change. PMID:25688017

  17. Cost-effective lignocellulolytic enzyme production by Trichoderma reesei on a cane molasses medium

    PubMed Central

    2014-01-01

    Background Cane molasses, an important residue of the sugar industry, have the potential as a cost-effective carbon source that could serve as nutrients for industrial enzyme-producing microorganisms, especially filamentous fungi. However, the enzyme mixtures produced in such a complex medium are poorly characterized. In this study, the secretome of Trichoderma reesei grown on a cane molasses medium (CMM) as well as on a lactose-based conventional medium (LCM) were compared and analyzed by using proteomics. Results In this study we show that both the CMM and LCM can serve as excellent growth media for T. reesei. The enzyme expression patterns in the two media were similar and a considerable number of the identified proteins on two-dimensional gel electrophoresis (2-DE) gels were those involved in biomass degradation. The most abundant cellulolytic enzymes identified in both media were cellobiohydrolases (Cel7A/Cel6A) and endoglucanases (Cel7A/Cel5A) and were found to be more abundant in CMM. We also found that both media can serve as an inducer of xylanolytic enzymes. The main xylanases (XYNI/XYNIV) and xyloglucanase (Cel74A) were found at higher concentrations in the CMM than LCM. Conclusions We analyzed the prevalent proteins secreted by T. reesei in the CMM and LCM. Here, we show that hydrolytic enzymes are cost-effective and can be produced on cane molasses as a carbon source which can be used to digest lignocellulolytic biomass. PMID:24655817

  18. Cost-effective conservation planning: lessons from economics.

    PubMed

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

    2013-08-15

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

  19. A Layered Decision Model for Cost-Effective System Security

    SciTech Connect

    Wei, Huaqiang; Alves-Foss, James; Soule, Terry; Pforsich, Hugh; Zhang, Du; Frincke, Deborah A.

    2008-10-01

    System security involves decisions in at least three areas: identification of well-defined security policies, selection of cost-effective defence strategies, and implementation of real-time defence tactics. Although choices made in each of these areas affect the others, existing decision models typically handle these three decision areas in isolation. There is no comprehensive tool that can integrate them to provide a single efficient model for safeguarding a network. In addition, there is no clear way to determine which particular combinations of defence decisions result in cost-effective solutions. To address these problems, this paper introduces a Layered Decision Model (LDM) for use in deciding how to address defence decisions based on their cost-effectiveness. To validate the LDM and illustrate how it is used, we used simulation to test model rationality and applied the LDM to the design of system security for an e-commercial business case.

  20. Evaluating cost-effectiveness using episodes of care.

    PubMed

    Lasdon, G S; Sigmann, P

    1977-03-01

    To test the feasibility of defining episodes of care as a cost-effectiveness measure, a pilot study was carried out in conjunction with an ongoing quality assessment program which involved abstracting prospective data from charts of patients treated for hypertension in the Primary Care Clinic of Hahnemann Medical College and Hospital. For comparison, data were abstracted retrospectively on hypertensive patients treated by faculty general internists in a fee-for-service private practice. The 12-month course of each patient was divided into controlled and uncontrolled episodes for which visit frequency rate and mean laboratory test utilization was calculated. Patient cost for each type of episode in each setting was calculated using standard charges. Results indicate that the episode definition is feasible and provides a measure for comparing the cost-effectiveness of different delivery systems treating the same health care problem. Factors omitted from the study that could affect cost-effectiveness are also discussed.

  1. Cost-effectiveness of Extended Cessation Treatment for Older Smokers

    PubMed Central

    Barnett, Paul G.; Wong, Wynnie; Jeffers, Abra; Munoz, Ricardo; Humfleet, Gary; Hall, Sharon

    2014-01-01

    Aims To examine the cost-effectiveness of extended smoking cessation treatment in older smokers. Design Participants who completed a 12 week smoking cessation program were factorial randomized to extended cognitive behavioral treatment and extended nicotine replacement therapy. Setting A free-standing smoking cessation clinic in the United States. Participants 402 smokers aged 50 years and older were recruited from the community. Measurements The trial measured biochemically-verified abstinence from cigarettes after 24 months and the quantity of smoking cessation services used. Trial findings were combined with literature on changes in smoking status and the age and gender adjusted effect of smoking on health care cost, mortality, and qualify of life over the long-term in a Markov model of cost-effectiveness over a lifetime horizon. Findings The addition of extended cognitive behavioral therapy added $83 in smoking cessation services cost (p =.012, CI $21-$212). At the end of follow-up, cigarette abstinence rates were 50.0% with extended cognitive behavioral therapy and 37.2% without this therapy (p <.05, odds ratio 1.69, CI 1.18-2.54). The model-based incremental cost-effectiveness ratio was $6,324 per Quality Adjusted Life Year (QALY). Probabilistic sensitivity analysis found that the additional $947 in lifetime cost of the intervention had a 95% confidence interval of –$331 – $2,081; the 0.150 additional QALYs had a confidence interval of 0.035- 0.280, and that the intervention was cost-effective against a $50,000/QALY acceptance criterion in 99.6% of the replicates. Extended nicotine replacement therapy was not cost-effective. Conclusions Adding extended cognitive behavior therapy to standard smoking cessation treatment can be cost-effective. PMID:24329972

  2. Economics of urolithiasis: cost-effectiveness of therapies.

    PubMed

    Chandhoke, P S

    2001-07-01

    The cost of treating urolithiasis with extracorporeal shockwave lithotripsy and endoscopic surgery continues to be a significant burden on a nation's healthcare economy. Cost-effectiveness evaluations of various medical and surgical treatment options for urolithiasis is a practical method of developing rational allocation strategies for limited economic resources. In this review, the cost-effectiveness of shockwave lithotripsy and that of endoscopic surgery in the management of kidney and ureteral stones are compared. This is followed by a discussion of the cost of the medical management of urolithiasis in comparison with repeated surgical treatment.

  3. Cost effective use of liquid nitrogen in cryogenic wind tunnels

    NASA Technical Reports Server (NTRS)

    Mcintosh, Glen E.; Lombard, David S.; Martindale, David L.; Dunn, Robert P.

    1987-01-01

    A method of reliquefying from 12 to 19% of the nitrogen exhaust gas from a cryogenic wind tunnel has been developed. Technical feasibility and cost effectiveness of the system depends on performance of an innovative positive displacement expander which requires scale model testing to confirm design studies. The existing cryogenic system at the 0.3-m transonic cryogenic tunnel has been surveyed and extensive upgrades proposed. Upgrades are generally cost effective and may be implemented immediately since they are based on established technology.

  4. Cost effectiveness studies of environmental technologies: Volume 1

    SciTech Connect

    Silva, E.M.; Booth, S.R.

    1994-02-01

    This paper examines cost effectiveness studies of environmental technologies including the following: (1) In Situ Air Stripping, (2) Surface Towed Ordinance Locator System, (3) Ditch Witch Horizontal Boring Technology, (4) Direct Sampling Ion Trap Mass Spectrometer, (5) In Situ Vitrification, (6) Site Characterization and Analysis Penetrometer System, (7) In Situ Bioremediation, and (8) SEAMIST Membrane System Technology.

  5. Cost Effectiveness of Current Awareness Sources in the Pharmaceutical Industry

    ERIC Educational Resources Information Center

    Ashmole, R. F.; And Others

    1973-01-01

    The cost effectiveness of several commercial data bases, journal scanning by information scientists, and the impact of private communication are compared in this study. A previously developed technique for measuring the usefulness of commercial data bases is utilized. (21 references) (Author/KE)

  6. Cost-Effectiveness Analysis of School Desegregation Plans.

    ERIC Educational Resources Information Center

    Rossell, Christine H.

    Cost-effectiveness analysis provides a useful tool for choosing between alternative desegregation plans or justifying one particular plan. Previous analyses of school desegregation effects on white enrollment, which focus only upon costs, have had limited use for policy. Traditional cost-benefit analysis poses problems because of the difficulty of…

  7. Cost-Effective Applications of Computer-Based Education

    ERIC Educational Resources Information Center

    Avner, R. A.

    1978-01-01

    Cost effective applications of CBE do exist; however, they demand detailed cost information for all appropriate alternatives to CAI, a thorough understanding of instructional design, and an expert knowledge of the relative capabilities of alternative media in supporting particular instructional approaches. (Author/RAO)

  8. Neural mechanisms and personality correlates of the sunk cost effect.

    PubMed

    Fujino, Junya; Fujimoto, Shinsuke; Kodaka, Fumitoshi; Camerer, Colin F; Kawada, Ryosaku; Tsurumi, Kosuke; Tei, Shisei; Isobe, Masanori; Miyata, Jun; Sugihara, Genichi; Yamada, Makiko; Fukuyama, Hidenao; Murai, Toshiya; Takahashi, Hidehiko

    2016-01-01

    The sunk cost effect, an interesting and well-known maladaptive behavior, is pervasive in real life, and thus has been studied in various disciplines, including economics, psychology, organizational behavior, politics, and biology. However, the neural mechanisms underlying the sunk cost effect have not been clearly established, nor have their association with differences in individual susceptibility to the effect. Using functional magnetic resonance imaging, we investigated neural responses induced by sunk costs along with measures of core human personality. We found that individuals who tend to adhere to social rules and regulations (who are high in measured agreeableness and conscientiousness) are more susceptible to the sunk cost effect. Furthermore, this behavioral observation was strongly mediated by insula activity during sunk cost decision-making. Tight coupling between the insula and lateral prefrontal cortex was also observed during decision-making under sunk costs. Our findings reveal how individual differences can affect decision-making under sunk costs, thereby contributing to a better understanding of the psychological and neural mechanisms of the sunk cost effect. PMID:27611212

  9. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cost-effectiveness. 457.1015 Section 457.1015 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

  10. 42 CFR 457.1015 - Cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... in an energy or water conservation measure retrofit to an existing Federal building is not life cycle... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit...

  12. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this...) Federal agencies performing LCC analysis on computers shall use either the Federal Buildings Life Cycle... building energy or water system with an energy or water conservation measure by retrofit to an...

  13. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this...) Federal agencies performing LCC analysis on computers shall use either the Federal Buildings Life Cycle... building energy or water system with an energy or water conservation measure by retrofit to an...

  14. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in an energy or water conservation measure retrofit to an existing Federal building is not life cycle... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit...

  15. 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... the investment and other costs for an energy or water conservation measure considered for retrofit...

  16. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Presuming cost-effectiveness results. 436.13 Section 436.13 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS... the investment and other costs for an energy or water conservation measure considered for retrofit...

  17. Research Report: Cost-Effectiveness of Curriculum Revision.

    ERIC Educational Resources Information Center

    Mulder, M.; And Others

    1991-01-01

    Evaluation of the cost effectiveness of a revised curriculum using computer-based training (CBT) in the Dutch postal service found cost savings and satisfactory training results, implying that CBT is an effective strategy for complex work organizations training considerable numbers of employees. (SK)

  18. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  19. The Political Arithmetic of Cost-Effectiveness Analysis.

    ERIC Educational Resources Information Center

    Levin, Henry M.; And Others

    1986-01-01

    Responding to a critique of their earlier article, authors Levin and Meister, joined by Glass, attempt to clarify some of the issues and to correct implicit misunderstandings in the critique, while detailing the application of cost-effectiveness to educational interventions. Twenty footnotes are appended. (IW)

  20. Systems Analysis for Program Planning and Cost Effectiveness. (An Application).

    ERIC Educational Resources Information Center

    van Gigch, John P.; Hill, Richard E.

    This paper describes an effort to implement a cost-effectiveness program using systems analysis in an elementary school district, the Rio Linda Union School District in California. The systems design cycle employed has three phases, policy-making evaluation, and action-implementation. During the first phase, the general philosophy or mission of…

  1. Cost-effectiveness of hysteroscopy screening for infertile women.

    PubMed

    Kasius, Jenneke C; Eijkemans, René J C; Mol, Ben W J; Fauser, Bart C J M; Fatemi, Human M; Broekmans, Frank J M

    2013-06-01

    This study assessed the cost-effectiveness of office hysteroscopy screening prior to IVF. Therefore, the cost-effectiveness of two distinct strategies - hysteroscopy after two failed IVF cycles (Failedhyst) and routine hysteroscopy prior to IVF (Routinehyst) - was compared with the reference strategy of no hysteroscopy (Nohyst). When present, intrauterine pathology was treated during hysteroscopy. Two models were constructed and evaluated in a decision analysis. In model I, all patients had an increase in pregnancy rate after screening hysteroscopy prior to IVF; in model II, only patients with intrauterine pathology would benefit. For each strategy, the total costs and live birth rates after a total of three IVF cycles were assessed. For model I (all patients benefit from hysteroscopy), Routinehyst was always cost-effective compared with Nohyst or Failedhyst. For the Routinehyst strategy, a monetary profit would be obtained in the case where hysteroscopy would increase the live birth rate after IVF by ≥ 2.8%. In model II (only patients with pathology benefit from hysteroscopy), Routinehyst also dominated Failedhyst. However, hysteroscopy performance resulted in considerable costs. In conclusion, the application of a routine hysteroscopy prior to IVF could be cost-effective. However, randomized trials confirming the effectiveness of hysteroscopy are needed.

  2. A Cost Effectiveness Model for Comparing Various Circulation Systems

    ERIC Educational Resources Information Center

    Burgess, Thomas K.

    1973-01-01

    Two models for circulation systems (manual and automated) costing are presented. Validation tests for the model assumptions are devised and explained. Use of the models for cost effectiveness comparison and for cost prediction are discussed and examples are given showing their application. (10 references) (Author/SJ)

  3. Evaluating the Cost-Effectiveness of Instructional Programs.

    ERIC Educational Resources Information Center

    Alkin, Marvin C.

    A model of cost-effectiveness is outlined which enables consideration of some non-financial, as well as financial, elements of educational systems at school or district levels. The model enables the decision-maker to compare educational outcomes of different units, to assess the impact of alternative levels of financial input, and to select…

  4. Cost-effectiveness of Anterior Implants versus Fixed Dental Prostheses

    PubMed Central

    Zitzmann, N.U.; Krastl, G.; Weiger, R.; Kühl, S.; Sendi, P.

    2013-01-01

    For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient’s perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs. PMID:24158338

  5. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... pursuant to § 455.20(u)(3). (2) The simple payback period of each renewable resource energy conservation... 10 Energy 3 2012-01-01 2012-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED...

  6. 10 CFR 455.63 - Cost-effectiveness testing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... pursuant to § 455.20(u)(3). (2) The simple payback period of each renewable resource energy conservation... 10 Energy 3 2014-01-01 2014-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED...

  7. Cost-Effectiveness of Evaluating the New Technologies.

    ERIC Educational Resources Information Center

    Kastner, Theodore A.

    1997-01-01

    This commentary on a study comparing use of the brand name drug Depakene with generic valproic acid to control seizures in people with mental retardation focuses on issues of cost-effectiveness. It notes existing guidelines for pharmacoeconomic evaluation and suggests a possible model to include a threshold price (per quality-adjusted life year)…

  8. Neural mechanisms and personality correlates of the sunk cost effect

    PubMed Central

    Fujino, Junya; Fujimoto, Shinsuke; Kodaka, Fumitoshi; Camerer, Colin F.; Kawada, Ryosaku; Tsurumi, Kosuke; Tei, Shisei; Isobe, Masanori; Miyata, Jun; Sugihara, Genichi; Yamada, Makiko; Fukuyama, Hidenao; Murai, Toshiya; Takahashi, Hidehiko

    2016-01-01

    The sunk cost effect, an interesting and well-known maladaptive behavior, is pervasive in real life, and thus has been studied in various disciplines, including economics, psychology, organizational behavior, politics, and biology. However, the neural mechanisms underlying the sunk cost effect have not been clearly established, nor have their association with differences in individual susceptibility to the effect. Using functional magnetic resonance imaging, we investigated neural responses induced by sunk costs along with measures of core human personality. We found that individuals who tend to adhere to social rules and regulations (who are high in measured agreeableness and conscientiousness) are more susceptible to the sunk cost effect. Furthermore, this behavioral observation was strongly mediated by insula activity during sunk cost decision-making. Tight coupling between the insula and lateral prefrontal cortex was also observed during decision-making under sunk costs. Our findings reveal how individual differences can affect decision-making under sunk costs, thereby contributing to a better understanding of the psychological and neural mechanisms of the sunk cost effect. PMID:27611212

  9. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... water system, considered in determining such matters as the optimal size of a solar energy system, the... 10 Energy 3 2014-01-01 2014-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology...

  10. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... water system, considered in determining such matters as the optimal size of a solar energy system, the... 10 Energy 3 2012-01-01 2012-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology...

  11. 10 CFR 436.18 - Measuring cost-effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this...) Federal agencies performing LCC analysis on computers shall use either the Federal Buildings Life Cycle...-effective if— (1) Life cycle costs, as described by § 436.19, are estimated to be lower; or (2) Net...

  12. Energy Submetering: The Key to Cost-Effective Conservation.

    ERIC Educational Resources Information Center

    Turner, W. D.; McBride, John R.

    1999-01-01

    Examines the monitoring results from two large-scale metering and energy information projects: Texas LoanSTAR Program; and the Texas A & M Campus Project. Data suggest implementing an energy metering system is cost effective, particularly if the system can be coupled with skilled engineering applications such as energy cost allocation and building…

  13. The Cost Effectiveness of Hepatitis Immunization for US College Students

    ERIC Educational Resources Information Center

    Jacobs, R. Jake; Saab, Sammy; Meyerhoff, Allen S.

    2003-01-01

    Hepatitis B immunization is recommended for all American children, and hepatitis A immunization is recommended for children who live in areas with elevated disease rates. Because hepatitis A and B occur most commonly in young adults, the authors examined the cost effectiveness of college-based vaccination. They developed epidemiologic models to…

  14. Biobanks and Electronic Medical Records: Enabling Cost-Effective Research

    PubMed Central

    Bowton, Erica; Field, Julie R.; Wang, Sunny; Schildcrout, Jonathan S.; Van Driest, Sara L.; Delaney, Jessica T.; Cowan, James; Weeke, Peter; Mosley, Jonathan D.; Wells, Quinn S.; Karnes, Jason H.; Shaffer, Christian; Peterson, Josh F.; Denny, Joshua C.; Roden, Dan M.; Pulley, Jill M.

    2014-01-01

    The use of electronic medical record data linked to biological specimens in health care settings is expected to enable cost-effective and rapid genomic analyses. Here, we present a model that highlights potential advantages for genomic discovery and describe the operational infrastructure that facilitated multiple simultaneous discovery efforts. PMID:24786321

  15. A Cost-Effectiveness Analysis of Early Literacy Interventions

    ERIC Educational Resources Information Center

    Simon, Jessica

    2011-01-01

    Success in early literacy activities is associated with improved educational outcomes, including reduced dropout risk, in-grade retention, and special education referrals. When considering programs that will work for a particular school and context; cost-effectiveness analysis may provide useful information for decision makers. The study…

  16. Cost-Effective School Alarm Systems. Security Topics Series.

    ERIC Educational Resources Information Center

    Kaufer, Steve

    This document outlines considerations in the selection of a cost-effective school-alarm system. Steps in the planning process include: conducting a district needs assessment; gathering input from all staff levels; consulting technical expertise; and selecting a security system that can be integrated with other site needs. It further describes the…

  17. Cost-effectiveness of anterior implants versus fixed dental prostheses.

    PubMed

    Zitzmann, N U; Krastl, G; Weiger, R; Kühl, S; Sendi, P

    2013-12-01

    For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient's perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs.

  18. Cost-effectiveness analysis and insurance coverage: solving a puzzle.

    PubMed

    Pauly, Mark

    2015-05-01

    The conventional model for the use of cost-effectiveness analysis for health programs involves determining whether the cost per unit of effectiveness of the program is lower than some socially determined maximum acceptable cost per unit of effectiveness. If a program is better by this criterion, the policy implication is that it should be implemented by full coverage of its cost by insurance; if not, the program should not be implemented. This paper examines the unanswered question of how cost-effectiveness analysis should be performed and interpreted when insurance coverage may involve cost sharing. It explores the question of how cost sharing should be related to the magnitude of a cost-effectiveness ratio. A common view that cost sharing should vary inversely with program cost-effectiveness is shown to be incorrect. A key issue in correct analysis is whether there is heterogeneity in marginal effectiveness of care that cannot be perceived by the social planner but is known by the demander. It is possible that some programs that would fail the social efficiency test at full coverage will be acceptable with positive cost sharing. Combining individual and social preferences affects both the choice of programs and the extent of cost sharing.

  19. Flipping the Calculus Classroom: A Cost-Effective Approach

    ERIC Educational Resources Information Center

    Young, Andrea

    2015-01-01

    This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.

  20. Cost Effectiveness of Premium Versus Regular Gasoline in MCPS Buses.

    ERIC Educational Resources Information Center

    Baacke, Clifford M.; Frankel, Steven M.

    The primary question posed in this study is whether premium or regular gasoline is more cost effective for the Montgomery County Public School (MCPS) bus fleet, as a whole, when miles-per-gallon, cost-per-gallon, and repair costs associated with mileage are considered. On average, both miles-per-gallon, and repair costs-per-mile favor premium…

  1. Cost-Effectiveness Affirmative Reading Skills Program, 1984-85.

    ERIC Educational Resources Information Center

    Gallagher, Michael P.

    The 1984-85 cost-effects study represents the third annual analysis of the components of Cleveland's Affirmative Reading Skills Plan, which offers three instructional strands--developmental (regular reading/language arts), support (additional enrichment, corrective or remedial), and compensatory (instruction for students having reading scores in…

  2. Final report: Compiled MPI. Cost-Effective Exascale Application Development

    SciTech Connect

    Gropp, William Douglas

    2015-12-21

    This is the final report on Compiled MPI: Cost-Effective Exascale Application Development, and summarizes the results under this project. The project investigated runtime enviroments that improve the performance of MPI (Message-Passing Interface) programs; work at Illinois in the last period of this project looked at optimizing data access optimizations expressed with MPI datatypes.

  3. Cost-effectiveness of a worksite hypertension treatment program.

    PubMed

    Logan, A G; Milne, B J; Achber, C; Campbell, W P; Haynes, R B

    1981-01-01

    The cost-effectiveness of treating hypertension at the patient's place of work was compared in a randomized controlled trial with care delivered in a community. The average total cost per patient for worksite care in this 12-month study was not significantly different from that for regular care ($242.86 +/- 6.94 vs $211.34 +/- 18.66, mean +/- SEM). The worksite health system cost was significantly more expensive ($197.36 +/- 4.99 vs $129.33 +/- 13.34, p less than 0.001) but the patient cost was significantly less ($45.40 +/- 3.23 vs $82.00 +/- 6.20, p less than 0.01). The mean reduction in diastolic blood pressure (BP) at the year-end assessment was significantly greater in the worksite group (12.1 +/- 0.6 vs 6.5 +/- 0.6 mm Hg, p less than 0.001). The incremental cost-effectiveness ratio of $5.63 per mm Hg for worksite care was less than the base cost-effectiveness ratio of $32.51 per mm Hg for regular care, indicating that the worksite program was substantially more cost-effective. Our findings support health policies that favor allocating resources to work-based hypertension treatment programs for the target group identified in this study. PMID:6783519

  4. Assessing the Cost-Effectiveness of Family Connections

    ERIC Educational Resources Information Center

    DePanfilis, Diane; Dubowitz, Howard; Kunz, James

    2008-01-01

    Objective: To assess the cost-effectiveness of two alternate forms of Family Connections (FC), a child neglect prevention program, in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes. Methods: In the original FC study, a sample of 154 families (473 children) in a poor, urban neighborhood,…

  5. Hepatocellular carcinoma: cost-effectiveness of screening. A systematic review.

    PubMed

    Ruggeri, Matteo

    2012-01-01

    Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide. HCC is a potential target for cancer surveillance (or screening) as it occurs in well-defined, at-risk populations. Curative therapy is possible only for small tumors and screening strategy has been recommended by the US, Italian, and other international liver societies and is practiced widely, but its benefits are not clearly established. The objective of this study was to review the available evidence with respect to the cost-effectiveness of key technologies in the prevention HCC. The literature search was conducted with the support of PubMed. Firstly we selected articles by reading the abstracts. Secondly, we read the articles and the revision was further restricted, with the following as inclusion criteria: (1) full economic evaluation of HCC screening programs; (2) comparison between HCC techniques; (3) outcome measures expressed in terms of quality adjusted life years (QALY); (4) full text availability. The initial review of the literature yielded 346 articles. Of those, 288 were excluded at the first stage. Of those excluded, 108 did not meet the target, 106 did not present the cost analysis, 33 did not analyze the treatment of the disease, and in 41 the abstract was not available. Of the 58 included in the first step, seven examined the cost-effectiveness of different HCC screening techniques, seven investigated the cost-effectiveness of HCC screening versus no screening, and one looked at the cost-effectiveness of timing for HCC surveillance and monitoring, while 43 were about HBV vaccination and screening. We included only the seven articles examining the cost-effectiveness of different HCC screening techniques. In general, incidence is the key parameter which determines the cost-effectiveness of HCC screening. Discrepancies in the results exist when determining the type of technology to be used. Ultrasound (US) alone or in association with alpha fetoprotein (AFP) technology is

  6. The polypill: at what price would it become cost effective?

    PubMed Central

    Franco, Oscar H; Steyerberg, Ewout W

    2006-01-01

    Introduction A promising concept in cardiovascular disease prevention (the polypill) was introduced in 2003. Although the polypill may seem as an effective intervention, data on its costs and cost effectiveness remain unknown. The aim of this study was to determine the maximum price of the polypill for it to be a cost effective alternative in the primary prevention of cardiovascular disease. Methods Data on the hypothetical effects of the polypill were taken from the literature. Using data from the Framingham heart study and the Framingham offspring study, life tables were built to model the assumed benefits of the polypill. Using a third party payer perspective and a 10 years time horizon, the authors calculated what should be the maximum drug cost of the polypill for it to be cost effective (using a €20 000/year of life saved threshold) in the primary prevention of cardiovascular disease among populations at different levels of absolute risk of coronary heart disease and age. Results To be cost effective among populations at levels of 10 year coronary heart disease risk over 20% (high risk), the annual cost of medication for the polypill therapy should be no more than €302 or €410 for men at age 50 and 60 years respectively. For cost effective prevention in populations at levels of coronary heart disease risk between 10% and 20% the costs should be two to three times lower. Conclusion Although the polypill could theoretically be a highly effective intervention, the costs of the medication could be its caveat for implementation in the primary prevention of cardiovascular disease. PMID:16476750

  7. Cost effectiveness analysis of larval therapy for leg ulcers

    PubMed Central

    Iglesias, Cynthia P; Bland, J Martin; Cullum, Nicky; Dumville, Jo C; Nelson, E Andrea; Torgerson, David J; Worthy, Gill

    2009-01-01

    Objective To assess the cost effectiveness of larval therapy compared with hydrogel in the management of leg ulcers. Design Cost effectiveness and cost utility analyses carried out alongside a pragmatic multicentre, randomised, open trial with equal randomisation. Population Intention to treat population comprising 267 patients with a venous or mixed venous and arterial ulcers with at least 25% coverage of slough or necrotic tissue. Interventions Patients were randomly allocated to debridement with bagged larvae, loose larvae, or hydrogel. Main outcome measure The time horizon was 12 months and costs were estimated from the UK National Health Service perspective. Cost effectiveness outcomes are expressed in terms of incremental costs per ulcer-free day (cost effectiveness analysis) and incremental costs per quality adjusted life years (cost utility analysis). Results The larvae arms were pooled for the main analysis. Treatment with larval therapy cost, on average, £96.70 (€109.61; $140.57) more per participant per year (95% confidence interval −£491.9 to £685.8) than treatment with hydrogel. Participants treated with larval therapy healed, on average, 2.42 days before those in the hydrogel arm (95% confidence interval −0.95 to 31.91 days) and had a slightly better health related quality of life, as the annual difference in QALYs was 0.011 (95% confidence interval −0.067 to 0.071). However, none of these differences was statistically significant. The incremental cost effectiveness ratio for the base case analysis was estimated at £8826 per QALY gained and £40 per ulcer-free day. Considerable uncertainty surrounds the outcome estimates. Conclusions Debridement of sloughy or necrotic leg ulcers with larval therapy is likely to produce similar health benefits and have similar costs to treatment with hydrogel. Trial registration Current Controlled Trials ISRCTN55114812 and National Research Register N0484123692. PMID:19304578

  8. The Cost-Effectiveness Analysis of Teleglaucoma Screening Device.

    PubMed

    Thomas, Sera; Hodge, William; Malvankar-Mehta, Monali

    2015-01-01

    Glaucoma is the leading cause of irreversible vision loss and costs the American economy $2.9 billion. Teleglaucoma remotely detects glaucoma improving access to ophthalmic care in rural areas. It helps manage glaucoma more efficiently to preserve vision and reduce healthcare costs. A cost-effectiveness analysis was conducted using healthcare provider or third-party payer perspective within rural Canada. The study population were patients at-risk of glaucoma which includes those with diabetes and/or hypertension, family history of glaucoma, adults older than 50 years, and concurrent ocular conditions in rural Alberta. Markov modelling was used to model glaucoma health states. Effectiveness was measured in Quality-Adjusted Life Years (QALYs) and costs were used in Canadian dollars. Using TreeAge Pro 2009, incremental cost-effectiveness ratios (ICER) were developed in dollars per QALYs. Deterministic and probabilistic sensitivity analyses were performed to assess the factors affecting cost-effectiveness. Teleglaucoma had a 20% increase in ophthalmologist-referral rate; it reduced patient travel times by 61 hours and physician wait times by 30% in comparison to in-person examination (standard of care). Teleglaucoma costs $872 per patient screened which was 80% less than in-person examination. Teleglaucoma had a greater incremental effectiveness providing an additional 0.12 QALY per patient examination. It was more sensitive (86.5%) and less specific (78.6%) than in-person examination. Teleglaucoma was more cost-effective than in-person examination with an ICER of-$27,460/QALY. This indicated that teleglaucoma will save $27, 460 for each additional QALY gained. Long term benefits showed teleglaucoma prevents 24% cases of glaucoma blindness after 30 years. Teleglaucoma demonstrated improved health outcomes, as well as, cost benefits. It increases access to ophthalmic care and improves healthcare service efficiency, specifically in rural areas. Teleglaucoma is more cost-effective

  9. Vaccination strategies for future influenza pandemics: a severity-based cost effectiveness analysis

    PubMed Central

    2013-01-01

    increased rates of vaccination further improved effectiveness and cost effectiveness. Conclusions The effectiveness and cost effectiveness consequences of the time-critical interplay of pandemic dynamics, vaccine availability and intervention timing has been quantified. For moderate and extreme pandemics, vaccination combined with rapidly activated antiviral and social distancing interventions of sufficient duration is cost effective from the perspective of life years saved. PMID:23398722

  10. 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

  11. Examining the cost-effectiveness of cancer screening promotion.

    PubMed

    Andersen, M Robyn; Urban, Nicole; Ramsey, Scott; Briss, Peter A

    2004-09-01

    Cost-effectiveness analyses (CEAs) can help to quantify the contribution of the promotion of a screening program to increased participation in screening. The cost-effectiveness (C/E) of screening promotion depends in large part on the endpoints of interest. At the most fundamental level, the C/E of a strategy for promoting screening would focus on the attendance rate, or cost per person screened, and the C/E would be influenced by the costs of promotion, as well as by the size and responsiveness of the target population. In addition, the costs of screening promotion (measured as the cost per additional participant in screening) can be included in a CEA estimate of the screening technology. In this case, depending on the efficacy of the screening test and the costs and influence of the promotion, the C/E of screening may improve or become poorer. In the current study, the authors reviewed the literature on the C/E of cancer screening promotion. The following lessons were learned regarding the C/E of screening and its promotion: 1) high-quality information on the C/E of screening is increasingly available; 2) cost-effective promotion of screening is dependent on cost-effective screening strategies; 3) quality-of-life effects may be important in assessing the overall C/E of screening programs; 4) research efforts aimed at identifying cost-effective approaches to screening promotion are useful but sparse; 5) C/E studies should be better incorporated into well designed effectiveness research efforts; 6) variations in C/E according to intervention characteristics, population characteristics, and context should be evaluated in greater depth; 7) the long-term effects of screening promotion are critical to assessing C/E; 8) the effects of promotion on costs of screening must be better understood; and 9) CEA must be interpreted in light of other information. The authors showed that CEA can be a valuable tool for understanding the merits of health promotion interventions and

  12. An fMRI study on sunk cost effect.

    PubMed

    Zeng, Jianmin; Zhang, Qinglin; Chen, Changming; Yu, Rongjun; Gong, Qiyong

    2013-06-26

    Sunk cost effect (also called escalation of commitment, etc) is a pervasive, interesting and famous decision bias, which has been intensively discussed in psychology, economics, management, political science, zoology, etc. To date, little has been known about the neural basis of this phenomenon. We investigated it by using functional magnetic resonance imaging (fMRI) to monitor healthy subjects' brain activities when they made decisions in a task wherein sunk cost and incremental cost were systematically manipulated. Higher sunk cost only increased activity of some brain areas (mainly lateral frontal and parietal cortices, which are involved in risk-taking), whereas lower incremental cost mainly increased activity of some brain areas (including striatum and medial prefrontal cortex, which are sensitive to rewards). No overlapping brain areas were found to respond to both sunk cost and incremental cost. These results favor certainty effect over self-justification or diminishing sensitivity as account of sunk cost effect.

  13. 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.

  14. 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

  15. 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.

  16. Cost-Effective TiAl based Materials

    NASA Technical Reports Server (NTRS)

    Moxson, V. S.; Sun, Fusheng; Draper, Susan L.; Froes, F. H.; Duz, V.

    2003-01-01

    Because of their inherent low ductility, TiAl-based materials are difficult to fabricate, especially thin gage titanium gamma aluminide (TiAl) sheet and foil. In this paper, an innovative powder metallurgy approach for producing cost-effective thin gage TiAl sheets (with 356 mm long and 235 mm wide, and a thickness of 0.74, 1.09, 1.55, and 2.34 mm, respectively) is presented. The microstructures and tensile properties at room and elevated temperatures of the thin gage TiAl are studied. Results show that these TiAl sheets have a relatively homogenous chemistry, uniform microstructure, and acceptable mechanical properties. This work demonstrates a cost-effective method for producing both flat products (sheet/foil) and complex chunky parts of TiAl for various advanced applications including aerospace and automotive industries.

  17. Cost-effective network design for groundwater flow monitoring

    NASA Astrophysics Data System (ADS)

    Andricevic, R.

    1990-03-01

    The extensive use of groundwater resources has increased the need for developing cost-effective monitoring networks to provide an indication of the degree to which the subsurface environment has been affected by human activities. This study presents a cost-effective approach to the design of groundwater flow monitoring networks. The groundwater network design is formulated with two problem formats: maximizing the statistical monitoring power for specified budget constraint and minimizing monitoring cost for statistical power requirement. The statistical monitoring power constraint is introduced with an information reliability threshold value. A branch and bound technique is employed to select the optimal solution from a discrete set of possible network alternatives. The method is tested to the design of groundwater flow monitoring problem in the Pomona County, California.

  18. A cost-effectiveness worksheet for patient-education programs.

    PubMed

    Welch, Janet L; Fisher, Mary L; Dayhoff, Nancy E

    2002-07-01

    This article describes the development, implementation, and evaluation of a worksheet used by nursing faculty in a graduate clinical nurse specialist course to assist students in learning to estimate the cost-effectiveness of patient-education programs.1 The worksheet was found to be a satisfactory method of facilitating student learning and could also be used in the service arena to evaluate the cost aspects of patient-education programs.

  19. Development and Manufacture of Cost Effective Composite Drill Pipe

    SciTech Connect

    James C. Leslie; James C. Leslie, II; Lee Truong; James T. Heard

    2006-09-29

    This technical report presents the engineering research, process development and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report presents progress made from October 1, 2005 through September 30, 2006 and contains the following discussions: Qualification Testing; Prototype Development and Testing of ''Smart Design'' Configuration; Field Test Demonstration; Development of Ultra-Short Radius Composite Drill Pipe (USR-CDP); and Development of Smart USR-CDP.

  20. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    PubMed Central

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status. PMID:27678365

  1. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    PubMed Central

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status.

  2. Modified Transverse Thoracosternotomy and Cost-Effective Reinforced Sternal Closure.

    PubMed

    Costa, Joseph; Sonett, Joshua R; D'Ovidio, Frank

    2015-12-01

    The bilateral transverse thoracosternotomy clamshell incision provides excellent exposure to the mediastinal structures in double lung transplantation. The use of a modified transverse sternotomy and a figure of 8 configuration with one monofilament metal wire, along with two longitudinal wires across the sternal division, results in greater stability and equally distributed oblique tension. Our described technique was more cost effective and resulted in no incidence of dehiscence. We present our experience using a modified transverse sternotomy and reinforced sternal closure method.

  3. The cost effectiveness of rotavirus vaccination in Iran

    PubMed Central

    Mousavi Jarrahi, Yasaman; Zahraei, Seyed Mohsen; Sadigh, Nader; Esmaeelpoor Langeroudy, Keyhan; Khodadost, Mahmoud; Ranjbaran, Mehdi; Sanjari Moghaddam, Ali; Besharat, Mehdi; Mosavi Jarrahi, Alireza

    2016-01-01

    ABSTRACT Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. Effective vaccines have recently been approved and successful vaccination program implemented. The aim of this study was to evaluate the cost effectiveness of mass rotavirus vaccination program in Iran. We developed a Markov model that reflects key features of rotavirus natural history. Parameters of the model were assessed by field study or developed through literature search and published data. We applied the model to the 2009 Iranian birth cohort and evaluated the cost-effectiveness of including the rotavirus vaccine (Rotarix®) into Iranian expanded immunization program (EPI). With an estimated hospitalization rate of 0.05 and outpatient rate of 0.23 cases per person-year, vaccinating cohort of 1231735 infants in Iran with 2 doses of (Rotarix®), would prevent 32092 hospitalizations, 158750 outpatient visits, and 1591 deaths during 5 y of follow-up. Under base-case assumption of $10 cost per course of vaccine, the vaccination would incur an extra cost of $1,019,192 from health care perspective and would avert 54680 DALYs. From societal perspective, there would be $15,192,568 saving for the society with the same averted DALYs. The incremental cost effectiveness ratio showed a cost of $19 US dollars per averted DALY from health care perspective and a saving of $278 US dollars for each averted DALY from societal perspective. Introducing rotavirus vaccine into EPI program would be highly cost-effective public health intervention in Iran. PMID:26360331

  4. Invisible Cost Effective Mechanics for Anterior Space Closure.

    PubMed

    Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

    2015-01-01

    The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role.

  5. Cost-effectiveness analysis for health communication programs.

    PubMed

    Guilkey, David K; Hutchinson, Paul; Lance, Peter

    2006-01-01

    This article describes methods for analyzing the cost-effectiveness of health communication programs, focusing in particular on estimating program effectiveness with econometric methods that address experimental and quasi-experimental designs (and their absence), national or subnational program coverage, and endogenously targeting of programs. Experimental designs provide a gold standard for assessing effectiveness but are seldom feasible for large-scale health communication programs. Even in the absence of such designs, however, fairly simple methods can be used to examine intermediate objectives, such as program reach, which in turn can be linked to program costs to estimate cost effectiveness. When moving beyond program reach to behavioral or other outcome measures, such as contraceptive use or fertility, or when faced with full-coverage national programs, more elaborate data and methods are required. We discuss data requirements and assumptions necessary in each case, focusing on single-equation multiple regression models, structural equations models, and fixed effects estimators for use with longitudinal data, and then describing how cost information can be incorporated into econometric models so as to get measures of the cost-effectiveness of communication interventions.

  6. Cost-effectiveness in Clostridium difficile treatment decision-making

    PubMed Central

    Nuijten, Mark JC; Keller, Josbert J; Visser, Caroline E; Redekop, Ken; Claassen, Eric; Speelman, Peter; Pronk, Marja H

    2015-01-01

    AIM: To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection (CDI). METHODS: CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for coverage decisions and guideline development in CDI. The model included pharmacotherapy with oral metronidazole or oral vancomycin, which is the mainstay for pharmacological treatment of CDI and is recommended by most treatment guidelines. RESULTS: A design for a patient-based cost-effectiveness model was developed, which can be used to estimate the cost-effectiveness of current and future treatment strategies in CDI. Patient-based outcomes were extrapolated to the population by including factors like, e.g., person-to-person transmission, isolation precautions and closing and cleaning wards of hospitals. CONCLUSION: The proposed framework for a population-based CDI model may be used for clinical and health economic assessments of CDI guidelines and coverage decisions for emerging treatments for CDI. PMID:26601096

  7. Cost-effectiveness of antiretroviral therapy expansion strategies in Vietnam.

    PubMed

    Tran, Dam Anh; Wilson, David P; Shakeshaft, Anthony; Ngo, Anh Duc; Reyes, Josephine; Doran, Christopher; Zhang, Lei

    2014-07-01

    This study determines an optimal strategy for scaling up ART in Vietnam by examining three initiation thresholds [350 cells/mm(3), 500 cells/mm(3), and treat all people living with HIV (PLHIV) regardless of CD4 cell counts] and treatment commencement rates among treatment-eligible PLHIV ranging from 5% to 100% within 12 months of diagnosis. Incremental cost-effectiveness ratios (ICERs) were calculated using a Markov model, based on data from a cohort of 3449 patients who initiated ART between January 1, 2005 and December 31, 2009 in 13 outpatient clinics across six provinces in Vietnam. Our analyses indicated that raising treatment eligibility criteria, in line with WHO guidelines (CD4 ≤500 cells/mm(3)) or removing CD4-based criteria would both be cost-effective in Vietnam. However, the cost-effective strategy from an economic viewpoint is first to increase coverage substantially among those with lowest CD4 levels, and only when coverage increases towards saturation should initiation criteria be lifted. Universal coverage under current guidelines would cost an additional $85 million and $96 million per year if the treatment threshold was 500 cells/mm(3). These scenarios would avert 15,000 and 22,000 HIV-related deaths in 2010-2019, with ICERs of $500-$660 per QALY gained. It is imperative to increase treatment coverage for newly diagnosed PLHIV in Vietnam according to the current guidelines prior to increasing the CD4 threshold for ART initiation.

  8. Cost-effectiveness of Chlamydia Vaccination Programs for Young Women

    PubMed Central

    Chesson, Harrell W.; Gift, Thomas L.; Brunham, Robert C.; Bolan, Gail

    2015-01-01

    We explored potential cost-effectiveness of a chlamydia vaccine for young women in the United States by using a compartmental heterosexual transmission model. We tracked health outcomes (acute infections and sequelae measured in quality-adjusted life-years [QALYs]) and determined incremental cost-effectiveness ratios (ICERs) over a 50-year analytic horizon. We assessed vaccination of 14-year-old girls and catch-up vaccination for 15–24-year-old women in the context of an existing chlamydia screening program and assumed 2 prevaccination prevalences of 3.2% by main analysis and 3.7% by additional analysis. Estimated ICERs of vaccinating 14-year-old girls were $35,300/QALY by main analysis and $16,200/QALY by additional analysis compared with only screening. Catch-up vaccination for 15–24-year-old women resulted in estimated ICERs of $53,200/QALY by main analysis and $26,300/QALY by additional analysis. The ICER was most sensitive to prevaccination prevalence for women, followed by cost of vaccination, duration of vaccine-conferred immunity, and vaccine efficacy. Our results suggest that a successful chlamydia vaccine could be cost-effective. PMID:25989525

  9. Cost-effectiveness of assisted conception for male subfertility.

    PubMed

    Moolenaar, Lobke M; Cissen, Maarje; de Bruin, Jan Peter; Hompes, Peter G A; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J

    2015-06-01

    Intrauterine insemination (IUI), with or without ovarian stimulation, IVF and intracytoplasmatic sperm injection (ICSI) are frequently used treatments for couples with male subfertility. No consensus has been reached on specific cut-off values for semen parameters, at which IVF would be advocated over IUI and ICSI over IVF. The aim of this study was to evaluate the cost-effectiveness of interventions for male subfertility according to total motile sperm count (TMSC). A computer-simulated cohort of subfertile women aged 30 years with a partner was analysed with a pre-wash TMSC of 0 to 10 million. Three treatments were evaluated: IUI with and without controlled ovarian stimulation; IVF; and ICSI. Main outcome was expected live birth; secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. The choice of IVF over IUI with ovarian stimulation and ICSI over IVF depends on the willingness to pay for an extra live birth. If only cost per live birth is considered for each treatment, above a pre-wash TMSC of 3 million, IUI is less costly than IVF and, below a pre-wash, TMSC of 3 million ICSI is less costly. Effectiveness needs to be confirmed in a large randomized controlled trial.

  10. Cost-effectiveness of assisted conception for male subfertility.

    PubMed

    Moolenaar, Lobke M; Cissen, Maarje; de Bruin, Jan Peter; Hompes, Peter G A; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J

    2015-06-01

    Intrauterine insemination (IUI), with or without ovarian stimulation, IVF and intracytoplasmatic sperm injection (ICSI) are frequently used treatments for couples with male subfertility. No consensus has been reached on specific cut-off values for semen parameters, at which IVF would be advocated over IUI and ICSI over IVF. The aim of this study was to evaluate the cost-effectiveness of interventions for male subfertility according to total motile sperm count (TMSC). A computer-simulated cohort of subfertile women aged 30 years with a partner was analysed with a pre-wash TMSC of 0 to 10 million. Three treatments were evaluated: IUI with and without controlled ovarian stimulation; IVF; and ICSI. Main outcome was expected live birth; secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. The choice of IVF over IUI with ovarian stimulation and ICSI over IVF depends on the willingness to pay for an extra live birth. If only cost per live birth is considered for each treatment, above a pre-wash TMSC of 3 million, IUI is less costly than IVF and, below a pre-wash, TMSC of 3 million ICSI is less costly. Effectiveness needs to be confirmed in a large randomized controlled trial. PMID:25900905

  11. Cost-effectiveness of primary tetanus vaccination among elderly Canadians.

    PubMed

    Hutchison, B G; Stoddart, G L

    1988-12-15

    Although tetanus is now rare, vaccination is currently recommended for the entire population. Most elderly North Americans have never received tetanus vaccination. We evaluated the expected cost-effectiveness of using mailed reminders from family physicians to increase primary tetanus vaccination coverage among elderly Canadians. We estimated that over 10 years the program would prevent five cases of tetanus and one death from tetanus, resulting in a gain of 13 life-years. There would be 16,700 adverse reactions to tetanus toxoid, 17% in people already immune to tetanus. The net cost of the program (in 1984 Canadian dollars) would be $1.9 million per case of tetanus prevented, $7.1 million per death prevented and $810,000 per life-year gained. These high cost-effectiveness ratios are largely attributable to the very low risk of tetanus, even among nonimmune elderly people. Tetanus toxoid and physicians' services for vaccination would account for 86% of the program costs. Because the mailed reminders would be responsible for only 13% of the program costs, other possible programs to increase primary tetanus vaccination coverage could not be expected to have substantially lower cost-effectiveness ratios. We conclude that efforts to increase primary tetanus vaccination coverage among elderly Canadians would be a questionable use of health care resources.

  12. Supported employment: cost-effectiveness across six European sites.

    PubMed

    Knapp, Martin; Patel, Anita; Curran, Claire; Latimer, Eric; Catty, Jocelyn; Becker, Thomas; Drake, Robert E; Fioritti, Angelo; Kilian, Reinhold; Lauber, Christoph; Rössler, Wulf; Tomov, Toma; van Busschbach, Jooske; Comas-Herrera, Adelina; White, Sarah; Wiersma, Durk; Burns, Tom

    2013-02-01

    A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment. PMID:23471803

  13. Cost effectiveness of detritiating water with resin columns

    SciTech Connect

    Drake, R.H.; Williams, D.S.

    1997-10-01

    There are technologies in use for cleaning up concentrated tritiated process water. These are not cost effective for tritiated water with low concentrations of tritium. There are currently no cost-effective technologies for cleaning up low-tritium-concentration tritiated water, such as most tritiated groundwater, spent fuel storage basin water, or underground storage tank water. Resin removal of tritium from tritiated water at low concentrations (near the order of magnitude of drinking water standard maximums) is being tested on TA-SO (Los Alamos National Laboratory`s Liquid Radioactive Waste Treatment Facility) waste streams. There are good theoretical and test indications that this may be a technologically effective means of removing tritium from tritiated water. Because of likely engineering design similarity, it is reasonable to anticipate that a resin column system`s costs will be similar to some common commercial water treatment systems. Thus, the potential cost effectiveness of a resin treatment system offers hope for treating tritiated water at affordable costs. The TA-50 resin treatment cost projection of $18 per 1,000 gallons is within the same order of magnitude as cost data for typical commercial groundwater cleanup projects. The prospective Los Alamos National Laboratory (LANL) resin treatment system at $18 per 1,000 gallons appears to have a likely cost advantage of at least an order of magnitude over the competing, developmental, water detritiation technologies.

  14. Cost-effectiveness of voluntary HIV screening in Russia.

    PubMed

    Tole, S P; Sanders, G D; Bayoumi, A M; Galvin, C M; Vinichenko, T N; Brandeau, M L; Owens, D K

    2009-01-01

    Russia has one of the world's fastest growing HIV epidemics, and HIV screening has been widespread. Whether such screening is an effective use of resources is unclear. We used epidemiologic and economic data from Russia to develop a Markov model to estimate costs, quality of life and survival associated with a voluntary HIV screening programme compared with no screening in Russia. We measured discounted lifetime health-care costs and quality-adjusted life years (QALYs) gained. We varied our inputs in sensitivity analysis. Early identification of HIV through screening provided a substantial benefit to persons with HIV, increasing life expectancy by 2.1 years and 1.7 QALYs. At a base-case prevalence of 1.2%, once-per-lifetime screening cost $13,396 per QALY gained, exclusive of benefit from reduced transmission. Cost-effectiveness of screening remained favourable until prevalence dropped below 0.04%. When HIV-transmission-related costs and benefits were included, once-per-lifetime screening cost $6910 per QALY gained and screening every two years cost $27,696 per QALY gained. An important determinant of the cost-effectiveness of screening was effectiveness of counselling about risk reduction. Early identification of HIV infection through screening in Russia is effective and cost-effective in all but the lowest prevalence groups.

  15. Rapid Bioassessment and In Situ Bioassay: Cost Effective Tools for Environmental Impact Assessment

    SciTech Connect

    Wike, L.D.

    2002-08-23

    Environmental impact can be difficult to assess, especially at the ecosystem level. Any impact assessment methodology that can give cost effective and timely results is highly desirable. Rapid bioassessment (RBA) is cost effective and produces timely results. Several types of RBA have been used at the Savannah River Site (SRS) to assess stream conditions, including the Index of Biotic Integrity (IBI) based on fish community characteristics, and various techniques using aquatic macroinvertebrate species diversity and abundance. In an attempt to broaden the applicability of the RBA concept, we have also begun to develop RBA techniques for seep-fed wetlands and terrestrial habitats. These techniques will focus on vertebrate and macroinvertebrate assemblages for seep-fed wetlands and arthropod assemblages for terrestrial habitats. In situ bioassay is another technique that could be used for rapid and economical assessment of the effects of anthropogenic disturbance. We propose the development of two methods of in situ bioassay that can address bioavailability of constituents of concern. The use of caged bioassay organisms can be applied to terrestrial systems such as capped or existing waste sites using the common house cricket. Another proposed bioassay could use a resident species, such as the imported red fire ant, which is found in disturbed habitats and open areas such as waste sites. Combining in situ techniques with RBA methodologies has the potential to provide a comprehensive assessment of chemical and physical impacts to a wide range of ecosystem types.

  16. A review of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer.

    PubMed

    Diaby, Vakaramoko; Tawk, Rima; Sanogo, Vassiki; Xiao, Hong; Montero, Alberto J

    2015-05-01

    Breast cancer is a global health concern. In fact, breast cancer is the primary cause of death among women worldwide and constitutes the most expensive malignancy to treat. As health care resources are finite, decisions regarding the adoption and coverage of breast cancer treatments are increasingly being based on "value for money," i.e., cost-effectiveness. As the evidence about the cost-effectiveness of breast cancer treatments is abundant, therefore difficult to navigate, systematic reviews of published systematic reviews offer the advantage of bringing together the results of separate systematic reviews in a single report. As a consequence, this paper presents an overview of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer to inform policy and reimbursement decision-making. A systematic review was conducted of published systematic reviews documenting cost-effectiveness analyses of breast cancer treatments from 2000 to 2014. Systematic reviews identified through a literature search of health and economic databases were independently assessed against inclusion and exclusion criteria. Systematic reviews of original evaluations were included only if they targeted breast cancer patients and specific breast cancer treatments (hormone therapy, chemotherapy, and targeted therapy only), documented incremental cost-effectiveness ratios, and were reported in the English language. The search strategy used a combination of these key words: "breast cancer," "systematic review/meta-analysis," and "cost-effectiveness/economics." Data were extracted using predefined extraction forms and qualitatively appraised using the assessment of multiple systematic reviews (AMSTAR) tool. The literature search resulted in 511 bibliographic records, of which ten met our inclusion criteria. Five reviews were conducted in the early-stage breast cancer setting and five reviews in the metastatic setting. In early-stage breast

  17. All together now? Sensitivity, dynamics, and predictability of planktonic foraminiferal species abundance versus community structure across Plio-Pleistocene glacial-interglacial cycles

    NASA Astrophysics Data System (ADS)

    Hull, P. M.; Norris, R. D.; Sexton, P.

    2012-12-01

    Most studies to date of biospheric sensitivity to global change have focused on understanding the sensitivity of modern species and communities to recent or experimental environmental change. However, it is unclear how to scale these results towards predicting the response of the biosphere to ongoing global change given that i) similar species often respond individualistically the same perturbation, ii) biotic response often scales nonlinearly with the size and/or duration of environmental change, and iii) many terrestrial and marine community types known from the recent past lack modern analogs. In this context, marine microfossils from deep sea sediments hold enormous promise for furthering our understanding of biotic sensitivity as they capture temporally expanded records of paleoceanographic and biotic response across a range climatic regimes (e.g., icehouse versus greenhouse climates), disturbance types (e.g., from background climate oscillations to mass extinctions), and habitats (e.g., low vs. high latitudes, upwelling vs. gyre ecosystems, etc). Here we use the repeated glacial-interglacial cycles and longer term trend of intensifying Northern Hemisphere glaciation from the Pliocene-Pleistocene to examine issues related to the sensitivity of planktonic foraminiferal species and communities to global change in an icehouse world. More specifically, we quantify the sensitivity and predictability of changes in planktonic foraminiferal species abundance (species specific mass accumulation rates) and community structure (dissimilarity indices and community classification) to glacial-interglacial cycles in the Plio-Pleistocene in two Atlantic sites (ODP Sites 999 and 662). We first examine whether the sensitivity of species and communities to glacial-interglacial cycles in the early Pliocene (~5-3 million years ago) is predictive of i) their sensitivity to the intensification of Northern Hemisphere glaciation (~3-2 million years ago), or ii) their sensitivity to

  18. Monitoring the abundance of plastic debris in the marine environment

    PubMed Central

    Ryan, Peter G.; Moore, Charles J.; van Franeker, Jan A.; Moloney, Coleen L.

    2009-01-01

    Plastic debris has significant environmental and economic impacts in marine systems. Monitoring is crucial to assess the efficacy of measures implemented to reduce the abundance of plastic debris, but it is complicated by large spatial and temporal heterogeneity in the amounts of plastic debris and by our limited understanding of the pathways followed by plastic debris and its long-term fate. To date, most monitoring has focused on beach surveys of stranded plastics and other litter. Infrequent surveys of the standing stock of litter on beaches provide crude estimates of debris types and abundance, but are biased by differential removal of litter items by beachcombing, cleanups and beach dynamics. Monitoring the accumulation of stranded debris provides an index of debris trends in adjacent waters, but is costly to undertake. At-sea sampling requires large sample sizes for statistical power to detect changes in abundance, given the high spatial and temporal heterogeneity. Another approach is to monitor the impacts of plastics. Seabirds and other marine organisms that accumulate plastics in their stomachs offer a cost-effective way to monitor the abundance and composition of small plastic litter. Changes in entanglement rates are harder to interpret, as they are sensitive to changes in population sizes of affected species. Monitoring waste disposal on ships and plastic debris levels in rivers and storm-water runoff is useful because it identifies the main sources of plastic debris entering the sea and can direct mitigation efforts. Different monitoring approaches are required to answer different questions, but attempts should be made to standardize approaches internationally. PMID:19528052

  19. Cost-effectiveness of febuxostat in chronic gout.

    PubMed

    Beard, Stephen M; von Scheele, Birgitta G; Nuki, George; Pearson, Isobel V

    2014-06-01

    Our objective was to evaluate data on the cost-effectiveness of febuxostat compared with standard clinical practice with allopurinol in patients with gout that was presented to the Scottish Medicines Consortium (SMC) in 2010. A Markov health-state model estimated the direct health-related costs and clinical benefits expressed as quality-adjusted life-years (QALYs). Adults with chronic gout and established hyperuricaemia received treatment sequences of daily doses of allopurinol 300 mg alone or allopurinol 300 mg followed by febuxostat 80 mg/120 mg. The proportion of patients achieving the target serum uric acid (sUA) level of less than 6 mg/dl (0.36 mmol/l) was linked to the utility per sUA level to generate an incremental cost-effectiveness ratio (ICER). Second-line therapy with febuxostat 80 mg/120 mg versus with allopurinol alone resulted in an ICER of £3,578 per QALY over a 5-year time horizon. Additional univariate analyses showed that ICER values were robust and ranged from £2,550 to £7,165 per QALY when different parameters (e.g., low- and high-dose allopurinol titrations and variations in treatment-induced flare rates) were varied. Febuxostat reduces sUA below the European League Against Rheumatism target of 0.36 mmol/l (6 mg/dl) in significantly more patients with gout than allopurinol in its most frequently prescribed dose of 300 mg per day. The SMC accepted febuxostat as cost-effective as a suitable second-line option for urate-lowering therapy for the treatment of patients with chronic hyperuricaemia in conditions where urate deposition has already occurred (including a history or presence of tophus and/or gouty arthritis) when treatment with allopurinol was inadequate, not tolerated, or contraindicated.

  20. 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

  1. Cost-effectiveness of hormone replacement therapy after the menopause.

    PubMed

    Tosteson, A N; Weinstein, M C

    1991-12-01

    The net resource costs and net health benefits of treating perimenopausal women with hormone replacement therapy were evaluated within the framework of cost-effectiveness analysis. Data from the epidemiological literature were used to estimate changes in discounted life expectancy from hip fracture, ischaemic heart disease and breast cancer that are associated with hormone replacement therapy under a variety of assumptions. Economic data were used to estimate changes in total discounted costs that result from the use of hormone replacement therapy. For women with a previous hysterectomy, 10- and 15-year courses of unopposed oestrogen were evaluated. The baseline assumptions for unopposed oestrogen were that breast cancer incidence would be increased for current users by 36% and that deaths from ischaemic heart disease would be reduced by 50% relative to non-users. Under these assumptions, oestrogen replacement therapy was found to be cost-effective, with ratios ranging from $9130 to $12,620 per additional year of life saved. For women who have not had a hysterectomy, 10- and 15-year courses of oestrogen combined with progestin were evaluated. The baseline assumptions for combined therapy were that breast cancer incidence and ischaemic heart disease deaths were unaffected. Under these assumptions, combined therapy was more costly, with ratios ranging from $86,100 to $88,500. Unless combined therapy is found to confer protection against ischaemic heart disease, the most cost-effective strategies for women with no prior hysterectomy may involve screening perimenopausal women to detect women at highest risk of hip fracture followed by selective treatment.

  2. Preliminary report on the cost effectiveness of ventricular assist devices.

    PubMed

    Takura, Tomoyuki; Kyo, Shunei; Ono, Minoru; Tominaga, Ryuji; Miyagawa, Shigeru; Tanoue, Yoshihisa; Sawa, Yoshiki

    2016-03-01

    The aim of the present study was to perform a cost-effectiveness analysis (CEA) of ventricular assist devices (VAD) implantation surgery in the Japanese medical reimbursement system. The study group consisted of thirty-seven patients who had undergone VAD implantation surgery for dilated cardiomyopathy (n = 25; 67.6 %) or hypertrophic cardiomyopathy (n = 4; 10.8 %), and others (n = 8; 21.6 %). Quality-adjusted life years (QALYs) were calculated using the utility score and years of life. Medical reimbursement bills were chosen as cost indices. The observation period was the 12-month period after surgery. Then, the incremental cost-effectiveness ratio was calculated according to the VAD type. In addition, the prognosis after 36 months was estimated on the basis of the results obtained using the Markov chain model. The mean preoperative INTERMACS profile score was 2.35 ± 0.77. Our results showed that the utility score, which indicates the effectiveness of VAD implantation surgery, improved by 0.279 ± 0.188 (ΔQALY, p < 0.05). The cost of VAD implantation surgery was 313,282 ± 25,275 (ΔUS$/year) on the basis of medical reimbursement bills associated with therapeutic interventions. The calculated result of CEA was 364,501 ± 190,599 (ΔUS$/QALY). The improvement in the utility score was greater for implantable versus extracorporeal VADs (0.233 ± 0.534 vs. 0.371 ± 0.238) and ICER was 303,104 (ΔUS$/ΔQALY). Furthermore, when we estimated CEA for 36 months, the expected baseline value was 102,712 (US$/QALY). Therefore, VAD implantation surgery was cost effective considering the disease specificities. PMID:26242357

  3. Cost-effectiveness analysis of quadrivalent influenza vaccine in Spain.

    PubMed

    García, Amos; Ortiz de Lejarazu, Raúl; Reina, Jordi; Callejo, Daniel; Cuervo, Jesús; Morano Larragueta, Raúl

    2016-09-01

    Influenza has a major impact on healthcare systems and society, but can be prevented using vaccination. The World Health Organization (WHO) currently recommends that influenza vaccines should include at least two virus A and one virus B lineage (trivalent vaccine; TIV). A new quadrivalent vaccine (QIV), which includes an additional B virus strain, received regulatory approval and is now recommended by several countries. The present study estimates the cost-effectiveness of replacing TIVs with QIV for risk groups and elderly population in Spain. A static, lifetime, multi-cohort Markov model with a one-year cycle time was adapted to assess the costs and health outcomes associated with a switch from TIV to QIV. The model followed a cohort vaccinated each year according to health authority recommendations, for the duration of their lives. National epidemiological data allowed the determination of whether the B strain included in TIVs matched the circulating one. Societal perspective was considered, costs and outcomes were discounted at 3% and one-way and probabilistic sensitivity analyses were performed. Compared to TIVs, QIV reduced more influenza cases and influenza-related complications and deaths during periods of B-mismatch strains in the TIV. The incremental cost-effectiveness ratio (ICER) was 8,748€/quality-adjusted life year (QALY). One-way sensitivity analysis showed mismatch with the B lineage included in the TIV was the main driver for ICER. Probabilistic sensitivity analysis shows ICER below 30,000€/QALY in 96% of simulations. Replacing TIVs with QIV in Spain could improve influenza prevention by avoiding B virus mismatch and provide a cost-effective healthcare intervention. PMID:27184622

  4. 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

  5. The cost-effectiveness of rotavirus vaccination in Armenia.

    PubMed

    Jit, Mark; Yuzbashyan, Ruzanna; Sahakyan, Gayane; Avagyan, Tigran; Mosina, Liudmila

    2011-11-01

    The cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to $830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by $34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about $650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI, $820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was $3800, rotavirus vaccination is likely to be regarded as "very cost-effective" from a WHO standpoint. Vaccination may still be "very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted.

  6. DEVELOPMENT AND MANUFACTURE OF COST EFFECTIVE COMPOSITE DRILL PIPE

    SciTech Connect

    James C. Leslie; James C. Leslie II; Lee Truong; James T. Heard; Peter Manekas

    2005-03-18

    This technical report presents the engineering research, process development and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report presents progress made from October 1, 2003 through September 30, 2004 and contains the following discussions: (1) Direct Electrical Connection for Rotary Shoulder Tool Joints; (2) Conductors for inclusion in the pipe wall (ER/DW-CDP); (3) Qualify fibers from Zoltek; (4) Qualify resin from Bakelite; (5) First commercial order for SR-CDP from Integrated Directional Resources (SR-CDP); and (6) Preparation of papers for publication and conference presentations.

  7. Operating Dedicated Data Centers - Is It Cost-Effective?

    NASA Astrophysics Data System (ADS)

    Ernst, M.; Hogue, R.; Hollowell, C.; Strecker-Kellog, W.; Wong, A.; Zaytsev, A.

    2014-06-01

    The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

  8. High-Energy-Density Cost-Effective Graphene Supercapacitors

    NASA Astrophysics Data System (ADS)

    Samuilov, Vladimir; Ying Mu, Ying; Hedayat, Nader; Solovyov, Vyacheslav; Sensor CAT at Stony Brook Team

    We introduce a cost-effective graphene platelet composite material as a replacement of an expensive reduced graphene oxide for electrodes in high energy density supercapacitors. We have tested a low size supercapacitor prototypes with the graphene platelets electrodes and newly developed polymer-gel Li + ion electrolyte. We discuss the ways how to increase the capacitance and the energy densities of the supercapacitor significantly. A working prototype for testing the concept of the high voltage supercapacitor has been developed as well. The first test done up to 10 V showed excellent performance of the multy-cell multi-layer high voltage test assembly.

  9. Cost effective fabrication method for large sapphire sensor windows

    NASA Astrophysics Data System (ADS)

    Walters, Mark; Gould, Alan; Bartlett, Kevin; Brophy, Matthew R.; DeGroote Nelson, Jessica

    2013-09-01

    Sapphire poses very difficult challenges to optical manufacturers due to its high hardness and anisotropic properties. These challenges can result in long lead times and high prices. Large optical sensor windows demand much higher precision surfaces compared to transparent armor (windshields) to achieve acceptable image quality. Optimax is developing a high speed, cost effective process to produce such windows. The Optimax high speed process is a two-step process that combines precision fixed abrasive grinding and high speed polishing. In-house studies have demonstrated cycle time reduction of up to 6X as compared to conventional processing.

  10. 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.

  11. Facilitating Sound, Cost-Effective Federal Energy Management (Fact Sheet)

    SciTech Connect

    Not Available

    2012-03-01

    This fact sheet is an overview of the U.S. Department of Energy's Federal Energy Management Program (FEMP). The Federal Government, as the nation's largest energy consumer, has a tremendous opportunity and acknowledged responsibility to lead by example. The U.S. Department of Energy's (DOE's) Federal Energy Management Program (FEMP) plays a critical role in this effort. FEMP facilitates the Federal Government's implementation of sound, cost-effective energy management and investment practices to enhance the nation's energy security and environmental stewardship. FEMP does this by focusing on the needs of its Federal customers, delivering an array of services across a variety of program areas.

  12. Prophylaxis of venous thromboembolism: analysis of cost effectiveness.

    PubMed Central

    Salzman, E W; Davies, G C

    1980-01-01

    The rapidly expanding literature regarding prevention of venous thromboembolism is confusing and contradictory, but, when analysed in the aggregate, the collective experience permits a judgment about the relative efficacy of different prophylactic regimens in specific patient populations, who vary in the risk factors predisposing them to thromboembolism. The dollar cost of the several approaches to prevention and their consequences should also be a matter of concern. Efficacy and dollar cost together determine cost effectiveness, which provides a practical guide to selection of the prophylactic approach appropriate to an individual patient. PMID:6767449

  13. 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.

  14. Cost effectiveness of stream-gaging program in Michigan

    USGS Publications Warehouse

    Holtschlag, D.J.

    1985-01-01

    This report documents the results of a study of the cost effectiveness of the stream-gaging program in Michigan. 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 percent for the current $718,100 budget. By adopting a flexible servicing schedule, the average standard error could be reduced to 11.1 percent. 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 percent. A budget of $789,900 (the maximum analyzed) would result in a decrease in the average standard error to 9.07 percent. Owing to continual changes in the composition of the network

  15. Soil Gas Surveys: A cost-effective site assessment technique

    SciTech Connect

    Barker, G.W.; Brown, D.R.; Corgan, J.M.

    1995-12-01

    Accurate delineation of the extent of subsurface hydrocarbon contamination in soils and ground water is important when initiating a monitoring plan or considering remediation options at E&P sites. Traditional site-assessment techniques used to delineate subsurface hydrocarbon contaminants (e.g., soil boreholes, excavation, monitor well installation, etc.) can be expensive, time-consuming, and disruptive to local land use or production operations. Soil gas surveys can provide a rapid, cost-effective, nonobtrusive alternative to traditional site-assessment techniques.

  16. Cost effectiveness of the stream-gaging program in Pennsylvania

    USGS Publications Warehouse

    Flippo, H.N.; Behrendt, T.E.

    1985-01-01

    This report documents a cost-effectiveness study of the stream-gaging program in Pennsylvania. Data uses and funding were identified for 223 continuous-record stream gages operated in 1983; four are planned for discontinuance at the close of water-year 1985; two are suggested for conversion, at the beginning of the 1985 water year, for the collection of only continuous stage records. Two of 11 special-purpose short-term gages are recommended for continuation when the supporting project ends; eight of these gages are to be discontinued and the other will be converted to a partial-record type. Current operation costs for the 212 stations recommended for continued operation is $1,199,000 per year in 1983. The average standard error of estimation for instantaneous streamflow is 15.2%. An overall average standard error of 9.8% could be attained on a budget of $1,271,000, which is 6% greater than the 1983 budget, by adopted cost-effective stream-gaging operations. (USGS)

  17. Cost-effective data acquisition for the Odin Field

    SciTech Connect

    Johnson, J.D. )

    1988-10-01

    This paper describes a cost-effective method for obtaining reservoir data to define the depletion mechanism in the small Odin gas field. The addition of a simple work program to the drilling plan for the first development well provided basic reservoir and aquifer data, and the well completion scheme provided for continuing reservoir surveillance. Cost-effective methods for reservoir data acquisition are particularly relevant for marginal developments. This discussion should be of interest to operators of gas fields where the depletion mechanism is not well defined and where early acquisition of additional data can indicate the mechanism. A brief development history of the Odin field illustrates the need for good reservoir data. Initially, some uncertainty surrounded the amount of bottomwater influx into the Odin gas sand and the resultant depletion mechanism. Conclusions about the expected type of reservoir depletion mechanisms were drawn from data that included conventional core analysis, measured pressure gradients, fluid saturation logs, and production well tests. Production history that confirms the conclusions made from the initial data acquisition is shown.

  18. Cost-effectiveness of growth monitoring and promotion.

    PubMed

    Dixon, R A

    1993-08-01

    50 million children/year are in growth monitoring and promotion (GMP) programs in developing countries and 30 million growth charts are printed annually in India alone. GMP is a simple technology of weighing and charting, but it must be properly implemented under conditions that are conducive to program success. Critics of GMP argue that its effectiveness remains to be proved. If GMP programs lead to improved growth, health, and nutritional status, will it work when expanded to the national level and is it cost-effective? A community intervention trial in South India considered the cost-effectiveness component of these concerns, but yielded only mixed results and the recommendation that replicate studies be conducted in other countries. An observational study of 179 health workers in 100 rural health facilities in 9 developing countries found deficiencies so severe in weighing, plotting, and interpreting that GMP activities simply consumed time and resources which could have been better allocated elsewhere within the health system. GMP is unlikely to succeed in the absence of training and supervision for assessment, analysis, and action. Community involvement in and ownership of GMP are also recommended.

  19. Strengthening Cost-Effectiveness Analysis for Public Health Policy.

    PubMed

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.

  20. 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

  1. Development and Manufacture of Cost Effective Composite Drill Pipe

    SciTech Connect

    James C. Leslie; James C. Leslie II; Lee Truong; James T. Heard; Steve Loya

    2006-02-20

    This technical report presents the engineering research, process development and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report presents progress made from October 1, 2004 through September 30, 2005 and contains the following discussions: (1) Qualification Testing; (2) Prototype Development and Testing of ''Smart Design'' Configuration; (3) Field Test Demonstration; and (4) Commercial order for SR-CDP from Torch International. The objective of this contract is to develop and demonstrate ''cost effective'' Composite Drill Pipe. It is projected that this drill pipe will weigh less than half of its steel counter part. The resultant weight reduction will provide enabling technology that will increase the lateral distance that can be reached from an offshore drilling platform and the depth of water in which drilling and production operations can be carried out. Further, composite drill pipe has the capability to carry real time signal and power transmission within the pipe walls. CDP can also accommodate much shorter drilling radius than is possible with metal drill pipe. As secondary benefits, the lighter weight drill pipe can increase the storage capability of floating off shore drilling platforms and provide substantial operational cost savings.

  2. Cost effectiveness of the 1995 model energy code in Massachusetts

    SciTech Connect

    Lucas, R.G.

    1996-02-01

    This report documents an analysis of the cost effectiveness of the Council of American Building Officials` 1995 Model Energy Code (MEC) building thermal-envelope requirements for single-family houses and multifamily housing units in Massachusetts. The goal was to compare the cost effectiveness of the 1995 MEC to the energy conservation requirements of the Massachusetts State Building Code-based on a comparison of the costs and benefits associated with complying with each.. This comparison was performed for three cities representing three geographical regions of Massachusetts--Boston, Worcester, and Pittsfield. The analysis was done for two different scenarios: a ``move-up`` home buyer purchasing a single-family house and a ``first-time`` financially limited home buyer purchasing a multifamily condominium unit. Natural gas, oil, and electric resistance heating were examined. The Massachusetts state code has much more stringent requirements if electric resistance heating is used rather than other heating fuels and/or equipment types. The MEC requirements do not vary by fuel type. For single-family homes, the 1995 MEC has requirements that are more energy-efficient than the non-electric resistance requirements of the current state code. For multifamily housing, the 1995 MEC has requirements that are approximately equally energy-efficient to the non-electric resistance requirements of the current state code. The 1995 MEC is generally not more stringent than the electric resistance requirements of the state code, in fact; for multifamily buildings the 1995 MEC is much less stringent.

  3. Cost effectiveness of the stream-gaging program in Nevada

    USGS Publications Warehouse

    Arteaga, F.E.

    1990-01-01

    The stream-gaging network in Nevada was evaluated as part of a nationwide effort by the U.S. Geological Survey to define and document the most cost-effective means of furnishing streamflow information. Specifically, the study dealt with 79 streamflow gages and 2 canal-flow gages that were under the direct operation of Nevada personnel as of 1983. Cost-effective allocations of resources, including budget and operational criteria, were studied using statistical procedures known as Kalman-filtering techniques. The possibility of developing streamflow data at ungaged sites was evaluated using flow-routing and statistical regression analyses. Neither of these methods provided sufficiently accurate results to warrant their use in place of stream gaging. The 81 gaging stations were being operated in 1983 with a budget of $465,500. As a result of this study, all existing stations were determined to be necessary components of the program for the foreseeable future. At the 1983 funding level, the average standard error of streamflow records was nearly 28%. This same overall level of accuracy could have been maintained with a budget of approximately $445,000 if the funds were redistributed more equitably among the gages. The maximum budget analyzed, $1,164 ,000 would have resulted in an average standard error of 11%. The study indicates that a major source of error is lost data. If perfectly operating equipment were available, the standard error for the 1983 program and budget could have been reduced to 21%. (Thacker-USGS, WRD)

  4. Staging of lung cancer. A cost-effectiveness analysis

    SciTech Connect

    Houston, G.A.; Sanders, J.A.; Little, D.D.; Griffith, J.E.; Clericuzio, C.; Balducci, L.

    1985-06-01

    Previous reports found the WXGa scan highly accurate in staging lung cancer. In the present study the cost-effectiveness of the WXGa scan was measured and compared with that of routine tests (radionuclide liver and bone scans, brain CT scan) used to stage lung cancer. In 160 patients, the WXGa scan had a lower sensitivity, specificity, and negative predictive value than the combination of routine tests in detecting metastatic disease. The WXGa scan was less accurate than the appropriate routine test in establishing the presence of liver, bone, and brain metastases. In the mediastinum the WXGa scan was not more accurate than the chest radiograph. The average cost to accurately stage a patient by WXGa scan was $812.12 and by routine tests was $737.60. The cost for metastatic disease was $1,417.70 by WXGa scan and $1,287.70 by routine tests. It is concluded that at our institution the use of WXGa scan to stage lung cancer is not cost-effective.

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

    PubMed

    Sinkey, Rachel G; Odibo, Anthony O

    2016-06-01

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

  6. Cost-effectiveness of pretransplant sofosbuvir for preventing recurrent hepatitis C virus infection after liver transplantation.

    PubMed

    Vitale, Alessandro; Spolverato, Gaya; Burra, Patrizia; De Feo, Tullia Maria; Belli, Luca; Donato, Francesca; Baroni, Gianluca Svegliati; Marianelli, Tania; Picciotto, Antonio; Toniutto, Pierluigi; Bhoori, Sherrie; Passigato, Nicola; Lucà, Maria Grazia; Russo, Francesco Paolo; Cillo, Umberto; Fagiuoli, Stefano

    2015-09-01

    There are reports of pretransplant sofosbuvir (SOF) plus ribavirin being effective in preventing recurrent hepatitis C virus (HCV) infection after liver transplantation (LT). The aim of this study was to assess the cost-effectiveness of this strategy in the area served by the North Italy Transplant program. We retrospectively assessed the impact of HCV infection on post-LT survival in 2376 consecutive adult patients (MELD ≤ 25, unknown genotype, period 2004-2009) and the prevalence costs of conventional standard of care (SOC) antiviral therapy (pegylated interferon plus ribavirin) after LT. A Markov model was developed to compare two strategies: 12-24 weeks of SOF+ ribavirin for pre-LT anti-HCV treatment versus on-demand post-LT SOC antiviral therapy. Among the 1794 patients undergoing LT, 860 (48%) were HCV+ and 50% of them were given SOC therapy after LT (mean cost of drugs and adverse effect management = 14,421€ per patient). HCV etiology had a strong impact on post-LT survival (hazard ratio = 1.59, 95% CI = 1.22-2.09, P = 0.0007). After Monte Carlo simulation, pre-LT SOF therapy showed a median survival benefit of 1.5 quality-adjusted life years and an Incremental cost-effectiveness ratio (ICER) of 30,663€/QALY, proving cost-effective in our particular Italian scenario. The costs of SOF therapy, sustained viral response rate 12 weeks after LT, and recipient's age were the main ICER predictors at multivariate analysis. This study proposes a dynamic model based on real-life data from northern Italy for adjusting the costs of pre-LT direct-acting antiviral therapies to the actual sustained virological response reached after LT. PMID:25865602

  7. Cost-effectiveness of pretransplant sofosbuvir for preventing recurrent hepatitis C virus infection after liver transplantation.

    PubMed

    Vitale, Alessandro; Spolverato, Gaya; Burra, Patrizia; De Feo, Tullia Maria; Belli, Luca; Donato, Francesca; Baroni, Gianluca Svegliati; Marianelli, Tania; Picciotto, Antonio; Toniutto, Pierluigi; Bhoori, Sherrie; Passigato, Nicola; Lucà, Maria Grazia; Russo, Francesco Paolo; Cillo, Umberto; Fagiuoli, Stefano

    2015-09-01

    There are reports of pretransplant sofosbuvir (SOF) plus ribavirin being effective in preventing recurrent hepatitis C virus (HCV) infection after liver transplantation (LT). The aim of this study was to assess the cost-effectiveness of this strategy in the area served by the North Italy Transplant program. We retrospectively assessed the impact of HCV infection on post-LT survival in 2376 consecutive adult patients (MELD ≤ 25, unknown genotype, period 2004-2009) and the prevalence costs of conventional standard of care (SOC) antiviral therapy (pegylated interferon plus ribavirin) after LT. A Markov model was developed to compare two strategies: 12-24 weeks of SOF+ ribavirin for pre-LT anti-HCV treatment versus on-demand post-LT SOC antiviral therapy. Among the 1794 patients undergoing LT, 860 (48%) were HCV+ and 50% of them were given SOC therapy after LT (mean cost of drugs and adverse effect management = 14,421€ per patient). HCV etiology had a strong impact on post-LT survival (hazard ratio = 1.59, 95% CI = 1.22-2.09, P = 0.0007). After Monte Carlo simulation, pre-LT SOF therapy showed a median survival benefit of 1.5 quality-adjusted life years and an Incremental cost-effectiveness ratio (ICER) of 30,663€/QALY, proving cost-effective in our particular Italian scenario. The costs of SOF therapy, sustained viral response rate 12 weeks after LT, and recipient's age were the main ICER predictors at multivariate analysis. This study proposes a dynamic model based on real-life data from northern Italy for adjusting the costs of pre-LT direct-acting antiviral therapies to the actual sustained virological response reached after LT.

  8. Impacts of rainfall variability and expected rainfall changes on cost-effective adaptation of water systems to climate change.

    PubMed

    van der Pol, T D; van Ierland, E C; Gabbert, S; Weikard, H-P; Hendrix, E M T

    2015-05-01

    Stormwater drainage and other water systems are vulnerable to changes in rainfall and runoff and need to be adapted to climate change. This paper studies impacts of rainfall variability and changing return periods of rainfall extremes on cost-effective adaptation of water systems to climate change given a predefined system performance target, for example a flood risk standard. Rainfall variability causes system performance estimates to be volatile. These estimates may be used to recurrently evaluate system performance. This paper presents a model for this setting, and develops a solution method to identify cost-effective investments in stormwater drainage adaptations. Runoff and water levels are simulated with rainfall from stationary rainfall distributions, and time series of annual rainfall maxima are simulated for a climate scenario. Cost-effective investment strategies are determined by dynamic programming. The method is applied to study the choice of volume for a storage basin in a Dutch polder. We find that 'white noise', i.e. trend-free variability of rainfall, might cause earlier re-investment than expected under projected changes in rainfall. The risk of early re-investment may be reduced by increasing initial investment. This can be cost-effective if the investment involves fixed costs. Increasing initial investments, therefore, not only increases water system robustness to structural changes in rainfall, but could also offer insurance against additional costs that would occur if system performance is underestimated and re-investment becomes inevitable.

  9. Impacts of rainfall variability and expected rainfall changes on cost-effective adaptation of water systems to climate change.

    PubMed

    van der Pol, T D; van Ierland, E C; Gabbert, S; Weikard, H-P; Hendrix, E M T

    2015-05-01

    Stormwater drainage and other water systems are vulnerable to changes in rainfall and runoff and need to be adapted to climate change. This paper studies impacts of rainfall variability and changing return periods of rainfall extremes on cost-effective adaptation of water systems to climate change given a predefined system performance target, for example a flood risk standard. Rainfall variability causes system performance estimates to be volatile. These estimates may be used to recurrently evaluate system performance. This paper presents a model for this setting, and develops a solution method to identify cost-effective investments in stormwater drainage adaptations. Runoff and water levels are simulated with rainfall from stationary rainfall distributions, and time series of annual rainfall maxima are simulated for a climate scenario. Cost-effective investment strategies are determined by dynamic programming. The method is applied to study the choice of volume for a storage basin in a Dutch polder. We find that 'white noise', i.e. trend-free variability of rainfall, might cause earlier re-investment than expected under projected changes in rainfall. The risk of early re-investment may be reduced by increasing initial investment. This can be cost-effective if the investment involves fixed costs. Increasing initial investments, therefore, not only increases water system robustness to structural changes in rainfall, but could also offer insurance against additional costs that would occur if system performance is underestimated and re-investment becomes inevitable. PMID:25704748

  10. 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

  11. Cost-Effective Icy Bodies Exploration using Small Satellite Missions

    NASA Technical Reports Server (NTRS)

    Jonsson, Jonas; Mauro, David; Stupl, Jan; Nayak, Michael; Aziz, Jonathan; Cohen, Aaron; Colaprete, Anthony; Dono-Perez, Andres; Frost, Chad; Klamm, Benjamin; McCafferty, Julian; McKay, Chris; Sears, Derek; Soulage, Michael; Swenson, Jason; Weston, Sasha; Yang Yang, Fan

    2015-01-01

    It has long been known that Saturn's moon Enceladus is expelling water-rich plumes into space, providing passing spacecraft with a window into what is hidden underneath its frozen crust. Recent discoveries indicate that similar events could also occur on other bodies in the solar system, such as Jupiter's moon Europa and the dwarf planet Ceres in the asteroid belt. These plumes provide a possible giant leap forward in the search for organics and assessing habitability beyond Earth, stepping stones toward the long-term goal of finding extraterrestrial life. The United States Congress recently requested mission designs to Europa, to fit within a cost cap of $1B, much less than previous mission designs' estimates. Here, innovative cost-effective small spacecraft designs for the deep-space exploration of these icy worlds, using new and emerging enabling technologies, and how to explore the outer solar system on a budget below the cost horizon of a flagship mission, are investigated. Science requirements, instruments selection, rendezvous trajectories, and spacecraft designs are some topics detailed. The mission concepts revolve around a comparably small-sized and low-cost Plume Chaser spacecraft, instrumented to characterize the vapor constituents encountered on its trajectory. In the event that a plume is not encountered, an ejecta plume can be artificially created by a companion spacecraft, the Plume Maker, on the target body at a location timed with the passage of the Plume Chaser spacecraft. Especially in the case of Ceres, such a mission could be a great complimentary mission to Dawn, as well as a possible future Europa Clipper mission. The comparably small volume of the spacecraft enables a launch to GTO as a secondary payload, providing multiple launch opportunities per year. Plume Maker's design is nearly identical to the Plume Chaser, and fits within the constraints for a secondary payload launch. The cost-effectiveness of small spacecraft missions enables the

  12. Cost-Effective NEO Characterization Using Solar Electric Propulsion (SEP)

    NASA Astrophysics Data System (ADS)

    Dissly, R. W.; Reinert, R.; Mitchell, S.

    2003-05-01

    We present a cost-effective multiple NEO rendezvous mission design optimized around the capabilities of Ball's 200-kg NEOX Solar Electric Propelled microsatellite. The NEOX spacecraft is 3-axis stabilized with better-than 1 milliradian pointing accuracy to serve as an excellent imaging platform; its DSN compatible telecommunications subsystem can support a 6.4-kbps downlink rate at 3 AU earth range. The spacecraft mass is <200kg at launch to allow launch as a cost-effective secondary payload. It uses proven SEP technology to provide 12km/s of Delta-V, which enables multiple rendezvous' in a single mission. Cost-effectiveness is optimized by launch as a secondary payload (e.g., Ariane-5 ASAP) or as a multiple manifest on a single dedicated launch vehicle (e.g., 4 on a Delta-II 2925). Following separation from the LV, we describe a candidate mission profile that minimizes cost by using the spacecraft's 12km/s of SEP Delta-V to allow orbiting up to 4 separate NEO's. Orbiting as opposed to flying by augments the mission's science return by providing the NEO mass and by allowing multiple phase angle imaging. The NEOX Spacecraft has the capability to support a 20kg payload drawing 100W average during SEP cruise, with >1kW available during the NEO orbital phase when the SEP thrusters are not powered. We will present a candidate payload suite that includes a visible/NIR imager, a laser altimeter, and a set of small, self-righting surface probes that can be used to assess the geophysical state of the object surface and near-surface environments. The surface probe payload notionally includes a set of cameras for imaging the body surface at mm-scale resolution, an accelerometer package to measure surface mechanical properties upon probe impact, a Langmuir probe to measure the electrostatic gradient immediately above the object surface, and an explosive charge that can be remotely detonated at the end of the surface mission to excavate an artificial crater that can be remotely

  13. Systematic review of cost effectiveness studies of telemedicine interventions

    PubMed Central

    Whitten, Pamela S; Mair, Frances S; Haycox, Alan; May, Carl R; Williams, Tracy L; Hellmich, Seth

    2002-01-01

    Objectives To systematically review cost benefit studies of telemedicine. Design Systematic review of English language, peer reviewed journal articles. Data sources Searches of Medline, Embase, ISI citation indexes, and database of Telemedicine Information Exchange. Studies selected 55 of 612 identified articles that presented actual cost benefit data. Main outcome measures Scientific quality of reports assessed by use of an established instrument for adjudicating on the quality of economic analyses. Results 557 articles without cost data categorised by topic. 55 articles with data initially categorised by cost variables employed in the study and conclusions. Only 24/55 (44%) studies met quality criteria justifying inclusion in a quality review. 20/24 (83%) restricted to simple cost comparisons. No study used cost utility analysis, the conventional means of establishing the “value for money” that a therapeutic intervention represents. Only 7/24 (29%) studies attempted to explore the level of utilisation that would be needed for telemedicine services to compare favourably with traditionally organised health care. None addressed this question in sufficient detail to adequately answer it. 15/24 (62.5%) of articles reviewed here provided no details of sensitivity analysis, a method all economic analyses should incorporate. Conclusion There is no good evidence that telemedicine is a cost effective means of delivering health care. What is already known on this topicThe use of telemedicine has garnered much attention in the past decadeHundreds of articles have been published claiming that telemedicine is cost effectiveHowever, missing from the literature is a synthesis or meta-analysis of these publicationsWhat this study addsA comprehensive literature search of cost related articles on telemedicine identified more than 600 articles, but only 9% contained any cost benefit dataOnly 4% of these articles met quality criteria justifying inclusion in a formalised quality

  14. 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

  15. The value of heterogeneity for cost-effectiveness subgroup analysis: conceptual framework and application.

    PubMed

    Espinoza, Manuel A; Manca, Andrea; Claxton, Karl; Sculpher, Mark J

    2014-11-01

    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.

  16. Cost-effective lightweight mirrors for aerospace and defense

    NASA Astrophysics Data System (ADS)

    Woodard, Kenneth S.; Comstock, Lovell E.; Wamboldt, Leonard; Roy, Brian P.

    2015-05-01

    The demand for high performance, lightweight mirrors was historically driven by aerospace and defense (A&D) but now we are also seeing similar requirements for commercial applications. These applications range from aerospace-like platforms such as small unmanned aircraft for agricultural, mineral and pollutant aerial mapping to an eye tracking gimbaled mirror for optometry offices. While aerospace and defense businesses can often justify the high cost of exotic, low density materials, commercial products rarely can. Also, to obtain high performance with low overall optical system weight, aspheric surfaces are often prescribed. This may drive the manufacturing process to diamond machining thus requiring the reflective side of the mirror to be a diamond machinable material. This paper summarizes the diamond machined finishing and coating of some high performance, lightweight designs using non-exotic substrates to achieve cost effective mirrors. The results indicate that these processes can meet typical aerospace and defense requirements but may also be competitive in some commercial applications.

  17. Novel cost-effective method of laparoscopic feeding-jejunostomy

    PubMed Central

    Mistry, Rajesh C; Mehta, Sanket S; Karimundackal, George; Pramesh, C S

    2009-01-01

    A feeding jejunostomy tube placement is required for entral feeding in a variety of clinical scenarios. It offers an advantage over gastrostomies by eliminating the risk of aspiration. Standard described laparoscopic methods require special instrumentation and expensive custom-made tubes. We describe a simple cost-effective method of feeding jejunostomy using regular laparoscopic instruments and an inexpensive readily available tube. The average operating time was 35 min. We had no intra-operative complications and only one post-operative complication in the form of extra-peritoneal leakage of feeds due to a damaged tube. No complications were encountered while pulling out the tubes after an average period of 5–6 weeks. PMID:19727379

  18. Cost-effectiveness of percutaneous vertebroplasty in osteoporotic vertebral fractures

    PubMed Central

    Masala, Salvatore; Ciarrapico, Anna Micaela; Vinicola, Vincenzo; Mammucari, Matteo; Simonetti, Giovanni

    2008-01-01

    A retrospective study was conducted in 179 consecutive patients (48 males, 131 females; mean age: 72.0 ± 8.59 years; range: 51–93) with single symptomatic acute amyelic osteoporotic vertebral fracture presenting between September 2004 and September 2005 to the Santa Lucia Foundation in Rome, Italy. Vertebral fractures usually become manifest due to pain which can be debilitating. Treatment depends on the presence or absence of spinal cord involvement. In the first case, surgical stabilization is mandatory. In the second case, treatment may be performed either by conservative medical therapy (CMT) or percutaneous vertebroplasty (PVT). The aim of this study was to evaluate the effectiveness, costs and cost-effectiveness of percutaneous vertebroplasty. After 2 weeks of analgesic therapy, 153 patients presented refractory pain and were offered treatment by PVT. A total of 58 patients accepted and underwent PVT (PVT group), while 95 refused and underwent conservative medical therapy (CMT group). Follow-up was performed by specialist consults, spine radiography and MRI and a self-assessment questionnaire evaluating pain using a Visual Analogue Scale (VAS) and function using an ambulation and an Activities of Daily Living (ADL) scale. A 12-month follow-up was obtained in 86 of 95 (90.5%) CMT group patients and 54 of 58 (93.1%) PVT group patients. Significant reduction of VAS and improvement of ambulation and ADL was observed in both groups at 1 week and 3 and 12 months (P < 0.05; Wilcoxon signed rank test), however, these results were significantly superior in the PVT group at 1 week and 3 months (P < 0.05; Mann–Whitney U test). Average cost per patient at 1 week and 3 and 12 months were respectively 755.49 ± 661.96, 3791.95 ± 3341.97 and 4299.55 ± 3211.53 € (CMT group) and 3311.35 ± 0.32, 3745.30 ± 3.59 and 4101.05 ± 755.41 € (PVT group). PVT resulted significantly more cost-effective than CMT with regards to the three scales at

  19. Comprehensive evaluation of cost effectiveness of solar electric power plants

    NASA Astrophysics Data System (ADS)

    Ibragimov, D. Y.; Filatov, A. I.

    1984-02-01

    The cost effectiveness of constructing a solar heating and electric power plant is evaluated on the basis of a compatibility analysis of its combination with a thermal electric power plant and a boiler-type heating plant, taking into account comprehensively economic factors as well as power requirements. Two variants of such a combination are considered and compared, assuming equal heating power and equal electric power respectively. Equations are set up for each variant covering fixed and variable costs of generating electric power and generating heat, as basis for comparing the two variants and optimizing them with respect to normalized annual total cost. Nomograms plotted for convenient numerical calculation of maximum economically worthwhile capital investment in a solar heating and electric power plant, depending on changes in various operating parameters, reveal that, as the time for constructing such a plant becomes longer, this maximum worthwhile investment in it increases for variant 1 and decreases for variant 2.

  20. Cost-effectiveness analysis of optimal control measures for tuberculosis.

    PubMed

    Rodrigues, Paula; Silva, Cristiana J; Torres, Delfim F M

    2014-10-01

    We propose and analyze an optimal control problem where the control system is a mathematical model for tuberculosis that considers reinfection. The control functions represent the fraction of early latent and persistent latent individuals that are treated. Our aim was to study how these control measures should be implemented, for a certain time period, in order to reduce the number of active infected individuals, while minimizing the interventions implementation costs. The optimal intervention is compared along different epidemiological scenarios, by varying the transmission coefficient. The impact of variation of the risk of reinfection, as a result of acquired immunity to a previous infection for treated individuals on the optimal controls and associated solutions, is analyzed. A cost-effectiveness analysis is done, to compare the application of each one of the control measures, separately or in combination.

  1. Development of a cost effective microscope heater stage

    NASA Astrophysics Data System (ADS)

    Dugre, Joshua; Prayaga, Chandra; Wade, Aaron

    Utilizing 3D printing technology, a heater stage has been developed and implemented for microscopic systems. Due to the flexibility of 3D printing,the heater stage can be easily modified to fit any sample size with only slight modifications to the heating element being required. The sample in contact with the heating element can also easily be secured in a thermal insulator, such as aluminum foil. The thermal gradient of the heater stage has been recorded to be less than 1°C and has been compared to more expensive designs, and the cost effectiveness of the system has been determined. The system has been tested with a sample of the liquid crystal 8CB in order to determine the exact temperatures of the phase transitions of the crystal to verify that the system is applicable to a wide range of experimental physics. UWF Quality Enhancement Plan Award.

  2. RTM: Cost-effective processing of composite structures

    NASA Technical Reports Server (NTRS)

    Hasko, Greg; Dexter, H. Benson

    1991-01-01

    Resin transfer molding (RTM) is a promising method for cost effective fabrication of high strength, low weight composite structures from textile preforms. In this process, dry fibers are placed in a mold, resin is introduced either by vacuum infusion or pressure, and the part is cured. RTM has been used in many industries, including automotive, recreation, and aerospace. Each of the industries has different requirements of material strength, weight, reliability, environmental resistance, cost, and production rate. These requirements drive the selection of fibers and resins, fiber volume fractions, fiber orientations, mold design, and processing equipment. Research is made into applying RTM to primary aircraft structures which require high strength and stiffness at low density. The material requirements are discussed of various industries, along with methods of orienting and distributing fibers, mold configurations, and processing parameters. Processing and material parameters such as resin viscosity, perform compaction and permeability, and tool design concepts are discussed. Experimental methods to measure preform compaction and permeability are presented.

  3. Cost effectiveness of ergonomic redesign of electronic motherboard.

    PubMed

    Sen, Rabindra Nath; Yeow, Paul H P

    2003-09-01

    A case study to illustrate the cost effectiveness of ergonomic redesign of electronic motherboard was presented. The factory was running at a loss due to the high costs of rejects and poor quality and productivity. Subjective assessments and direct observations were made on the factory. Investigation revealed that due to motherboard design errors, the machine had difficulty in placing integrated circuits onto the pads, the operators had much difficulty in manual soldering certain components and much unproductive manual cleaning (MC) was required. Consequently, there were high rejects and occupational health and safety (OHS) problems, such as, boredom and work discomfort. Also, much labour and machine costs were spent on repairs. The motherboard was redesigned to correct the design errors, to allow more components to be machine soldered and to reduce MC. This eliminated rejects, reduced repairs, saved US dollars 581495/year and improved operators' OHS. The customer also saved US dollars 142105/year on loss of business. PMID:12963331

  4. Cost-effectiveness of an immunization programme in Indonesia

    PubMed Central

    Barnum, H. N.; Tarantola, D.; Setiady, I. F.

    1980-01-01

    The economic analysis reported below, based on hypothetical estimates of the programme impact, indicates that an expanded programme of immunization for diphtheria, pertussis, tetanus, and tuberculosis can be expected to be highly cost-effective in comparison with treatment. Sensitivity tests illustrate that this conclusion remains valid even when costs are increased by 20% and benefits reduced by 50%. A separate analysis was made of the DPT—tetanus toxoid and BCG components of the programme. The analysis revealed that although the BCG programme may not be justifiable when operated independently, its inclusion in a joint immunization programme is strongly justifiable on economic grounds (assuming a vaccine efficacy of 0.5). This result confirms one of the basic arguments advanced for the WHO programmes of expanded immunization and illustrates that other immunizations, such as for poliomyelitis and measles, which may not be cost-efficient by themselves may be economically justifiable when included as part of a larger immunization programme. PMID:6774826

  5. Manage leak detection and repair programs cost-effectively

    SciTech Connect

    Stobbe, A.W. )

    1995-01-01

    Because of recently imposed lower fugitive-release limits for pumps and valves, refiners must use innovative, cost-effective ways to find, repair, monitoring, record and report process emissions. New regulations such as SOCMI HON (Synthetic Organic Chemical Manufacturing industry Hazardous Organic NESHAP) and Refinery MACT (Maximum Achievable Control Technology) set performance goals for hydrocarbon processing industry (HPI) facilities. To meet these performance standards, HPI facilities must set up stringent LDAR (Leak Detection and Repair) programs. Preparation methods define how to set up a database-management system to monitor/reduce fugitive emissions. The paper describes the database-management system, then discusses the determination of goals, collecting data, analyzing data, and management solutions to minimize costs.

  6. DEVELOPMENT AND MANUFACTURE OF COST EFFECTIVE COMPOSITE DRILL PIPE

    SciTech Connect

    James C. Leslie; James C. Leslie II; Lee Truong; James T. Heard

    2003-03-30

    This technical report presents the engineering research and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report presents accomplishments made from October 1, 2002 through September 30, 2003. The following have been accomplished and are reported in detail herein: Metal-to-Composite Interface (MCI) redesign and testing; Successful demonstration of MCI connection for both SR and ER/DW CDP; Specifications for a 127mm (5 inch) ID by 152.4 mm (6 inch) OD composite drill pipe have been finalized for Extended Reach/Deep Water applications (ER/DW); Field testing of Short Radius CDP (SR); Sealing composite laminate to contain high pressure; Amendments; Amendment for ''Smart'' feature added to ER/DW development along with time and funding to complete battery of qualification tests with option for field demonstration; and Preparation of papers for publication and conference presentations.

  7. Cost-effectiveness analysis of rheumatic heart disease prevention strategies.

    PubMed

    Manji, Rizwan A; Witt, Julia; Tappia, Paramjit S; Jung, Young; Menkis, Alan H; Ramjiawan, Bram

    2013-12-01

    Rheumatic heart disease (RHD), secondary to group A streptococcal infection is endemic in the developing as well as parts of the developed world with significant costs to the patient, and to the healthcare system. We briefly review the prevalence and cost of RHD in developed and developing nations. We subsequently develop a Markov model to evaluate the cost-effectiveness of three strategies (vs standard no prevention) for preventing RHD in a developing world country: primary prophylaxis (throat swab to detect and subsequently treat group A streptococci as needed); primary prophylaxis (antibiotic prophylaxis for all) with benzathine penicillin G once monthly to all patients (ages 5-21 years) regardless of evidence of infection; and secondary prophylaxis with monthly only to those with echocardiographic evidence of early RHD. Our model suggests that echocardiographic screening and secondary prophylaxis is the best strategy although the strategies change depending on parameters used.

  8. Mechanical impedance measurements for improved cost-effective process monitoring

    NASA Astrophysics Data System (ADS)

    Clopet, Caroline R.; Pullen, Deborah A.; Badcock, Rodney A.; Ralph, Brian; Fernando, Gerard F.; Mahon, Steve W.

    1999-06-01

    The aerospace industry has seen a considerably growth in composite usage over the past ten years, especially with the development of cost effective manufacturing techniques such as Resin Transfer Molding and Resin Infusion under Flexible Tooling. The relatively high cost of raw material and conservative processing schedules has limited their growth further in non-aerospace technologies. In-situ process monitoring has been explored for some time as a means to improving the cost efficiency of manufacturing with dielectric spectroscopy and optical fiber sensors being the two primary techniques developed to date. A new emerging technique is discussed here making use of piezoelectric wafers with the ability to sense not only aspects of resin flow but also to detect the change in properties of the resin as it cures. Experimental investigations to date have shown a correlation between mechanical impedance measurements and the mechanical properties of cured epoxy systems with potential for full process monitoring.

  9. Detecting Proximal Secondary Caries Lesions: A Cost-effectiveness Analysis.

    PubMed

    Schwendicke, F; Brouwer, F; Paris, S; Stolpe, M

    2016-02-01

    When choosing detection methods for secondary caries lesions, dentists need to weigh sensitivity, allowing early initiation of retreatments to avoid lesion progression, against specificity, aiming to reduce risks of false-positive diagnoses and invasive overtreatments. We assessed the cost-effectiveness of different detection methods for proximal secondary lesions using Monte Carlo microsimulations. A vital permanent molar with an occlusal-proximal restoration was simulated over the lifetime of an initially 20-y-old. Three methods were compared: biannual tactile detection, radiographic detection every 2 y, and biannual laser fluorescence detection. Methods were employed either on their own or in pairwise combinations at sensitive and specific thresholds estimated with systematically collected data. A mixed public-private payer perspective in the context of German health care was applied. Effectiveness was calculated as years of tooth retention. Net-benefit analyses were used to evaluate cost-effectiveness acceptability at different willingness-to-pay thresholds. Radiographic detection verified by tactile assessment (both at specific thresholds) was least costly (mean, 1,060 euros) but had limited effectiveness (mean retention time, 50 y). The most effective but also more costly combination was laser fluorescence detection verified by radiography, again at specific thresholds (1157 euros, 53 y, acceptable if willingness to pay >32 euro/y). In the majority of simulations, not combining detection methods or applying them at sensitive thresholds was less effective and more costly. Net benefits were not greatly altered by applying different discounting rates or using different baseline prevalence of secondary lesions. Current detection methods for secondary lesions should best be used in combination, not on their own, at specific thresholds to avoid false-positive diagnoses leading to costly and invasive overtreatment. The relevant characteristics, such as predictive

  10. 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

  11. A Cost Effective System Design Approach for Critical Space Systems

    NASA Technical Reports Server (NTRS)

    Abbott, Larry Wayne; Cox, Gary; Nguyen, Hai

    2000-01-01

    NASA-JSC required an avionics platform capable of serving a wide range of applications in a cost-effective manner. In part, making the avionics platform cost effective means adhering to open standards and supporting the integration of COTS products with custom products. Inherently, operation in space requires low power, mass, and volume while retaining high performance, reconfigurability, scalability, and upgradability. The Universal Mini-Controller project is based on a modified PC/104-Plus architecture while maintaining full compatibility with standard COTS PC/104 products. The architecture consists of a library of building block modules, which can be mixed and matched to meet a specific application. A set of NASA developed core building blocks, processor card, analog input/output card, and a Mil-Std-1553 card, have been constructed to meet critical functions and unique interfaces. The design for the processor card is based on the PowerPC architecture. This architecture provides an excellent balance between power consumption and performance, and has an upgrade path to the forthcoming radiation hardened PowerPC processor. The processor card, which makes extensive use of surface mount technology, has a 166 MHz PowerPC 603e processor, 32 Mbytes of error detected and corrected RAM, 8 Mbytes of Flash, and I Mbytes of EPROM, on a single PC/104-Plus card. Similar densities have been achieved with the quad channel Mil-Std-1553 card and the analog input/output cards. The power management built into the processor and its peripheral chip allows the power and performance of the system to be adjusted to meet the requirements of the application, allowing another dimension to the flexibility of the Universal Mini-Controller. Unique mechanical packaging allows the Universal Mini-Controller to accommodate standard COTS and custom oversized PC/104-Plus cards. This mechanical packaging also provides thermal management via conductive cooling of COTS boards, which are typically

  12. Cost-Effectiveness of Maintenance Hemodialysis in Japan.

    PubMed

    Takura, Tomoyuki; Nakanishi, Takeshi; Kawanishi, Hideki; Nitta, Kosaku; Akizawa, Tadao; Hiramatsu, Makoto; Kawasaki, Tadayuki; Kukita, Kazutaka; Soejima, Hidehisa; Hirakata, Hideki; Yoshida, Toyohiko; Miyamoto, Takashi; Takahashi, Susumu

    2015-10-01

    The cost-effectiveness according to primary disease or dialysis duration has never been analyzed with respect to maintenance hemodialysis (MHD). Study candidates were > 20 years of age and had received hemodialysis for at least 6 months. Hemodialysis patients were prospectively observed for 36 months, and patient utility was assessed based on the Euro-QOL 5-dimensions (EQ-5D), from which the quality adjusted life years (QALYs) were estimated. Medical costs were calculated based on medical service fees. The cost-effectiveness defined as the incremental cost utility ratio (ICUR) was analyzed from a social perspective. A total of 29 patients (mean age; 59.9 ± 13.1 years) undergoing 437 dialysis sessions were analyzed. Utility based upon the EQ-5D score was 0.75 ± 0.21, and the estimated total medical cost for one year of MHD treatment was 4.52 ± 0.88 US$10 000. ICUR was 6.88 ± 4.47 US$10 000/QALY on average, and when comparing ICUR based on the causes of kidney failure, the value for diabetic nephropathy was found to be higher than that for glomerulonephritis (8.17 ± 6.28 vs. 6.82 ± 4.07). ICUR after 36 months observation increased mainly in the patients below 65 years of age (All; P < 0.05, <65; P < 0.01, 65≤; not significant). MHD is a treatment that could improve the socioeconomic state of elderly patients with end-stage kidney disease (ESKD), but the ICUR for diabetic nephropathy was higher than that for glomerulonephritis. PMID:26387878

  13. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    ERIC Educational Resources Information Center

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  14. Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

    ERIC Educational Resources Information Center

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-01-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three…

  15. Cost Effectiveness Ratio: Evaluation Tool for Comparing the Effectiveness of Similar Extension Programs

    ERIC Educational Resources Information Center

    Jayaratne, K. S. U.

    2015-01-01

    Extension educators have been challenged to be cost effective in their educational programming. The cost effectiveness ratio is a versatile evaluation indicator for Extension educators to compare the cost of achieving a unit of outcomes or educating a client in similar educational programs. This article describes the cost effectiveness ratio and…

  16. Controls and dynamics of biochar decay and soil microbial abundance, carbon use efficiency during long-term biochar-amended soil incubations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biochar addition to soil has been proposed as a management strategy to sequester a recalcitrant form of carbon (C). However, there is growing evidence that biochar can be degraded by soil microbes and modify their abundance, community composition and activity. Yet we lack an understanding of how mic...

  17. Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States

    PubMed Central

    Furiak, Nicolas M; Ascher-Svanum, Haya; Klein, Robert W; Smolen, Lee J; Lawson, Anthony H; Conley, Robert R; Culler, Steven D

    2009-01-01

    Background Schizophrenia is often a persistent and costly illness that requires continued treatment with antipsychotics. Differences among antipsychotics on efficacy, safety, tolerability, adherence, and cost have cost-effectiveness implications for treating schizophrenia. This study compares the cost-effectiveness of oral olanzapine, oral risperidone (at generic cost, primary comparator), quetiapine, ziprasidone, and aripiprazole in the treatment of patients with schizophrenia from the perspective of third-party payers in the U.S. health care system. Methods A 1-year microsimulation economic decision model, with quarterly cycles, was developed to simulate the dynamic nature of usual care of schizophrenia patients who switch, continue, discontinue, and restart their medications. The model captures clinical and cost parameters including adherence levels, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment discontinuation by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct medical care costs. Published medical literature and a clinical expert panel were used to develop baseline model assumptions. Key model outcomes included mean annual total direct cost per treatment, cost per stable patient, and incremental cost-effectiveness values per QALY gained. Results The results of the microsimulation model indicated that olanzapine had the lowest mean annual direct health care cost ($8,544) followed by generic risperidone ($9,080). In addition, olanzapine resulted in more QALYs than risperidone (0.733 vs. 0.719). The base case and multiple sensitivity analyses found olanzapine to be the dominant choice in terms of incremental cost-effectiveness per QALY gained. Conclusion The utilization of olanzapine is predicted in this model to result in better clinical outcomes and lower total direct health care costs compared to generic risperidone, quetiapine, ziprasidone, and aripiprazole. Olanzapine

  18. Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold

    PubMed Central

    Griffiths, Elizabeth A; Hendrich, Janek K; Stoddart, Samuel DR; Walsh, Sean CM

    2015-01-01

    Objectives In health technology assessment (HTA) agencies where cost-effectiveness plays a role in decision-making, an incremental cost-effectiveness ratio (ICER) threshold is often used to inform reimbursement decisions. The acceptance of submissions with ICERs higher than the threshold was assessed across different agencies and across indications, in order to inform future reimbursement submissions. Methods All HTA appraisals from May 2000 to May 2014 from National Institute for Health and Care Excellence (NICE), Scottish Medicines Consortium (SMC), Pharmaceutical Benefits Advisory Committee (PBAC), and Canadian Agency for Drugs and Technologies in Health (CADTH) were assessed. Multiple technology appraisals, resubmissions, vaccination programs, and requests for advice were excluded. Submissions not reporting an ICER, or for which an ICER could not be determined were also excluded. The remaining appraisals were reviewed, and the submitted ICER, recommendation, and reasoning behind the recommendation were extracted. Results NICE recommended the highest proportion of submissions with ICERs higher than the threshold (34% accepted without restrictions; 20% with restrictions), followed by PBAC (16% accepted without restrictions; 4% with restrictions), SMC (11% accepted without restrictions; 14% accepted with restrictions), and CADTH (0% accepted without restrictions; 26% with restrictions). Overall, the majority of higher-than-threshold ICER submissions were classified into the “malignant disease and immunosuppression” therapeutic category; however, there was no notable variation in acceptance rates by disease area. Reasons for accepting submissions reporting ICERs above the threshold included high clinical benefit over the standard of care, and addressing an unmet therapeutic need. Conclusion Acceptance of submissions with higher-than-threshold ICERs varied by HTA agency and was not significantly influenced by disease category. Such submissions must be

  19. Cost-effective isobaric tagging for quantitative phosphoproteomics using DiART reagents.

    PubMed

    Ramsubramaniam, Nikhil; Tao, Feng; Li, Shuwei; Marten, Mark R

    2013-12-01

    We describe the use of an isobaric tagging reagent, Deuterium isobaric Amine Reactive Tag (DiART), for quantitative phosphoproteomic experiments. Using DiART tagged custom mixtures of two phosphorylated peptides from alpha casein and their non-phosphorylated counterparts, we demonstrate the compatibility of DiART with TiO2 affinity purification of phosphorylated peptides. Comparison of theoretical vs. experimental reporter ion ratios reveals accurate quantification of phosphorylated peptides over a dynamic range of more than 15-fold. Using DiART labelling and TiO2 enrichment (DiART-TiO2) with large quantities of proteins (8 mg) from the cell lysate of model fungus Aspergillus nidulans, we quantified 744 unique phosphopeptides. Overlap of median values of TiO2 enriched phosphopeptides with theoretical values indicates accurate trends. Altogether these findings confirm the feasibility of performing quantitative phosphoproteomic experiments in a cost-effective manner using isobaric tagging reagents, DiART.

  20. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa

    PubMed Central

    Thomas, Ranjeeta; Fraser, Christophe; Cori, Anne

    2016-01-01

    Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness. PMID:27391129

  1. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

    PubMed

    Heffernan, Alastair; Barber, Ella; Thomas, Ranjeeta; Fraser, Christophe; Pickles, Michael; Cori, Anne

    2016-01-01

    Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness.

  2. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

    PubMed

    Heffernan, Alastair; Barber, Ella; Thomas, Ranjeeta; Fraser, Christophe; Pickles, Michael; Cori, Anne

    2016-01-01

    Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness. PMID:27391129

  3. Critical Research for Cost-Effective Photoelectrochemical Production of Hydrogen

    SciTech Connect

    Xu, Liwei; Deng, Xunming; Abken, Anka; Cao, Xinmin; Du, Wenhui; Vijh, Aarohi; Ingler, William; Chen, Changyong; Fan, Qihua; Collins, Robert; Compaan, Alvin; Yan, Yanfa; Giolando, Dean; Turner, John

    2014-10-29

    The objective of this project is to develop critical technologies required for cost-effective production of hydrogen from sunlight and water using a-Si triple junction solar cell based photo-electrodes. In this project, Midwest Optoelectronics, LLC (MWOE) and its collaborating organizations utilize triple junction a-Si thin film solar cells as the core element to fabricate photoelectrochemical (PEC) cells. Triple junction a-Si/a-SiGe/a-SiGe solar cell is an ideal material for making cost-effective PEC system which uses sun light to split water and generate hydrogen. It has the following key features: 1) It has an open circuit voltage (Voc ) of ~ 2.3V and has an operating voltage around 1.6V. This is ideal for water splitting. There is no need to add a bias voltage or to inter-connect more than one solar cell. 2) It is made by depositing a-Si/a-SiGe/aSi-Ge thin films on a conducting stainless steel substrate which can serve as an electrode. When we immerse the triple junction solar cells in an electrolyte and illuminate it under sunlight, the voltage is large enough to split the water, generating oxygen at the Si solar cell side (for SS/n-i-p/sunlight structure) and hydrogen at the back, which is stainless steel side. There is no need to use a counter electrode or to make any wire connection. 3) It is being produced in large rolls of 3ft wide and up to 5000 ft long stainless steel web in a 25MW roll-to-roll production machine. Therefore it can be produced at a very low cost. After several years of research with many different kinds of material, we have developed promising transparent, conducting and corrosion resistant (TCCR) coating material; we carried out extensive research on oxygen and hydrogen generation catalysts, developed methods to make PEC electrode from production-grade a-Si solar cells; we have designed and tested various PEC module cases and carried out extensive outdoor testing; we were able to obtain a solar to hydrogen conversion efficiency (STH

  4. Cost-effectiveness analysis of antipsychotics in reducing schizophrenia relapses

    PubMed Central

    2012-01-01

    Background Schizophrenia is a severe form of mental illness which is associated with significant and long-lasting health, social and financial burdens. The aim of this project is to assess the efficiency of the antipsychotics used in Spain in reducing schizophrenia relapses under the Spanish Health System perspective. Material and methods A decision-analytic model was developed to explore the relative cost-effectiveness of five antipsychotic medications, amisulpride, aripiprazole, olanzapine, paliperidone Extended-Release (ER) and risperidone, compared to haloperidol, over a 1-year treatment period among people living in Spain with schizophrenia. The transition probabilities for assessed therapies were obtained from the systemic review and meta-analysis performed by National Institute for Health and Clinical Excellence (NICE). Results Paliperidone ER was the option that yielded more quality-adjusted life years (QALYs) gained per patient (0.7573). In addition, paliperidone ER was the least costly strategy (€3,062), followed by risperidone (€3,194), haloperidol (€3,322), olanzapine (€3,893), amisulpride (€4,247) and aripiprazole (€4,712). In the incremental cost-effectiveness (ICE) analysis of the assessed antipsychotics compared to haloperidol, paliperidone ER and risperidone were dominant options. ICE ratios for other medications were €23,621/QALY gained, €91,584/QALY gained and €94,558/QALY gained for olanzapine, amisulpride and aripiprazole, respectively. Deterministic sensitivity analysis showed that risperidone is always dominant when compared to haloperidol. Paliperidone ER is also dominant apart from the exception of the scenario with a 20% decrease in the probability of relapses. Conclusions Our findings may be of interest to clinicians and others interested in outcomes and cost of mental health services among patients with schizophrenia. Paliperidone ER and risperidone were shown to be dominant therapies compared to haloperidol in Spain

  5. Controlling Reactive Nitrogen: Attaining Cost Effectiveness and Institutional Alignment

    NASA Astrophysics Data System (ADS)

    Doering, O.

    2012-12-01

    The fact that reactive nitrogen (Nr) cascades by changing form and moving between air, land and water makes its management and control especially difficult. The cascade means that excess Nr's negative impacts may initially occur, flow through, or linger in air, land or water. The critical question becomes where and how to interdict, not only in terms of technical capacity but also in terms of cost effectiveness and institutional capacity. The nature of Nr also needs to inform the questions that need to be asked to be able to deal with Nr. For much of the world, agriculture is the major contributor to Nr.The stark trade-off often involves excess Nr that is the product of increased food production. As it is often the largest source of excess Nr, agriculture has to be a focus for Nr control and management efforts. This paper will start with the Nr balance sheet for the US and outline some of the trade-offs and opportunities for controlling Nr.The institutional responsibility and capacity to take effective action will be assessed on the basis of US institutions and their history. This will involve illustrating some of the difficulties posed by the cascading nature of Nr as it movesfrom one regulatory jurisdiction to another. Within the US agricultural sector. the history and politics of dealing with such problems will be traced as they relate to the willingness and capacity of the sector to more effectively control or manage problems like Nr. The institutional history of the sector has a strong influence onwhat can be accomplished in a cost effective way - one that is very different from the history and practice in Australia or Europe. The EPA Science Advisory Boards' suggestion that a twenty five percent reduction in excess Nr should be achievable will be traced through for agriculture and allied situations illustrating some of the possibilities and dilemmas. Finally, the issue of metrics will be addressed. As a caution to policy makers, one can obtain very different

  6. Cost-Effectiveness Analysis of Infrapopliteal Drug-Eluting Stents

    SciTech Connect

    Katsanos, Konstantinos Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Siablis, Dimitris

    2013-02-15

    IntroductionThere are no cost-utility data about below-the-knee placement of drug-eluting stents. The authors determined the cost-effectiveness of infrapopliteal drug-eluting stents for critical limb ischemia (CLI) treatment. The event-free individual survival outcomes defined by the absence of any major events, including death, major amputation, and target limb repeat procedures, were reconstructed on the basis of two published infrapopliteal series. The first included spot Bail-out use of Sirolimus-eluting stents versus bare metal stents after suboptimal balloon angioplasty (Bail-out SES).The second was full-lesion Primary Everolimus-eluting stenting versus plain balloon angioplasty and bail-out bare metal stenting as necessary (primary EES). The number-needed-to-treat (NNT) to avoid one major event and incremental cost-effectiveness ratios (ICERs) were calculated for a 3-year postprocedural period for both strategies. Overall event-free survival was significantly improved in both strategies (hazard ratio (HR) [confidence interval (CI)]: 0.68 [0.41-1.12] in Bail-out SES and HR [CI]: 0.53 [0.29-0.99] in Primary EES). Event-free survival gain per patient was 0.89 (range, 0.11-3.0) years in Bail-out SES with an NNT of 4.6 (CI: 2.5-25.6) and a corresponding ICER of 6,518 Euro-Sign (range 1,685-10,112 Euro-Sign ). Survival gain was 0.91 (range 0.25-3.0) years in Primary EES with an NNT of 2.7 (CI: 1.7-5.8) and an ICER of 11,581 Euro-Sign (range, 4,945-21,428 Euro-Sign ) per event-free life-year gained. Two-way sensitivity analysis showed that stented lesion length >10 cm and/or DES list price >1000 Euro-Sign were associated with the least economically favorable scenario in both strategies. Both strategies of bail-out SES and primary EES placement in the infrapopliteal arteries for CLI treatment exhibit single-digit NNT and relatively low corresponding ICERs.

  7. HIV prevention cost-effectiveness: a systematic review

    PubMed Central

    2009-01-01

    Background After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion criteria included: HIV prevention intervention, year for publication (2005-2008), setting (low- and middle-income countries), and CE estimation (empirical or modeling) using outcomes in terms of cost per HIV infection averted and/or cost per disability-adjusted life year (DALY) or quality-adjusted life year (QALY). Results We found 21 distinct studies analyzing the CE of HIV-prevention interventions published in the past four years (2005-2008). Seventeen CE studies analyzed biomedical interventions; only a few dealt with behavioral and environmental/structural interventions. Sixteen studies focused on sub-Saharan Africa, and only a handful on Asia, Latin America and Eastern Europe. Many HIV-prevention interventions are very cost effective in absolute terms (using costs per DALY averted), and also in country-specific relative terms (in cost per DALY measured as percentage of GDP per capita). Conclusion There are several types of interventions for which CE studies are still not available or insufficient, including surveillance, abstinence, school-based education, universal precautions, prevention for positives and most structural interventions. The sparse CE evidence available is not easily comparable; thus, not very useful for decision

  8. Cost effectiveness of a pentavalent rotavirus vaccine in Oman

    PubMed Central

    2014-01-01

    Background Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman Methods A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. Results A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Conclusions Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal

  9. The theoretical impact and cost-effectiveness of vaccines that protect against sexually transmitted infections and disease.

    PubMed

    Garnett, Geoff P

    2014-03-20

    Sexually transmitted diseases, a source of widespread morbidity and sometimes mortality, are caused by a diverse group of infections with a common route of transmission. Existing vaccines against hepatitis B virus (HBV) and human papilloma virus 16, 18, 6 and 11 are highly efficacious and cost effective. In reviewing the potential role for other vaccines against sexually transmitted infections (STIs) a series of questions needs to be addressed about the burden of disease, the potential characteristics of a new vaccine, and the impact of other interventions. These questions can be viewed in the light of the population dynamics of sexually transmitted infections as a group and how a vaccine can impact these dynamics. Mathematical models show the potential for substantial impact, especially if vaccines are widely used. To better make the case for sexually transmitted infection vaccines we need better data and analyses of the burden of disease, especially severe disease. However, cost effectiveness analyses using a wide range of assumptions show that STI vaccines would be cost effective and their development a worthwhile investment.

  10. Reach-scale distribution dynamics of a grazing stream insect, Micrasema quadriloba Martynov (Brachycentridae, Trichoptera), in relation to current velocity and periphyton abundance.

    PubMed

    Katano, Izumi; Mitsuhashi, Hiromune; Isobe, Yu; Sato, Hiroaki; Oishi, Tadashi

    2005-08-01

    Reach-scale temporal shifts in the distribution of larvae of a grazing caddisfly, Micrasema quadriloba (Brachycentridae), were investigated in a Japanese mountain stream. The larvae showed an aggregated distribution within the reach at the beginning of the immigration, then became randomly dispersed throughout the reach as the immigration progressed. The abundance of periphyton in the reach decreased dramatically with increasing dispersal of the larvae. Simple regression analyses revealed that the stream's flow regime was the most important environmental factor that determined the reach-scale distribution of the larvae and that the relationship between the flow regime and the distribution of the larvae shifted temporally. In addition, our results suggest that only this species of grazing insect, which was dominant in the study reach, controlled the reach-scale abundance of the periphyton.

  11. Cost effectiveness of the stream-gaging program in Ohio

    USGS Publications Warehouse

    Shindel, H.L.; Bartlett, W.P.

    1986-01-01

    This report documents the results of the cost effectiveness of the stream-gaging program in Ohio. Data uses and funding sources were identified for 107 continuous stream gages currently being operated by the U.S. Geological Survey in Ohio with a budget of $682,000; this budget includes field work for other projects and excludes stations jointly operated with the Miami Conservancy District. No stream gage were identified as having insufficient reason to continue their operation; nor were any station identified as having uses specifically only for short-term studies. All 107 station should be maintained in the program for the foreseeable future. The average standard error of estimation of stream flow records is 29.2 percent at its present level of funding. A minimum budget of $679,000 is required to operate the 107-gage program; a budget less than this does no permit proper service and maintenance of the gages and recorders. At the minimum budget, the average standard error is 31.1 percent The maximum budget analyzed was $1,282,000, which resulted in an average standard error of 11.1 percent. A need for additional gages has been identified by the other agencies that cooperate in the program. It is suggested that these gage be installed as funds can be made available.

  12. Cost effectiveness of in situ bioremediation at Savannah River

    SciTech Connect

    Saaty, R.P.; Showalter, W.E.; Booth, S.R.

    1995-09-01

    In situ bioremediation (ISBR) is an innovative new remediation technology for the removal of chlorinated solvents from contaminated soils and groundwater. The principal contaminant at the Savannah River Integrated Demonstration is tricloroethylene (TCE) a volatile organic compound (VOC). A 384-day test run at Savannah River, sponsored by the US Department of Energy (DOE), Office of Technology Development (EM-50), furnished information about the performance and applications of ISBR. In situ bioremediation, as tested, is based on two distinct processes occurring simultaneously; the physical process of in situ air stripping and the biological process of bioremediation. Both processes have the potential to remediate some amount of contamination. A quantity of VOCs, directly measured from the extracted airstream, was removed from the test area by the physical process of air stripping. The biological process is difficult to examine. However, the results of several tests performed at the SRID and independent numerical modeling determined that the biological process remediated an additional 40% above the physical process. Given these data, the cost effectiveness of this new technology can be evaluated.

  13. Rockot - a new cost effective launcher for small satellites

    NASA Astrophysics Data System (ADS)

    Mosenkis, Regina

    1996-01-01

    Daimler-Benz Aerospace of Germany and the Russian Khrunichev State Research and Production Space Center have formed a jointly owned EUROCKOT Launch Services GmbH to offer worldwide cost effective launch services for the ROCKOT launch vehicle. ROCKOT, produced by Khrunichev, builder of the famous PROTON launcher, aims at the market of small and medium size satellites ranging from 300 to 1800 kg to be launched into low earth or sunsynchronous orbits. These comprize scientific, earth observation and polar meteorological satellites as well as the new generation of small communication satellites in low earth orbits, known as the ``Constellations''. ROCKOT is a three stage liquid propellant launch vehicle, composed of a former Russian SS 19 strategic missile, which has been withdrawn from military use, and a highly sophisticated, flight-proven upper stage named Breeze, which is particularly suited for a variety of civic and commercial space applications. Usable payload envelope has a length of 4.75 meters and a maximum diameter of 2.26 meters for accomodating the payload within the payload fairing. ROCKOT can also accomodate multiple payloads which can be deployed into the same or different orbits. So far ROCKOT has been successfully launched three times from Baikonur. The commercial launch services on ROCKOT from the Plesetsk launch site, Russia, will begin in 1997 and will be available worldwide at a highly competitive price.

  14. Cost-Effective Marine Protection--A Pragmatic Approach.

    PubMed

    Oinonen, Soile; Hyytiäinen, Kari; Ahlvik, Lassi; Laamanen, Maria; Lehtoranta, Virpi; Salojärvi, Joona; Virtanen, Jarno

    2016-01-01

    This paper puts forward a framework for probabilistic and holistic cost-effectiveness analysis to provide support in selecting the least-cost set of measures to reach a multidimensional environmental objective. Following the principles of ecosystem-based management, the framework includes a flexible methodology for deriving and populating criteria for effectiveness and costs and analyzing complex ecological-economic trade-offs under uncertainty. The framework is applied in the development of the Finnish Programme of Measures (PoM) for reaching the targets of the EU Marine Strategy Framework Directive (MSFD). The numerical results demonstrate that substantial cost savings can be realized from careful consideration of the costs and multiple effects of management measures. If adopted, the proposed PoM would yield improvements in the state of the Baltic Sea, but the overall objective of the MSFD would not be reached by the target year of 2020; for various environmental and administrative reasons, it would take longer for most measures to take full effect. PMID:26751965

  15. Phycoremediation: key issues for cost-effective nutrient removal processes.

    PubMed

    Olguín, Eugenia J

    2003-12-01

    Phycoremediation applied to the removal of nutrients from animal wastewater and other high organic content wastewater is a field with a great potential and demand considering that surface and underground water bodies in several regions of the world are suffering of eutrophication. However, the development of more efficient nutrient removal algal systems requires further research in key areas. Algae growth rate controls directly and indirectly the nitrogen and phosphorus removal efficiency. Thus, maximum algae productivity is required for effective nutrient removal and must be considered as a key area of research. Likewise, low harvesting costs are also required for a cost-effective nutrient removal system. The use of filamentous microalgae with a high autoflocculation capacity and the use of immobilized cells have been investigated in this respect. Another key area of research is the use of algae strains with special attributes such as tolerance to extreme temperature, chemical composition with predominance of high added value products, a quick sedimentation behavior, or a capacity for growing mixotrophically. Finally, to combine most of the achievements from key areas and to design integrated recycling systems (IRS) should be an ultimate and rewarding goal. PMID:14623045

  16. Repairing an offshore jacket structure proves cost effective

    SciTech Connect

    Still, J.R.; Blackwood, V.

    2000-05-01

    During inclement weather in the southern North Sea, an off-shore supply boat collided with a 25-year-old gas production platform. The impact occurred just over 2 m (5.56 ft) from the lowest annual tide and was sufficient to buckle, then shear, one end of a horizontal bracing from the jacket leg and to cause further damage at a node joint. Inspection personnel performed an initial examination of the damage to the eight-leg jacket structure using rope access techniques (abseiling), which offered substantial cost saving over erecting scaffolding. A structural analysis confirmed the jacket's integrity was not impaired and loss of the horizontal bracing would not significantly affect the structure. The analysis also confirmed repair of the node weld cracks and of the sheared area on the leg should be performed as soon as practical. In the end, the repair went smoothly. The repair area was above the waterline, and the weather cooperated perfectly. The repairs were done using rope access techniques, and using austenitic electrodes reduced the possibility of HAZ hydrogen cracking. Nondestructive examination confirmed no cracking had been experienced and no other defects existed. Indeed, this methodology is considered extremely practical, cost effective and ideal for use on offshore structures--with damage close to the waterline, and with the need to execute immediate repairs.

  17. Cost-Effectiveness in Low- and Middle-Income Countries

    PubMed Central

    Shillcutt, Samuel D.; Walker, Damian G.; Goodman, Catherine A.; Mills, Anne J.

    2010-01-01

    Cost-effectiveness analysis (CEA) is increasingly important in public health decision making, including in low- and middle-income countries. The decision makers' valuation of a unit of health gain, or ceiling ratio (λ), is important in CEA as the relative value against which acceptability is defined, although values are usually chosen arbitrarily in practice. Reference case estimates for λ are useful to promote consistency, facilitate new developments in decision analysis, compare estimates against benefit-cost ratios from other economic sectors, and explicitly inform decisions about equity in global health budgets. The aim of this article is to discuss values for λ used in practice, including derivation based on affordability expectations (such as $US150 per disability-adjusted life-year [DALY]), some multiple of gross national income or gross domestic product, and preference-elicitation methods, and explore the implications associated with each approach. The background to the debate is introduced, the theoretical bases of current values are reviewed, and examples are given of their application in practice. Advantages and disadvantages of each method for defining λ are outlined, followed by an exploration of methodological and policy implications. PMID:19888791

  18. Cost-Effective Marine Protection - A Pragmatic Approach

    PubMed Central

    Oinonen, Soile; Hyytiäinen, Kari; Ahlvik, Lassi; Laamanen, Maria; Lehtoranta, Virpi; Salojärvi, Joona; Virtanen, Jarno

    2016-01-01

    This paper puts forward a framework for probabilistic and holistic cost-effectiveness analysis to provide support in selecting the least-cost set of measures to reach a multidimensional environmental objective. Following the principles of ecosystem-based management, the framework includes a flexible methodology for deriving and populating criteria for effectiveness and costs and analyzing complex ecological-economic trade-offs under uncertainty. The framework is applied in the development of the Finnish Programme of Measures (PoM) for reaching the targets of the EU Marine Strategy Framework Directive (MSFD). The numerical results demonstrate that substantial cost savings can be realized from careful consideration of the costs and multiple effects of management measures. If adopted, the proposed PoM would yield improvements in the state of the Baltic Sea, but the overall objective of the MSFD would not be reached by the target year of 2020; for various environmental and administrative reasons, it would take longer for most measures to take full effect. PMID:26751965

  19. Deactivating a major nuclear fuels reprocessing facility cost effectively

    SciTech Connect

    LeBaron, G.J.

    1997-08-15

    This paper describes three key processes used in deactivating the Plutonium Uranium Extraction (PUREX) Facility, a large, complex nuclear reprocessing facility, 15 months ahead of schedule and $77 million under budget. The organization was reengineered to refine its business processes and more effectively organize around the deactivation work scope. Multi-disciplined work teams were formed to be self-sufficient and empowered to make decisions and perform work. A number of benefits were realized by reengineering. A comprehensive process to develop end points which clearly identified specific results and the post-project facility configuration was developed so all areas of a facility were addressed. Clear and specific end points allowed teams to focus on completing deactivation activities and helped ensure there were no unfulfilled end-of-project expectations. The RCRA regulations require closure of permitted facilities within 180 days after cessation of operations which may essentially necessitate decommissioning. A more cost effective approach was adopted which significantly reduced risk to human health and the environment by taking the facility to a passive, safe, inexpensive-to-maintain surveillance and maintenance condition (deactivation) prior to disposition. PUREX thus became the first large reprocessing facility with active TSD [treatment, storage, and disposal] units to be deactivated under the RCRA regulations.

  20. DEVELOPMENT AND MANUFACTURE OF COST EFFECTIVE COMPOSITE DRILL PIPE

    SciTech Connect

    James C. Leslie; Jeffrey R. Jean; Hans Neubert; Lee Truong

    2001-10-30

    This technical report presents the engineering research and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report discusses and illustrates all progress in the first two years of this NETL/DOE supported program. The following have been accomplished and are reported in detail herein: (1) Specifications for both 5 5/16 inch and 3 3/8 inch composite drill pipe have been finalized. (2) All basic laboratory testing has been completed and has provide sufficient data for the selection of materials for the composite tubing, adhesives, and abrasion coatings. (3) Successful demonstration of composite/metal joint interfacial connection. (4) Upgrade of facilities to provide a functional pilot plant manufacturing facility. (5) Arrangements to have the 3 3/8 inch CDP used in a drilling operation early in C.Y. 2002. (6) Arrangements to have the 5 5/16 inch CDP marketed and produced by a major drill pipe manufacturer.

  1. Development and Manufacture of Cost Effective Composite Drill Pipe

    SciTech Connect

    James C. Leslie; Jeffrey R. Jean; Hans Neubert; Lee Truong; James T. Heard

    2002-09-29

    This technical report presents the engineering research and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report reiterates the presentation made to DOE/NETL in Morgantown, WV on August 1st, 2002 with the addition of accomplishments made from that time forward until the issue date. The following have been accomplished and are reported in detail herein: {sm_bullet} Specifications for both 5-1/2'' and 1-5/8'' composite drill pipe have been finalized. {sm_bullet} Full scale testing of Short Radius (SR) CDP has been conducted. {sm_bullet} Successful demonstration of metal to composite interface (MCI) connection. {sm_bullet} Preparations for full scale manufacturing of ER/DW CDP have begun. {sm_bullet} Manufacturing facility rearranged to accommodate CDP process flow through plant. {sm_bullet} Arrangements to have the 3 3/8'' CDP used in 4 separate drilling applications in Oman, Oklahoma, and Texas.

  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. 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)

  4. Climate targets and cost-effective climate stabilization pathways

    NASA Astrophysics Data System (ADS)

    Held, H.

    2015-08-01

    Climate economics has developed two main tools to derive an economically adequate response to the climate problem. Cost benefit analysis weighs in any available information on mitigation costs and benefits and thereby derives an "optimal" global mean temperature. Quite the contrary, cost effectiveness analysis allows deriving costs of potential policy targets and the corresponding cost- minimizing investment paths. The article highlights pros and cons of both approaches and then focusses on the implications of a policy that strives at limiting global warming to 2 °C compared to pre-industrial values. The related mitigation costs and changes in the energy sector are summarized according to the IPCC report of 2014. The article then points to conceptual difficulties when internalizing uncertainty in these types of analyses and suggests pragmatic solutions. Key statements on mitigation economics remain valid under uncertainty when being given the adequate interpretation. Furthermore, the expected economic value of perfect climate information is found to be on the order of hundreds of billions of Euro per year if a 2°-policy were requested. Finally, the prospects of climate policy are sketched.

  5. A cost-effective strategy for nonoscillatory convection without clipping

    NASA Technical Reports Server (NTRS)

    Leonard, B. P.; Niknafs, H. S.

    1990-01-01

    Clipping of narrow extrema and distortion of smooth profiles is a well known problem associated with so-called high resolution nonoscillatory convection schemes. A strategy is presented for accurately simulating highly convective flows containing discontinuities such as density fronts or shock waves, without distorting smooth profiles or clipping narrow local extrema. The convection algorithm is based on non-artificially diffusive third-order upwinding in smooth regions, with automatic adaptive stencil expansion to (in principle, arbitrarily) higher order upwinding locally, in regions of rapidly changing gradients. This is highly cost effective because the wider stencil is used only where needed-in isolated narrow regions. A recently developed universal limiter assures sharp monotonic resolution of discontinuities without introducing artificial diffusion or numerical compression. An adaptive discriminator is constructed to distinguish between spurious overshoots and physical peaks; this automatically relaxes the limiter near local turning points, thereby avoiding loss of resolution in narrow extrema. Examples are given for one-dimensional pure convection of scalar profiles at constant velocity.

  6. Cost effective waste management through composting in Africa.

    PubMed

    Couth, R; Trois, C

    2012-12-01

    Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

  7. Distribution, Abundance, and Population Dynamics of Northern Squawfish, Walleye, Smallmouth Bass, and Channel Catfish in John Day Reservoir, 1986 Annual Report.

    SciTech Connect

    Beamesderfer, Raymond C.

    1987-04-01

    John Day Reservoir was sampled from 25 March to 1 September 1986 using gill nets, trap nets, boat electrofishers, hook and line, and an angler survey to collect 4945 northern squawfish Ptychocheilus oregonesis, 602 walleye Stizostedion vitreum 2894 smallmouth bass Micropterus dolomieui, and 563 channel catfish Icatalurus punctatus. Distribution, abundance and population parameters of each species were examined. One year growth, mortality, and relative year class strength was described.

  8. Cost-effective electric vehicle charging infrastructure siting for Delhi

    NASA Astrophysics Data System (ADS)

    Sheppard, Colin J. R.; Gopal, Anand R.; Harris, Andrew; Jacobson, Arne

    2016-06-01

    Plug-in electric vehicles (PEVs) represent a substantial opportunity for governments to reduce emissions of both air pollutants and greenhouse gases. The Government of India has set a goal of deploying 6-7 million hybrid and PEVs on Indian roads by the year 2020. The uptake of PEVs will depend on, among other factors like high cost, how effectively range anxiety is mitigated through the deployment of adequate electric vehicle charging stations (EVCS) throughout a region. The Indian Government therefore views EVCS deployment as a central part of their electric mobility mission. The plug-in electric vehicle infrastructure (PEVI) model—an agent-based simulation modeling platform—was used to explore the cost-effective siting of EVCS throughout the National Capital Territory (NCT) of Delhi, India. At 1% penetration in the passenger car fleet, or ˜10 000 battery electric vehicles (BEVs), charging services can be provided to drivers for an investment of 4.4 M (or 440/BEV) by siting 2764 chargers throughout the NCT of Delhi with an emphasis on the more densely populated and frequented regions of the city. The majority of chargers sited by this analysis were low power, Level 1 chargers, which have the added benefit of being simpler to deploy than higher power alternatives. The amount of public infrastructure needed depends on the access that drivers have to EVCS at home, with 83% more charging capacity required to provide the same level of service to a population of drivers without home chargers compared to a scenario with home chargers. Results also depend on the battery capacity of the BEVs adopted, with approximately 60% more charging capacity needed to achieve the same level of service when vehicles are assumed to have 57 km versus 96 km of range.

  9. A cost-effective target supply for inertial fusion energy

    NASA Astrophysics Data System (ADS)

    Goodin, D. T.; Alexander, N. B.; Brown, L. C.; Frey, D. T.; Gallix, R.; Gibson, C. R.; Maxwell, J. L.; Nobile, A.; Olson, C.; Petzoldt, R. W.; Raffray, R.; Rochau, G.; Schroen, D. G.; Tillack, M.; Rickman, W. S.; Vermillion, B.

    2004-12-01

    A central feature of an inertial fusion energy (IFE) power plant is a target that has been compressed and heated to fusion conditions by the energy input of the driver. This is true whether the driver is a laser system, heavy ion beams or Z-pinch system. The IFE target fabrication, injection and tracking programmes are focusing on methods that will scale to mass production. We are working closely with target designers, and power plant systems specialists, to make specifications and material selections that will satisfy a wide range of required and desirable target characteristics. One-of-a-kind capsules produced for today's inertial confinement fusion experiments are estimated to cost about US2500 each. Design studies of cost-effective power production from laser and heavy-ion driven IFE have suggested a cost goal of about 0.25-0.30 for each injected target (corresponding to ~10% of the 'electricity value' in a target). While a four orders of magnitude cost reduction may seem at first to be nearly impossible, there are many factors that suggest this is achievable. This paper summarizes the design, specifications, requirements and proposed manufacturing processes for the future for laser fusion, heavy ion fusion and Z-pinch driven targets. These target manufacturing processes have been developed—and are proposed—based on the unique materials science and technology programmes that are ongoing for each of the target concepts. We describe the paradigm shifts in target manufacturing methodologies that will be needed to achieve orders of magnitude reductions in target costs, and summarize the results of 'nth-of-a-kind' plant layouts and cost estimates for future IFE power plant fuelling. These engineering studies estimate the cost of the target supply in a fusion economy, and show that costs are within the range of commercial feasibility for electricity production.

  10. Cost effectiveness of magnetic resonance imaging in the neurosciences.

    PubMed Central

    Szczepura, A K; Fletcher, J; Fitz-Patrick, J D

    1991-01-01

    higher cost. Techniques for monitoring the cost effectiveness of this technology need to be developed. PMID:1819260

  11. Cost-effective electric vehicle charging infrastructure siting for Delhi

    NASA Astrophysics Data System (ADS)

    Sheppard, Colin J. R.; Gopal, Anand R.; Harris, Andrew; Jacobson, Arne

    2016-06-01

    Plug-in electric vehicles (PEVs) represent a substantial opportunity for governments to reduce emissions of both air pollutants and greenhouse gases. The Government of India has set a goal of deploying 6–7 million hybrid and PEVs on Indian roads by the year 2020. The uptake of PEVs will depend on, among other factors like high cost, how effectively range anxiety is mitigated through the deployment of adequate electric vehicle charging stations (EVCS) throughout a region. The Indian Government therefore views EVCS deployment as a central part of their electric mobility mission. The plug-in electric vehicle infrastructure (PEVI) model—an agent-based simulation modeling platform—was used to explore the cost-effective siting of EVCS throughout the National Capital Territory (NCT) of Delhi, India. At 1% penetration in the passenger car fleet, or ∼10 000 battery electric vehicles (BEVs), charging services can be provided to drivers for an investment of 4.4 M (or 440/BEV) by siting 2764 chargers throughout the NCT of Delhi with an emphasis on the more densely populated and frequented regions of the city. The majority of chargers sited by this analysis were low power, Level 1 chargers, which have the added benefit of being simpler to deploy than higher power alternatives. The amount of public infrastructure needed depends on the access that drivers have to EVCS at home, with 83% more charging capacity required to provide the same level of service to a population of drivers without home chargers compared to a scenario with home chargers. Results also depend on the battery capacity of the BEVs adopted, with approximately 60% more charging capacity needed to achieve the same level of service when vehicles are assumed to have 57 km versus 96 km of range.

  12. Cost-effectiveness of a helpline for suicide prevention.

    PubMed

    Pil, Lore; Pauwels, Kirsten; Muijzers, Ekke; Portzky, Gwendolyn; Annemans, Lieven

    2013-07-01

    We evaluated the cost-effectiveness and budget impact of a suicide helpline in Belgium, consisting of a telephone- and a chat service. An age- and gender-dependent Markov model with a ten-year time horizon and a one-year cycle length was developed, assuming a societal perspective, to predict cumulative costs and quality-adjusted life-years (QALYs) in the helpline users. The model included six transition states: the initial state (at risk), first attempt, re-attempt, follow-up, suicide and death from other causes. Data on the effect of the helpline and costs associated with model states were obtained from the literature. One-way and probabilistic sensitivity analyses were performed to capture uncertainty. In addition, the budget impact of the helpline was analysed. Over ten years, the telephone- as well as the chat service could avoid about 36% of suicides and attempts in this high-risk population. In males, 0.063 QALYs (95% confidence interval, CI 0.030-0.097) and 0.035 QALYs (95%CI -0.026-0.096) were gained by users of the telephone- and chat service respectively. The corresponding values for females were 0.019 QALYs (95%CI -0.015-0.052) and a QALY-neutral result of -0.005 (95%CI -0.071-0.062). There were net societal savings of respectively €2382 (95%CI 1953-2859) and €2282 (95%CI 1855-2758) in male users; €2171 (95%CI 1735-2664) and €2458 (95%CI 1945-3025) in female users. At the population level, an investment of €218,899 saved €1,452,022 for the public health service (national health insurance), mainly due to the telephone service. The analysis predicted that both means of telemedicine for suicide prevention in Flanders are cost-saving, and have a modest effect on QALYs.

  13. Cost effective waste management through composting in Africa

    SciTech Connect

    Couth, R.; Trois, C.

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer The financial/social/institutional sustainability of waste management in Africa is analysed. Black-Right-Pointing-Pointer This note is a compendium of a study on the potential for GHG control via improved zero waste in Africa. Black-Right-Pointing-Pointer This study provides the framework for Local Authorities for realizing sustained GHG reductions. - Abstract: Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

  14. Manufactured Homes Simulated Thermal Analysis and Cost Effectiveness Report.

    SciTech Connect

    Baylon, David

    1990-05-17

    In 1988 and 1989, 150 manufactured homes were built to comply with Super Good Cents (SGC) specifications adapted from the existing specifications for site-built homes under the Residential Construction Demonstration Project (RCDP). Engineering calculations and computer simulations were used to estimate the effects of the SGC specifications on the thermal performance of the homes. These results were compared with consumer costs to establish the cost-effectiveness of individual measures. Heat loss U-factors for windows, walls, floors and ceilings were established using the standard ASHRAE parallel heat flow method. Adjustments resulted in higher U-factors for ceilings and floors than assumed at the time the homes were approved as meeting the SGC specifications. Except for those homes which included heat pumps, most of the homes did not meet the SGC compliance standards. Nonetheless these homes achieved substantial reductions in overall heat loss rate (UA) compared to UAs estimated for the same homes using the standard insulation packages provided by the manufacturers in the absence of the RCDP program. Homes with conventional electric furnaces showed a 35% reduction in total UA while homes with heat pumps had a 25% reduction. A regression analysis showed no significant relationship between climate zone, manufacturer and UA. A modified version of SUNDAY building simulation program which simulates duct and heat pump performance was used to model the thermal performance of each RCDP home as built and the same home as it would have been built without SGC specifications (base case). Standard assumptions were used for thermostat setpoint, thermal mass, internal gains and infiltration rates. 11 refs., 5 figs., 5 tabs.

  15. Comparison of harvest scenarios for the cost-effective suppression of Lake Trout in Swan Lake, Montana

    USGS Publications Warehouse

    Syslo, John M.; Guy, Christopher S.; Cox, Benjamin S.

    2013-01-01

    Given the large amount of resources required for long-term control or eradication projects, it is important to assess strategies and associated costs and outcomes before a particular plan is implemented. We developed a population model to assess the cost-effectiveness of mechanical removal strategies for suppressing long-term abundance of nonnative Lake Trout Salvelinus namaycush in Swan Lake, Montana. We examined the efficacy of targeting life stages (i.e., juveniles or adults) using temporally pulsed fishing effort for reducing abundance and program cost. Exploitation rates were high (0.80 for juveniles and 0.68 for adults) compared with other lakes in the western USA with Lake Trout suppression programs. Harvesting juveniles every year caused the population to decline, whereas harvesting only adults caused the population to increase above carrying capacity. Simultaneous harvest of juveniles and adults was required to cause the population to collapse (i.e., 95% reduction relative to unharvested abundance) with 95% confidence. The population could collapse within 15 years for a total program cost of US$1,578,480 using the most aggressive scenario. Substantial variation in cost existed among harvest scenarios for a given reduction in abundance; however, total program cost was minimized when collapse was rapid. Our approach provides a useful case study for evaluating long-term mechanical removal options for fish populations that are not likely to be eradicated.

  16. A simple cost-effective method of microsurgical simulation training: the turkey wing model.

    PubMed

    Bates, Benjamin J; Wimalawansa, Sunishka M; Monson, Benjamin; Rymer, Michael C; Shapiro, Ryan; Johnson, R Michael

    2013-11-01

    The rat femoral artery (RFA) anastomosis model has been the gold standard in microsurgical simulation training. While effective, live animal use requires animal use committee regulation and costly maintenance. Our institution's animal laboratory is remote to the hospital, limiting access by our busy surgical residents with their limited duty hours. We present an alternative convenient, cost-effective model. Ten frozen turkey wings were divided into distal and proximal segments. Vessel diameter, length, and anastomosis perfusion were assessed. Proximal brachial arteries ("humeral" segments) measured 8.85 ± 1.14 cm long with diameter 1.69 ± 0.27 mm. Distal brachial arteries ("forearm") measured 10.5 ± 2.06 cm long with diameter 1.25 ± 0.25 mm. An 8-lb box (~20 wings) cost $13.76. Separate use of the segments provides two training sessions with $0.35 per session effective cost. Our average cost for RFA microsurgical training sessions was $120 dollars for a single rat 2-hour session and $66 per rat if a maximum crate load of six rats was used. Besides significant cost, not all training programs are equipped to house, care for, and use rats in microsurgical training. We now use turkey wings for microvascular training. They are cheap, abundant, readily accessible for training, and consistent with tissue quality and vessel size approximating human systems.

  17. Cost-effective targeting of conservation investments to reduce the northern Gulf of Mexico hypoxic zone.

    PubMed

    Rabotyagov, Sergey S; Campbell, Todd D; White, Michael; Arnold, Jeffrey G; Atwood, Jay; Norfleet, M Lee; Kling, Catherine L; Gassman, Philip W; Valcu, Adriana; Richardson, Jeffrey; Turner, R Eugene; Rabalais, Nancy N

    2014-12-30

    A seasonally occurring summer hypoxic (low oxygen) zone in the northern Gulf of Mexico is the second largest in the world. Reductions in nutrients from agricultural cropland in its watershed are needed to reduce the hypoxic zone size to the national policy goal of 5,000 km(2) (as a 5-y running average) set by the national Gulf of Mexico Task Force's Action Plan. We develop an integrated assessment model linking the water quality effects of cropland conservation investment decisions on the more than 550 agricultural subwatersheds that deliver nutrients into the Gulf with a hypoxic zone model. We use this integrated assessment model to identify the most cost-effective subwatersheds to target for cropland conservation investments. We consider targeting of the location (which subwatersheds to treat) and the extent of conservation investment to undertake (how much cropland within a subwatershed to treat). We use process models to simulate the dynamics of the effects of cropland conservation investments on nutrient delivery to the Gulf and use an evolutionary algorithm to solve the optimization problem. Model results suggest that by targeting cropland conservation investments to the most cost-effective location and extent of coverage, the Action Plan goal of 5,000 km(2) can be achieved at a cost of $2.7 billion annually. A large set of cost-hypoxia tradeoffs is developed, ranging from the baseline to the nontargeted adoption of the most aggressive cropland conservation investments in all subwatersheds (estimated to reduce the hypoxic zone to less than 3,000 km(2) at a cost of $5.6 billion annually).

  18. Cost-effectiveness analysis of risk-reduction measures to reach water safety targets.

    PubMed

    Lindhe, Andreas; Rosén, Lars; Norberg, Tommy; Bergstedt, Olof; Pettersson, Thomas J R

    2011-01-01

    Identifying the most suitable risk-reduction measures in drinking water systems requires a thorough analysis of possible alternatives. In addition to the effects on the risk level, also the economic aspects of the risk-reduction alternatives are commonly considered important. Drinking water supplies are complex systems and to avoid sub-optimisation of risk-reduction measures, the entire system from source to tap needs to be considered. There is a lack of methods for quantification of water supply risk reduction in an economic context for entire drinking water systems. The aim of this paper is to present a novel approach for risk assessment in combination with economic analysis to evaluate risk-reduction measures based on a source-to-tap approach. The approach combines a probabilistic and dynamic fault tree method with cost-effectiveness analysis (CEA). The developed approach comprises the following main parts: (1) quantification of risk reduction of alternatives using a probabilistic fault tree model of the entire system; (2) combination of the modelling results with CEA; and (3) evaluation of the alternatives with respect to the risk reduction, the probability of not reaching water safety targets and the cost-effectiveness. The fault tree method and CEA enable comparison of risk-reduction measures in the same quantitative unit and consider costs and uncertainties. The approach provides a structured and thorough analysis of risk-reduction measures that facilitates transparency and long-term planning of drinking water systems in order to avoid sub-optimisation of available resources for risk reduction.

  19. Cost-effective targeting of conservation investments to reduce the northern Gulf of Mexico hypoxic zone

    PubMed Central

    Rabotyagov, Sergey S.; Campbell, Todd D.; White, Michael; Arnold, Jeffrey G.; Atwood, Jay; Norfleet, M. Lee; Kling, Catherine L.; Gassman, Philip W.; Valcu, Adriana; Richardson, Jeffrey; Turner, R. Eugene; Rabalais, Nancy N.

    2014-01-01

    A seasonally occurring summer hypoxic (low oxygen) zone in the northern Gulf of Mexico is the second largest in the world. Reductions in nutrients from agricultural cropland in its watershed are needed to reduce the hypoxic zone size to the national policy goal of 5,000 km2 (as a 5-y running average) set by the national Gulf of Mexico Task Force’s Action Plan. We develop an integrated assessment model linking the water quality effects of cropland conservation investment decisions on the more than 550 agricultural subwatersheds that deliver nutrients into the Gulf with a hypoxic zone model. We use this integrated assessment model to identify the most cost-effective subwatersheds to target for cropland conservation investments. We consider targeting of the location (which subwatersheds to treat) and the extent of conservation investment to undertake (how much cropland within a subwatershed to treat). We use process models to simulate the dynamics of the effects of cropland conservation investments on nutrient delivery to the Gulf and use an evolutionary algorithm to solve the optimization problem. Model results suggest that by targeting cropland conservation investments to the most cost-effective location and extent of coverage, the Action Plan goal of 5,000 km2 can be achieved at a cost of $2.7 billion annually. A large set of cost-hypoxia tradeoffs is developed, ranging from the baseline to the nontargeted adoption of the most aggressive cropland conservation investments in all subwatersheds (estimated to reduce the hypoxic zone to less than 3,000 km2 at a cost of $5.6 billion annually). PMID:25512489

  20. EPICE-HIV: An Epidemiologic Cost-Effectiveness Model for HIV Treatment

    PubMed Central

    Vandewalle, Björn; Llibre, Josep M.; Parienti, Jean-Jacques; Ustianowski, Andrew; Camacho, Ricardo; Smith, Colette; Miners, Alec; Ferreira, Diana; Félix, Jorge

    2016-01-01

    The goal of this research was to establish a new and innovative framework for cost-effectiveness modeling of HIV-1 treatment, simultaneously considering both clinical and epidemiological outcomes. EPICE-HIV is a multi-paradigm model based on a within-host micro-simulation model for the disease progression of HIV-1 infected individuals and an agent-based sexual contact network (SCN) model for the transmission of HIV-1 infection. It includes HIV-1 viral dynamics, CD4+ T cell infection rates, and pharmacokinetics/pharmacodynamics modeling. Disease progression of HIV-1 infected individuals is driven by the interdependent changes in CD4+ T cell count, changes in plasma HIV-1 RNA, accumulation of resistance mutations and adherence to treatment. The two parts of the model are joined through a per-sexual-act and viral load dependent probability of disease transmission in HIV-discordant couples. Internal validity of the disease progression part of the model is assessed and external validity is demonstrated in comparison to the outcomes observed in the STaR randomized controlled clinical trial. We found that overall adherence to treatment and the resulting pattern of treatment interruptions are key drivers of HIV-1 treatment outcomes. Our model, though largely independent of efficacy data from RCT, was accurate in producing 96-week outcomes, qualitatively and quantitatively comparable to the ones observed in the STaR trial. We demonstrate that multi-paradigm micro-simulation modeling is a promising tool to generate evidence about optimal policy strategies in HIV-1 treatment, including treatment efficacy, HIV-1 transmission, and cost-effectiveness analysis. PMID:26870960

  1. EPICE-HIV: An Epidemiologic Cost-Effectiveness Model for HIV Treatment.

    PubMed

    Vandewalle, Björn; Llibre, Josep M; Parienti, Jean-Jacques; Ustianowski, Andrew; Camacho, Ricardo; Smith, Colette; Miners, Alec; Ferreira, Diana; Félix, Jorge

    2016-01-01

    The goal of this research was to establish a new and innovative framework for cost-effectiveness modeling of HIV-1 treatment, simultaneously considering both clinical and epidemiological outcomes. EPICE-HIV is a multi-paradigm model based on a within-host micro-simulation model for the disease progression of HIV-1 infected individuals and an agent-based sexual contact network (SCN) model for the transmission of HIV-1 infection. It includes HIV-1 viral dynamics, CD4+ T cell infection rates, and pharmacokinetics/pharmacodynamics modeling. Disease progression of HIV-1 infected individuals is driven by the interdependent changes in CD4+ T cell count, changes in plasma HIV-1 RNA, accumulation of resistance mutations and adherence to treatment. The two parts of the model are joined through a per-sexual-act and viral load dependent probability of disease transmission in HIV-discordant couples. Internal validity of the disease progression part of the model is assessed and external validity is demonstrated in comparison to the outcomes observed in the STaR randomized controlled clinical trial. We found that overall adherence to treatment and the resulting pattern of treatment interruptions are key drivers of HIV-1 treatment outcomes. Our model, though largely independent of efficacy data from RCT, was accurate in producing 96-week outcomes, qualitatively and quantitatively comparable to the ones observed in the STaR trial. We demonstrate that multi-paradigm micro-simulation modeling is a promising tool to generate evidence about optimal policy strategies in HIV-1 treatment, including treatment efficacy, HIV-1 transmission, and cost-effectiveness analysis. PMID:26870960

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

    PubMed

    Sinkey, Rachel G; Odibo, Anthony O

    2016-06-01

    Cost-effectiveness analyses allow assessment of whether marginal gains from new technology are worth increased costs. Several studies have examined cost-effectiveness of Down syndrome (DS) screening and found it to be cost-effective. Noninvasive prenatal screening also appears to be cost-effective among high-risk women with respect to DS screening, but not for the general population. Chromosomal microarray (CMA) is a genetic sequencing method superior to but more expensive than karyotype. In light of CMAs greater ability to detect genetic abnormalities, it is cost-effective when used for prenatal diagnosis of an anomalous fetus. This article covers methodology and salient issues of cost-effectiveness. PMID:27235909

  3. Cost-effectiveness of a Multicondition Collaborative Care Intervention

    PubMed Central

    Katon, Wayne; Russo, Joan; Lin, Elizabeth H. B.; Schmittdiel, Julie; Ciechanowski, Paul; Ludman, Evette; Peterson, Do; Young, Bessie; Von Korff, Michael

    2013-01-01

    Context Patients with depression and poorly controlled diabetes mellitus, coronary heart disease (CHD), or both have higher medical complication rates and higher health care costs, suggesting that more effective care management of psychiatric and medical disease control might also reduce medical service use and enhance quality of life. Objective To evaluate the cost-effectiveness of a multicondition collaborative treatment program (TEAM-care) compared with usual primary care (UC) in outpatients with depression and poorly controlled diabetes or CHD. Design Randomized controlled trial of a systematic care management program aimed at improving depression scores and hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-C) levels. Setting Fourteen primary care clinics of an integrated health care system. Patients Population-based screening identified 214 adults with depressive disorder and poorly controlled diabetes or CHD. Intervention Physician-supervised nurses collaborated with primary care physicians to provide treatment of multiple disease risk factors. Main Outcome Measures Blinded assessments evaluated depressive symptoms, SBP, and HbA1c at baseline and at 6, 12, 18, and 24 months. Fasting LDL-C concentration was assessed at baseline and at 12 and 24 months. Health plan accounting records were used to assess medical service costs. Quality-adjusted life-years (QALYs) were assessed using a previously developed regression model based on intervention vs UC differences in HbA1c, LDL-C, and SBP levels over 24 months. Results Over 24 months, compared with UC controls, intervention patients had a mean of 114 (95% CI, 79 to 149) additional depression-free days and an estimated 0.335 (95% CI, −0.18 to 0.85) additional QALYs. Intervention patients also had lower mean outpatient health costs of $594 per patient (95% CI, −$3241 to $2053) relative to UC patients. Conclusions For adults with depression and poorly controlled

  4. Biogeologic Carbon Sequestration - a Cost-Effective Proposal

    NASA Astrophysics Data System (ADS)

    Shaw, G. H.; Kuhns, R.

    2009-05-01

    Carbon sequestration has been proposed as a strategy for reducing the impact of carbon dioxide emissions from burning of fossil fuels. There are two main routes: 1) capture CO2 emissions from power plants or other large point sources followed by some form of "burial/sequestration", and 2) extraction of CO2 from the ambient atmosphere (involving substantial concentration relative to atmospheric levels) also followed by burial/sequestration. In either case the goal is to achieve significant long-term isolation of CO2 at an economically sustainable price, perhaps measured by some "market price" for CO2, such as the European carbon futures market, where the price is now (2/3/09) about 14-15/tonne of CO2. The second approach, removal of CO2 from the atmosphere, has the potential benefit of reversing the previous buildup of atmospheric CO2, and perhaps even providing a means to "adjust" terrestrial climate by regulating atmospheric CO2 concentrations. For the present, ideas of planetary "geo-engineering" are not as popular as reducing the impact of continued CO2 emissions. In fact, the energy and capital costs of extraction from a dilute atmosphere appear to make this approach uneconomical. Proposals to fertilize the open ocean suffer from concerns about long term ecosystem effects, to say nothing of a lack of verifiability. There is, however, an approach using biological systems that can not only extract significant amounts of CO2, but can do so cost-effectively. Lakes are known in which primary productivity approaches or exceeds 1gm C/cm2-yr. This equates to removal of 35,000 tonnes of CO2 per km2 per year, with a "market value" of about 500,000/yr. Such productivity only occurs under highly eutrophic conditions, and presumably requires significant nutrient additions. As such it would be unthinkable to pursue this technique on a large scale in extant lakes. If, however, it is possible to produce one or more large artificial lakes under acceptable conditions it is

  5. Palm oil: a healthful and cost-effective dietary component.

    PubMed

    Ong, A S H; Goh, S H

    2002-03-01

    Palm oil is an excellent choice for food manufacturers because of its nutritional benefits and versatility. The oil is highly structured to contain predominantly oleic acid at the sn2-position in the major triacylglycerols to account for the beneficial effects described in numerous nutritional studies. Oil quality and nutritional benefits have been assured for the variety of foods that can be manufactured from the oil directly or from blends with other oils while remaining trans-free. The oxidative stability coupled with the cost-effectiveness is unparalleled among cholesterol-free oils, and these values can be extended to blends of polyunsaturated oils to provide long shelf-life. Presently the supply of genetic-modification-free palm oil is assured at economic prices, since the oil palm is a perennial crop with unparalleled productivity. Numerous studies have confirmed the nutritional value of palm oil as a result of the high monounsaturation at the crucial 2-position of the oil's triacylglycerols, making the oil as healthful as olive oil. It is now recognized that the contribution of dietary fats to blood lipids and cholesterol modulation is a consequence of the digestion, absorption, and metabolism of the fats. Lipolytic hydrolysis of palm oil glycerides containing predominantly oleic acid at the 2 position and palmitic and stearic acids at the 1 and 3 positions allows for the ready absorption of the 2-monoacrylglycerols while the saturated free fatty acids remain poorly absorbed. Dietary palm oil in balanced diets generally reduced blood cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides while raising the high-density lipoprotein (HDL) cholesterol. Improved lipoprotein(a) and apo-A1 levels were also demonstrated from palm oil diets; an important benefits also comes from the lowering of blood triglycerides (or reduced fat storage) as compared with those from polyunsaturated fat diets. Virgin palm oil also provides carotenes apart from

  6. Cost-effectiveness of translocation options for a threatened waterbird.

    PubMed

    Martínez-Abraín, Alejandro; Regan, Helen M; Viedma, Covadonga; Villuendas, Elena; Bartolomé, Miguel Angel; Gómez, Juan Antonio; Oro, Daniel

    2011-08-01

    Reintroduction of captive-reared animals has become increasingly popular in recent decades as a conservation technique, but little is known of how demographic factors affect the success of reintroductions. We believe whether the increase in population persistence associated with reintroduction is sufficient to warrant the cost of rearing and relocating individuals should be considered as well. We examined the trade-off between population persistence and financial cost of a reintroduction program for Crested Coots (Fulica cristata). This species was nearly extirpated from southern Europe due to unsustainable levels of hunting and reduction in amount and quality of habitat. We used a stochastic, stage-based, single-sex, metapopulation model with site-specific parameters to examine the demographic effects of releasing juveniles or adults in each population for a range of durations. We parameterized the model with data from an unsuccessful reintroduction program in which juvenile captive-bred Crested Coots were released between 2000 and 2009. Using economic data from the captive-breeding program, we also determined whether the strategy that maximized abundance coincided with the least expensive strategy. Releasing adults resulted in slightly larger final abundance than the release of nonreproductive juveniles. Both strategies were equally poor in achieving a viable metapopulation, but releasing adults was 2-4 times more expensive than releasing juveniles. To obtain a metapopulation that would be viable for 30 years, fecundity in the wild would need to increase to the values observed in captivity and juvenile survival would need to increase to almost unity. We suggest that the most likely way to increase these vital rates is by increasing habitat quality at release sites. PMID:21676027

  7. 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.

  8. Cost-effective and full-field method for measuring vibration of loudspeaker membrane using fringe projection

    NASA Astrophysics Data System (ADS)

    Wang, Jian; Li, Yong; Zhang, Zhiliang; Gao, Peng

    2014-11-01

    We proposed a cost-effective and full-field method for measuring vibration of loudspeaker using general industrial camera and fringe projection. The loudspeaker is excited by a sinusoidal signal. The fringe pattern is projected on the measured loudspeaker membrane that is dynamically deformed. Then the deformed fringes are captured by a camera. A trigger generation circuit is designed to control the camera. The Fourier Transform Profilometry (FTP) is adopted for 3D shape reconstruction. The validity of this method is approved by experiments. The cost of proposed measurement system is dramatically lower than that using high-speed camera.

  9. Design and Construction of a Cost-Effective Spinning Disk System for Live Imaging of Inner Ear Tissue.

    PubMed

    Ceriani, Federico; Ciubotaru, Catalin D; Bortolozzi, Mario; Mammano, Fabio

    2016-01-01

    Confocal imaging of fluorescent probes offers a powerful, non-invasive tool which enables data collection from vast population of cells at high spatial and temporal resolution. Spinning disk confocal microscopy parallelizes the imaging process permitting the study of dynamic events in populations of living cells on the millisecond time scale. Several spinning disk microscopy solutions are commercially available, however these are often poorly configurable and relatively expensive. This chapter describes a procedure to assemble a cost-effective homemade spinning disk system for fluorescence microscopy, which is highly flexible and easily configurable. We finally illustrate a reliable protocol to obtain high-quality Ca(2+) and voltage imaging data from cochlear preparations.

  10. Solar abundance of osmium

    PubMed Central

    Jacoby, George; Aller, Lawrence H.

    1976-01-01

    The abundance parameter, log gfA, where g is the statistical weight of the lower level, f is the oscillator strength, and A is the abundance (by numbers of atoms with respect to hydrogen), has been derived for three lines of osmium by a method of spectrum synthesis. An apparent discordance of the derived abundance with that found from the carbonaceous chondrites is probably to be attributed primarily to errors in the f-values, and blending with unknown contributors. PMID:16592314

  11. 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.

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

    PubMed Central

    Bünger, Cody E.; Laurberg, Ida; Christensen, Finn B.

    2007-01-01

    Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full-scale economic evaluation, including extra-hospital effects such as service utilization in the primary health care sector and return-to-work, is conducted. The objective of this study was to conduct such evalution i.e. investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion (indicated by chronic low back pain and localized pathology) were randomized 3 months after their spinal fusion. Validated pain- and disability index scales were applied at baseline and at 2 years postoperative. Costs were measured in a full-scale societal perspective. The probability of the behavioural approach being cost-effective was close to 1 given pain as the prioritized effect measure, and 0.8 to 0.6 (dependent on willingness to pay per effect unit) given disability as the prioritized effect measure. The probability of the exercise therapy approach being cost-effective was modest due to inferior effectiveness. Results proved robust to relevant sensitivity analysis although a differentiated cost-effectiveness ratio between males and females was suspected. In conclusion, a simple behavioural extension, of setting up group meetings for patients, to a regimen with a strict physiotherapeutic focus was found cost-effective, whereas the cost-effectiveness of increasing frequency and guidance of a traditional physiotherapeutic regimen was unlikely in present trial setting. PMID

  13. Evaluating the Cost-Effectiveness of a Freshman Studies Program on an Urban Campus.

    ERIC Educational Resources Information Center

    Murtuza, Athar; Ketkar, Kusum W.

    1995-01-01

    A study investigated the cost effectiveness of a Seton Hall University (New Jersey) freshman studies program designed to improve retention, stabilize enrollments, and enrich campus life. Data were analyzed from short- and long-term perspectives. Results indicate that, despite increasing costs, the program is a cost-effective approach to student…

  14. 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…

  15. Low cost space operations - Empty promise or future reality. [cost effectiveness problems of NASA programs

    NASA Technical Reports Server (NTRS)

    Bader, M.

    1976-01-01

    Organizational obstacles to the achievement of a cost-effective Space Shuttle service are examined. Among the factors considered are the difficulties of fostering concern for cost-effectiveness among the NASA research and development team and elimination of unnecessary systems and personnel. The effect of foreign or commercial competition and the extent to which governmental funding and control should be implemented are considered.

  16. Cost-Effectiveness of Management Training in the Informal Sector. Discussion Paper No. 101.

    ERIC Educational Resources Information Center

    Nubler, Irmgard

    A research project in the Ivory Coast, Kenya, and Tanzania evaluated the cost effectiveness of management training seminars for women entrepreneurs in the informal sector. Women, a large and growing part of entrepreneurs, had less access to needed resources, skills, and information than men. Reasons for failure to study the cost effectiveness and…

  17. Making Sense of Cost-Effectiveness and Benefit-Cost Analyses.

    ERIC Educational Resources Information Center

    Temkin, Sanford

    Although two economic methods, cost effectiveness and benefit-cost analysis, are frequently mentioned as useful tools for educational decision making, only one, cost effectiveness, has potential for making a contribution to this field. A benefit-cost analysis tries for each alternative to measure benefits and costs, which are then discounted to…

  18. Cost-Effectiveness Analysis of Early Reading Programs: A Demonstration with Recommendations for Future Research

    ERIC Educational Resources Information Center

    Hollands, Fiona M.; Kieffer, Michael J.; Shand, Robert; Pan, Yilin; Cheng, Henan; Levin, Henry M.

    2016-01-01

    We review the value of cost-effectiveness analysis for evaluation and decision making with respect to educational programs and discuss its application to early reading interventions. We describe the conditions for a rigorous cost-effectiveness analysis and illustrate the challenges of applying the method in practice, providing examples of programs…

  19. Cost-Effectiveness Analysis of Various Methods of Instruction in Developmental Mathematics.

    ERIC Educational Resources Information Center

    Carman, Robert A.

    This paper examined in a critical fashion the existing applications of cost-effectiveness analysis in education, particularly the study of instructional effectiveness in the community college. Various schemes for measuring costs of instruction such as cost benefit analysis, cost-effectiveness analysis and planning programming budgeting systems…

  20. The State of Cost-Benefit and Cost-Effectiveness Analyses in Education.

    ERIC Educational Resources Information Center

    Hummel-Rossi, Barbara; Ashdown, Jane

    2002-01-01

    Examines the state of cost-benefit and cost-effectiveness analysis in education, first examining the progress that has been made in these fields in the health and medical sectors. Explores one outstanding example of cost-benefit analysis and critiques four other educational evaluations. Synthesizes strengths of cost-effectiveness analysis in…

  1. 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…

  2. The cost-effectiveness of octreotide acetate in the treatment of carcinoid syndrome and VIPoma.

    PubMed

    Schonfeld, W H; Eikin, E P; Woltering, E A; Modlin, I M; Anthony, L; Villa, K F; Zagari, M

    1998-01-01

    Markov modeling was used to evaluate the cost-effectiveness of octreotide in treating carcinoid syndrome and VIPoma. For each condition, using octreotide was associated with doubled survival time. Octreotide was cost-effective for treating carcinoid tumor ($752 per additional year of life, two additional years on average), and cost saving for VIPoma.

  3. The Learning Curve Model for Analysing the Cost-Effectiveness of a Training System.

    ERIC Educational Resources Information Center

    Offir, Baruch; Katz, Yaacov J.

    1990-01-01

    Discussion of industrial-educational cooperation focuses on the Learning Curve model, which can be used to evaluate the cost effectiveness of learning programs. Cost effectiveness for homogeneous and heterogeneous groups is discussed, and the use of computers to gather information about learning achievement is considered. (Six references) (LRW)

  4. The Treatment of Challenging Behaviour in Intellectual Disabilities: Cost-Effectiveness Analysis

    ERIC Educational Resources Information Center

    Romeo, R.; Knapp, M.; Tyrer, P.; Crawford, M.; Oliver-Africano, P.

    2009-01-01

    Background: Antipsychotic drugs are used in the routine treatment of adults with intellectual disabilities (ID) and challenging behaviour in the UK despite limited evidence of their effectiveness. There is no evidence on their cost-effectiveness. Methods: The relative cost-effectiveness of risperidone, haloperidol and placebo in treating…

  5. Cost Effectiveness of Cooperative Vocational Education for Capstone and Diversified Occupations. Final Report.

    ERIC Educational Resources Information Center

    Welch, Frederick G.

    A study was conducted to develop baseline information about the cost effectiveness of cooperative vocational education to be used in teacher education programs in Pennsylvania. Information gathered included data on cost effectiveness, types of occupations for which students were prepared, the effect of school dropout and youth employment on local…

  6. 10 CFR 436.42 - Evaluation of Life-Cycle Cost Effectiveness.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Evaluation of Life-Cycle Cost Effectiveness. 436.42... PROGRAMS Agency Procurement of Energy Efficient Products § 436.42 Evaluation of Life-Cycle Cost...) ENERGY STAR qualified and FEMP designated products may be assumed to be life-cycle cost-effective. (b)...

  7. 10 CFR 436.42 - Evaluation of Life-Cycle Cost Effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Evaluation of Life-Cycle Cost Effectiveness. 436.42... PROGRAMS Agency Procurement of Energy Efficient Products § 436.42 Evaluation of Life-Cycle Cost...) ENERGY STAR qualified and FEMP designated products may be assumed to be life-cycle cost-effective. (b)...

  8. 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…

  9. Cost-Effectiveness of Interventions to Improve Moderate Physical Activity: A Study in Nine UK Sites

    ERIC Educational Resources Information Center

    Pringle, Andy; Cooke, Carlton; Gilson, Nicholas; Marsh, Kevin; McKenna, Jim

    2010-01-01

    Objective: With growing concerns to establish the value for returns on public health investment, there is a need to identify cost-effective physical activity interventions. This study measured change in moderate physical activity (MPA) in seven community-based intervention types, costs and cost-effectiveness of the interventions, and possible…

  10. Implementing a Cost Effectiveness Analyzer for Web-Supported Academic Instruction: A Campus Wide Analysis

    ERIC Educational Resources Information Center

    Cohen, Anat; Nachmias, Rafi

    2009-01-01

    This paper describes the implementation of a quantitative cost effectiveness analyzer for Web-supported academic instruction that was developed in Tel Aviv University during a long term study. The paper presents the cost effectiveness analysis of Tel Aviv University campus. Cost and benefit of 3,453 courses were analyzed, exemplifying campus-wide…

  11. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs AGENCY: Office of Management... updated discount rates are shown below. The discount rates in Appendix C are to be used for cost... Management and Budget. Appendix C (Revised December 2012) Discount Rates for Cost-Effectiveness,...

  12. Cost-Effectiveness Predictors in Chapter 1 Programs: The Minnesota Example.

    ERIC Educational Resources Information Center

    Fitzgerald, Nicholas B.; Hunt, Rodney K.

    Reductions in the funding of compensatory education along with observed discrepancies in per-pupil cost among equally effective schools created a compelling case for the study of the determinants of cost-effective Chapter 1 programs in the state of Minnesota. Cost-effectiveness (CE) indexes for Chapter 1 reading and math services reflected a ratio…

  13. 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…

  14. 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…

  15. Flame treatment of graphene oxides: cost-effective production of nanoporous graphene electrode for Lithium-ion batteries

    PubMed Central

    Jiang, Hao-Bo; Zhang, Yong-Lai; Zhang, Yi; Liu, Yan; Fu, Xiu-Yan; Liu, Yu-Qing; Wang, Chun-Dong; Sun, Hong-Bo

    2015-01-01

    A facile production of highly porous graphene foam by using flame treatment of graphene oxide (GO) is proposed. Highly porous architectures with randomly distributed micro-crack and micro-slit were produced due to the high temperature induced ruinous reduction and rapid expansion of GO. Synchronously, abundant oxygen-containing groups (OCGs) on GO sheets could be effectively removed after flame treatment, which renders significantly increased conductivity to the resultant flame reduced GO (FR-GO). The synergistic effect of micro/nanostructuring and the OCGs removal makes FR-GO a promising candidate for electrode materials. Compared with chemically reduced GO (CR-GO), FR-GO delivers much higher specific capacity. It gives us some hints that flame treatment of graphene-based material is a smart strategy for cost-effective production of anode materials for commercial application. PMID:26659254

  16. Flame treatment of graphene oxides: cost-effective production of nanoporous graphene electrode for Lithium-ion batteries.

    PubMed

    Jiang, Hao-Bo; Zhang, Yong-Lai; Zhang, Yi; Liu, Yan; Fu, Xiu-Yan; Liu, Yu-Qing; Wang, Chun-Dong; Sun, Hong-Bo

    2015-01-01

    A facile production of highly porous graphene foam by using flame treatment of graphene oxide (GO) is proposed. Highly porous architectures with randomly distributed micro-crack and micro-slit were produced due to the high temperature induced ruinous reduction and rapid expansion of GO. Synchronously, abundant oxygen-containing groups (OCGs) on GO sheets could be effectively removed after flame treatment, which renders significantly increased conductivity to the resultant flame reduced GO (FR-GO). The synergistic effect of micro/nanostructuring and the OCGs removal makes FR-GO a promising candidate for electrode materials. Compared with chemically reduced GO (CR-GO), FR-GO delivers much higher specific capacity. It gives us some hints that flame treatment of graphene-based material is a smart strategy for cost-effective production of anode materials for commercial application.

  17. Flame treatment of graphene oxides: cost-effective production of nanoporous graphene electrode for Lithium-ion batteries

    NASA Astrophysics Data System (ADS)

    Jiang, Hao-Bo; Zhang, Yong-Lai; Zhang, Yi; Liu, Yan; Fu, Xiu-Yan; Liu, Yu-Qing; Wang, Chun-Dong; Sun, Hong-Bo

    2015-12-01

    A facile production of highly porous graphene foam by using flame treatment of graphene oxide (GO) is proposed. Highly porous architectures with randomly distributed micro-crack and micro-slit were produced due to the high temperature induced ruinous reduction and rapid expansion of GO. Synchronously, abundant oxygen-containing groups (OCGs) on GO sheets could be effectively removed after flame treatment, which renders significantly increased conductivity to the resultant flame reduced GO (FR-GO). The synergistic effect of micro/nanostructuring and the OCGs removal makes FR-GO a promising candidate for electrode materials. Compared with chemically reduced GO (CR-GO), FR-GO delivers much higher specific capacity. It gives us some hints that flame treatment of graphene-based material is a smart strategy for cost-effective production of anode materials for commercial application.

  18. Caveat emptor NICE: biased use of cost-effectiveness is inefficient and inequitable

    PubMed Central

    Dowie, Jack; Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2015-01-01

    Concern with the threshold applied in cost-effectiveness analyses by bodies such as NICE distracts attention from their biased use of the principle. The bias results from the prior requirement that an intervention be effective (usually 'clinically effective') before its cost-effectiveness is considered. The underlying justification for the use of cost-effectiveness as a criterion, whatever the threshold adopted, is that decisions in a resource-constrained system have opportunity costs. Their existence rules out any restriction to those interventions that are 'incrementally cost-effective' at a chosen threshold and requires acceptance of those that are 'decrementally cost-effective' at the same threshold. Interventions that fall under the linear ICER line in the South-West quadrant of the cost-effectiveness plane are cost-effective because they create net health benefits, as do those in the North-East quadrant. If there is objection to the fact that they are cost-effective by reducing effectiveness as well as costs, it is possible to reject them, but only on policy grounds other than their failure to be cost-effective. Having established this, the paper considers and seeks to counter the arguments based on these other grounds. Most notably these include those proposing a different threshold in the South-West quadrant from the North-East one, i.e. propose a 'kinked ICER'. Another undesirable consequence of the biased use of cost-effectiveness is the failure to stimulate innovations that would increase overall health gain by being less effective in the condition concerned, but generate more benefits elsewhere. NICE can only reward innovations that cost more. PMID:27803795

  19. Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain.

    PubMed

    Taylor, Penny; Pezzullo, Lynne; Grant, Suzanne J; Bensoussan, Alan

    2014-09-01

    Cost-effectiveness is a major criterion underpinning decisions in mainstream health care. Acupuncture is increasingly used in patients with chronic lower back pain (LBP), but there is a lack of evidence on cost-effectiveness. The objective of this study was to assess the cost-effectiveness of acupuncture in alleviating chronic LBP either alone or in conjunction with standard care compared with patients receiving routine care, and/or sham. To determine effectiveness, we undertook meta-analyses which found a significant improvement in pain in those receiving acupuncture and standard care compared with those receiving standard care alone. For acupuncture and standard care vs. standard care and sham, a weak positive effect was found for weeks 12 to 16, but this was not significant. For acupuncture alone vs. standard care alone, a significant positive effect was found at week 8, but not at weeks 26 or 52. The main outcome parameters for our cost-effectiveness analysis were the incremental cost-effectiveness ratio (ICER) of acupuncture treatment presented as cost (A$) per disability-adjusted life-year (DALY) saved. The WHO benchmark for a very highly cost-effective intervention is one that costs less than gross domestic product per capita per quality-adjusted life-year (QALY) gained or DALY averted, or less than around $A52,000 in 2009 (the base year for the analysis). According to this threshold, acupuncture as a complement to standard care for relief of chronic LBP is highly cost-effective, costing around $48,562 per DALY avoided. When comorbid depression is alleviated at the same rate as pain, cost is around $18,960 per DALY avoided. Acupuncture as a substitute for standard care was not found to be cost-effective unless comorbid depression was included. According to the WHO cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy in patients with chronic LBP.

  20. Cost-effectiveness of tenofovir gel in urban South Africa: model projections of HIV impact and threshold product prices

    PubMed Central

    2014-01-01

    Background There is urgent need for effective HIV prevention methods that women can initiate. The CAPRISA 004 trial showed that a tenofovir-based vaginal microbicide had significant impact on HIV incidence among women. This study uses the trial findings to estimate the population-level impact of the gel on HIV and HSV-2 transmission, and price thresholds at which widespread product introduction would be as cost-effective as male circumcision in urban South Africa. Methods The estimated ‘per sex-act’ HIV and HSV-2 efficacies were imputed from CAPRISA 004. A dynamic HIV/STI transmission model, parameterised and fitted to Gauteng (HIV prevalence of 16.9% in 2008), South Africa, was used to estimate the impact of gel use over 15 years. Uptake was assumed to increase linearly to 30% over 10 years, with gel use in 72% of sex-acts. Full economic programme and averted HIV treatment costs were modelled. Cost per DALY averted is estimated and a microbicide price that equalises its cost-effectiveness to that of male circumcision is estimated. Results Using plausible assumptions about product introduction, we predict that tenofovir gel use could lead to a 12.5% and 4.9% reduction in HIV and HSV-2 incidence respectively, by year 15. Microbicide introduction is predicted to be highly cost-effective (under $300 per DALY averted), though the dose price would need to be just $0.12 to be equally cost-effective as male circumcision. A single dose or highly effective (83% HIV efficacy per sex-act) regimen would allow for more realistic threshold prices ($0.25 and $0.33 per dose, respectively). Conclusions These findings show that an effective coitally-dependent microbicide could reduce HIV incidence by 12.5% in this setting, if current condom use is maintained. For microbicides to be in the range of the most cost-effective HIV prevention interventions, product costs will need to decrease substantially. PMID:24405719

  1. Adsorption of dimethyl sulfide from aqueous solution by a cost-effective bamboo charcoal.

    PubMed

    Wang, Ming; Huang, Zheng-Hong; Liu, Guangjia; Kang, Feiyu

    2011-06-15

    The adsorption of dimethyl sulfide from an aqueous solution by a cost-effective bamboo charcoal from Dendrocalamus was studied in comparison with other carbon adsorbents. The bamboo charcoal exhibited superior adsorption on dimethyl sulfide compared with powdered activated carbons at different adsorbent dosages. The adsorption characteristics of dimethyl sulfide onto bamboo charcoal were investigated under varying experimental conditions such as particle size, contact time, initial concentration and adsorbent dosage. The dimethyl sulfide removal was enhanced from 31 to 63% as the particle size was decreased from 24-40 to >300 mesh for the bamboo charcoal. The removal efficiency increased with increasing the adsorbent dosage from 0.5 to 10mg, and reached 70% removal efficiency at 10mg adsorbed. The adsorption capacity (μg/g) increased with increasing concentration of dimethyl sulfide while the removal efficiency decreased. The adsorption process conforms well to a pseudo-second-order kinetics model. The adsorption of dimethyl sulfide is more appropriately described by the Freundlich isotherm (R(2), 0.9926) than by the Langmuir isotherm (R(2), 0.8685). Bamboo charcoal was characterized by various analytical methods to understand the adsorption mechanism. Bamboo charcoal is abundant in acidic and alcohol functional groups normally not observed in PAC. A distinct difference is that the superior mineral composition of Fe (0.4 wt%) and Mn (0.6 wt%) was detected in bamboo charcoal-elements not found in PAC. Acidic functional group and specific adsorption sites would be responsible for the strong adsorption of dimethyl sulfide onto bamboo charcoal of Dendrocalamus origin.

  2. Adsorption of dimethyl sulfide from aqueous solution by a cost-effective bamboo charcoal.

    PubMed

    Wang, Ming; Huang, Zheng-Hong; Liu, Guangjia; Kang, Feiyu

    2011-06-15

    The adsorption of dimethyl sulfide from an aqueous solution by a cost-effective bamboo charcoal from Dendrocalamus was studied in comparison with other carbon adsorbents. The bamboo charcoal exhibited superior adsorption on dimethyl sulfide compared with powdered activated carbons at different adsorbent dosages. The adsorption characteristics of dimethyl sulfide onto bamboo charcoal were investigated under varying experimental conditions such as particle size, contact time, initial concentration and adsorbent dosage. The dimethyl sulfide removal was enhanced from 31 to 63% as the particle size was decreased from 24-40 to >300 mesh for the bamboo charcoal. The removal efficiency increased with increasing the adsorbent dosage from 0.5 to 10mg, and reached 70% removal efficiency at 10mg adsorbed. The adsorption capacity (μg/g) increased with increasing concentration of dimethyl sulfide while the removal efficiency decreased. The adsorption process conforms well to a pseudo-second-order kinetics model. The adsorption of dimethyl sulfide is more appropriately described by the Freundlich isotherm (R(2), 0.9926) than by the Langmuir isotherm (R(2), 0.8685). Bamboo charcoal was characterized by various analytical methods to understand the adsorption mechanism. Bamboo charcoal is abundant in acidic and alcohol functional groups normally not observed in PAC. A distinct difference is that the superior mineral composition of Fe (0.4 wt%) and Mn (0.6 wt%) was detected in bamboo charcoal-elements not found in PAC. Acidic functional group and specific adsorption sites would be responsible for the strong adsorption of dimethyl sulfide onto bamboo charcoal of Dendrocalamus origin. PMID:21549503

  3. Abundance estimation and conservation biology

    USGS Publications Warehouse

    Nichols, J.D.; MacKenzie, D.I.

    2004-01-01

    should be focused on relationships between demographic processes such as survival and recruitment, the two quantities responsible for changes in abundance, rather than simply on the magnitudes of these quantities. They describe a type of Jolly–Seber capture–recapture model that permits inference about the underlying relationship between per capita recruitment rates and survival rates (Link & Barker, this volume). Implementation used Bayesian Markov Chain Monte Carlo methods and appeared to work well, yielding inferences about the relationship between recruitment and survival that were robust to selection of prior distribution. We believe that readers will find their arguments compelling, and we expect to see increased use of hierarchical modeling approaches in capture–recapture and related fields. Otto (presentation without paper) also recommended use of hierarchical models in analysis of multiple data sources dealing with population dynamics of North American mallards. He integrated survival inferences from ringing data, abundance information from aerial survey data, and recruitment information based on age ratios from a harvest survey. He used a Leslie matrix population projection model as an integrating framework and obtained estimates of breeding population size using all data.Otto’s approach also permitted inference about biases in estimated quantities. As with the work of Link & Barker (2004), we find Otto’s recommendation to use hierarchical models to integrate data from multiple sources to be very compelling. Alisauskas et al. (2004) report results of an analysis of capture–recapture data for a askatchewan population of white–winged scoters. They used the approach of Pradel (1996) to estimate population growth rate (See the PDF) directly. Estimates for 1975–1985 were quite low, but estimates for the recent period, 2000–2003,increased to values > 1. Parameter estimates for seniority, survival and per capita recruitment (Pradel, 1996) led to the

  4. Evaluating noninvasive genetic sampling techniques to estimate large carnivore abundance.

    PubMed

    Mumma, Matthew A; Zieminski, Chris; Fuller, Todd K; Mahoney, Shane P; Waits, Lisette P

    2015-09-01

    Monitoring large carnivores is difficult because of intrinsically low densities and can be dangerous if physical capture is required. Noninvasive genetic sampling (NGS) is a safe and cost-effective alternative to physical capture. We evaluated the utility of two NGS methods (scat detection dogs and hair sampling) to obtain genetic samples for abundance estimation of coyotes, black bears and Canada lynx in three areas of Newfoundland, Canada. We calculated abundance estimates using program capwire, compared sampling costs, and the cost/sample for each method relative to species and study site, and performed simulations to determine the sampling intensity necessary to achieve abundance estimates with coefficients of variation (CV) of <10%. Scat sampling was effective for both coyotes and bears and hair snags effectively sampled bears in two of three study sites. Rub pads were ineffective in sampling coyotes and lynx. The precision of abundance estimates was dependent upon the number of captures/individual. Our simulations suggested that ~3.4 captures/individual will result in a < 10% CV for abundance estimates when populations are small (23-39), but fewer captures/individual may be sufficient for larger populations. We found scat sampling was more cost-effective for sampling multiple species, but suggest that hair sampling may be less expensive at study sites with limited road access for bears. Given the dependence of sampling scheme on species and study site, the optimal sampling scheme is likely to be study-specific warranting pilot studies in most circumstances.

  5. Cost-effective test methods for Shuttle payloads

    NASA Technical Reports Server (NTRS)

    Tinker, Michael L.

    1993-01-01

    Techniques are discussed for deriving constrained vibration mode shapes for Space Shuttle payloads using unconstrained or free-boundary dynamic properties. Application of the residual flexibility method requires measurement of a set of free-boundary modes plus the residual flexibility of the payload-to-orbiter interfaces. The mass-additive approach involves the measurement of unconstrained modes and frequencies of a payload with large masses attached to the interfaces. In either case, the orbiter interfaces of the test-verified payload model are analytically constrained to provide the mode shapes for the Shuttle-constrained configuration. Use of these methods or a hybrid combination of them for structures to which they are applicable allows the difficult and expense associated with development and verification of fixed-base test fixtures to be avoided.

  6. Cost-effective test methods for Shuttle payloads

    NASA Technical Reports Server (NTRS)

    Tinker, Michael L.

    1993-01-01

    Techniques are discussed for deriving constrained vibration mode shapes for space shuttle payloads using unconstrained or free-boundary dynamic properties. Application of the residual flexibility method requires measurement of a set of free boundary modes plus the residual flexibility of the payload-to-orbiter interfaces. The mass-additive approach involves the measurement of unconstrained modes and frequencies of a payload with large masses attached to the interfaces. In either case, the orbiter interfaces of the test-verified payload model are analytically constrained to provide the mode shapes for the shuttle-constrained configuration. Use of these methods or a hybrid combination of them for structures to which they are applicable allows the difficulty and expense associated with development and verification of fixed-base test fixtures to be avoided.

  7. Cost-Effective Encryption-Based Autonomous Routing Protocol for Efficient and Secure Wireless Sensor Networks.

    PubMed

    Saleem, Kashif; Derhab, Abdelouahid; Orgun, Mehmet A; Al-Muhtadi, Jalal; Rodrigues, Joel J P C; Khalil, Mohammed Sayim; Ali Ahmed, Adel

    2016-01-01

    The deployment of intelligent remote surveillance systems depends on wireless sensor networks (WSNs) composed of various miniature resource-constrained wireless sensor nodes. The development of routing protocols for WSNs is a major challenge because of their severe resource constraints, ad hoc topology and dynamic nature. Among those proposed routing protocols, the biology-inspired self-organized secure autonomous routing protocol (BIOSARP) involves an artificial immune system (AIS) that requires a certain amount of time to build up knowledge of neighboring nodes. The AIS algorithm uses this knowledge to distinguish between self and non-self neighboring nodes. The knowledge-building phase is a critical period in the WSN lifespan and requires active security measures. This paper proposes an enhanced BIOSARP (E-BIOSARP) that incorporates a random key encryption mechanism in a cost-effective manner to provide active security measures in WSNs. A detailed description of E-BIOSARP is presented, followed by an extensive security and performance analysis to demonstrate its efficiency. A scenario with E-BIOSARP is implemented in network simulator 2 (ns-2) and is populated with malicious nodes for analysis. Furthermore, E-BIOSARP is compared with state-of-the-art secure routing protocols in terms of processing time, delivery ratio, energy consumption, and packet overhead. The findings show that the proposed mechanism can efficiently protect WSNs from selective forwarding, brute-force or exhaustive key search, spoofing, eavesdropping, replaying or altering of routing information, cloning, acknowledgment spoofing, HELLO flood attacks, and Sybil attacks. PMID:27043572

  8. Cost-Effective Encryption-Based Autonomous Routing Protocol for Efficient and Secure Wireless Sensor Networks

    PubMed Central

    Saleem, Kashif; Derhab, Abdelouahid; Orgun, Mehmet A.; Al-Muhtadi, Jalal; Rodrigues, Joel J. P. C.; Khalil, Mohammed Sayim; Ali Ahmed, Adel

    2016-01-01

    The deployment of intelligent remote surveillance systems depends on wireless sensor networks (WSNs) composed of various miniature resource-constrained wireless sensor nodes. The development of routing protocols for WSNs is a major challenge because of their severe resource constraints, ad hoc topology and dynamic nature. Among those proposed routing protocols, the biology-inspired self-organized secure autonomous routing protocol (BIOSARP) involves an artificial immune system (AIS) that requires a certain amount of time to build up knowledge of neighboring nodes. The AIS algorithm uses this knowledge to distinguish between self and non-self neighboring nodes. The knowledge-building phase is a critical period in the WSN lifespan and requires active security measures. This paper proposes an enhanced BIOSARP (E-BIOSARP) that incorporates a random key encryption mechanism in a cost-effective manner to provide active security measures in WSNs. A detailed description of E-BIOSARP is presented, followed by an extensive security and performance analysis to demonstrate its efficiency. A scenario with E-BIOSARP is implemented in network simulator 2 (ns-2) and is populated with malicious nodes for analysis. Furthermore, E-BIOSARP is compared with state-of-the-art secure routing protocols in terms of processing time, delivery ratio, energy consumption, and packet overhead. The findings show that the proposed mechanism can efficiently protect WSNs from selective forwarding, brute-force or exhaustive key search, spoofing, eavesdropping, replaying or altering of routing information, cloning, acknowledgment spoofing, HELLO flood attacks, and Sybil attacks. PMID:27043572

  9. Key issues for estimating the impact and cost-effectiveness of seasonal influenza vaccination strategies.

    PubMed

    Jit, Mark; Newall, Anthony T; Beutels, Philippe

    2013-04-01

    Many countries have considered or are considering modifying their seasonal influenza immunization policies. Estimating the impact of such changes requires understanding the existing clinical and economic burden of influenza, as well as the potential impact of different vaccination options. Previous studies suggest that vaccinating clinical risk groups, health care workers, children and the elderly may be cost-effective. However, challenges in such estimation include: (1) potential cases are not usually virologically tested; (2) cases have non-specific symptoms and are rarely reported to surveillance systems; (3) endpoints for influenza proxies (such as influenza-like illness) need to be matched to case definitions for treatment costs, (4) disease burden estimates vary from year to year with strain transmissibility, virulence and prior immunity, (5) methods to estimate productivity losses due to influenza vary, (6) vaccine efficacy estimates from trials differ due to variation in subtype prevalence, vaccine match and case ascertainment, and (7) indirect (herd) protection from vaccination depends on setting-specific variables that are difficult to directly measure. Given the importance of knowing the impact of changes to influenza policy, such complexities need careful treatment using tools such as population-based trial designs, meta-analyses, time-series analyses and transmission dynamic models.

  10. Simple and cost-effective fabrication of highly flexible, transparent superhydrophobic films with hierarchical surface design.

    PubMed

    Kim, Tae-Hyun; Ha, Sung-Hun; Jang, Nam-Su; Kim, Jeonghyo; Kim, Ji Hoon; Park, Jong-Kweon; Lee, Deug-Woo; Lee, Jaebeom; Kim, Soo-Hyung; Kim, Jong-Man

    2015-03-11

    Optical transparency and mechanical flexibility are both of great importance for significantly expanding the applicability of superhydrophobic surfaces. Such features make it possible for functional surfaces to be applied to various glass-based products with different curvatures. In this work, we report on the simple and potentially cost-effective fabrication of highly flexible and transparent superhydrophobic films based on hierarchical surface design. The hierarchical surface morphology was easily fabricated by the simple transfer of a porous alumina membrane to the top surface of UV-imprinted polymeric micropillar arrays and subsequent chemical treatments. Through optimization of the hierarchical surface design, the resultant superhydrophobic films showed superior surface wetting properties (with a static contact angle of >170° and contact angle hysteresis of <3.5°) in the Cassie-Baxter wetting regime, considerable dynamic water repellency (with perfect bouncing of a water droplet dropped from an impact height of 30 mm), and good optical transparency (>82% at 550 nm wavelength). The superhydrophobic films were also experimentally found to be robust without significant degradation in the superhydrophobicity, even under repetitive bending and pressing for up to 2000 cycles. Finally, the practical usability of the proposed superhydorphobic films was clearly demonstrated by examining the antiwetting performance in real time while pouring water on the film and submerging the film in water. PMID:25688451

  11. Cost-Effective Encryption-Based Autonomous Routing Protocol for Efficient and Secure Wireless Sensor Networks.

    PubMed

    Saleem, Kashif; Derhab, Abdelouahid; Orgun, Mehmet A; Al-Muhtadi, Jalal; Rodrigues, Joel J P C; Khalil, Mohammed Sayim; Ali Ahmed, Adel

    2016-01-01

    The deployment of intelligent remote surveillance systems depends on wireless sensor networks (WSNs) composed of various miniature resource-constrained wireless sensor nodes. The development of routing protocols for WSNs is a major challenge because of their severe resource constraints, ad hoc topology and dynamic nature. Among those proposed routing protocols, the biology-inspired self-organized secure autonomous routing protocol (BIOSARP) involves an artificial immune system (AIS) that requires a certain amount of time to build up knowledge of neighboring nodes. The AIS algorithm uses this knowledge to distinguish between self and non-self neighboring nodes. The knowledge-building phase is a critical period in the WSN lifespan and requires active security measures. This paper proposes an enhanced BIOSARP (E-BIOSARP) that incorporates a random key encryption mechanism in a cost-effective manner to provide active security measures in WSNs. A detailed description of E-BIOSARP is presented, followed by an extensive security and performance analysis to demonstrate its efficiency. A scenario with E-BIOSARP is implemented in network simulator 2 (ns-2) and is populated with malicious nodes for analysis. Furthermore, E-BIOSARP is compared with state-of-the-art secure routing protocols in terms of processing time, delivery ratio, energy consumption, and packet overhead. The findings show that the proposed mechanism can efficiently protect WSNs from selective forwarding, brute-force or exhaustive key search, spoofing, eavesdropping, replaying or altering of routing information, cloning, acknowledgment spoofing, HELLO flood attacks, and Sybil attacks.

  12. Can Water-Injected Turbomachines Provide Cost-Effective Emissions and Maintenance Reductions?

    NASA Technical Reports Server (NTRS)

    Hendricks, Robert C.; Daggett, David L.; Shouse, Dale T.; Roquemore, William M.; Brankovic, Andreja; Ryder, Robert C., Jr.

    2011-01-01

    An investigation has been performed to evaluate the effect of water injection on the performance of the Air Force Research Laboratory (AFRL, Wright-Patterson Air Force Base (WPAFB)) experimental trapped vortex combustor (TVC) over a range of fuel-to-air and water-to-fuel ratios. Performance is characterized by combustor exit quantities: temperature and emissions measurements using rakes, and overall pressure drop, from upstream plenum to combustor exit. Combustor visualization is performed using gray-scale and color still photographs and high-frame-rate videos. A parallel investigation evaluated the performance of a computational fluid dynamics (CFD) tool for the prediction of the reacting flow in a liquid fueled combustor (e.g., TVC) that uses water injection for control of pollutant emissions and turbine inlet temperature. Generally, reasonable agreement is found between data and NO(x) computations. Based on a study assessing the feasibility and performance impact of using water injection on a Boeing 747-400 aircraft to reduce NO(x) emissions during takeoff, retrofitting does not appear to be cost effective; however, an operator of a newly designed engine and airframe might be able to save up to 1.0 percent in operating costs. Other challenges of water injection will be discussed.

  13. Cost-effective mitigation of diffuse pollution: setting criteria for river basin management at multiple locations.

    PubMed

    Hutchins, Mike; Fezzi, Carlo; Bateman, Ian; Posen, Paulette; Deflandre-Vlandas, Amelie

    2009-08-01

    A case study of the Yorkshire Derwent (UK) catchment is used to illustrate an integrated approach for assessing the viability of policy options for reducing diffuse nitrate losses to waterbodies. For a range of options, modeling methods for simulating river nitrate levels are combined with techniques for estimating the economic costs to agriculture of modifying those levels. By incorporating spatially explicit data and information on catchment residence times (which may span many decades particularly in areas of groundwater discharge) a method is developed for efficient spatial targeting of measures, for example, to the most at-risk freshwater environments. Combining hydrological and economic findings, the analysis reveals that, in terms of cost-effectiveness, the ranking of options is highly sensitive to both (i) whether or not specific stretches of river within a catchment are regarded as a priority for protection, and (ii) the criterion of nitrate concentration deemed most appropriate as an indicator of the health of the environment. Therefore, given the focus under European legislation upon ecological status of freshwaters, these conclusions highlight the need to improve understanding of mechanistic linkages between the chemical and biological dynamics of aquatic systems.

  14. Simple and cost-effective fabrication of highly flexible, transparent superhydrophobic films with hierarchical surface design.

    PubMed

    Kim, Tae-Hyun; Ha, Sung-Hun; Jang, Nam-Su; Kim, Jeonghyo; Kim, Ji Hoon; Park, Jong-Kweon; Lee, Deug-Woo; Lee, Jaebeom; Kim, Soo-Hyung; Kim, Jong-Man

    2015-03-11

    Optical transparency and mechanical flexibility are both of great importance for significantly expanding the applicability of superhydrophobic surfaces. Such features make it possible for functional surfaces to be applied to various glass-based products with different curvatures. In this work, we report on the simple and potentially cost-effective fabrication of highly flexible and transparent superhydrophobic films based on hierarchical surface design. The hierarchical surface morphology was easily fabricated by the simple transfer of a porous alumina membrane to the top surface of UV-imprinted polymeric micropillar arrays and subsequent chemical treatments. Through optimization of the hierarchical surface design, the resultant superhydrophobic films showed superior surface wetting properties (with a static contact angle of >170° and contact angle hysteresis of <3.5°) in the Cassie-Baxter wetting regime, considerable dynamic water repellency (with perfect bouncing of a water droplet dropped from an impact height of 30 mm), and good optical transparency (>82% at 550 nm wavelength). The superhydrophobic films were also experimentally found to be robust without significant degradation in the superhydrophobicity, even under repetitive bending and pressing for up to 2000 cycles. Finally, the practical usability of the proposed superhydorphobic films was clearly demonstrated by examining the antiwetting performance in real time while pouring water on the film and submerging the film in water.

  15. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    PubMed

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. PMID:27094234

  16. The cost-effectiveness of health communication programs: what do we know?

    PubMed

    Hutchinson, Paul; Wheeler, Jennifer

    2006-01-01

    While a considerable body of evidence has emerged supporting the effectiveness of communication programs in augmenting health, only a very small subset of studies has examined also whether these programs are cost-effective, that is, whether they achieve greater health gains for available financial resources than alternative interventions. In this article, we examine the available literature on the cost-effectiveness of health behavior change communication programs, focusing on communication interventions involving mass media, and, to a lesser extent, community mobilization and interpersonal communication or counseling. Our objective is to identify the state of past and current research efforts of the cost-effectiveness of behavior change communication programs. This review makes three principal conclusions. First, the analysis of the cost-effectiveness of health communication programs commonly has not been performed. Second, the studies reviewed here have utilized a considerable diversity of methods and have reflected varying levels of quality and adherence to standard cost-effectiveness methodologies. This leads to problems of transparency, comparability, and generalizability. Third, while the available studies generally are indicative of the cost-effectiveness of communication interventions relative to alternatives, the evidence base clearly needs to be expanded by additional rigorous cost-effectiveness analyses.

  17. Cost-effectiveness of bupropion, nortriptyline, and psychological intervention in smoking cessation.

    PubMed

    Hall, Sharon M; Lightwood, James M; Humfleet, Gary L; Bostrom, Alan; Reus, Victor I; Muñoz, Ricardo

    2005-01-01

    Sustained-release bupropion and nortriptyline have been shown to be efficacious in treating cigarette smoking. Psychological intervention is also recognized as efficacious. The cost and cost-effectiveness of the 2 drug therapies have not been estimated. It was hypothesized that nortriptyline would be more cost-effective than bupropion. Hypotheses were not originally proposed concerning the cost-effectiveness of psychological versus drug treatment, but the 2 were compared using exploratory analyses. This was a 3 (bupropion versus nortriptyline versus placebo) by 2 (medical management alone versus medical management plus psychological intervention) randomized trial. Participants were 220 cigarette smokers. Outcome measures were cost and cost-effectiveness computed at week 52. Nortriptyline cost less than bupropion. Nortriptyline was more cost-effective than bupropion; the difference was not statistically significant. Psychological intervention cost less than the 2 drug treatments, and was more cost-effective, but not significantly so. Prospective investigations of the cost and cost-effectiveness of psychological and pharmacological intervention, using adequate sample sizes, are warranted. PMID:16215448

  18. Which treatments are cost-effective in the management of varicose veins?

    PubMed

    Gohel, M

    2013-03-01

    In the current economic climate, the cost-effectiveness of health-care interventions is under great scrutiny. In this article, the evidence for cost-effectiveness of treatments for varicose veins is summarized. The majority of studies evaluating treatments for varicose veins have not assessed health economic outcomes, but have focused on clinical and anatomical measures. The cost-effectiveness of treating varicose veins (compared with conservative management) was demonstrated in the REACTIV trial. Other in-trial economic analyses suggested that endovenous interventions are likely to be cost-effective and a decision tree analysis demonstrated that the greatest cost-effectiveness may be present for procedures performed under local or tumescent anaesthesia in the office or outpatient setting. However, the treatment modality that offers the greatest cost-effectiveness remains unclear. In conclusion, endovenous treatment performed in the outpatient setting under local anaesthesia is likely to be the most cost-effective treatment strategy for varicose veins. Better quality health economic analyses are needed to refine this conclusion.

  19. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    PubMed

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

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

    PubMed Central

    2012-01-01

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

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

    PubMed

    Korenromp, Eline L

    2012-03-28

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

  2. Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis

    PubMed Central

    Ramponi, Francesco; Ronco, Claudio; Mason, Giacomo; Rettore, Enrico; Marcelli, Daniele; Martino, Francesca; Neri, Mauro; Martin-Malo, Alejandro; Canaud, Bernard; Locatelli, Francesco

    2016-01-01

    Background Clinical studies suggest that hemodiafiltration (HDF) may lead to better clinical outcomes than high-flux hemodialysis (HF-HD), but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD. Methods The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1) estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2) simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3) application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different risk profiles, for example, by age (patients aged 40, 50, and 60 years), sex, and diabetic status. Scatter plots of simulations in the cost-effectiveness plane were produced, incremental cost-effectiveness ratios were estimated, and cost-effectiveness acceptability curves were computed. Results An incremental cost-effectiveness ratio of €6,982/quality-adjusted life years (QALY) was estimated for the baseline cohort of 50-year-old male patients. Given the commonly accepted threshold of €40,000/QALY, HDF is cost-effective. The probabilistic sensitivity analysis showed that HDF is cost-effective with a probability of ~81% at a threshold of €40,000/QALY. It is fundamental to measure the outcome also in terms of quality of life. HDF is more cost-effective for younger patients. Conclusion HDF can be considered cost-effective compared to HF-HD. PMID:27703388

  3. Effectiveness and Cost-effectiveness of Four Treatment Modalities for Substance Disorders: A Propensity Score Analysis

    PubMed Central

    Mojtabai, Ramin; Graff Zivin, Joshua

    2003-01-01

    Objective To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. Data Sources The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemographic, substance use, and clinical data were abstracted from treatment records. Substance abuse outcome and treatment history following discharge from index facilities were assessed using a comprehensive interview with 1,799 of these individuals five years after discharge. Treatment success was defined in two ways: as abstinence and as any reduction in substance use. Study Design Effectiveness and cost-effectiveness of four modalities were compared: inpatient, residential, outpatient detox/methadone, and outpatient drug-free. Clients were stratified based on propensity scores and analyses were conducted within these strata. Sensitivity analyses examined the impact of future substance abuse treatment on effectiveness and cost-effectiveness estimates. Principal Findings Treatment of substance disorders appears to be cost-effective compared to other health interventions. The cost per successfully treated abstinent case in the least costly modality, the outpatient drug-free programs, was $6,300 (95 percent confidence intervals: $5,200–$7,900) in 1990 dollars. There were only minor differences between various modalities of treatment with regard to effectiveness. However, modalities varied considerably with regard to cost-effectiveness. Outpatient drug-free programs were the most cost-effective. There was little evidence that relative effectiveness or cost-effectiveness of programs varied according to factors that were associated with selection into different programs. Conclusions Substance disorders can be treated most cost-effectively in outpatient drug-free settings. Savings from transitioning to the most cost-effective treatment modality may free

  4. Genome-wide analysis of tandem repeats in Tribolium castaneum genome reveals abundant and highly dynamic tandem repeat families with satellite DNA features in euchromatic chromosomal arms.

    PubMed

    Pavlek, Martina; Gelfand, Yevgeniy; Plohl, Miroslav; Meštrović, Nevenka

    2015-12-01

    Although satellite DNAs are well-explored components of heterochromatin and centromeres, little is known about emergence, dispersal and possible impact of comparably structured tandem repeats (TRs) on the genome-wide scale. Our bioinformatics analysis of assembled Tribolium castaneum genome disclosed significant contribution of TRs in euchromatic chromosomal arms and clear predominance of satellite DNA-typical 170 bp monomers in arrays of ≥5 repeats. By applying different experimental approaches, we revealed that the nine most prominent TR families Cast1-Cast9 extracted from the assembly comprise ∼4.3% of the entire genome and reside almost exclusively in euchromatic regions. Among them, seven families that build ∼3.9% of the genome are based on ∼170 and ∼340 bp long monomers. Results of phylogenetic analyses of 2500 monomers originating from these families show high-sequence dynamics, evident by extensive exchanges between arrays on non-homologous chromosomes. In addition, our analysis shows that concerted evolution acts more efficiently on longer than on shorter arrays. Efficient genome-wide distribution of nine TR families implies the role of transposition only in expansion of the most dispersed family, and involvement of other mechanisms is anticipated. Despite similarities in sequence features, FISH experiments indicate high-level compartmentalization of centromeric and euchromatic tandem repeats.

  5. [Cost-effectiveness alone is not sufficient as basis for prioritization].

    PubMed

    Laine, Juha

    2014-01-01

    Cost-effectiveness has been suggested as the sole ethical basis for prioritization systems. The methods of health economics per se may be beneficial in decision making situations of various types. The structure of Finnish healthcare system and value-based choices associated with the application of cost-effectiveness make, however, utilizability more difficult than thought. Analysis of cost- effectiveness is worth using, but criteria and methods of decision making of health economics cannot be harnessed as tools for technocratic decision-making. Value-based choices should be subjected to wide public debate.

  6. General methodology: Costing, budgeting, and techniques for benefit-cost and cost-effectiveness analysis

    NASA Technical Reports Server (NTRS)

    Stretchberry, D. M.; Hein, G. F.

    1972-01-01

    The general concepts of costing, budgeting, and benefit-cost ratio and cost-effectiveness analysis are discussed. The three common methods of costing are presented. Budgeting distributions are discussed. The use of discounting procedures is outlined. The benefit-cost ratio and cost-effectiveness analysis is defined and their current application to NASA planning is pointed out. Specific practices and techniques are discussed, and actual costing and budgeting procedures are outlined. The recommended method of calculating benefit-cost ratios is described. A standardized method of cost-effectiveness analysis and long-range planning are also discussed.

  7. Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

    PubMed

    Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

    2014-01-01

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members. PMID:25496555

  8. Cost-Effective Strategies for Rural Community Outreach, Hawaii, 2010–2011

    PubMed Central

    Barbato, Anna; Holuby, R. Scott; Ciarleglio, Anita E.; Taniguchi, Ronald

    2014-01-01

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members. PMID:25496555

  9. Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

    PubMed

    Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

    2014-12-11

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

  10. Cost-effective solutions to maintaining smart grid reliability

    NASA Astrophysics Data System (ADS)

    Qin, Qiu

    As the aging power systems are increasingly working closer to the capacity and thermal limits, maintaining an sufficient reliability has been of great concern to the government agency, utility companies and users. This dissertation focuses on improving the reliability of transmission and distribution systems. Based on the wide area measurements, multiple model algorithms are developed to diagnose transmission line three-phase short to ground faults in the presence of protection misoperations. The multiple model algorithms utilize the electric network dynamics to provide prompt and reliable diagnosis outcomes. Computational complexity of the diagnosis algorithm is reduced by using a two-step heuristic. The multiple model algorithm is incorporated into a hybrid simulation framework, which consist of both continuous state simulation and discrete event simulation, to study the operation of transmission systems. With hybrid simulation, line switching strategy for enhancing the tolerance to protection misoperations is studied based on the concept of security index, which involves the faulted mode probability and stability coverage. Local measurements are used to track the generator state and faulty mode probabilities are calculated in the multiple model algorithms. FACTS devices are considered as controllers for the transmission system. The placement of FACTS devices into power systems is investigated with a criterion of maintaining a prescribed level of control reconfigurability. Control reconfigurability measures the small signal combined controllability and observability of a power system with an additional requirement on fault tolerance. For the distribution systems, a hierarchical framework, including a high level recloser allocation scheme and a low level recloser placement scheme, is presented. The impacts of recloser placement on the reliability indices is analyzed. Evaluation of reliability indices in the placement process is carried out via discrete event

  11. OXYGEN ABUNDANCES IN CEPHEIDS

    SciTech Connect

    Luck, R. E.; Andrievsky, S. M.; Korotin, S. N.; Kovtyukh, V. V. E-mail: serkor@skyline.od.ua E-mail: scan@deneb1.odessa.ua

    2013-07-01

    Oxygen abundances in later-type stars, and intermediate-mass stars in particular, are usually determined from the [O I] line at 630.0 nm, and to a lesser extent, from the O I triplet at 615.7 nm. The near-IR triplets at 777.4 nm and 844.6 nm are strong in these stars and generally do not suffer from severe blending with other species. However, these latter two triplets suffer from strong non-local thermodynamic equilibrium (NLTE) effects and thus see limited use in abundance analyses. In this paper, we derive oxygen abundances in a large sample of Cepheids using the near-IR triplets from an NLTE analysis, and compare those abundances to values derived from a local thermodynamic equilibrium (LTE) analysis of the [O I] 630.0 nm line and the O I 615.7 nm triplet as well as LTE abundances for the 777.4 nm triplet. All of these lines suffer from line strength problems making them sensitive to either measurement complications (weak lines) or to line saturation difficulties (strong lines). Upon this realization, the LTE results for the [O I] lines and the O I 615.7 nm triplet are in adequate agreement with the abundance from the NLTE analysis of the near-IR triplets.

  12. Interstellar Abundance Standards Revisited

    NASA Astrophysics Data System (ADS)

    Sofia, Ulysses J.; Meyer, David M.

    2001-06-01

    We evaluate the stellar abundances often used to represent the total (gas plus dust) composition of the interstellar medium. Published abundances for B stars, young later type (F and G) stars, and the Sun are compared to the modeled dust-phase and measured gas-phase compositions of the interstellar medium. This study uses abundances for the five most populous elements in dust grains-C, O, Mg, Si, and Fe-and the cosmically abundant element, N. We find that B stars have metal abundances that are too low to be considered valid representations of the interstellar medium. The commonly invoked interstellar standard that is two-thirds of the solar composition is also rejected by recent observations. Young (<=2 Gyr) F and G disk stars and the Sun, however, cannot be ruled out as reliable proxies for the total interstellar composition. If their abundances are valid representations of the interstellar medium, then the apparent underabundance of carbon with respect to that required by dust models, i.e., the carbon crisis, is substantially eased.

  13. Can Occupancy–Abundance Models Be Used to Monitor Wolf Abundance?

    PubMed Central

    Latham, M. Cecilia; Latham, A. David M.; Webb, Nathan F.; Mccutchen, Nicole A.; Boutin, Stan

    2014-01-01

    Estimating the abundance of wild carnivores is of foremost importance for conservation and management. However, given their elusive habits, direct observations of these animals are difficult to obtain, so abundance is more commonly estimated from sign surveys or radio-marked individuals. These methods can be costly and difficult, particularly in large areas with heavy forest cover. As an alternative, recent research has suggested that wolf abundance can be estimated from occupancy–abundance curves derived from “virtual” surveys of simulated wolf track networks. Although potentially more cost-effective, the utility of this approach hinges on its robustness to violations of its assumptions. We assessed the sensitivity of the occupancy–abundance approach to four assumptions: variation in wolf movement rates, changes in pack cohesion, presence of lone wolves, and size of survey units. Our simulations showed that occupancy rates and wolf pack abundances were biased high if track surveys were conducted when wolves made long compared to short movements, wolf packs were moving as multiple hunting units as opposed to a cohesive pack, and lone wolves were moving throughout the surveyed landscape. We also found that larger survey units (400 and 576 km2) were more robust to changes in these factors than smaller survey units (36 and 144 km2). However, occupancy rates derived from large survey units rapidly reached an asymptote at 100% occupancy, suggesting that these large units are inappropriate for areas with moderate to high wolf densities (>15 wolves/1,000 km2). Virtually-derived occupancy–abundance relationships can be a useful method for monitoring wolves and other elusive wildlife if applied within certain constraints, in particular biological knowledge of the surveyed species needs to be incorporated into the design of the occupancy surveys. Further, we suggest that the applicability of this method could be extended by directly incorporating some of its

  14. Cost-Effectiveness of HBV and HCV Screening Strategies – A Systematic Review of Existing Modelling Techniques

    PubMed Central

    Geue, Claudia; Wu, Olivia; Xin, Yiqiao; Heggie, Robert; Hutchinson, Sharon; Martin, Natasha K.; Fenwick, Elisabeth; Goldberg, David

    2015-01-01

    Introduction Studies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches. Methods A structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions. Results The overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology. Conclusion When assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers. PMID:26689908

  15. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom

    PubMed Central

    Long, Elisa F.; Mandalia, Roshni; Mandalia, Sundhiya; Alistar, Sabina S.

    2014-01-01

    Objective In many high-income countries with low HIV prevalence, significant numbers of persons living with HIV (PLHIV) remain undiagnosed. Identification of PLHIV via HIV testing offers timely access to lifesaving antiretroviral therapy (ART) and decreases HIV transmission. We estimated the effectiveness and cost-effectiveness of HIV testing in the United Kingdom (UK), where 25% of PLHIV are estimated to be undiagnosed. Design We developed a dynamic compartmental model to analyze strategies to expand HIV testing and treatment in the UK, with particular focus on men who have sex with men (MSM), people who inject drugs (PWID), and individuals from HIV-endemic countries. Methods We estimated HIV prevalence, incidence, quality-adjusted life years (QALYs), and health care costs over 10 years, and cost-effectiveness. Results Annual HIV testing of all adults could avert 5% of new infections, even with no behavior change following HIV diagnosis because of earlier ART initiation, or up to 18% if risky behavior is halved. This strategy costs £67,000–£106,000/QALY gained. Providing annual testing only to MSM, PWID, and people from HIV-endemic countries, and one-time testing for all other adults, prevents 4–15% of infections, requires one-fourth as many tests to diagnose each PLHIV, and costs £17,500/QALY gained. Augmenting this program with increased ART access could add 145,000 QALYs to the population over 10 years, at £26,800/QALY gained. Conclusions Annual HIV testing of key populations in the UK is very cost-effective. Additional one-time testing of all other adults could identify the majority of undiagnosed PLHIV. These findings are potentially relevant to other low-prevalence, high-income countries. PMID:24763373

  16. Cost-effectiveness analysis: a proposal of new reporting standards in statistical analysis.

    PubMed

    Bang, Heejung; Zhao, Hongwei

    2014-01-01

    Cost-effectiveness analysis (CEA) is a method for evaluating the outcomes and costs of competing strategies designed to improve health, and has been applied to a variety of different scientific fields. Yet there are inherent complexities in cost estimation and CEA from statistical perspectives (e.g., skewness, bidimensionality, and censoring). The incremental cost-effectiveness ratio that represents the additional cost per unit of outcome gained by a new strategy has served as the most widely accepted methodology in the CEA. In this article, we call for expanded perspectives and reporting standards reflecting a more comprehensive analysis that can elucidate different aspects of available data. Specifically, we propose that mean- and median-based incremental cost-effectiveness ratios and average cost-effectiveness ratios be reported together, along with relevant summary and inferential statistics, as complementary measures for informed decision making.

  17. Nonparametric inference for time-dependent incremental cost-effectiveness ratios.

    PubMed

    Yee, Laura M; Gary Chan, Kwun Chuen

    2015-12-30

    As the costs of medical care increase, more studies are evaluating cost in addition to effectiveness of treatments. Cost-effectiveness analyses in randomized clinical trials have typically been conducted only at the end of follow-up. However, cost-effectiveness may change over time. We therefore propose a nonparametric estimator to assess the incremental cost-effectiveness ratio over time. We also derive the asymptotic variance of our estimator and present formulation of Fieller-based simultaneous confidence bands. Simulation studies demonstrate the performance of our point estimators, variance estimators, and confidence bands. We also illustrate our methods using data from a randomized clinical trial, the second Multicenter Automatic Defibrillator Implantation Trial. This trial studied the effects of implantable cardioverter-defibrillators on patients at high risk for cardiac arrhythmia. Results show that our estimator performs well in large samples, indicating promising future directions in the field of cost-effectiveness. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Twice-weighted multiple interval estimation of a marginal structural model to analyze cost-effectiveness.

    PubMed

    Goldfeld, K S

    2014-03-30

    Cost-effectiveness analysis is an important tool that can be applied to the evaluation of a health treatment or policy. When the observed costs and outcomes result from a nonrandomized treatment, making causal inference about the effects of the treatment requires special care. The challenges are compounded when the observation period is truncated for some of the study subjects. This paper presents a method of unbiased estimation of cost-effectiveness using observational study data that is not fully observed. The method-twice-weighted multiple interval estimation of a marginal structural model-was developed in order to analyze the cost-effectiveness of treatment protocols for advanced dementia residents living nursing homes when they become acutely ill. A key feature of this estimation approach is that it facilitates a sensitivity analysis that identifies the potential effects of unmeasured confounding on the conclusions concerning cost-effectiveness.

  19. Efficiency and Cost-Effectiveness of Recruitment Methods for Male Latino Smokers

    ERIC Educational Resources Information Center

    Graham, Amanda L.; Lopez-Class, Maria; Mueller, Noel T.; Mota, Guadalupe; Mandelblatt, Jeanne

    2011-01-01

    Little is known about the most effective strategies to recruit male Latino smokers to cessation research studies. The purpose of this study was to identify efficient and cost-effective research recruitment strategies for this priority population. (Contains 4 tables.)

  20. Rational Planning and the Case of Cost-Effectiveness Analysis for Vocational Education.

    ERIC Educational Resources Information Center

    Pershing, James A.; Schwandt, Thomas A.

    1980-01-01

    The rational application of planning tools is discussed in relation to four decision-making settings. The requirements, advantages, and disadvantages of cost-effectiveness analysis are examined in terms of their appropriateness and applicability to vocational education planning. (SK)

  1. Cost-effectiveness of screening women at moderate risk for genital infections caused by Chlamydia trachomatis.

    PubMed

    Nettleman, M D; Jones, R B

    1988-07-01

    We evaluated the cost-effectiveness of screening women at moderate (prevalence, 7.9%) risk for urogenital infections with Chlamydia trachomatis. The characteristics of culture and direct antigen tests were based on published values. Those of serology were based on a comparative study in 434 college women. Three serological tests were evaluated: microimmunofluorescence, an indirect fluorescent antibody assay, and an enzyme-linked immunoassay. Their sensitivities and specificities were 97% and 64%, 87% and 64%, and 84% and 51%, respectively, compared with culture. Screening all patients with a direct antigen test costing less than $12 was more cost-effective than neither testing nor treating patients, although only 53% of patients with positive test results would actually be infected. The use of culture alone or as a confirmatory test was less cost-effective but had high positive predictive values. Seropositivity was not highly predictive of active infection. Chlamydial screening can be cost-effective in moderate-risk women. PMID:3133496

  2. Cost-effectiveness of Management Options for Small Renal Mass: A Systematic Review.

    PubMed

    Wang, Ye; Chen, Yu-Wei; Leow, Jeffrey J; Levy, Alison C; Chang, Steven L; Gelpi, Francisco-Hammerschmidt

    2016-10-01

    Costs of surgery for small renal masses (SRMs) are high. This study aimed to systematically review and evaluate the cost-effectiveness analyses of management options for SRMs. Six databases were searched from inception to August 2015. Inclusion criteria were full original research, full economic evaluation of management options for SRM, and written in English. Among 776 studies screened, 6 met the inclusion criteria. Ablation was cost-effective versus nephron-sparing surgery. Laparoscopic partial nephrectomy was cost-effective versus the open approach. Renal mass biopsy dominated immediate treatment in the United States, but not in Canada. According to the Consolidated Health Economic Evaluation Reporting Standards, all the studies had relatively good quality. Despite the observed evidence, future research is needed to fill in the knowledge gap. A few suggestions should be kept in mind such as conducting the cost-effectiveness analysis in a variety of countries.

  3. Cost-effectiveness of cervical cancer prevention in Central and Eastern Europe and Central Asia.

    PubMed

    Berkhof, Johannes; Bogaards, Johannes A; Demirel, Erhan; Diaz, Mireia; Sharma, Monisha; Kim, Jane J

    2013-12-31

    We studied the cost-effectiveness of cervical cancer prevention strategies in the Central and Eastern Europe and Central Asia (CEECA) region. The cost-effectiveness of human papillomavirus (HPV)16/18 vaccination of 12 year-old girls was calculated for 28 countries, under the assumption that vaccination prevents 70% of all cervical cancer cases and that cervical cancer and all-cause mortality rates are stable without vaccination. At three-dose vaccination costs of I$ 100 per vaccinated girl (currency 2005 international dollars), HPV16/18 vaccination was very cost-effective in 25 out of 28 countries using the country's gross domestic product (GDP) per capita as cost-effectiveness threshold (criterion by World Health Organization). A three-dose vaccination cost of I$ 100 is within the current range of vaccine costs in European immunization programs, and therefore our results indicate that HPV vaccination may be good value for money. To evaluate the cost-effectiveness of cervical cancer screening combined with vaccination, we calibrated a published simulation model to HPV genotype data collected in Slovenia, Poland, and Georgia. The screening interval was varied at 3, 6, and 10 years starting at age 25 or 30 and ending at age 60. In Slovenia and Poland, combined vaccination and 10-yearly HPV (DNA) screening (vaccination coverage 70%, screening coverage per round 70%) was very cost-effective when the cost of three-dose vaccination was I$ 100 per vaccinated girl. More intensive screening was very cost-effective when the screening coverage per round was 30% or 50%. In Georgia, 10-yearly Pap screening was very cost-effective in unvaccinated women. Vaccination combined with 10-yearly HPV screening was likely to be cost-effective if the three-dose vaccination cost was I$ 50 per vaccinated girl. To conclude, cervical cancer prevention strategies utilizing both HPV16/18 vaccination and HPV screening are very cost-effective in countries with sufficient resources. In low

  4. Cost-effectiveness analysis for priority-setting in South Africa--what are the possibilities?

    PubMed

    Doherty, Jane

    2010-12-01

    Priority-setting in the health system is necessary because resources are constrained. The role of cost-effectiveness analysis in supporting decision-making around health care priorities in South Africa is explored by referring to South African studies that have provided clinical and policy guidance at the levels of the patient, the service and the population. Cost-effectiveness evidence is positioned in relation to other concerns such as equity and the overall performance of the health system.

  5. Cost-Effectiveness of Chemoprevention with Proton Pump Inhibitors in Barrett’s Esophagus

    PubMed Central

    Freedberg, Daniel E.; Abrams, Julian A.; Wang, Y. Claire

    2015-01-01

    Background Proton pump inhibitors (PPIs) may reduce the risk of esophageal adenocarcinoma (EAC) in patients with Barrett’s esophagus. PPIs are prescribed for virtually all patients with Barrett’s esophagus, irrespective of the presence of reflux symptoms, and represent a de facto chemopreventive agent in this population. However, long-term PPI use has been associated with several adverse effects, and the cost-effectiveness of chemoprevention with PPIs has not been evaluated. Aim The purpose of this study was to assess the cost-effectiveness of PPIs for the prevention of EAC in Barrett’s esophagus without reflux. Methods We designed a state-transition Markov micro-simulation model of a hypothetical cohort of 50-year-old white men with Barrett’s esophagus. We modeled chemoprevention with PPIs or no chemoprevention, with endoscopic surveillance for all treatment arms. Outcome measures were life-years, quality-adjusted life years (QALYs), incident EAC cases and deaths, costs, and incremental cost-effectiveness ratios. Results Assuming 50 % reduction in EAC, chemoprevention with PPIs was a cost-effective strategy compared to no chemoprevention. In our model, administration of PPIs cost $23,000 per patient and resulted in a gain of 0.32 QALYs for an incremental cost-effectiveness ratio of $12,000/QALY. In sensitivity analyses, PPIs would be cost-effective at $50,000/QALY if they reduce EAC risk by at least 19 %. Conclusions Chemoprevention with PPIs in patients with Barrett’s esophagus without reflux is cost-effective if PPIs reduce EAC by a minimum of 19 %. The identification of subgroups of Barrett’s esophagus patients at increased risk for progression would lead to more cost-effective strategies for the prevention of esophageal adenocarcinoma. PMID:24795040

  6. Reading a cost-effectiveness or decision analysis study: Five things to consider.

    PubMed

    Young, Kate C; Kelly, Adam G; Holloway, Robert G

    2013-10-01

    Cost-effectiveness studies and decision analyses of neurologic practices, treatments, and technologies are increasing in the literature and have an emerging role within both medicine and neurology. Knowledge about these research approaches, how to interpret the results of such studies, as well as an understanding of their limitations will be of growing importance for the practicing neurologist. We discuss 5 aspects of these analyses to increase awareness about the uses and limitations of cost-effectiveness articles in everyday practice. PMID:24175157

  7. Cost-effectiveness of a hypertension management programme in an elderly population: a Markov model

    PubMed Central

    2011-01-01

    Background Mounting evidence shows that multi-intervention programmes for hypertension treatment are more effective than an isolated pharmacological strategy. Full economic evaluations of hypertension management programmes are scarce and contain methodological limitations. The aim of the study was to evaluate if a hypertension management programme for elderly patients is cost-effective compared to usual care from the perspective of a third-party payer. Methods We built a cost-effectiveness model using published evidence of effectiveness of a comprehensive hypertension programme vs. usual care for patients 65 years or older at a community hospital in Buenos Aires, Argentina. We explored incremental cost-effectiveness between groups. The model used a life-time framework adopting a third-party payer's perspective. Incremental cost-effectiveness ratio (ICER) was calculated in International Dollars per life-year gained. We performed a probabilistic sensitivity analysis (PSA) to explore variable uncertainty. Results The ICER for the base-case of the "Hypertension Programme" versus the "Usual care" approach was 1,124 International Dollars per life-year gained. PSA did not significantly influence results. The programme had a probability of 43% of being dominant (more effective and less costly) and, overall, 95% chance of being cost-effective. Discussion Results showed that "Hypertension Programme" had high probabilities of being cost-effective under a wide range of scenarios. This is the first sound cost-effectiveness study to assess a comprehensive hypertension programme versus usual care. This study measures hard outcomes and explores robustness through a probabilistic sensitivity analysis. Conclusions The comprehensive hypertension programme had high probabilities of being cost-effective versus usual care. This study supports the idea that similar programmes could be the preferred strategy in countries and within health care systems where hypertension treatment for

  8. Evaluation of the cost effectiveness of HOV (high-occupancy vehicle) lanes. Final report

    SciTech Connect

    Ulberg, C.

    1987-07-01

    The cost effectiveness of high-occupancy vehicle (HOV) lanes was analyzed by comparing the costs and benefits of existing HOV lanes with the hypothetical alternatives of doing nothing or adding a lane for general traffic. Three specific sites in the Seattle area were studied. A life-cycle costing approach was used. The main result of the study was that for the three locations studied the construction of HOV lanes was the most cost-effective alternative.

  9. A guide to economic evaluation: methods for cost-effectiveness analysis of person-level data.

    PubMed

    Hoch, Jeffrey S; Smith, Mark W

    2006-12-01

    The authors introduce economic evaluation with particular attention to cost-effectiveness analysis. They begin by establishing why health care decisions should be guided by economics. They then explore different types of economic evaluations. To illustrate how to conduct and evaluate a cost-effectiveness analysis, a hypothetical study about the treatment of posttraumatic stress disorder with psychotherapy versus pharmacotherapy is considered. The authors conclude with recommendations for increasing the strength and relevance of economic evaluations.

  10. Spatial Targeting of Agri-Environmental Measures: Cost-Effectiveness and Distributional Consequences

    NASA Astrophysics Data System (ADS)

    Uthes, Sandra; Matzdorf, Bettina; Müller, Klaus; Kaechele, Harald

    2010-09-01

    Agri-environmental measures are payments to farmers to reduce environmental risks or to preserve cultivated landscapes. These measures are codified in European Union regulations. Poor spatial targeting is one of the major causes of low cost-effectiveness in agri-environmental measures. Existing studies on spatial targeting focus primarily on selected individual measures; hence, they do not allow for conclusions at the program level, where the planning and implementing of decisions on a number of different measures has to be made. In this study, we analyzed the impacts of two spatial targeting options (targeting of erosion-reducing measures on erosion vulnerable areas; targeting of grassland extensification on N-pollution vulnerable areas) on the cost-effectiveness of the single measures and the entire agri-environmental program of the federal state of Brandenburg in Germany. The methodological steps included an analysis of empirical data on land use and program participation, an expert-based environmental impact assessment and a spatial allocation procedure based on linear programming. The environmental impact assessment delivered goal-specific index values for each measures-land parcel combination expressing the suitability of the measures for contributing to four regionally relevant program objectives. The cost-effectiveness of the measures and the program were calculated by putting budgetary costs in relation to the achieved environmental index sum. The calculated cost-effectiveness of the program in 2006 was 89.6% of the simulated optimal cost-effectiveness. The spatial targeting of erosion-reducing measures on erosion vulnerable areas caused an increase in the cost-effectiveness at the measures level and almost no changes at the program level. The spatial targeting of grassland extensification on N-pollution vulnerable areas, despite also improving the cost-effectiveness of this measure, had negative effects on the cost-effectiveness of the program.

  11. A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus

    PubMed Central

    Ulfsdotter, Malin

    2015-01-01

    Objective There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. Methods A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. Results The cost was €326.3 per parent, of which €53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and €272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of €47 290 per gained QALY. The sensitivity analyses resulted in ratios from €41 739 to €55 072. With the common Swedish threshold value of €55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Conclusion Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation. PMID:26681349

  12. The augmented representation of the cost-effectiveness acceptability curve for economic evaluation of health technology.

    PubMed

    Araki, Daiji; Kamae, Isao

    2015-03-24

    New schemes on the cost-effectiveness acceptability curve (CEAC) were developed, which can make the CEAC augmented to be more informative regarding the types of acceptance and statistical inference. Theoretical approaches have been undertaken to address two questions: 1) how the area under the curve (AUC) can be zoned by different types of acceptance displayed on the incremental cost-effectiveness plane, and 2) how the accepted dataset of incremental cost-effectiveness ratios (ICERs), which are generated by simulation runs, can be statistically associated with a threshold of ICER for acceptance. To address the first question, the AUC of a typically sigmoid-shaped CEAC was divided into three zones according to the three segmentations of the scattered plots accepted at South-east, North-east and South-west quadrants on the incremental cost-effectiveness plane. A solution for the second question was "a new CEAC of the mean" (mCEAC), which is defined by plotting a pair of the mean and its occurrence probability of ICER accepted at North-east quadrant on the incremental cost-effectiveness plane. All those schemes were graphically illustrated based on hypothetical examples using the bootstrapping simulation. Our new schemes on CEAC will provide decision makers with useful information on cost-effectiveness assessment beyond the standard presentation of CEAC.

  13. Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

    PubMed

    Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

    2015-09-15

    This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options. PMID:26172106

  14. Cost-effectiveness analysis and policy choices: investing in health systems.

    PubMed Central

    Murray, C. J.; Kreuser, J.; Whang, W.

    1994-01-01

    The role of health systems infrastructure in studies of cost-effectiveness analysis and health resource allocation is discussed, and previous health sector cost-effectiveness analyses are cited. Two substantial difficulties concerning the nature of health system costs and the policy choices are presented. First, the issue of health system infrastructure can be addressed by use of computer models such as the Health Resource Allocation Model (HRAM) developed at Harvard, which integrates cost-effectiveness and burden of disease data. It was found that a model which allows for expansion in health infrastructure yields nearly 40% more total DALYs for a hypothetical sub-Saharan African country than a model which neglects infrastructure expansion. Widespread use of cost-effectiveness databases for resource allocations in the health sector will require the cost-effectiveness analyses shift from reporting costs to reporting production functions. Second, three distinct policy questions can be treated using these tools, each necessitating its own inputs and constraints: allocations when given a fixed budget and health infrastructure, or when given resources for marginal expansion, or when given a politically constrained situation of expanding resources. Confusion concerning which question is being addressed must be avoided through development of a consistent and rigorous approach to using cost-effectiveness data for informing resource allocations. PMID:7923545

  15. A decision-theoretic framework for the application of cost-effectiveness analysis in regulatory processes.

    PubMed

    Baio, Gianluca; Russo, Pierluigi

    2009-01-01

    Cost-effectiveness analysis (CEA) represents the most important tool in the health economics literature to quantify and qualify the reasoning behind the optimal decision process in terms of the allocation of resources to a given health intervention. However, the practical application of CEA in the regulatory process is often limited by some critical barriers, and decisions in clinical practice are frequently influenced by factors that do not contribute to efficient resource allocation, leading to inappropriate drug prescription and utilization. Moreover, most of the time there is uncertainty about the real cost-effectiveness profile of an innovative intervention, with the consequence that it is usually impossible to obtain an immediate and perfect substitution of a product with another having a better cost-effectiveness ratio. The objective of this article is to propose a rational approach to CEA within regulatory processes, basing our analysis in a Bayesian decision-theoretic framework and proposing an extension of the application of well known tools (such as the expected value of information) to such cases. The regulator can use these tools to identify the economic value of reducing the uncertainty surrounding the cost-effectiveness profile of the several alternatives. This value can be compared with the one that is generated by the actual market share of the different treatment options: one that is the most cost effective and others in the same therapeutic category that, despite producing clinical benefits, are less cost effective.

  16. Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

    PubMed

    Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

    2015-09-15

    This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options.

  17. National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.

    PubMed

    Durham, David P; Ndeffo-Mbah, Martial L; Skrip, Laura A; Jones, Forrest K; Bauch, Chris T; Galvani, Alison P

    2016-05-01

    Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms. PMID:27091978

  18. Towards Scalable Cost-Effective Service and Survivability Provisioning in Ultra High Speed Networks

    SciTech Connect

    Bin Wang

    2006-12-01

    Optical transport networks based on wavelength division multiplexing (WDM) are considered to be the most appropriate choice for future Internet backbone. On the other hand, future DOE networks are expected to have the ability to dynamically provision on-demand survivable services to suit the needs of various high performance scientific applications and remote collaboration. Since a failure in aWDMnetwork such as a cable cut may result in a tremendous amount of data loss, efficient protection of data transport in WDM networks is therefore essential. As the backbone network is moving towards GMPLS/WDM optical networks, the unique requirement to support DOE’s science mission results in challenging issues that are not directly addressed by existing networking techniques and methodologies. The objectives of this project were to develop cost effective protection and restoration mechanisms based on dedicated path, shared path, preconfigured cycle (p-cycle), and so on, to deal with single failure, dual failure, and shared risk link group (SRLG) failure, under different traffic and resource requirement models; to devise efficient service provisioning algorithms that deal with application specific network resource requirements for both unicast and multicast; to study various aspects of traffic grooming in WDM ring and mesh networks to derive cost effective solutions while meeting application resource and QoS requirements; to design various diverse routing and multi-constrained routing algorithms, considering different traffic models and failure models, for protection and restoration, as well as for service provisioning; to propose and study new optical burst switched architectures and mechanisms for effectively supporting dynamic services; and to integrate research with graduate and undergraduate education. All objectives have been successfully met. This report summarizes the major accomplishments of this project. The impact of the project manifests in many aspects: First

  19. Solar abundance of platinum

    PubMed Central

    Burger, Harry; Aller, Lawrence H.

    1975-01-01

    Three lines of neutral platinum, located at λ 2997.98 Å, λ 3064.71 Å, and λ 3301.86 Å have been used to determine the solar platinum abundance by the method of spectral synthesis. On the scale, log A(H) = 12.00, the thus-derived solar platinum abundance is 1.75 ± 0.10, in fair accord with Cameron's value of log A(Pt) = 1.69 derived by Mason from carbonaceous chondrites and calculated on the assumption that log A(Si) = 7.55 in the sun. PMID:16592278

  20. Accounting for the drug life cycle and future drug prices in cost-effectiveness analysis.

    PubMed

    Hoyle, Martin

    2011-01-01

    Economic evaluations of health technologies typically assume constant real drug prices and model only the cohort of patients currently eligible for treatment. It has recently been suggested that, in the UK, we should assume that real drug prices decrease at 4% per annum and, in New Zealand, that real drug prices decrease at 2% per annum and at patent expiry the drug price falls. It has also recently been suggested that we should model multiple future incident cohorts. In this article, the cost effectiveness of drugs is modelled based on these ideas. Algebraic expressions are developed to capture all costs and benefits over the entire life cycle of a new drug. The lifetime of a new drug in the UK, a key model parameter, is estimated as 33 years, based on the historical lifetime of drugs in England over the last 27 years. Under the proposed methodology, cost effectiveness is calculated for seven new drugs recently appraised in the UK. Cost effectiveness as assessed in the future is also estimated. Whilst the article is framed in mathematics, the findings and recommendations are also explained in non-mathematical language. The 'life-cycle correction factor' is introduced, which is used to convert estimates of cost effectiveness as traditionally calculated into estimates under the proposed methodology. Under the proposed methodology, all seven drugs appear far more cost effective in the UK than published. For example, the incremental cost-effectiveness ratio decreases by 46%, from £61, 900 to £33, 500 per QALY, for cinacalcet versus best supportive care for end-stage renal disease, and by 45%, from £31,100 to £17,000 per QALY, for imatinib versus interferon-α for chronic myeloid leukaemia. Assuming real drug prices decrease over time, the chance that a drug is publicly funded increases over time, and is greater when modelling multiple cohorts than with a single cohort. Using the methodology (compared with traditional methodology) all drugs in the UK and New

  1. The Cost-Effectiveness of Replacing the Bottom Quartile of Novice Teachers through Value-Added Teacher Assessment

    ERIC Educational Resources Information Center

    Yeh, Stuart S.; Ritter, Joseph

    2009-01-01

    A cost-effectiveness analysis was conducted of Gordon, Kane, and Staiger's (2006) proposal to raise student achievement by identifying and replacing the bottom quartile of novice teachers, using value-added assessment of teacher performance. The cost effectiveness of this proposal was compared to the cost effectiveness of voucher programs, charter…

  2. The cost and cost-effectiveness of gender-responsive interventions for HIV: a systematic review

    PubMed Central

    Remme, Michelle; Siapka, Mariana; Vassall, Anna; Heise, Lori; Jacobi, Jantine; Ahumada, Claudia; Gay, Jill; Watts, Charlotte

    2014-01-01

    Introduction Harmful gender norms and inequalities, including gender-based violence, are important structural barriers to effective HIV programming. We assess current evidence on what forms of gender-responsive intervention may enhance the effectiveness of basic HIV programmes and be cost-effective. Methods Effective intervention models were identified from an existing evidence review (“what works for women”). Based on this, we conducted a systematic review of published and grey literature on the costs and cost-effectiveness of each intervention identified. Where possible, we compared incremental costs and effects. Results Our effectiveness search identified 36 publications, reporting on the effectiveness of 22 HIV interventions with a gender focus. Of these, 11 types of interventions had a corresponding/comparable costing or cost-effectiveness study. The findings suggest that couple counselling for the prevention of vertical transmission; gender empowerment, community mobilization, and female condom promotion for female sex workers; expanded female condom distribution for the general population; and post-exposure HIV prophylaxis for rape survivors are cost-effective HIV interventions. Cash transfers for schoolgirls and school support for orphan girls may also be cost-effective in generalized epidemic settings. Conclusions There has been limited research to assess the cost-effectiveness of interventions that seek to address women's needs and transform harmful gender norms. Our review identified several promising, cost-effective interventions that merit consideration as critical enablers in HIV investment approaches, as well as highlight that broader gender and development interventions can have positive HIV impacts. By no means an exhaustive package, these represent a first set of interventions to be included in the investment framework. PMID:25373519

  3. 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

  4. Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions

    PubMed Central

    Angell, Blake J.; Muhunthan, Janani; Irving, Michelle; Eades, Sandra; Jan, Stephen

    2014-01-01

    Abstract Background Indigenous populations around the world have consistently been shown to bear a greater burden of disease, death and disability than their non-Indigenous counterparts. Despite this, little is known about what constitutes cost-effective interventions in these groups. The objective of this paper was to assess the global cost-effectiveness literature in Indigenous health to identify characteristics of successful and unsuccessful interventions and highlight areas for further research. Methods and Findings A systematic review of the published literature was carried out. MEDLINE, PSYCINFO, ECONLIT, EMBASE and CINAHL were searched with terms to identify cost-effectiveness evaluations of interventions in Indigenous populations around the world. The WHO definition was followed in identifying Indigenous populations. 19 studies reporting on 27 interventions were included in the review. The majority of studies came from high-income nations with only two studies of interventions in low and middle-income nations. 22 of the 27 interventions included in the analysis were found to be cost-effective or cost-saving by the respective studies. There were only two studies that focused on Indigenous communities in urban areas, neither of which was found to be cost-effective. There was little attention paid to Indigenous conceptions of health in included studies. Of the 27 included studies, 23 were interventions that specifically targeted Indigenous populations. Outreach programs were shown to be consistently cost-effective. Conclusion The comprehensive review found only a small number of studies examining the cost-effectiveness of interventions into Indigenous communities around the world. Given the persistent disparities in health outcomes faced by these populations and commitments from governments around the world to improving these outcomes, it is an area where the health economics and public health fields can play an important role in improving the health of

  5. Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease

    SciTech Connect

    Patterson, R.E.; Eng, C.; Horowitz, S.F.; Gorlin, R.; Goldstein, S.R.

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV).

  6. Cost-effectiveness of Total Knee Arthroplasty in the United States

    PubMed Central

    Losina, Elena; Walensky, Rochelle P.; Kessler, Courtenay L.; Emrani, Parastu S.; Reichmann, William M.; Wright, Elizabeth A.; Holt, Holly L.; Solomon, Daniel H.; Yelin, Edward; Paltiel, A. David; Katz, Jeffrey N.

    2009-01-01

    Background Total knee arthroplasty (TKA) relieves pain and improves quality of life for persons with advanced knee osteoarthritis. However, to our knowledge, the cost-effectiveness of TKA and the influences of hospital volume and patient risk on TKA cost-effectiveness have not been investigated in the United States. Methods We developed a Markov, state-transition, computer simulation model and populated it with Medicare claims data and cost and outcomes data from national and multinational sources. We projected lifetime costs and quality-adjusted life expectancy (QALE) for different risk populations and varied TKA intervention and hospital volume. Cost-effectiveness of TKA was estimated across all patient risk and hospital volume permutations. Finally, we conducted sensitivity analyses to determine various parameters’ influences on cost-effectiveness. Results Overall, TKA increased QALE from 6.822 to 7.957 quality-adjusted life years (QALYs). Lifetime costs rose from $37 100 (no TKA) to $57 900 after TKA, resulting in an incremental cost-effectiveness ratio of $18 300 per QALY. For high-risk patients, TKA increased QALE from 5.713 to 6.594 QALY, yielding a cost-effectiveness ratio of $28 100 per QALY. At all risk levels, TKA was more costly and less effective in low-volume centers than in high-volume centers. Results were insensitive to variations of key input parameters within policy-relevant, clinically plausible ranges. The greatest variations were seen for the quality of life gain after TKA and the cost of TKA. Conclusions Total knee arthroplasty appears to be cost-effective in the US Medicare-aged population, as currently practiced across all risk groups. Policy decisions should be made on the basis of available local options for TKA. However, when a high-volume hospital is available, TKAs performed in a high-volume hospital confer even greater value per dollar spent than TKAs performed in low-volume centers. PMID:19546411

  7. Global warming and urban smog: The cost effectiveness of CAFE standards and alternative fuels

    SciTech Connect

    Krupnick, A.J.; Walls, M.A.; Collins, C.T.

    1992-01-01

    This paper evaluates alternative transportation policies for reducing greenhouse gas emissions and ozone precursors. The net cost-effectiveness -- i.e., the cost per ton of greenhouse gas reduced, adjusted for ozone reduction benefits -- of substituting methanol, compressed natural gas (CNG), and reformulated gasoline for conventional gasoline is assessed and compared with the cost-effectiveness of raising the corporate average fuel economy (CAFE) standard to 38 miles per gallon. Computing this [open quotes]net[close quotes] cost-effectiveness is one way of measuring the joint environmental benefits that these alternatives provide. Greenhouse gas emissions are assessed over the entire fuel cycle and include not only carbon dioxide emissions, but also methane, carbon monoxide, and nitrous oxide emissions. In computing cost-effectiveness, we account for the so-called [open quotes]rebound effect[close quotes] -- the impact on vehicle-miles traveled of higher or lower fuel costs. CNG is found to be the most cost-effective of these alternatives, followed by increasing the CAFE standard, substituting methanol for gasoline, and substituting reformulated for conventional gasoline. Including the ozone reduction benefits does not change the rankings of the alternatives, but does make the alternative fuels look better relative to increasing the CAFE standard. Incorporating the rebound effect greatly changes the magnitude of the estimates but does not change the rankings of the alternatives. None of the alternatives look cost-effective should a carbon tax of $35 per ton be passes (the proposal in the Stark bill, H.R. 1086), and only CNG under optimistic assumptions looks cost-effective if a tax of $100 per ton of carbon is passed.

  8. Cost effectiveness of cardiovascular disease prevention strategies: a perspective on EU food based dietary guidelines.

    PubMed

    Brunner, E; Cohen, D; Toon, L

    2001-04-01

    For policymakers considering strategy options for the prevention of cardiovascular disease (CVD) the distinction between effectiveness and cost effectiveness is critical. When cost limitations apply, an evaluation of cost effectiveness is essential if a rational decision is to be made. Policy changes and resource reallocation have opportunity costs, and therefore it is necessary to compare the cost of health gains achievable by means of different policies. Here the broad question is: How cost effective are diet change strategies compared to other measures aimed at reducing cardiovascular disease in EU member states? An overview of published studies of cost-effectiveness in the primary and secondary prevention of cardiovascular disease was conducted. Few comprehensive studies were available. Estimated costs per life year gained were as follows: population-based healthy eating Pound Sterling 14-560; smoking cessation Pound Sterling 300-790; nurse screening and life style advice Pound Sterling 900 (minimum); simvastatin (HMGCoA reductase inhibitor) Pound Sterling 6200-11,300. Cost effectiveness is dependent on the underlying level of CVD risk in the target population, and the duration of the achieved alterations in behaviours and risk factors. The limited evidence from these studies tends to support the view that health protection strategies which promote healthy eating are likely to be more cost-effective than strategies involving modern cholesterol-lowering drugs, screening and advice in primary care, and are comparable to or less expensive per year of life saved than anti-smoking strategies. Given the considerable diversity in food habits, health care and public health systems among current and prospective EU member states, careful appraisal of the policy options within each member state is desirable to ensure that health gain is maximised. EU wide food based dietary guidelines are potentially the basis of large health gains in Europe, and cost-effectiveness

  9. 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

  10. Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States

    PubMed Central

    Farnham, Paul G.; Sansom, Stephanie L.; Yaylali, Emine; Mermin, Jonathan H.

    2016-01-01

    Purpose: Data showing a high incidence of HIV infection among men who have sex with men (MSM) who had annual testing suggest that more frequent HIV testing may be warranted. Testing technology is also a consideration given the availability of sensitive testing modalities and the increased use of less-sensitive rapid, point-of-care antibody tests. We assessed the cost-effectiveness of HIV testing of MSM and injection drug users (IDUs) at 3- and 6-month intervals using fourth-generation and rapid tests. Methods: We used a published mathematical model of HIV transmission to evaluate testing intervals for each population using cohorts of 10,000 MSM and IDU. We incorporated HIV transmissions averted due to serostatus awareness and viral suppression. We included costs for HIV testing and treatment initiation, and also treatment costs saved from averted transmissions. Results: For MSM, HIV testing was cost saving or cost effective over a 1-year period for both 6-month compared with annual testing and quarterly compared with 6-month testing using either test. Testing IDU every 6 months compared with annually was moderately cost effective over a 1-year period with a fourth-generation test, while testing with rapid, point-of-care tests or quarterly was not cost effective. MSM results remained robust in sensitivity analysis, whereas IDU results were sensitive to changes in HIV incidence and continuum-of-care parameters. Threshold analyses on costs suggested that additional implementation costs could be incurred for more frequent testing for MSM while remaining cost effective. Conclusions: HIV testing of MSM as frequently as quarterly is cost effective compared with annual testing, but testing IDU more frequently than annually is generally not cost effective. PMID:26361172

  11. The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis

    PubMed Central

    Chun, June Sang; Har, Alix; Lim, Hyun-Pil

    2016-01-01

    PURPOSE This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10th year after the treatment, and more cost-effective regardless of the WTP from 20th year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10th year after the prosthodontic treatment, more than 35,000 won at the 20th year after prosthodontic treatment. CONCLUSION The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10th year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed. PMID:26949488

  12. Abundances of light elements.

    PubMed Central

    Pagel, B E

    1993-01-01

    Recent developments in the study of abundances of light elements and their relevance to cosmological nucleosynthesis are briefly reviewed. The simplest model, based on standard cosmology and particle physics and assuming homogeneous baryon density at the relevant times, continues to stand up well. PMID:11607388

  13. Cost-Effectiveness Analysis of Brief and Expanded Evidence-Based Risk Reduction Interventions for HIV-Infected People Who Inject Drugs in the United States

    PubMed Central

    Song, Dahye L.; Altice, Frederick L.; Copenhaver, Michael M.; Long, Elisa F.

    2015-01-01

    Aims Two behavioral HIV prevention interventions for people who inject drugs (PWID) infected with HIV include the Holistic Health Recovery Program for HIV+ (HHRP+), a comprehensive evidence-based CDC-supported program, and an abbreviated Holistic Health for HIV (3H+) Program, an adapted HHRP+ version in treatment settings. We compared the projected health benefits and cost-effectiveness of both programs, in addition to opioid substitution therapy (OST), to the status quo in the U.S. Methods A dynamic HIV transmission model calibrated to epidemic data of current US populations was created. Projected outcomes include future HIV incidence, HIV prevalence, and quality-adjusted life years (QALYs) gained under alternative strategies. Total medical costs were estimated to compare the cost-effectiveness of each strategy. Results Over 10 years, expanding HHRP+ access to 80% of PWID could avert up to 29,000 HIV infections, or 6% of the projected total, at a cost of $7,777/QALY gained. Alternatively, 3H+ could avert 19,000 infections, but is slightly more cost-effective ($7,707/QALY), and remains so under widely varying effectiveness and cost assumptions. Nearly two-thirds of infections averted with either program are among non-PWIDs, due to reduced sexual transmission from PWID to their partners. Expanding these programs with broader OST coverage could avert up to 74,000 HIV infections over 10 years and reduce HIV prevalence from 16.5% to 14.1%, but is substantially more expensive than HHRP+ or 3H+ alone. Conclusions Both behavioral interventions were effective and cost-effective at reducing HIV incidence among both PWID and the general adult population; however, 3H+, the economical HHRP+ version, was slightly more cost-effective than HHRP+. PMID:25658949

  14. Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?

    PubMed Central

    2012-01-01

    Background Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both

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

    PubMed Central

    2012-01-01

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

  16. Cost-effectiveness Analysis on Measures to Improve China's Coal-fired Industrial Boiler

    SciTech Connect

    Liu, Manzhi; Shen, Bo; Han, Yafeng; Price, Lynn; Xu, Mingchao

    2015-08-01

    Tackling coal-burning industrial boiler is becoming one of the key programs to solve the environmental problem in China. Assessing the economics of various options to address coal-fired boiler is essential to identify cost-effective solutions. This paper discusses our work in conducting a cost-effectiveness analysis on various types of improvement measures ranging from energy efficiency retrofits to switch from coal to other fuels in China. Sensitivity analysis was also performed in order to understand the impacts of some economic factors such as discount rate and energy price on the economics of boiler improvement options. The results show that nine out of 14 solutions are cost-effective, and a lower discount rate and higher energy price will result in more energy efficiency measures being cost-effective. Both monetary and non-monetary barriers to energy-efficiency improvement are discussed and policies to tackle these barriers are recommended. Our research aims at providing a methodology to assess cost-effective solutions to boiler problems.

  17. Cost-effectiveness Analysis on Measures to Improve China's Coal-fired Industrial Boiler

    DOE PAGES

    Liu, Manzhi; Shen, Bo; Han, Yafeng; Price, Lynn; Xu, Mingchao

    2015-08-01

    Tackling coal-burning industrial boiler is becoming one of the key programs to solve the environmental problem in China. Assessing the economics of various options to address coal-fired boiler is essential to identify cost-effective solutions. This paper discusses our work in conducting a cost-effectiveness analysis on various types of improvement measures ranging from energy efficiency retrofits to switch from coal to other fuels in China. Sensitivity analysis was also performed in order to understand the impacts of some economic factors such as discount rate and energy price on the economics of boiler improvement options. The results show that nine out ofmore » 14 solutions are cost-effective, and a lower discount rate and higher energy price will result in more energy efficiency measures being cost-effective. Both monetary and non-monetary barriers to energy-efficiency improvement are discussed and policies to tackle these barriers are recommended. Our research aims at providing a methodology to assess cost-effective solutions to boiler problems.« less

  18. Economic methods for valuing the outcomes of genetic testing: beyond cost-effectiveness analysis.

    PubMed

    Grosse, Scott D; Wordsworth, Sarah; Payne, Katherine

    2008-09-01

    Genetic testing in health care can provide information to help with disease prediction, diagnosis, prognosis, and treatment. Assessing the clinical utility of genetic testing requires a process to value and weight different outcomes. This article discusses the relative merits of different economic measures and methods to inform recommendations relative to genetic testing for risk of disease, including cost-effectiveness analysis and cost-benefit analysis. Cost-effectiveness analyses refer to analyses that calculate the incremental cost per unit of health outcomes, such as deaths prevented or life-years saved because of some intervention. Cost-effectiveness analyses that use preference-based measures of health state utility such as quality-adjusted life-years to define outcomes are referred to as cost-utility analyses. Cost-effectiveness analyses presume that health policy decision makers seek to maximize health subject to resource constraints. Cost-benefit analyses can incorporate monetary estimates of willingness-to-pay for genetic testing, including the perceived value of information independent of health outcomes. These estimates can be derived from contingent valuation or discrete choice experiments. Because important outcomes of genetic testing do not fit easily within traditional measures of health, cost-effectiveness analyses do not necessarily capture the full range of outcomes of genetic testing that are important to decision makers and consumers. We recommend that health policy decision makers consider the value to consumers of information and other nonhealth attributes of genetic testing strategies. PMID:18978674

  19. The sunk cost effect in pigeons and people: a case of within-trials contrast?

    PubMed

    White, K Geoffrey; Magalhães, Paula

    2015-03-01

    Pigeons show the sunk cost effect in procedures in which their choice between two outcomes is biased by a prior investment. We review recent studies of the sunk cost effect in pigeons, in which choice procedures are analogous to studies with humans using hypothetical scenarios to make explicit a prior investment and the later choice. Zentall's (2010) theory of within-trial contrast can account for the sunk cost effect - an effortful prior investment contrasts with choice outcomes to increase the value of the outcome in which the prior investment was made. The account correctly predicts that in both pigeons and humans, increased prior investment increases the sunk cost effect. We present data from a study with humans using hypothetical scenarios in which delay was varied between the time of the prior investment and later choice. Extending the delay reduced the sunk cost effect, suggesting the need for a second process by which value is depreciated, in addition to the value-enhancing effect of contrast. This article is part of a Special Issue entitled: Tribute to Tom Zentall.

  20. The Cost-Effectiveness of Repeat HIV Testing During Pregnancy in a Resource-Limited Setting

    PubMed Central

    Kim, Lena H.; Cohan, Deborah L.; Sparks, Teresa N.; Pilliod, Rachel A.; Arinaitwe, Emmanuel; Caughey, Aaron B.

    2013-01-01

    OBJECTIVE To estimate the cost-effectiveness of HIV screening strategies for the prevention of perinatal transmission in Uganda, a resource-limited country with high HIV prevalence and incidence. STUDY DESIGN We designed a decision-analytic model from a health care system perspective to assess the vertical transmission rates and cost-effectiveness of four different HIV screening strategies in pregnancy: 1) Rapid HIV antibody (Ab) test at initial visit (current standard of care); 2) Strategy 1 + HIV RNA at initial visit (adds detection of acute HIV); 3) Strategy 1 + repeat HIV Ab at delivery (adds detection of incident HIV); 4) Strategy 3 + HIV RNA at delivery (adds detection of acute HIV at delivery). Model estimates were derived from the literature and local sources, and life years saved were discounted at a rate of 3% per year. Based on World Health Organization guidelines, we defined our cost-effectiveness threshold as ≤3 times the gross domestic product per capita, which for Uganda was US$3300 in 2008. RESULTS Using base case estimates of 10% HIV prevalence among women entering prenatal care and 3% incidence during pregnancy, strategy 3 was incrementally the cost-effective option that led to the greatest total life years. CONCLUSION Repeat rapid HIV Ab testing at the time of labor is a cost-effective strategy even in a resource-limited setting such as Uganda. PMID:23392461

  1. Comparative effectiveness and cost-effectiveness analyses frequently agree on value.

    PubMed

    Glick, Henry A; McElligott, Sean; Pauly, Mark V; Willke, Richard J; Bergquist, Henry; Doshi, Jalpa; Fleisher, Lee A; Kinosian, Bruce; Perfetto, Eleanor; Polsky, Daniel E; Schwartz, J Sanford

    2015-05-01

    The Patient-Centered Outcomes Research Institute, known as PCORI, was established by Congress as part of the Affordable Care Act (ACA) to promote evidence-based treatment. Provisions of the ACA prohibit the use of a cost-effectiveness analysis threshold and quality-adjusted life-years (QALYs) in PCORI comparative effectiveness studies, which has been understood as a prohibition on support for PCORI's conducting conventional cost-effectiveness analyses. This constraint complicates evidence-based choices where incremental improvements in outcomes are achieved at increased costs of care. How frequently this limitation inhibits efficient cost containment, also a goal of the ACA, depends on how often more effective treatment is not cost-effective relative to less effective treatment. We examined the largest database of studies of comparisons of effectiveness and cost-effectiveness to see how often there is disagreement between the more effective treatment and the cost-effective treatment, for various thresholds that may define good value. We found that under the benchmark assumption, disagreement between the two types of analyses occurs in 19 percent of cases. Disagreement is more likely to occur if a treatment intervention is musculoskeletal and less likely to occur if it is surgical or involves secondary prevention, or if the study was funded by a pharmaceutical company. PMID:25941282

  2. Scaling-up essential neuropsychiatric services in Ethiopia: a cost-effectiveness analysis

    PubMed Central

    Strand, Kirsten Bjerkreim; Chisholm, Dan; Fekadu, Abebaw; Johansson, Kjell Arne

    2016-01-01

    Introduction There is an immense need for scaling-up neuropsychiatric care in low-income countries. Contextualized cost-effectiveness analyses (CEAs) provide relevant information for local policies. The aim of this study is to perform a contextualized CEA of neuropsychiatric interventions in Ethiopia and to illustrate expected population health and budget impacts across neuropsychiatric disorders. Methods A mathematical population model (PopMod) was used to estimate intervention costs and effectiveness. Existing variables from a previous WHO-CHOICE regional CEA model were substantially revised. Treatments for depression, schizophrenia, bipolar disorder and epilepsy were analysed. The best available local data on epidemiology, intervention efficacy, current and target coverage, resource prices and salaries were used. Data were obtained from expert opinion, local hospital information systems, the Ministry of Health and literature reviews. Results Treatment of epilepsy with a first generation antiepileptic drug is the most cost-effective treatment (US$ 321 per DALY adverted). Treatments for depression have mid-range values compared with other interventions (US$ 457–1026 per DALY adverted). Treatments for schizophrenia and bipolar disorders are least cost-effective (US$ 1168–3739 per DALY adverted). Conclusion This analysis gives the Ethiopian government a comprehensive overview of the expected costs, effectiveness and cost-effectiveness of introducing basic neuropsychiatric interventions. PMID:26491060

  3. Comparative effectiveness and cost-effectiveness analyses frequently agree on value.

    PubMed

    Glick, Henry A; McElligott, Sean; Pauly, Mark V; Willke, Richard J; Bergquist, Henry; Doshi, Jalpa; Fleisher, Lee A; Kinosian, Bruce; Perfetto, Eleanor; Polsky, Daniel E; Schwartz, J Sanford

    2015-05-01

    The Patient-Centered Outcomes Research Institute, known as PCORI, was established by Congress as part of the Affordable Care Act (ACA) to promote evidence-based treatment. Provisions of the ACA prohibit the use of a cost-effectiveness analysis threshold and quality-adjusted life-years (QALYs) in PCORI comparative effectiveness studies, which has been understood as a prohibition on support for PCORI's conducting conventional cost-effectiveness analyses. This constraint complicates evidence-based choices where incremental improvements in outcomes are achieved at increased costs of care. How frequently this limitation inhibits efficient cost containment, also a goal of the ACA, depends on how often more effective treatment is not cost-effective relative to less effective treatment. We examined the largest database of studies of comparisons of effectiveness and cost-effectiveness to see how often there is disagreement between the more effective treatment and the cost-effective treatment, for various thresholds that may define good value. We found that under the benchmark assumption, disagreement between the two types of analyses occurs in 19 percent of cases. Disagreement is more likely to occur if a treatment intervention is musculoskeletal and less likely to occur if it is surgical or involves secondary prevention, or if the study was funded by a pharmaceutical company.

  4. The sunk cost effect in pigeons and people: a case of within-trials contrast?

    PubMed

    White, K Geoffrey; Magalhães, Paula

    2015-03-01

    Pigeons show the sunk cost effect in procedures in which their choice between two outcomes is biased by a prior investment. We review recent studies of the sunk cost effect in pigeons, in which choice procedures are analogous to studies with humans using hypothetical scenarios to make explicit a prior investment and the later choice. Zentall's (2010) theory of within-trial contrast can account for the sunk cost effect - an effortful prior investment contrasts with choice outcomes to increase the value of the outcome in which the prior investment was made. The account correctly predicts that in both pigeons and humans, increased prior investment increases the sunk cost effect. We present data from a study with humans using hypothetical scenarios in which delay was varied between the time of the prior investment and later choice. Extending the delay reduced the sunk cost effect, suggesting the need for a second process by which value is depreciated, in addition to the value-enhancing effect of contrast. This article is part of a Special Issue entitled: Tribute to Tom Zentall. PMID:25305066

  5. Modeling the cost effectiveness of injury interventions in lower and middle income countries: opportunities and challenges

    PubMed Central

    Bishai, David M; Hyder, Adnan A

    2006-01-01

    Background This paper estimates the cost-effectiveness of five interventions that could counter injuries in lower and middle income countries(LMICs): better traffic enforcement, erecting speed bumps, promoting helmets for bicycles, promoting helmets for motorcycles, and storing kerosene in child proof containers. Methods We adopt an ingredients based approach to form models of what each intervention would cost in 6 world regions over a 10 year period discounted at both 3% and 6% from both the governmental and societal perspectives. Costs are expressed in local currency converted into US $2001. Each of these interventions has been assessed for effectiveness in a LMIC in limited region, these effectiveness estimates have been used to form models of disability adjusted life years (DALYs) averted for various regions, taking account of regional differences in the baseline burden of injury. Results The interventions modeled in this paper have cost effectiveness ratios ranging from US $5 to $ 556 per DALY averted depending on region. Depending on local acceptability thresholds many of them could be judged cost-effective relative to interventions that are already adopted. Enhanced enforcement of traffic regulations is the most cost-effective interventions with an average cost per DALY of $64 Conclusion Injury counter measures appear to be cost-effective based on models. More evaluations of real interventions will help to strengthen the evidence basis. PMID:16423285

  6. Cost-effectiveness of two interventions for the prevention of postpartum hemorrhage in Senegal

    PubMed Central

    Vlassoff, Michael; Diallo, Alioune; Philbin, Jesse; Kost, Kathryn; Bankole, Akin

    2016-01-01

    Objective While several clinical studies have compared the prophylactic efficacy of oxytocin and misoprostol for prevention of postpartum hemorrhage (PPH), no studies have examined these interventions at the community level. This cost-effectiveness analysis is the first to do so. Methods This cost-effectiveness study accompanied a randomized trial comparing the prophylactic effectiveness of misoprostol with that of oxytocin conducted in rural Senegal from June to September 2013 of consenting women delivering in maternity huts. We compared the two interventions, with PPH referrals to a higher level facility being the outcome measure. We calculated costs and effects for two hypothetical cohorts of women delivering during a one-year period, each receiving one of the interventions. A third cohort simulated current standard of care (SOC). A sensitivity analysis was performed to estimate the impact of variation in model assumptions. Results The incremental cost-effectiveness ratios (ICER) for the misoprostol intervention was USD 40 per PPH case averted and USD 120 for oxytocin. In all scenarios, the misoprostol intervention dominated except in the worst-case scenario, where the oxytocin intervention was slightly more cost-effective. Conclusion Our findings suggest that use of misoprostol for PPH prevention would be cost-effective in countries with inadequate maternal health care. PMID:26952348

  7. 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

  8. Effectiveness and Cost Effectiveness of Oral Pre-Exposure Prophylaxis in a Portfolio of Prevention Programs for Injection Drug Users in Mixed HIV Epidemics

    PubMed Central

    Alistar, Sabina S.; Owens, Douglas K.; Brandeau, Margaret L.

    2014-01-01

    Background Pre-exposure prophylaxis with oral antiretroviral treatment (oral PrEP) for HIV-uninfected injection drug users (IDUs) is potentially useful in controlling HIV epidemics with a significant injection drug use component. We estimated the effectiveness and cost effectiveness of strategies for using oral PrEP in various combinations with methadone maintenance treatment (MMT) and antiretroviral treatment (ART) in Ukraine, a representative case for mixed HIV epidemics. Methods and Findings We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs who inject opiates, and IDUs in MMT, adding an oral PrEP program (tenofovir/emtricitabine, 49% susceptibility reduction) for uninfected IDUs. We analyzed intervention portfolios consisting of oral PrEP (25% or 50% of uninfected IDUs), MMT (25% of IDUs), and ART (80% of all eligible patients). We measured health care costs, quality-adjusted life years (QALYs), HIV prevalence, HIV infections averted, and incremental cost effectiveness. A combination of PrEP for 50% of IDUs and MMT lowered HIV prevalence the most in both IDUs and the general population. ART combined with MMT and PrEP (50% access) averted the most infections (14,267). For a PrEP cost of $950, the most cost-effective strategy was MMT, at $520/QALY gained versus no intervention. The next most cost-effective strategy consisted of MMT and ART, costing $1,000/QALY gained compared to MMT alone. Further adding PrEP (25% access) was also cost effective by World Health Organization standards, at $1,700/QALY gained. PrEP alone became as cost effective as MMT at a cost of $650, and cost saving at $370 or less. Conclusions Oral PrEP for IDUs can be part of an effective and cost-effective strategy to control HIV in regions where injection drug use is a significant driver of the epidemic. Where budgets are limited, focusing on MMT and ART access should be the priority, unless PrEP has low cost. PMID:24489747

  9. Solar abundance of iridium

    PubMed Central

    Drake, Stephen; Aller, Lawrence H.

    1976-01-01

    By a method of spectrum synthesis, which yields log gfA, where g is the statistical weight of the lower level, f is the oscillator strength, and A is the abundance, an attempt is made to deduce the solar iridium abundance from one relatively unblended, but fairly weak IrI line, λ 3220.78 Å. If the Corliss-Bozman f-value for this line is adopted, we find log A(Ir) = 0.82 on the scale log A(H) = 12.00. The discordance with the value found from carbonaceous chondrites may arise from faulty f-values or from difficulties arising from line blending in this far ultraviolet domain of the solar spectrum. PMID:16578735

  10. 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

  11. Cost Effectiveness Analysis of Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis. A Systematic Review Literature

    PubMed Central

    Benucci, Maurizio; Saviola, Gianantonio; Manfredi, Mariangela; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola

    2011-01-01

    The cost effectiveness of treatments that have changed the “natural history” of a chronic progressive disease needs to be evaluated over the long term. Disease-modifying antirheumatic drugs (DMARDs) are the standard treatment of rheumatoid arthritis (RA) and should be started as early as possible. A number of studies have shown that they are effective in improving disease activity and function, and in joint damage. Our review was focused on revision and critical evaluation of the studies including the literature on cost effectiveness of DMARDs (cyclosporine A, sulphasalazine, leflunomide, and methotrexate). The European League Against Rheumatism (EULAR) recommendations showed that traditional DMARDs are cost effective at the time of disease onset. They are less expensive than biological DMARDs and can be useful in controlling disease activity in early RA. PMID:22162693

  12. Incremental Cost-Effectiveness Analysis of Gestational Diabetes Mellitus Screening Strategies in Singapore.

    PubMed

    Chen, Pin Yu; Finkelstein, Eric A; Ng, Mor Jack; Yap, Fabian; Yeo, George S H; Rajadurai, Victor Samuel; Chong, Yap Seng; Gluckman, Peter D; Saw, Seang Mei; Kwek, Kenneth Y C; Tan, Kok Hian

    2016-01-01

    The objective of this study was to conduct an incremental cost-effectiveness analysis from the payer's perspective in Singapore of 3 gestational diabetes mellitus screening strategies: universal, targeted, or no screening. A decision tree model assessed the primary outcome: incremental cost per quality-adjusted life year (QALY) gained. Probabilities, costs, and utilities were derived from the literature, the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study, and the KK Women's and Children's Hospital's database. Relative to targeted screening using risk factors, universal screening generates an incremental cost-effectiveness ratio (ICER) of $USD10,630/QALY gained. Sensitivity analyses show that disease prevalence rates and intervention effectiveness of glycemic management have the biggest impacts on the ICERs. Based on the model and best available data, universal screening is a cost-effective approach for reducing the complications of gestational diabetes mellitus in Singapore as compared with the targeted screening approach or no screening. PMID:26512030

  13. Preventing unintended pregnancy: the cost-effectiveness of three methods of emergency contraception.

    PubMed Central

    Trussell, J; Koenig, J; Ellertson, C; Stewart, F

    1997-01-01

    OBJECTIVES: This study examined the cost-effectiveness of emergency contraceptive pills, minipills, and the copper-T intrauterine device (IUD) as emergency contraception. METHODS: Cost savings were modeled for both (1) a single contraceptive treatment following unprotected intercourse and (2) emergency contraceptive pills provided in advance. RESULTS: In a managed care (public payer) setting, a single treatment of emergency contraception after unprotected intercourse saves $142 ($54) with emergency contraceptive pills and $119 ($29) with minipills. The copper-T IUD is not cost-effective as an emergency contraceptive alone, but savings quickly accrue as use continues. Advance provision of emergency contraceptive pills to women using barrier contraceptives, spermicides, withdrawal, or periodic abstinence saves from $263 to $498 ($99 to $205) annually. CONCLUSIONS: Emergency contraception is cost-effective whether provided when the emergency arises or in advance to be used as needed. Greater use of emergency contraception could reduce the considerable medical and social costs of unintended pregnancies. PMID:9224172

  14. Cost-effective prophylaxis against venous thromboembolism after total joint arthroplasty: warfarin versus aspirin.

    PubMed

    Mostafavi Tabatabaee, Reza; Rasouli, Mohammad R; Maltenfort, Mitchell G; Parvizi, Javad

    2015-02-01

    Although recent guidelines suggest aspirin for venous thromboembolism (VTE) prophylaxis in low risk patients following total hip arthroplasty (THA) and total knee arthroplasty (TKA), there are no cost-effectiveness studies comparing aspirin and warfarin. In a Markov cohort cost-effectiveness analysis, we found that aspirin cost less and saved more quality-adjusted life-years (QALYs) than warfarin in all age groups. Cost per QALY gained by aspirin was $24,506.20 at age of 55 and $47,148.10 at the age of 85 following THA and $15,117.20 and $24,458.10 after TKA, which were greater than warfarin. In patients undergoing THA/TKA without prior VTE, aspirin is more cost-effective prophylactic agent than warfarin. Warfarin might be a better prophylaxis in TKA patients with high probability of VTE and very low probability of bleeding. PMID:25534862

  15. A cost-effectiveness analysis of a residential radon remediation programme in the United Kingdom

    PubMed Central

    Kennedy, C A; Gray, A M; Denman, A R; Phillips, P S

    1999-01-01

    As residential radon programmes of identification and remediation have proceeded, so questions have been raised about their costs and benefits. This study presents a generalizable model for estimating the cost-effectiveness of a radon mitigation programme using the methodological framework now considered appropriate in the economic evaluation of health interventions. Its use will help to inform future discussion of radon remediation and lung cancer prevention programmes. Data from Northamptonshire were analysed, resulting in a societal cost-effectiveness ratio of £13250 per life-year gained in 1997. The percentage of houses found to be over the action level, and the percentage of householders who decide to remediate are shown to be important parameters for the cost-effectiveness analysis. Questions are raised about the particular importance of perspective in this type of analysis and suggestions are made for future research directions. © 1999 Cancer Research Campaign PMID:10584889

  16. Incremental Cost-Effectiveness Analysis of Gestational Diabetes Mellitus Screening Strategies in Singapore.

    PubMed

    Chen, Pin Yu; Finkelstein, Eric A; Ng, Mor Jack; Yap, Fabian; Yeo, George S H; Rajadurai, Victor Samuel; Chong, Yap Seng; Gluckman, Peter D; Saw, Seang Mei; Kwek, Kenneth Y C; Tan, Kok Hian

    2016-01-01

    The objective of this study was to conduct an incremental cost-effectiveness analysis from the payer's perspective in Singapore of 3 gestational diabetes mellitus screening strategies: universal, targeted, or no screening. A decision tree model assessed the primary outcome: incremental cost per quality-adjusted life year (QALY) gained. Probabilities, costs, and utilities were derived from the literature, the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study, and the KK Women's and Children's Hospital's database. Relative to targeted screening using risk factors, universal screening generates an incremental cost-effectiveness ratio (ICER) of $USD10,630/QALY gained. Sensitivity analyses show that disease prevalence rates and intervention effectiveness of glycemic management have the biggest impacts on the ICERs. Based on the model and best available data, universal screening is a cost-effective approach for reducing the complications of gestational diabetes mellitus in Singapore as compared with the targeted screening approach or no screening.

  17. Methodology for Evaluating Cost-effectiveness of Commercial Energy Code Changes

    SciTech Connect

    Hart, Philip R.; Liu, Bing

    2015-01-31

    This document lays out the U.S. Department of Energy’s (DOE’s) method for evaluating the cost-effectiveness of energy code proposals and editions. The evaluation is applied to provisions or editions of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 90.1 and the International Energy Conservation Code (IECC). The method follows standard life-cycle cost (LCC) economic analysis procedures. Cost-effectiveness evaluation requires three steps: 1) evaluating the energy and energy cost savings of code changes, 2) evaluating the incremental and replacement costs related to the changes, and 3) determining the cost-effectiveness of energy code changes based on those costs and savings over time.

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

    PubMed

    Schuster, Richard; 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.

  19. An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

    PubMed

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

    2016-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem.

  20. Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity.

    PubMed

    Peterson, Michael; Chandlee, Margaret; Abraham, Avron

    2008-10-01

    A cost-effectiveness analysis of a statewide social marketing campaign was performed using a statewide surveillance survey distributed to 6th through 12th graders, media production and placement costs, and 2000 census data. Exposure to all three advertisements had the highest impact on both intent and behavior with 65.6% of the respondents considering becoming more active and 58.3% reporting becoming more active. Average cost of the entire campaign was $4.01 per person to see an ad, $7.35 per person to consider being more active, and $8.87 per person to actually become more active, with billboards yielding the most positive cost-effectiveness. Findings highlight market research as an essential part of social marketing campaigns and the importance of using multiple marketing modalities to enhance cost-effectiveness and impact. PMID:18367641

  1. 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.

  2. The value of vocational rehabilitation in substance user treatment: a cost-effectiveness framework.

    PubMed

    Shepard, Donald S; Reif, Sharon

    2004-01-01

    Vocational rehabilitation (VR) programs within addiction treatment traditionally consider employment as the desired outcome. This singular focus ignores other benefits, such as.reduced substance use. A framework for evaluating the cost-effectiveness of VR within addiction treatment is presented and illustrated with data from the Alcohol and Drug Services Study (ADSS, 1996--1999). VR was associated with a 2.5% increase in probability of abstinence at an $883 increase in cost per admission. Thus, the estimated cost-effectiveness of VR in promoting abstinence is $35,000 per additional abstinent client ($883/0.025), indicating that VR is a cost-effective contributor to other goals of addiction treatment.

  3. An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

    PubMed

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

    2016-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

  4. Cost-effectiveness of universal MRSA screening on admission to surgery.

    PubMed

    Murthy, A; De Angelis, G; Pittet, D; Schrenzel, J; Uckay, I; Harbarth, S

    2010-12-01

    Policy-makers have recommended universal screening to reduce nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Risk profiling of MRSA carriers and rapid PCR tests are now available, yet cost-effectiveness data are limited. The present study assessed the cost-effectiveness of universal PCR screening on admission to surgery. A decision analysis model from the hospital perspective compared costs and the probability of any MRSA infection across three strategies: (i) PCR screening; (ii) screening for risk factors (prior hospitalization or antibiotic use) combined with pre-emptive isolation and contact precautions pending chromogenic agar results; and (iii) no screening. Clinical data were taken from studies at a Swiss teaching hospital as well as from published literature. Costs were derived from hospital accounting systems. Compared to no screening, the PCR strategy resulted in higher costs (CHF 10503 vs. 10358) but a lower infection probability (0.0041 vs. 0.0088), producing a base-case incremental cost-effectiveness ratio of CHF 30784 per MRSA infection avoided. The risk factor strategy was more costly yet less effective than PCR, although, after varying epidemiologic inputs, the costs and effects of both screening strategies were similar. Sensitivity analyses suggested that on-admission prevalence of MRSA carriage predicts cost-effectiveness, alongside the probability of cross-transmission, and the costs of MRSA infection, screening and contact precautions. Although reducing the risk of MRSA infection, universal PCR screening is not strongly cost-effective at our centre. However, local epidemiology plays a critical role. Settings with a higher prevalence of MRSA colonization may find universal screening cost-effective and, in some cases, cost-saving.

  5. Cost-effectiveness of pazopanib compared with sunitinib in metastatic renal cell carcinoma in Canada

    PubMed Central

    Amdahl, J.; Diaz, J.; Park, J.; Nakhaipour, H.R.; Delea, T.E.

    2016-01-01

    Background In Canada and elsewhere, pazopanib and sunitinib—tyrosine kinase inhibitors targeting the vascular endothelial growth factor receptors—are recommended as first-line treatment for patients with metastatic renal cell carcinoma (mrcc). A large randomized noninferiority trial of pazopanib versus sunitinib (comparz) demonstrated that the two drugs have similar efficacy; however, patients randomized to pazopanib experienced better health-related quality of life (hrqol) and nominally lower rates of non-study medical resource utilization. Methods The cost-effectiveness of pazopanib compared with sunitinib for first-line treatment of mrcc from a Canadian health care system perspective was evaluated using a partitioned-survival model that incorporated data from comparz and other secondary sources. The time horizon of 5 years was based on the maximum duration of follow-up in the final analysis of overall survival from the comparz trial. Analyses were conducted first using list prices for pazopanib and sunitinib and then by assuming that the prices of sunitinib and pazopanib would be equivalent. Results Based on list prices, expected costs were CA$10,293 less with pazopanib than with sunitinib. Pazopanib was estimated to yield 0.059 more quality-adjusted life-years (qalys). Pazopanib was therefore dominant (more qalys and lower costs) compared with sunitinib in the base case. In probabilistic sensitivity analyses, pazopanib was dominant in 79% of simulations and was cost-effective in 90%–100% of simulations at a threshold cost-effectiveness ratio of CA$100,000. Assuming equivalent pricing, pazopanib yielded CA$917 in savings in the base case, was dominant in 36% of probabilistic sensitivity analysis simulations, and was cost-effective in 89% of simulations at a threshold cost-effectiveness ratio of CA$100,000. Conclusions Compared with sunitinib, pazopanib is likely to be a cost-effective option for first-line treatment of mrcc from a Canadian health care

  6. Cost and Cost-Effectiveness of the COMBINE Study for Alcohol-Dependent Patients

    PubMed Central

    Zarkin, Gary A.; Bray, Jeremy W.; Aldridge, Arnie; Mitra, Debanjali; Couper, David J.; Cisler, Ron A.

    2011-01-01

    Context The COMBINE clinical trial recently evaluated the efficacy of medications, behavioral therapies, and their combinations for the outpatient treatment of alcohol dependence. The costs and cost-effectiveness of these combinations are unknown and of interest to clinicians and policy makers. Objective To evaluate the costs and cost-effectiveness of the COMBINE interventions at the end of 16 weeks of treatment. Design, Setting, and Participants A prospective cost and cost-effectiveness study of patients in COMBINE, a randomized controlled clinical trial (RCT) involving 1383 patients with diagnoses of primary alcohol dependence across 11 US clinical sites. Interventions Nine treatment arms, with 4 arms receiving medical management with 16 weeks of naltrexone (100 mg/d) or acamprosate (3 g/d), both, and/or placebo; 4 arms receiving the same options as above but delivered with combined behavioral intervention (CBI); and 1 arm receiving CBI only. Main Outcomes Measures Incremental cost per percentage point increase in percent days abstinent (PDA), incremental cost per patient of avoiding heavy drinking, and incremental cost per patient of achieving a good clinical outcome. Results Based on the mean values of cost and effectiveness, 3 interventions are cost-effective options relative to the other interventions for all three outcomes: medical management (MM) with placebo ($409 cost per patient), MM + naltrexone ($671 cost per patient), and MM + naltrexone + acamprosate ($1003 cost per patient). Conclusions This is only the second prospective RCT-designed cost-effectiveness study that has been performed for the treatment of alcohol dependence. Focusing just on effectiveness, MM + naltrexone + acamprosate is not significantly better than MM + naltrexone. However, looking at cost and effectiveness, MM + naltrexone + acamprosate may be a cost-effective choice, depending on whether the cost of the incremental increase in effectiveness is worth it to the decision maker. PMID

  7. The cost-effectiveness of shopping to a predetermined grocery list to reduce overweight and obesity

    PubMed Central

    Au, N; Marsden, G; Mortimer, D; Lorgelly, P K

    2013-01-01

    Background: Pre-commitment strategies can encourage participants to commit to a healthy food plan and have been suggested as a potential strategy for weight loss. However, it is unclear whether such strategies are cost-effective. Objective: To analyse whether pre-commitment interventions that facilitate healthier diets are a cost-effective approach to tackle obesity. Methods: Effectiveness evidence was obtained from a systematic review of the literature. For interventions demonstrating a clinically significant change in weight, a Markov model was employed to simulate the long-term health and economic consequences. The review supported modelling just one intervention: grocery shopping to a predetermined list combined with standard behavioural therapy (SBT). SBT alone and do nothing were used as comparators. The target population was overweight or obese adult women. A lifetime horizon for health effects (expressed as quality-adjusted life years (QALYs)) and costs from the perspective of the UK health sector were used to calculate incremental cost-effectiveness ratios (ICERs). Results: In the base case analysis, the pre-commitment strategy of shopping to a list was found to be more effective and cost saving when compared against SBT, and cost-effective when compared against ‘do nothing' (ICER=£166 per QALY gained). A sensitivity analysis indicated that shopping to a list remained dominant or cost-effective under various scenarios. Conclusion: Our findings suggest grocery shopping to a predetermined list combined with SBT is a cost-effective means for reducing obesity and its related health conditions. PMID:23797384

  8. Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program

    PubMed Central

    Hollenbeak, Christopher S.; Weinstock, Ruth S.; Cibula, Donald; Delahanty, Linda M.; Trief, Paula M.

    2016-01-01

    BACKGROUND The Support, Health Information, Nutrition, and Exercise (SHINE) trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP) lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC) adaptation was cost effective relative to an individual call (IC) adaptation of the DPP lifestyle intervention in the primary care setting. METHODS We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. The primary outcomes were incremental cost-effectiveness ratios estimated for weight loss, body mass index (BMI), waist circumference, and quality-adjusted life years (QALYs). Costs were estimated from the perspective of society and included direct medical costs, indirect costs, and intervention costs. RESULTS After one year, participants receiving the CC intervention accumulated fewer costs ($2,831 vs. $2,933) than the IC group, lost more weight (6.2 kg vs. 5.1 kg), had greater reduction in BMI (2.1 vs. 1.9), and had greater reduction in waist circumference (6.5 cm vs. 5.9 cm). However, participants in the CC group had fewer QALYs than those in the IC group (0.635 vs. 0.646). The incremental cost-effectiveness ratio for CC vs. IC was $9,250/QALY, with a 48% probability of being cost-effective at a willingness-to-pay of $100,000/QALY. CONCLUSIONS CC delivery of the DPP was cost effective relative to IC delivery in the first year in terms of cost per clinical measure (weight lost, BMI, and waist circumference) but not in terms of cost per QALY, most likely because of the short time horizon. PMID:27429556

  9. 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

  10. Application of Bayesian Approach to Cost-Effectiveness Analysis of Antiviral Treatments in Chronic Hepatitis B

    PubMed Central

    Zhang, Hua; Huo, Mingdong; Chao, Jianqian; Liu, Pei

    2016-01-01

    Background Hepatitis B virus (HBV) infection is a major problem for public health; timely antiviral treatment can significantly prevent the progression of liver damage from HBV by slowing down or stopping the virus from reproducing. In the study we applied Bayesian approach to cost-effectiveness analysis, using Markov Chain Monte Carlo (MCMC) simulation methods for the relevant evidence input into the model to evaluate cost-effectiveness of entecavir (ETV) and lamivudine (LVD) therapy for chronic hepatitis B (CHB) in Jiangsu, China, thus providing information to the public health system in the CHB therapy. Methods Eight-stage Markov model was developed, a hypothetical cohort of 35-year-old HBeAg-positive patients with CHB was entered into the model. Treatment regimens were LVD100mg daily and ETV 0.5 mg daily. The transition parameters were derived either from systematic reviews of the literature or from previous economic studies. The outcome measures were life-years, quality-adjusted lifeyears (QALYs), and expected costs associated with the treatments and disease progression. For the Bayesian models all the analysis was implemented by using WinBUGS version 1.4. Results Expected cost, life expectancy, QALYs decreased with age. Cost-effectiveness increased with age. Expected cost of ETV was less than LVD, while life expectancy and QALYs were higher than that of LVD, ETV strategy was more cost-effective. Costs and benefits of the Monte Carlo simulation were very close to the results of exact form among the group, but standard deviation of each group indicated there was a big difference between individual patients. Conclusions Compared with lamivudine, entecavir is the more cost-effective option. CHB patients should accept antiviral treatment as soon as possible as the lower age the more cost-effective. Monte Carlo simulation obtained costs and effectiveness distribution, indicate our Markov model is of good robustness. PMID:27574976

  11. Cost-Effectiveness of Increasing Influenza Vaccination Coverage in Adults with Type 2 Diabetes in Turkey

    PubMed Central

    Akın, Levent; Macabéo, Bérengère; Caliskan, Zafer; Altinel, Serdar; Satman, Ilhan

    2016-01-01

    Objective In Turkey, the prevalence of diabetes is high but the influenza vaccination coverage rate (VCR) is low (9.1% in 2014), despite vaccination being recommended and reimbursed. This study evaluated the cost-effectiveness of increasing the influenza VCR of adults with type 2 diabetes in Turkey to 20%. Methods A decision-analytic model was adapted to Turkey using data derived from published sources. Direct medical costs and indirect costs due to productivity loss were included in the societal perspective. The time horizon was set at 1 year to reflect the seasonality of influenza. Results Increasing the VCR for adults with type 2 diabetes to 20% is predicted to avert an additional 19,777 influenza cases, 2376 hospitalizations, and 236 deaths. Associated influenza costs avoided were estimated at more than 8.3 million Turkish Lira (TRY), while the cost of vaccination would be more than TRY 8.4 million. The incremental cost-effectiveness ratio was estimated at TRY 64/quality-adjusted life years, which is below the per capita gross domestic product of TRY 21,511 and therefore very cost-effective according to World Health Organization guidelines. Factors most influencing the incremental cost-effectiveness ratio were the excess hospitalization rate, inpatient cost, vaccine effectiveness against hospitalization, and influenza attack rate. Increasing the VCR to >20% was also estimated to be very cost-effective. Conclusions Increasing the VCR for adults with type 2 diabetes in Turkey to ≥20% would be very cost-effective. PMID:27322384

  12. Cost-Effectiveness of Interventions to Promote Fruit and Vegetable Consumption

    PubMed Central

    Cobiac, Linda J.; Vos, Theo; Veerman, J. Lennert

    2010-01-01

    Background Fruits and vegetables are an essential part of the human diet, but many people do not consume the recommended serves to prevent cardiovascular disease and cancer. In this research, we evaluate the cost-effectiveness of interventions to promote fruit and vegetable consumption to determine which interventions are good value for money, and by how much current strategies can reduce the population disease burden. Methods/Principal Findings In a review of published literature, we identified 23 interventions for promoting fruit and vegetable intake in the healthy adult population that have sufficient evidence for cost-effectiveness analysis. For each intervention, we model the health impacts in disability-adjusted life years (DALYs), the costs of intervention and the potential cost-savings from averting disease treatment, to determine cost-effectiveness of each intervention over the lifetime of the population, from an Australian health sector perspective. Interventions that rely on dietary counselling, telephone contact, worksite promotion or other methods to encourage change in dietary behaviour are not highly effective or cost-effective. Only five out of 23 interventions are less than an A$50,000 per disability-adjusted life year cost-effectiveness threshold, and even the most effective intervention can avert only 5% of the disease burden attributed to insufficient fruit and vegetable intake. Conclusions/Significance We recommend more investment in evaluating interventions that address the whole population, such as changing policies influencing price or availability of fruits and vegetables, to see if these approaches can provide more effective and cost-effective incentives for improving fruit and vegetable intake. PMID:21152389

  13. 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.

  14. 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.

  15. Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India

    PubMed Central

    Prinja, Shankar; Bahuguna, Pankaj; Mohan, Pavitra; Mazumder, Sarmila; Taneja, Sunita; Bhandari, Nita; van den Hombergh, Henri; Kumar, Rajesh

    2016-01-01

    Introduction Despite the evidence for preventing childhood morbidity and mortality, financial resources are cited as a constraint for Governments to scale up the key health interventions in some countries. We evaluate the cost effectiveness of implementing IMNCI program in India from a health system and societal perspective. Methods We parameterized a decision analytic model to assess incremental cost effectiveness of IMNCI program as against routine child health services for infant population at district level in India. Using a 15-years time horizon from 2007 to 2022, we populated the model using data on costs and effects as found from a cluster-randomized trial to assess effectiveness of IMNCI program in Haryana state. Effectiveness was estimated as reduction in infant illness episodes, deaths and disability adjusted life years (DALY). Incremental cost per DALY averted was used to estimate cost effectiveness of IMNCI. Future costs and effects were discounted at a rate of 3%. Probabilistic sensitivity analysis was undertaken to estimate the probability of IMNCI to be cost effective at varying willingness to pay thresholds. Results Implementation of IMNCI results in a cumulative reduction of 57384 illness episodes, 2369 deaths and 76158 DALYs among infants at district level from 2007 to 2022. Overall, from a health system perspective, IMNCI program incurs an incremental cost of USD 34.5 (INR 1554) per DALY averted, USD 34.5 (INR 1554) per life year gained, USD 1110 (INR 49963) per infant death averted. There is 90% probability for ICER to be cost effective at INR 2300 willingness to pay, which is 5.5% of India’s GDP per capita. From a societal perspective, IMNCI program incurs an additional cost of USD 24.1 (INR 1082) per DALY averted, USD 773 (INR 34799) per infant death averted and USD 26.3 (INR 1183) per illness averted in during infancy. Conclusion IMNCI program in Indian context is very cost effective and should be scaled-up as a major child survival

  16. Developing an algorithm for cost-effective, clinically judicious management of peripheral nerve tumors

    PubMed Central

    Birk, Harjus; Zygourakis, Corinna C.; Kliot, Michel

    2016-01-01

    Peripheral nerve tumors such as neurofibromas and schwannomas have become increasingly identified secondary to improved imaging modalities including magnetic resonance neurogram and ultrasound. Given that a majority of these peripheral nerve tumors are benign lesions, it becomes important to determine appropriate management of such asymptomatic masses. We propose a normal cost-effective management paradigm for asymptomatic peripheral nerve neurofibromas and schwannomas that has been paired with economic analyses. Specifically, our management paradigm identifies patients who would benefit from surgery for asymptomatic peripheral nerve tumors, while providing cost-effective recommendations regarding clinical exams and serial imaging for such patients. PMID:27625890

  17. Developing an algorithm for cost-effective, clinically judicious management of peripheral nerve tumors

    PubMed Central

    Birk, Harjus; Zygourakis, Corinna C.; Kliot, Michel

    2016-01-01

    Peripheral nerve tumors such as neurofibromas and schwannomas have become increasingly identified secondary to improved imaging modalities including magnetic resonance neurogram and ultrasound. Given that a majority of these peripheral nerve tumors are benign lesions, it becomes important to determine appropriate management of such asymptomatic masses. We propose a normal cost-effective management paradigm for asymptomatic peripheral nerve neurofibromas and schwannomas that has been paired with economic analyses. Specifically, our management paradigm identifies patients who would benefit from surgery for asymptomatic peripheral nerve tumors, while providing cost-effective recommendations regarding clinical exams and serial imaging for such patients.

  18. Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis

    PubMed Central

    Shen, Kunling; Xiong, Tengbin; Tan, Seng Chuen; Wu, Jiuhong

    2016-01-01

    Background Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor—a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China. Objective To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI. Methods We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER). Results In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy

  19. Cost-effective learning aids for a variety of learning styles

    SciTech Connect

    Wyckoff, D.J.

    1993-11-01

    Some people learn easily while others find learning difficult. Trainers need to provide a variety of cost-effective learning experiences to meet the needs of all individuals. There are four techniques that can be used individually, in small groups, or in a large group to achieve the required cost effectiveness and aid the learning process. The first is flash cards, the second in a simple computer board that lights up when correct matches are made. The third technique uses popular game show format wherein objectives are used as answers and trainees come up with the questions. Demonstrating the expected learning behavior is the fourth technique, accomplished by guided practice.

  20. Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan

    PubMed Central

    Chen, Ying-Erh; Kao, Sung-Shuo; Chung, Ren-Hua

    2016-01-01

    Patients with Lynch syndrome (LS) have a significantly increased risk of developing colorectal cancer (CRC) and other cancers. Genetic screening for LS among patients with newly diagnosed CRC aims to identify mutations in the disease-causing genes (i.e., the DNA mismatch repair genes) in the patients, to offer genetic testing for relatives of the patients with the mutations, and then to provide early prevention for the relatives with the mutations. Several genetic tests are available for LS, such as DNA sequencing for MMR genes and tumor testing using microsatellite instability and immunohistochemical analyses. Cost-effectiveness analyses of different genetic testing strategies for LS have been performed in several studies from different countries such as the US and Germany. However, a cost-effectiveness analysis for the testing has not yet been performed in Taiwan. In this study, we evaluated the cost-effectiveness of four genetic testing strategies for LS described in previous studies, while population-specific parameters, such as the mutation rates of the DNA mismatch repair genes and treatment costs for CRC in Taiwan, were used. The incremental cost-effectiveness ratios based on discounted life years gained due to genetic screening were calculated for the strategies relative to no screening and to the previous strategy. Using the World Health Organization standard, which was defined based on Taiwan’s Gross Domestic Product per capita, the strategy based on immunohistochemistry as a genetic test followed by BRAF mutation testing was considered to be highly cost-effective relative to no screening. Our probabilistic sensitivity analysis results also suggest that the strategy has a probability of 0.939 of being cost-effective relative to no screening based on the commonly used threshold of $50,000 to determine cost-effectiveness. To the best of our knowledge, this is the first cost-effectiveness analysis for evaluating different genetic testing strategies for LS